Low-density lipoprotein cholesterol predicts coronary artery calcification events in patients with type 2 diabetes: a longitudinal study.

IF 3.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetology & Metabolic Syndrome Pub Date : 2025-02-12 DOI:10.1186/s13098-025-01625-8

Zhi Zou, Yongbing Sun, Lijun Zou, Yang Zhou, Xinbei Lin, Jing Zhou, Zhonglin Li, Xiaoling Wu, Ling Wang, Xiaodong Li, Yong Wang, Yangxi Hu, Fengli Li, Jiancheng Zhang, Yongli Li

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引用次数: 0

Abstract

Background: Coronary Artery Calcification (CAC) is a major risk factor for various cardiovascular diseases. Low-Density Lipoprotein Cholesterol (LDL-C) is a significant factor in atherosclerotic cardiovascular diseases and is usually elevated in patients with Type 2 Diabetes Mellitus (T2DM). However, the association between LDL-C levels and incident CAC in asymptomatic T2DM patients remains unclear.

Methods: This study is a single-center retrospective cohort study conducted from January 2018 to December 2023, including 2,631 asymptomatic T2DM patients who underwent regular health screenings. All participants were confirmed to be free of CAC at baseline by computed tomography (CT). Based on baseline LDL-C levels, participants were divided into three groups (T1: 0.66-2.43 mmol/L; T2: 2.44-3.18 mmol/L; T3: 3.19-7.21 mmol/L). The follow-up endpoint was the occurrence of incident CAC, with a total follow-up period of 72 months. Kaplan-Meier survival curves were used for analysis, followed by log-rank tests. Univariate and multivariate Cox proportional hazards regression models were employed to investigate the relationship between LDL-C and incident CAC, and subgroup analysis was performed to test the robustness of the LDL-C and CAC relationship.

Results: During a median follow-up period of 29.9 months, 885 (33.64%) participants developed incident CAC occurred. The cumulative incidence of incident CAC increased progressively with higher LDL-C levels (log-rank test, P < 0.001). After adjusting for confounding factors, multivariable Cox proportional hazards regression results showed a significant association between LDL-C and incident CAC (hazard ratio [HR], 1.77; 95% confidence interval [CI], 1.64-1.92). When LDL-C was treated as a categorical variable, elevated levels in T2 (adjusted HR, 1.62; 95% CI, 1.36-1.93; P < 0.001) and T3 (adjusted HR, 3.38; 95% CI, 2.84-4.03; P < 0.001) were significantly associated with the risk of incident CAC. Additionally, subgroup analysis demonstrated a consistent association between LDL-C and incident CAC.

Conclusion: High LDL-C levels are associated with incident CAC in asymptomatic T2DM patients, suggesting that LDL-C may be useful for risk stratification in this population.

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低密度脂蛋白胆固醇预测2型糖尿病患者冠状动脉钙化事件：一项纵向研究

背景：冠状动脉钙化（CAC）是多种心血管疾病的主要危险因素。低密度脂蛋白胆固醇（LDL-C）是动脉粥样硬化性心血管疾病的一个重要因素，在2型糖尿病（T2DM）患者中通常升高。然而，无症状T2DM患者LDL-C水平与CAC发生率之间的关系尚不清楚。方法：本研究是一项单中心回顾性队列研究，于2018年1月至2023年12月进行，包括2,631例定期进行健康筛查的无症状T2DM患者。所有参与者在基线时均通过计算机断层扫描（CT）确认无CAC。根据基线LDL-C水平，参与者分为三组(T1: 0.66-2.43 mmol/L；T2: 2.44-3.18 mmol/L；T3: 3.19-7.21 mmol/L)。随访终点为CAC的发生，总随访期为72个月。Kaplan-Meier生存曲线进行分析，然后进行log-rank检验。采用单因素和多因素Cox比例风险回归模型探讨LDL-C与事件CAC的关系，并采用亚组分析检验LDL-C与CAC关系的稳健性。结果：在29.9个月的中位随访期间，885名（33.64%）参与者发生了CAC事件。随着LDL-C水平的升高，CAC的累积发生率逐渐增加（log-rank检验，P）。结论：高LDL-C水平与无症状T2DM患者的CAC发生率相关，提示LDL-C可能对该人群的风险分层有用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetology & Metabolic Syndrome ENDOCRINOLOGY & METABOLISM-

CiteScore

6.20

自引率

0.00%

发文量

170

审稿时长

7.5 months

期刊介绍： Diabetology & Metabolic Syndrome publishes articles on all aspects of the pathophysiology of diabetes and metabolic syndrome. By publishing original material exploring any area of laboratory, animal or clinical research into diabetes and metabolic syndrome, the journal offers a high-visibility forum for new insights and discussions into the issues of importance to the relevant community.