August 17, 2019Open Access

U-shaped association between low-density lipid cholesterol and diabetes mellitus in patients with hypertension

LLLin LiuCangzhou Central Hospital GSGeng ShenCapital Medical University JHJiayi HuangChongqing University

Structured PICO

Does LDL-C level associate with the prevalence of diabetes mellitus in hypertensive patients?

Population

9,892 adults over 18 years of age with hypertension (SBP ≥140 mmHg, DBP ≥90 mmHg, and/or use of antihypertensive medications), mean age 62.9, 49.7% male, from a registry in Dongguan, Guangdong, China.

Intervention

LDL-C levels (analyzed as a continuous variable and stratified into desirable <3.4 mmol/L, borderline high 3.4-4.1 mmol/L, and high ≥4.1 mmol/L)

Comparator

Different LDL-C levels (e.g., lowest vs highest quartile)

Outcome

Prevalence of diabetes mellitus

There is a U-shaped association between LDL-C levels and diabetes mellitus prevalence in Chinese patients with hypertension, suggesting both very low and high LDL-C levels may be associated with increased DM risk.

Abstract

BACKGROUND: The magnitude and direction of association of low-density lipid cholesterol (LDL-C) with diabetes mellitus (DM) might differ by hypertensive status, but there is limited epidemiological evidence in China. METHODS: We examined the association between LDL-C levels and DM in 9892 participants with hypertension using logistic regression. Participants were stratified into three groups according to LDL-C levels (desirable, borderline high or high), then further divided into quartiles. Restricted cubic spline regression models, subgroup analysis and interaction tests were also conducted to evaluate the shape of association. RESULTS: After adjusting for covariates, lower LDL-C had a significant and inverse association with the likelihood of DM in all participants (OR: 0.944, 95% CI = 0.893, 0.998). In participants with desirable LDL-C concentrations ( 4.1 mmol/L), LDL-C increased the DM likelihood (OR = 1.536, 95% CI = 1.126, 2.096 per 1 mmol/L increase). Restricted cubic spline regression also found a U-shaped association between LDL-C levels and DM prevalence. CONCLUSIONS: There was a U-shaped association between LDL-C levels and DM in Chinese patients with hypertension.

KI fragen

Bookmark

View Full Paper