Clinical macrovascular disease in Caucasoid diabetic subjects: logistic regression analysis of risk variables

Abstract

Summary.A cross-sectional study of 1084 Caucasoid diabetic subjects in rural Western Australia revealed a high rate of clinical macrovascular disease (46%), including coronary heart disease (13%), stroke (8%), and peripheral vascular disease (38%). Age was the major time-related variable for total macrovascular disease and for peripheral vascular disease, with identical prevalence rates in Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetes when age was taken into account. In 179 Type t diabetic subjects, logistic regression analysis showed no associated risk factors other than age. In 905 Type 2 diabetic subjects the independent risk factors for total macrovascular disease, identified by a forward stepwise selection procedure, were age as the major contributor, with plasma creatinine levels and plasma glucose levels (all p < 0.001), high-density lipoprotein cholesterol levels, serum total cholesterol levels, and the (supine-erect) systolic blood pressure difference (all p < 0.05). There were no direct associations with percentage desirable weight, cigarette smoking or male sex. Type 2 diabetic subjects demonstrated a very strong negative association between high-density lipoprotein cholesterol levels and coronary heart disease, and significant associations were found also between plasma glucose levels and coronary heart disease (p < 0.01), and glycosylated haemoglobin levels and peripheral vascular disease (p < 0.001).

Association of plasma triglyceride and C-peptide with coronary heart disease in Japanese-American men with a high prevalence of glucose intolerance

“…Studies examining populations of diabetic subjects have also demonstrated the association of low HDL and HDL2 cholesterol levels with coronary heart disease [16,47,48]. In the present study sample known to have a high pre-R. W. Bergstrom et al: Triglyceride and C-peptide with heart disease valence of Type 2 diabetes and impaired glucose tolerance, both reduced HDL and HDL2 cholesterol levels and reduced apoprotein A~ were associated with the presence of coronary heart disease.…”

The fourth Musketeer — from Alexandre Dumas to Claude Bernard

“…In addition to being a common phenomenon, hypertriglyceridaemia is also associated with coronary heart disease (CHD) in patients with NIDDM [51][52][53][54]. A great deal of controversy has been generated as to whether hypertriglyceridaemia, per se, increases risk of CHD [55].…”

Gemfibrozil treatment increases low-density lipoprotein particle size in Type 2 diabetes mellitus but does not alterin vitro oxidizability

“…[1][2][3][4] In particular, elevated levels of triglycerides and reduced levels of high density lipoprotein (HDL) cholesterol have been well described [5][6][7][8] and are thought to contribute significantly to the greatly increased risk of cardiovascular disease in these patients. [9][10][11][12][13][14] Recently, another lipid risk factor for atherosclerotic cardiovascular disease has been identified, namely small low density Abbreviations: CETP cholesterol ester transfer protein; HDL high density lipoprotein; LDL low density lipoprotein; PAI-I plasminogen activator inhibitor-1; PPAR peroxisone proliferator activated receptor; VLDL very low density lipoprotein Sponsors: Parke-Davis * Correspondence to: Associate Professor James Best, Department of Medicine, University of Melbourne, St Vincent's Hospital, Fitzroy, Victoria 3065, Australia lipoprotein (LDL) particle size. 15,16 A predominance of small LDL particles is found more frequently in patients with Type 2 DM and has been linked with other abnormalities of diabetic dyslipidaemia, such as hypertriglyceridaemia and reduced HDL-cholesterol level.…”