HDL Composition Predicts New-Onset Cardiovascular Disease in Patients With Type 1 Diabetes

doi:10.2337/dc07-0030

HDL Composition Predicts New-Onset Cardiovascular Disease in Patients With Type 1 Diabetes

Per-Henrik Groop, MD, DMSC12,
Merlin C. Thomas, MBCHB, PHD3,
Milla Rosengård-Bärlund, MD12,
Vashti Mills, BSC4,
Mats Rönnback, MD12,
Stephen Thomas, PHD, MRCP4,
Carol Forsblom, MD, DMSC12,
Maria-Rita Taskinen, MD, DMSC2 and
Giancarlo Viberti, FRCP4

¹Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland
²Divisions of Nephrology and Cardiology, Helsinki University Central Hospital, Helsinki, Finland
³Baker Heart Research Institute, Melbourne, Victoria, Australia
⁴Cardiovascular Division, Guy's, King's, and St. Thomas' School of Medicine, Guy's Hospital, King's College, London, U.K

Address correspondence and reprint requests to Per-Henrik Groop, Folkhälsan Research Center, Biomedicum Helsinki, P.O. Box 63, FIN-00014 University of Helsinki, Finland. E-mail: per-henrik.groop{at}helsinki.fi

Dyslipidemia is independently associated with cardiovascular disease (CVD) in type 1 diabetes (1,2). In this article, we report the specific lipid abnormalities associated with new-onset CVD in an enriched cohort of patients with type 1 diabetes.

RESEARCH DESIGN AND METHODS—

The study design and selection criteria have been previously described (3,4). Briefly, 153 patients with type 1 diabetes were recruited in the U.K. from the Diabetes outpatient clinics at Guy's and King's College Hospitals (n = 75) and in Finland from the Helsinki University Central Hospital (n = 78). Patients were recruited to represent differing degrees of urinary albumin excretion and matched for duration of diabetes and glycemic control. Participants were then followed for a median of 8.8 years, during which time they received standard medical care, including lipid-lowering agents where indicated.

Full methods of baseline examination have been published elsewhere (3–6). Briefly, clinical data were obtained from patient records including age, sex, diabetes onset, duration of diabetes, medication history, and the presence of microvascular complications. Lipids and lipid fractions were estimated in fasting samples and processed as previously described (3–6). The study outcome was defined post hoc by the occurrence of a fatal or nonfatal cardiovascular event, including coronary heart disease (myocardial infarction, coronary revascularization, or angioplasty), cerebrovascular disease (stroke), or peripheral vascular disease (amputation associated with large vessel disease) based on clinical records.