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Research suggests increasing HDL reduces CVD risk in diabetes

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EASD 47th Annual Meeting

LISBON — Increasing HDL cholesterol levels and preventing declines may be important and effective strategies to reduce the risk for hospitalization from cardiovascular disease among patients with diabetes.

Researchers at Kaiser Permanente conducted a study of more than 30,000 patients with type 2 diabetes whose HDL was measured twice between 2001 and 2006; measurements were conducted 6 to 24 months apart. Follow-up lasted 7.5 years, during which researchers continuously monitored HDL change. Patients were stratified accordingly by HDL levels: increase of 6.5 mg/dL or more (n=18,449); decrease of 6.5 mg/dL (n=6,488); or levels that remained above or below 6.4 mg/dL (n=5,130).

During the study, HDL levels increased by 6.5 mg/dL or more in 21.6% of the patients, decreased in 17% and remained above or below 6.4 mg/dL in 61.4%. Twelve percent of patients were hospitalized for CVD during a mean follow-up to 55.8 months.

According to the researchers, each 5-mg/dL increase in HDL was significantly associated with a 7% decrease in the risk for CVD hospitalization (HR=0.93; 95% CI, 0.92-0.95). Similarly, each 5-mg/dL increase in HDL change was associated with a 5% reduction in CVD risk (HR=0.95; 95% CI, 0.93-0.97). An HDL decrease of 6.5 mg/dL or more was associated with a 15% increased risk for CVD (HR=1.15; 95% CI, 1.05-1.27); an increase of 6.5 mg/dL or more was associated with a 10% reduction in CVD risk (HR=0.90; 95% CI, 0.83-0.98).

Suma Vupputuri, PhD, MPH, from Kaiser Permanente Georgia, noted several limitations of the study, including its observational design and the inability to comprehensively assess changes in HDL.

“Despite these limitations, we feel confident that [based on this study] HDL changes are associated with CV risk. Although the benefit of raising HDL was not as great as some other studies, it still represents a potentially important finding,” she said during an oral session here. “Finally, our finding that decline in HDL was associated with increased CV risk is at least important and deserves further study,” – by Stacey L. Fisher

Disclosures: This research was funded by Takeda Pharmaceuticals.

For more information:

• Vupputuri S. Abstract #49. Presented at: The European Association for the Study of Diabetes 47th Annual Meeting; Sept. 12-16, 2011; Lisbon.

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