[Association of remnant cholesterol with the risk of cardiovascular disease in patients with type 2 diabetes].

Abstract

Objective: To investigate the association between remnant cholesterol (RC) and the incidence of cardiovascular disease (CVD) and its subtypes among patients with type 2 diabetes mellitus (T2DM) in Jiangsu Province. Methods: This study was based on data from a community-based cohort of patients with type 2 diabetes in Jiangsu Province. Baseline data were collected between 2013 and 2014, with follow-up through December 31, 2021. Cox proportional hazards regression models were used to examine the associations between RC and the risk of CVD and its subtypes, estimating HRs and 95%CIs. Restricted cubic spline (RCS) analyses were applied to explore the dose-response relationship between RC and CVD risk. Results: Among 15 119 T2DM participants with a median follow-up of 8.04 years, 3 043 new CVD cases were identified, including 1 047 coronary heart disease (CHD) and 2 497 stroke cases. In multivariable- adjusted Cox proportional hazards regression models, compared with participants in the lowest RC quartile, those in the highest quartile had higher risks of CVD (HR=1.19, 95%CI: 1.08-1.33) and stroke (HR=1.22, 95%CI: 1.08-1.37), whereas the association between the highest RC quartile and CHD risk was not statistically significant (HR=1.15, 95%CI: 0.95-1.38). RCS analyses showed positive linear associations between RC levels and the risks of incident CVD and stroke in patients with T2DM (P for nonlinear=0.117 and 0.109, respectively). Subgroup analyses showed a multiplicative interaction between RC levels and age for stroke risk (P for interaction <0.05), with a stronger association observed among participants aged <65 years. Conclusions: Higher RC levels were associated with increased risks of CVD and stroke among patients with T2DM, with approximately linear positive associations observed for CVD and stroke. The association between RC and stroke risk was stronger among individuals aged <65 years.