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Impact of Severe Hypercholesterolemia on Cardiovascular Risk in Individuals With or Without Diabetes Mellitus

 Chan Joo Lee  ;  Sanghyun Park  ;  Kyungdo Han  ;  Sang-Hak Lee 
 Journal of Lipid and Atherosclerosis, Vol.11(3) : 299-307, 2022-09 
Journal Title
Journal of Lipid and Atherosclerosis
Issue Date
Coronary artery disease ; Diabetes mellitus, type 2 ; Hyperlipoproteinemia type II ; Outcome assessment, health care
Objective: The aim of the current study was to investigate whether the impact of low-density lipoprotein-cholesterol (LDL-C) levels on cardiovascular risk is different between individuals with severe hypercholesterolemia and diabetes mellitus (DM) and those without DM.

Methods: This study used the database of a National Health Insurance Service cohort of Korea. Among individuals who underwent health check-up, 2,261,332 were included and categorized into 3 groups with severe hypercholesterolemia, >260, 225-259, and 190-224 mg/dL groups, and a control group (<160 mg/dL). Risks of composite events (myocardial infarction [MI], coronary revascularization, and ischemic stroke) and total mortality were analyzed, according to the presence of DM.

Results: Of the study population, 5.2% had DM. During median follow-up of 6.1 years, the rates of composite events (/1,000 person-year) in non-DM and DM subjects were up to 5.66 and 8.92, respectively. Adjusted hazard ratios (aHRs) of the composite events ranged up to 3.11 and 1.44 in non-DM and DM groups, respectively (p<0.0001 between LDL-C categories in both groups). Dependency of aHR on LDL-C levels was more prominent in the non-DM group. aHRs of MI and coronary revascularization showed similar tendency to the composite events. Although aHRs of ischemic stroke (p<0.0001) and total mortality (p=0.002) were different according to LDL-C categories in the non-DM group, these relations were not observed in DM group.

Conclusion: Although individuals with severe hypercholesterolemia had high cardiovascular risk when DM was present, the impact of LDL-C on the risk was attenuated in this population.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Sang Hak(이상학) ORCID logo https://orcid.org/0000-0002-4535-3745
Lee, Chan Joo(이찬주) ORCID logo https://orcid.org/0000-0002-8756-409X
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