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High-density lipoprotein subclasses and cardiovascular disease and mortality in type 2 diabetes: analysis from the Hong Kong Diabetes Biobank.


ABSTRACT:

Objective

High-density lipoproteins (HDL) comprise particles of different size, density and composition and their vasoprotective functions may differ. Diabetes modifies the composition and function of HDL. We assessed associations of HDL size-based subclasses with incident cardiovascular disease (CVD) and mortality and their prognostic utility.

Research design and methods

HDL subclasses by nuclear magnetic resonance spectroscopy were determined in sera from 1991 fasted adults with type 2 diabetes (T2D) consecutively recruited from March 2014 to February 2015 in Hong Kong. HDL was divided into small, medium, large and very large subclasses. Associations (per SD increment) with outcomes were evaluated using multivariate Cox proportional hazards models. C-statistic, integrated discrimination index (IDI), and categorial and continuous net reclassification improvement (NRI) were used to assess predictive value.

Results

Over median (IQR) 5.2 (5.0-5.4) years, 125 participants developed incident CVD and 90 participants died. Small HDL particles (HDL-P) were inversely associated with incident CVD [hazard ratio (HR) 0.65 (95% CI 0.52, 0.81)] and all-cause mortality [0.47 (0.38, 0.59)] (false discovery rate < 0.05). Very large HDL-P were positively associated with all-cause mortality [1.75 (1.19, 2.58)]. Small HDL-P improved prediction of mortality [C-statistic 0.034 (0.013, 0.055), IDI 0.052 (0.014, 0.103), categorical NRI 0.156 (0.006, 0.252), and continuous NRI 0.571 (0.246, 0.851)] and CVD [IDI 0.017 (0.003, 0.038) and continuous NRI 0.282 (0.088, 0.486)] over the RECODe model.

Conclusion

Small HDL-P were inversely associated with incident CVD and all-cause mortality and improved risk stratification for adverse outcomes in people with T2D. HDL-P may be used as markers for residual risk in people with T2D.

SUBMITTER: Jin Q 

PROVIDER: S-EPMC9805680 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Publications

High-density lipoprotein subclasses and cardiovascular disease and mortality in type 2 diabetes: analysis from the Hong Kong Diabetes Biobank.

Jin Qiao Q   Lau Eric S H ESH   Luk Andrea O AO   Tam Claudia H T CHT   Ozaki Risa R   Lim Cadmon K P CKP   Wu Hongjiang H   Chow Elaine Y K EYK   Kong Alice P S APS   Lee Heung Man HM   Fan Baoqi B   Ng Alex C W ACW   Jiang Guozhi G   Lee Ka Fai KF   Siu Shing Chung SC   Hui Grace G   Tsang Chiu Chi CC   Lau Kam Piu KP   Leung Jenny Y JY   Tsang Man-Wo MW   Cheung Elaine Y N EYN   Kam Grace G   Lau Ip Tim IT   Li June K JK   Yeung Vincent T VT   Lau Emmy E   Lo Stanley S   Fung Samuel S   Cheng Yuk Lun YL   Chow Chun Chung CC   Yu Weichuan W   Tsui Stephen K W SKW   Huang Yu Y   Lan Hui-Yao HY   Szeto Cheuk Chun CC   So Wing Yee WY   Jenkins Alicia J AJ   Chan Juliana C N JCN   Ma Ronald C W RCW  

Cardiovascular diabetology 20221231 1


<h4>Objective</h4>High-density lipoproteins (HDL) comprise particles of different size, density and composition and their vasoprotective functions may differ. Diabetes modifies the composition and function of HDL. We assessed associations of HDL size-based subclasses with incident cardiovascular disease (CVD) and mortality and their prognostic utility.<h4>Research design and methods</h4>HDL subclasses by nuclear magnetic resonance spectroscopy were determined in sera from 1991 fasted adults with  ...[more]

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