Pennington Biomedical Research Center, Baton Rouge, LA, United States; School of Human Ecology, Louisiana State University AgCenter, Baton Rouge, LA, United States; Department of Experimental Statistics, Louisiana State University, Baton Rouge, LA, United States.
Diabetes Res Clin Pract. 2013 Oct;102(1):65-75. doi: 10.1016/j.diabres.2013.07.009. Epub 2013 Aug 9.
To estimate the prospective association of low-density lipoprotein (LDL) cholesterol on cardiovascular disease (CVD) risk among people with type 2 diabetes.
We used extensive literature searching strategies to locate prospective cohort studies that reported LDL cholesterol levels as a risk factor for cardiovascular events. We conducted meta-analytic procedures for two outcomes: incident CVD and CVD mortality.
A total of 16 studies were included in this analysis with a mean follow-up range of 4.8-11 years. The pooled relative risk associated with a 1mmol/L increase in LDL cholesterol in people with type 2 diabetes was 1.30 (95% confidence interval [CI], 1.19-1.43) for incident CVD, and 1.50 (95% CI, 1.25-1.80) for CVD mortality, respectively. Subgroup analyses showed that for incident CVD, the pooled relative risk was 1.28 (95% CI, 1.17-1.41) for 7 studies adjusted for blood pressure and/or glucose concentration (or insulin concentration, glycated hemoglobin) and 1.40 (95% CI, 1.05-1.86) for 3 studies that did not adjust for these variables.
Our study demonstrates that LDL cholesterol was associated with an increased risk for cardiovascular outcomes in people with type 2 diabetes, independent of other conventional risk factor.
评估低密度脂蛋白（LDL）胆固醇在 2 型糖尿病患者心血管疾病（CVD）风险中的前瞻性关联。
我们使用广泛的文献搜索策略来定位报告 LDL 胆固醇水平作为心血管事件风险因素的前瞻性队列研究。我们对两个结局进行了荟萃分析程序：新发 CVD 和 CVD 死亡率。
共有 16 项研究纳入本分析，平均随访范围为 4.8-11 年。在 2 型糖尿病患者中，LDL 胆固醇每增加 1mmol/L，与新发 CVD 相关的 pooled 相对风险为 1.30（95%置信区间 [CI]，1.19-1.43），与 CVD 死亡率相关的 pooled 相对风险为 1.50（95% CI，1.25-1.80）。亚组分析显示，对于新发 CVD，在调整血压和/或血糖浓度（或胰岛素浓度、糖化血红蛋白）的 7 项研究中，pooled 相对风险为 1.28（95% CI，1.17-1.41），而在未调整这些变量的 3 项研究中，pooled 相对风险为 1.40（95% CI，1.05-1.86）。
我们的研究表明，LDL 胆固醇与 2 型糖尿病患者心血管结局风险增加相关，独立于其他传统危险因素。
