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

Cardiovascular Diabetology

Research

Vincent T. Yeung¹  Weichuan Yu²  Ka Fai Lee³  Samuel Fung⁴  Jenny Y. Leung⁵  Elaine Y. N. Cheung⁶  Man-wo Tsang⁶  Grace Kam⁶  Qiao Jin⁷  Heung Man Lee⁷  Alex C. W. Ng⁷  Chun Chung Chow⁷  Eric S. H. Lau⁸  Hongjiang Wu⁸  Risa Ozaki⁸  Wing Yee So⁹  Alice P. S. Kong⁹  Andrea O. Luk⁹  Elaine Y. K. Chow⁹  Juliana C. N. Chan^1,10  Cadmon K. P. Lim^1,10  Baoqi Fan^1,10  Ronald C. W. Ma^1,10  Claudia H. T. Tam^1,10  Hui-yao Lan^1,11  Cheuk Chun Szeto^1,11  Alicia J. Jenkins^1,12  Yuk Lun Cheng^1,13  Stanley Lo^1,14  Emmy Lau^1,14  June K. Li^1,15  Grace Hui^1,16  Shing Chung Siu^1,16  Chiu Chi Tsang^1,17  Kam Piu Lau^1,18  Stephen K. W. Tsui^1,19  Yu Huang^2,20  Guozhi Jiang^2,21  Ip Tim Lau^2,22 

[1] Centre for Diabetes Education and Management, Our Lady of Maryknoll Hospital, Wong Tai Sin, Hong Kong Special Administrative Region, China;Department of Electronic and Computer Engineering, The Hong Kong University of Science and Technology, Kowloon, Hong Kong Special Administrative Region, China;Department of Medicine and Geriatrics, Kwong Wah Hospital, Yau Ma Tei, Hong Kong Special Administrative Region, China;Department of Medicine and Geriatrics, Princess Margaret Hospital, Lai Chi Kok, Hong Kong Special Administrative Region, China;Department of Medicine and Geriatrics, Ruttonjee Hospital, Wan Chai, Hong Kong Special Administrative Region, China;Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Hong Kong Special Administrative Region, China;Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;CUHK-SJTU Joint Research Centre on Diabetes Genomics and Precision Medicine, Shatin, Hong Kong Special Administrative Region, China;Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia;Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong Special Administrative Region, China;Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong Special Administrative Region, China;Department of Medicine, Yan Chai Hospital, Tsuen Wan, Hong Kong Special Administrative Region, China;Diabetes Centre, Tung Wah Eastern Hospital, Sheung Wan, Hong Kong Special Administrative Region, China;Diabetes and Education Centre, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong Special Administrative Region, China;North District Hospital, Sheung Shui, Hong Kong Special Administrative Region, China;School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China;Department of Biomedical Sciences, City University of Hong Kong, Kowloon, Hong Kong Special Administrative Region, China;School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, China;Tseung Kwan O Hospital, Hang Hau, Hong Kong Special Administrative Region, China;

关键词: Cardiovascular disease;    High-density lipoprotein particles;    High-density lipoprotein subclasses;    Mortality;    Prognostic marker;    Residual risk;    Risk stratification;    Type 2 diabetes;   

DOI  :  10.1186/s12933-022-01726-y

 received in 2022-11-09, accepted in 2022-12-13,  发布年份 2022

来源: Springer

【 摘 要 】

ObjectiveHigh-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 methodsHDL 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.ResultsOver 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.ConclusionSmall 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.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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Fig. 4