Association of BMI, lipid-lowering medication, and age with prevalence of type 2 diabetes in adults with heterozygous familial hypercholesterolaemia: a worldwide cross-sectional study
Authors' conclusion
Adults with heterozygous familial hypercholesterolaemia in most WHO regions have a higher type 2 diabetes prevalence than in Europe. Obesity markedly increases the risk of diabetes associated with age and use of statins in these patients. Our results suggest that heterozygous familial hypercholesterolaemia does not protect against type 2 diabetes, hence managing obesity is essential to reduce type 2 diabetes in this patient population.
Study context
- Population
- Adults >18 years with clinical or genetic diagnosis of heterozygous familial hypercholesterolaemia, EAS FHSC registry, 44 countries; homozygous FH and T1D excluded
- Participants
- 24,784 adults44 countries
- Exposure
- Risk categories by age tertile, obesity and statin use
- Outcome
- Prevalence of T2D overall and by WHO region, and in relation to obesity (BMI ≥30.0 kg/m²) and lipid-lowering medication
Methodological detailsworldwide, individual-level registry data (EAS FHSC)
- Worldwide
- Individual-level registry data (EAS FHSC)
Main finding
As reported in the abstract
T2D prevalence
Each group vs lowest risk categoryOdds ratio (95% CI)
Highest risk category
74.42(47.04–117.73)
Upper age tertile, no obesity, statins
24.42(15.57–38.31)
- T2D prevalence, total population
- 5.7% (1415 of 24 784)
- T2D prevalence, Eastern Mediterranean
- 58 [29.9%] of 194
- T2D prevalence, South-East Asia and Western Pacific
- 214 [12.0%] of 1785
- T2D prevalence, Americas
- 166 [8.5%] of 1955
- T2D prevalence, Europe (excluding the Netherlands)
- 527 [8.0%] of 6579
Observational data: associations, not effects.
Further findings
| Outcome | OR (CI) | |
|---|---|---|
| Genetically diagnosed cohortHighest risk categoryvs Lowest risk category | 65.04 (40.67–104.02) | |
| Genetically diagnosed cohortUpper age tertile, no obesity, statinsvs Lowest risk category | 20.07 (12.73–31.65) | |
| 0.050.21520Odds ratio (log scale) |
- Genetically diagnosed cohort — Genetically confirmed diagnosis
- 19 818 (80%)
- Genetically diagnosed cohort — T2D prevalence, genetically diagnosed cohort
- 4.1% (817 of 19 818)
Original publication
Association of BMI, lipid-lowering medication, and age with prevalence of type 2 diabetes in adults with heterozygous familial hypercholesterolaemia: a worldwide cross-sectional study. Lancet Diabetes Endocrinol. Published 4 October 2024. doi:10.
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