Low HDL Cholesterol Is Associated With the Risk of Stroke in Elderly Diabetic Individuals

doi:10.2337/dc08-1677

Low HDL Cholesterol Is Associated With the Risk of Stroke in Elderly Diabetic Individuals

Changes in the risk for atherosclerotic diseases at various ages

Toshio Hayashi, MD, PHD¹,
Seinosuke Kawashima, MD, PHD²,
Hideki Itoh, MD, PHD³,
Nobuhiro Yamada, MD, PHD⁴,
Hirohito Sone, MD, PHD⁵,
Hiroshi Watanabe, MD, PHD⁶,
Yoshiyuki Hattori, MD, PHD⁷,
Takashi Ohrui, MD, PHD⁸,
Koutaro Yokote, MD, PHD⁹,
Hideki Nomura, MD, PHD¹⁰,
Hiroyuki Umegaki, MD, PHD¹ and
Akihisa Iguchi, MD, PHD¹ on behalf of the Japan CDM Group

¹Department of Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan;
²Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan;
³Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan;
⁴Department of Internal Medicine, Endocrinology and Metabolism, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan;
⁵Department of Nutrition, Ochanomizu University, Tokyo, Japan;
⁶Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan;
⁷Department of Endocrinology and Metabolism, Dokkyo University School of Medicine, Mibu, Japan;
⁸Department of Geriatric Medicine, Tohoku University School of Medicine, Sendai, Japan;
⁹Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Chiba University Hospital, Chiba, Japan;
¹⁰Department of Geriatrics, Nagoya Kita Hospital, Nagoya, Japan.

Corresponding author: Toshio Hayashi, hayashi{at}med.nagoya-u.ac.jp.

Abstract

OBJECTIVE To clarify the relationship between lipid levels and ischemic heart disease (IHD) and cerebrovascular disease (CVD) in diabetic individuals.

RESEARCH DESIGN AND METHODS The Japan Cholesterol and Diabetes Mellitus Study is a prospective cohort study of 4,014 type 2 diabetic patients (1,936 women; mean ± SD age 67.4 ± 9.5 years). Lipid and glucose levels and other factors were investigated in relation to occurrence of IHD or CVD.

RESULTS IHD and CVD occurred in 1.59 and 1.43% of participants, respectively, over a 2-year period. The relation of lower HDL or higher LDL cholesterol to occurrence of IHD in subjects <65 years old was significant. Lower HDL cholesterol was also significantly related to CVD in subjects ≥65 years old and especially in those >75 years old (n = 1,016; odds ratio 0.511 [95% CI 0.239–0.918]; P < 0.05). Stepwise multiple regression analysis with onset of CVD as a dependent variable showed the same result.

CONCLUSIONS Lower HDL cholesterol is an important risk factor for not only IHD but also CVD, especially in diabetic elderly individuals.

Footnotes

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- Received September 18, 2008.
- Accepted January 7, 2009.
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