The relationship between serum HDL-cholesterol, cardiovascular disease and mortality in community-based people with type 2 diabetes: the Fremantle Diabetes Study phase 2
Authors' conclusion
There was a significant U-shaped relationship between serum HDL-cholesterol and both 3-point MACE and all-cause death in females with type 2 diabetes after adjustment for confounders. There was no such relationship for 3-point MACE in males but a low HDL-cholesterol was associated with all-cause mortality. These data have sex-specific implications for assessment of serum lipid profiles in the clinical management of type 2 diabetes.
Study context
- Population
- Community-based participants with confirmed T2D, Fremantle Diabetes Study Phase II, followed from entry (2008–2011) to death/end-2021; 713 females (mean age 65.6 years), 763 males (mean age 65.9 years)
- Participants
- 1,479 participants
- Exposure
- Sex-specific quintiles of serum HDL-C
- Outcome
- 3-point MACE (non-fatal MI, non-fatal stroke, cardiovascular death) and all-cause mortality
- Follow-up
- Entry (2008-2011) to death/end-2021
Methodological detailscommunity-based, sex-specific quintiles of HDL-C, Cox and competing risk models
- Community-based
- Sex-specific quintiles of HDL-C
- Cox and competing risk models
Main finding
As reported in the abstract
- Females Q1 vs Females Q2: P < 0.027
- Females Q5 vs Females Q2: P < 0.027
- Females Q1 vs Females Q2: P < 0.019
- Females Q5 vs Females Q2: P < 0.019
- Adjusted for demographic, clinical and laboratory variables
- Excluding participants with prior myocardial infarction (MI)/stroke (MACE analysis)
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| All-cause death in malesMales Q1 vs Males Q4 · Q1 a significant predictor of death after adjustment | P = 0.026 |
3-point MACE in males
- HDL-C quintile did not add to the most parsimonious model for 3-point MACE in males
Competing risk analyses for 3-point MACE
- Similar results to the Cox models for both sexes
Original publication
The relationship between serum HDL-cholesterol, cardiovascular disease and mortality in community-based people with type 2 diabetes: the Fremantle Diabetes Study phase 2. Cardiovasc Diabetol. Published 14 October 2024. doi:10.
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