NDLI: Is HDL cholesterol protective in patients with type 2 diabetes? A retrospective population-based cohort study

Content Provider	Springer Nature : BioMed Central
Author	Fanni, Giovanni Rosato, Rosalba Gentile, Luigi Anselmino, Matteo Frea, Simone Ponzo, Valentina Pellegrini, Marianna Broglio, Fabio Pivari, Francesca De Ferrari, Gaetano Maria Ghigo, Ezio Bo, Simona
Abstract	Background The protective role of high HDL cholesterol levels against cardiovascular diseases has been recently questioned. Limited data are available on this specific topic in patients with type 2 diabetes mellitus (T2DM). We aimed to evaluate the association of HDL cholesterol concentrations with all-cause and cause-specific mortality in a historical cohort of T2DM patients with 14 years of follow-up. Methods This is a retrospective population-based cohort study involving 2113 T2DM patients attending the Diabetic Clinic of Asti. Survival analyses were performed to assess hazard ratios for overall and specific-cause mortality by HDL cholesterol tertiles, using the middle HDL cholesterol tertile as a reference. Results The mean age was 66 ± 11 years; 51.4% of patients had low HDL-cholesterol levels. After a 14-year follow-up, 973/2112 patients had died (46.1%). The HDL cholesterol tertile cut-off points were 37.5 and 47.5 mg/dL (males) and 41.5 and 52.0 mg/dL (females). No associations between lower and upper HDL cholesterol tertiles respectively and all-cause (HR = 1.12; 95% CI 0.96–1.32; HR = 1.11; 0.95–1.30), cardiovascular (HR = 0.97; 0.77–1.23; HR = 0.94; 0.75–1.18) or cancer (HR = 0.92; 0.67–1.25; HR = 0.89; 0.66–1.21) mortality were found. A significantly increased risk for infectious disease death was found both in the lower (HR = 2.62; 1.44–4.74) and the upper HDL-cholesterol tertiles (HR = 2.05; 1.09–3.85) when compared to the reference. Individuals in the upper tertile showed an increased risk for mortality due to diabetes-related causes (HR = 1.87; 1.10–3.15). Conclusions Our results corroborate the hypothesis that HDL cholesterol levels are nonprotective in T2DM patients. The U-shaped association between HDL-cholesterol levels and mortality associated with infectious diseases should be verified by further studies.
Related Links	https://translational-medicine.biomedcentral.com/counter/pdf/10.1186/s12967-020-02357-1.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14795876
DOI	10.1186/s12967-020-02357-1
Journal	Journal of Translational Medicine
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2020-05-06
Access Restriction	Open
Subject Keyword	Biomedicine Medicine Public Health High-density lipoprotein Type 2 diabetes mellitus Infectious diseases Mortality Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Biochemistry, Genetics and Molecular Biology Medicine
Journal Impact Factor	6.1/2023
5-Year Journal Impact Factor	6.3/2023

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