Low HDL‐cholesterol is common in European Type 2 diabetic patients receiving treatment for dyslipidaemia: data from a pan‐European survey

Bruckert, Éric; Baccara‐Dinet, Marie T.; Eschwège, É.

doi:10.1111/j.1464-5491.2007.02111.x

Cited by 40 publications

(27 citation statements)

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“…Compared with other studies conducted in different population settings, the prevalence of atherogenic dyslipidemia was lower than was expected. 13,18 Beyond the heterogeneity in cutoff values used to define such a disease, particular or associated factors in the different population sets may also explain the differences reported. The present results also confirm the particular place of other metabolic diseases.…”

Section: Discussionmentioning

confidence: 92%

“…6 Such atherogenic dyslipidemia profile is particularly prevalent in patients with type 2 diabetes mellitus, obesity, metabolic syndrome, and/or established cardiovascular disease-a number of conditions associated with a high vascular risk. [12][13][14] In contrast, in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, in which fenofibrate or placebo on top of statin therapy was evaluated (a study that was negative overall), the subgroup analysis of individuals with both low HDL-C and high triglyceride concentrations suggested a possible benefit of adjunctive fenofibrate treatment. 15 In a meta analysis of fibrate trials, we have also shown a significant treatment by atherogenic dyslipidemia interaction, suggesting that this group of patients could be a target for effective fibrate therapy.…”

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confidence: 97%

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Atherogenic Dyslipidemia in Patients With Transient Ischemic Attack

Gaia

Deplanque

Lavallée

et al. 2011

Stroke

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Background and Purpose-There is mounting evidence that atherogenic dyslipidemia (ie, low high-density lipoprotein cholesterol combined with high triglyceride concentrations) is an independent predictor of high cardiovascular risk and possibly of stroke. Methods-All patients included in the SOS-TIA cohort underwent an initial standardized evaluation, including medical history, physical examination, routine blood biochemistry, and diagnostic testing, and were followed for 1 year. Lipid profile was evaluated under fasting conditions. Atherogenic dyslipidemia was defined as high-density lipoprotein cholesterol blood concentration Յ40 mg/dL and triglycerides Ն150 mg/dL. Results-Among 1471 consecutive patients with transient ischemic attack (TIA) or minor stroke, overall prevalence of atherogenic dyslipidemia was 5.8%, but varied from 4.6% to 11.1%, depending on final diagnosis (possible TIA or TIA with a cerebral ischemic lesion, respectively). Prevalence of atherogenic dyslipidemia was independently associated with male sex, diabetes, and body mass index, but not with ABCD2 score. Atherogenic dyslipidemia also strongly associated with symptomatic intracranial stenosis Ն50% (adjusted odds ratio, 2.77; 95% CI, 1.38 -5.55), but not with symptomatic extracranial stenosis Ն50% (adjusted odds ratio, 1.20; 95% CI, 0.64 -2.26). Despite appropriate secondary prevention treatment, 90-day stroke risk was greater in patients with versus without atherogenic dyslipidemia (4.8% versus 1.7%; Pϭ0.04). Conclusions-The atherogenic dyslipidemia phenotype in patients with TIA may be associated with intracranial artery stenosis and higher risk of early recurrent stroke. Additional data are needed to confirm these findings and to assess the best way to reduce important residual risk in such patients. (Stroke. 2011;42:2131-2137.)

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Section: Discussionmentioning

confidence: 92%

mentioning

confidence: 97%

Atherogenic Dyslipidemia in Patients With Transient Ischemic Attack

Gaia

Deplanque

Lavallée

et al. 2011

Stroke

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“…Clinical and epidemiological studies have demonstrated an inverse association between high-density lipoprotein cholesterol (HDL-C) concentrations and cardiovascular disease risk (1,2). This association is supported by the anti-atherogenic properties of HDL-C; in particular, HDL-C functions in reverse cholesterol transport (RCT) (3).…”

Section: Introductionmentioning

confidence: 93%

Involvement of ATP-binding cassette, subfamily A polymorphism with susceptibility to coronary artery disease

et al. 2013

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Abstract. Coronary artery disease (CAD) is one of the leading causes of mortality in developed countries. Adenosine triphosphate (ATP)-binding cassette A1 (ABCA1) belongs to the superfamily of membrane proteins that function as a key factor in the regulation of plasma high-density lipoprotein cholesterol (HDL-C) and the metabolism of apolipoprotein A-I (Apo AI). The role of this gene in CAD remains controversial. The aim of this study was to investigate the frequency of single-nucleotide polymorphism (SNP) rs2230806 in the ABCA1 gene of 120 CAD patients and 100 age-matched, healthy controls using restriction fragment length polymorphism and direct sequencing. Total serum cholesterol, HDL-C and serum triglyceride levels were also assayed. Low-density lipoprotein cholesterol (LDL-C) was calculated using the Friedewald formula. When compared, the G allele occurred significantly more frequently in CAD patients compared to the control subjects. The odds ratio (OR) for CAD conferred by carrying the ABCA1 G allele was 2.362 [95% confidence interval (CI) 0.9055-6.161] (P<0.08). The K variant of SNP rs2230806 in the G allele was associated with a decrease in HDL-C levels, but an increased frequency of CAD. In conclusion, the results showed that SNP rs2230806 in the ABCA1 gene is significantly associated with the incidence of CAD. Homozygosity for the G allelic variant in CAD patients may be associated with an increased risk of CAD/MI.

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“…[2][3][4][5] The combination of these lipoprotein abnormalities, termed atherogenic dyslipidemia (AD), is highly prevalent in patients with diabetes mellitus or metabolic syndrome, and, in addition to high LDL-C, contributes independently to cardiovascular risk. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] Treatment with fibrates may reduce cardiovascular risk in patients with AD associated with metabolic syndrome and type 2 diabetes mellitus. 20 However, in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, the use of fenofibrate and simvastatin did not reduce the rates of cardiovascular events compared with simvastatin alone.…”

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confidence: 99%

Atherogenic Dyslipidemia and Residual Cardiovascular Risk in Statin-Treated Patients

Gaia

Labreuche

Bruckert

et al. 2014

Stroke

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Background and Purpose-Treatment with statins reduces the rate of cardiovascular events in high-risk patients, but residual risk persists. At least part of that risk may be attributable to atherogenic dyslipidemia characterized by low highdensity lipoprotein cholesterol (≤40 mg/dL) and high triglycerides (triglycerides ≥150 mg/dL). Methods-We studied subjects with stroke or transient ischemic attack in the Prevention of Cerebrovascular and Cardiovascular Events of Ischemic Origin With Terutroban in Patients With a History of Ischemic Stroke or Transient Ischemic Attack (PERFORM; n=19 100) and Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL; n=4731) trials who were treated with a statin and who had high-density lipoprotein cholesterol and triglycerides measurements 3 months after randomization (n=10 498 and 2900, respectively). The primary outcome measure for this exploratory analysis was the occurrence of major cardiovascular events (nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death). We also performed a time-varying analysis to account for all available high-density lipoprotein cholesterol and triglyceride measurements. Results-A total of 10% of subjects in PERFORM and 9% in SPARCL had atherogenic dyslipidemia after ≥3 months on start statin therapy. After a follow-up of 2.3 years (PERFORM) and 4.9 years (SPARCL), a major cardiovascular event occurred in 1123 and 485 patients in the 2 trials, respectively. The risk of major cardiovascular events was higher in subjects with versus those without atherogenic dyslipidemia in both PERFORM (hazard ratio, 1.36; 95% confidence interval, 1.14-1.63) and SPARCL (hazard ratio, 1.40; 95% confidence interval, 1.06-1.85). The association was attenuated after multivariable adjustment (hazard ratio, 1.23; 95% confidence interval, 1.03-1.48 in PERFORM and hazard ratio, 1.24; 95% confidence interval, 0.93-1.65 in SPARCL). Time-varying analysis confirmed these findings. Conclusions-The presence of atherogenic dyslipidemia was associated with higher residual cardiovascular risk in PERFORM and SPARCL subjects with stroke or transient ischemic attack receiving statin therapy. Specific therapeutic interventions should now be trialed to address this residual risk.

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Low HDL‐cholesterol is common in European Type 2 diabetic patients receiving treatment for dyslipidaemia: data from a pan‐European survey

Abstract: Low HDL-cholesterol is common in diabetes: one in two diabetic women has low HDL-cholesterol and one diabetic man in four has very low HDL-cholesterol. Management strategies should include correction of low HDL-cholesterol to optimize cardiovascular risk in diabetes.

Cited by 40 publications

References 23 publications

Atherogenic Dyslipidemia in Patients With Transient Ischemic Attack

Atherogenic Dyslipidemia in Patients With Transient Ischemic Attack

Involvement of ATP-binding cassette, subfamily A polymorphism with susceptibility to coronary artery disease

Atherogenic Dyslipidemia and Residual Cardiovascular Risk in Statin-Treated Patients

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