Low HDL-cholesterol is associated with the risk of stroke in elderly diabetic individuals: Changes in the risk for atherosclerotic diseases at various ages

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, PhD (hayashi{at}med.nagoya-u.ac.jp)1,
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, PhD on behalf of Japan CDM group1

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

Abstract

Objectives: To clarify the relation of lipid levels to ischemic heart disease (IHD) and cerebrovascular disease (CVD) in diabetic individuals.

Research Design and Methods: Prospective cohort study (Japan Cholesterol and Diabetes Mellitus Study) of 4014 type 2 diabetic patients (1936 women, 67.4+9.5 y.o.). The levels of lipid, glucose, and other factors were investigated in the relation to occurrence of IHD or CVD.

Results: IHD and CVD occurred in 1.59% and 1.43% of participants over 2-year period. The relation of lower HDL-cholesterol and/or higher LDL-cholesterol to occurrence of IHD in subjects<65 y.o. was significant. Lower HDL-cholesterol was also significantly related to CVD in subjects >=65y.o. and especially those>=75 y.o. (n=1016; 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 same result.

Conclusion: Lower HDL-cholesterol is an important risk factor for not only IHD but also CVD, especially in the diabetic elderly.