Lipids and apolipoproteins and the risk of vascular disease and mortality outcomes in women and men with type 2 diabetes in the ADVANCE study
Authors' conclusion
All established lipid risk markers, except triglycerides, were predictors of macrovascular complications, but not microvascular complications, in patients with type 2 diabetes. The ApoB/ApoA1 ratio was associated with major macro- and microvascular complications, but there was no evidence that apolipoproteins are better than established lipid risk markers in predicting cardiovascular complications in patients with type 2 diabetes.
Study context
- Population
- Individuals with T2D from the ADVANCE trial; apolipoproteins and very-low-density lipoprotein (VLDL) cholesterol in the ADVANCE case-cohort study3,586 in ADVANCE CC
- Participants
- 11,140 individuals
- Comparison
- Established lipid risk markers and apolipoproteins vs risk of macro- and microvascular events and death
- Primary endpoint
- Major macro- and microvascular events and death
Methodological detailscase-cohort substudy (ADVANCE CC), nuclear magnetic resonance (NMR) lipid analyses in biobanked samples, Cox proportional hazards models adjusted for confounders, subgroup analyses by sex
- Case-cohort substudy (ADVANCE CC)
- NMR lipid analyses in biobanked samples
- Cox proportional hazards models adjusted for confounders
- Subgroup analyses by sex
Primary result
As reported in the abstract
Macro- and microvascular complications (HR [95% CI])
- Macrovascular, high-density lipoprotein (HDL) cholesterol (ADVANCE): HR 0.88, 95% CI
- 0.82-0.95
- Macrovascular, total cholesterol (ADVANCE): HR 1.10, 95% CI
- 1.04-1.17
- Macrovascular, low-density lipoprotein (LDL) cholesterol (ADVANCE): HR 1.15, 95% CI
- 1.08-1.22
- Macrovascular, non-HDL cholesterol (ADVANCE): HR 1.13, 95% CI
- 1.07-1.20
- Macrovascular, total cholesterol/HDL ratio (ADVANCE): HR 1.20, 95% CI
- 1.14-1.27
- Macrovascular, ApoB/ApoA1 ratio (ADVANCE CC): HR 1.13, 95% CI
- 1.03-1.24
- Microvascular, ApoB/ApoA1 ratio: HR 1.19, 95% CI
- 1.06-1.34
Further findings
Sex differences
- No statistically significant sex differences for any established lipid risk marker or apolipoprotein with any outcome
Prediction improvement (C-statistics, net reclassification improvement (NRI))
- No significant improvement in predicting all outcomes by adding lipids or apolipoproteins to confounder-only models
Original publication
Lipids and apolipoproteins and the risk of vascular disease and mortality outcomes in women and men with type 2 diabetes in the ADVANCE study. Diabetes Obes Metab. Published 10 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →