Low HDL cholesterol and the risk of diabetic nephropathy and retinopathy: Results of the advance study

Jamie Morton, Sophia Zoungas*, Qiang Li, Anushka A. Patel, John Chalmers, Mark Woodward, David S. Celermajer, Joline W J Beulens, Ronald P. Stolk, Paul Glasziou, Martin K C Ng

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

60 Citations (Scopus)
91 Downloads (Pure)

Abstract

OBJECTIVE - Although low HDL cholesterol (HDL-C) is an established risk factor for atherosclerosis, data on HDL-C and the risk ofmicrovascular disease are limited.We tested the association between HDL-C and microvascular disease in a cohort of patients with type 2 diabetes. RESEARCH DESIGN AND METHODS - A total of 11,140 patients with type 2 diabetes and at least one additional vascular risk factor were followed a median of 5 years. Cox proportional hazardsmodelswere used to assess the association between baselineHDL-C and the development of new or worsening microvascular disease, defined prospectively as a composite of renal and retinal events. RESULTS - The mean baseline HDL-C level was 1.3 mmol/L (SD 0.45mmol/L [range 0.1-4.0]). During follow-up, 32% of patients developed new or worsening microvascular disease, with 28% experiencing a renal event and 6%a retinal event. Compared with patients in the highest third, those in the lowest third had a 17% higher risk of microvascular disease (adjusted hazard ratio 1.17 [95% CI 1.06-1.28], P = 0.001) after adjustment for potential confounders and regression dilution. Thiswas driven by a 19%higher risk of renal events (1.19 [1.08-1.32], P = 0.0005). There was no association between thirds of HDL-C and retinal events (1.01 [0.82-1.25], P = 0.9). CONCLUSIONS - In patients with type 2 diabetes, HDL-C level is an independent risk factor for the development of microvascular disease affecting the kidney but not the retina.

Original languageEnglish
Pages (from-to)2201-2206
Number of pages6
JournalDiabetes Care
Volume35
Issue number11
DOIs
Publication statusPublished - Nov 2012

    Fingerprint

Cite this

Morton, J., Zoungas, S., Li, Q., Patel, A. A., Chalmers, J., Woodward, M., ... Ng, M. K. C. (2012). Low HDL cholesterol and the risk of diabetic nephropathy and retinopathy: Results of the advance study. Diabetes Care, 35(11), 2201-2206. https://doi.org/10.2337/dc12-0306