Non‐high‐density lipoprotein cholesterol: An important predictor of stroke and diabetes‐related mortality in Japanese elderly diabetic patients

Abstract

Aims: To evaluate the association of low‐density lipoprotein, high‐density lipoprotein and non‐high‐density lipoprotein cholesterol with the risk of stroke, diabetes‐related vascular events and mortality in elderly diabetes patients. Methods: This study was carried out as a post‐hoc landmark analysis of a randomized, controlled, multicenter, prospective intervention trial. We included 1173 elderly type 2 diabetes patients (aged ≥65 years) from 39 Japanese institutions who were enrolled in the Japanese elderly diabetes intervention trial study and who could be followed up for 1 year. A landmark survival analysis was carried out in which follow up was set to start 1 year after the initial time of entry. Results: During 6 years of follow up, there were 38 cardiovascular events, 50 strokes, 21 diabetes‐related deaths and 113 diabetes‐related events. High low‐density lipoprotein cholesterol was associated with incident cardiovascular events, and high glycated hemoglobin was associated with strokes. After adjustment for possible covariables, non‐high‐density lipoprotein cholesterol showed a significant association with increased risk of stroke, diabetes‐related mortality and total events. The adjusted hazard ratios (95% confidence intervals) of non‐high‐density lipoprotein cholesterol were 1.010 (1.001–1.018, P = 0.029) for stroke, 1.019 (1.007–1.031, P < 0.001) for diabetes‐related death and 1.008 (1.002–1.014; P < 0.001) for total diabetes‐related events. Conclusions: Higher non‐high‐density lipoprotein cholesterol was associated with an increased risk of stroke, diabetes‐related mortality and total events in elderly diabetes patients. Geriatr Gerontol Int 2012; 12 (Suppl. 1): 18–28.