Key result
Highest glycated LDL-C linked to ~180% higher MACE risk in patients with type 2 diabetes.
Why the study?
The global burden and serious outcomes of coronary heart disease highlight the need to explore the predictive value of G-apoA1 and G-LDL-C levels for coronary artery obstruction severity and future MACEs in patients with T2DM.
Are elevated levels of glycated apolipoprotein A1 and glycated low-density lipoprotein cholesterol associated with increased coronary disease severity and risk of major adverse cardiovascular events in patients with type 2 diabetes?
Cohort (n=3,292)
Yes
Are elevated levels of glycated apolipoprotein A1 and glycated low-density lipoprotein cholesterol associated with increased coronary disease severity and risk of major adverse cardiovascular events in patients with type 2 diabetes?
Hazard Ratio: 2.798 (95% CI 2.053–3.812)
Absolute Event Rate: 21.94% vs 7.75%
p-value: p=<0.001
Elevated levels of glycated apoA1 and glycated LDL-C are independently associated with greater coronary obstruction severity and a higher risk of future major adverse cardiovascular events in patients with type 2 diabetes.
The global burden and serious outcomes of coronary heart disease (CHD) highlight the need for further comprehensive research. This study explored the predictive value of glycated apolipoprotein A-1 (G-apoA1) and glycated low-density lipoprotein cholesterol (G-LDL-C) levels for coronary artery obstruction severity and future major adverse cardiovascular events (MACEs) among patients with type 2 diabetes mellitus (T2DM). This study included 3,292 patients with T2DM who were followed up for 5 years. Patients were stratified into quartiles of G-apoA1 and G-LDL-C, and associations with the incidence of MACEs were assessed by comparing quartile groups. Logistic regression and Spearman’s correlation analyses were conducted to evaluate the associations of G‑apoA1 and G‑LDL‑C with CHD risk, while Cox regression was used to estimate the risk of MACEs. G-apoA1 and G-LDL-C levels were significantly higher in patients with T2DM and CHD than in those with T2DM without CHD and were identified as independent risk factors for CHD [G-apoA1: odds ratio (OR) = 2.021, 95%CI: 1.622–2.519, p < 0.001; G-LDL-C: OR = 2.038, 95%CI: 1.616–2.570, p < 0.001]. These levels were also positively correlated with the number of obstructed coronary arteries and the Gensini score (GS). During the 5-year follow-up period, 443 patients experienced MACEs. An analysis using restricted cubic spline models revealed that the incidence of MACEs increased with higher G-apoA1 and G-LDL-C levels. Multivariate Cox regression analysis showed a significantly higher risk of MACEs among patients in the highest quartile than among those in the lowest quartile [G-apoA1: hazard ratio (HR):2.183, 95%CI: 1.630–2.923, p < 0.001; G-LDL-C: HR:2.798, 95%CI: 2.053–3.812, p < 0.001]. This study showed that G-apoA1 and G-LDL-C levels were associated with CHD in patients with T2DM and correlated with the severity of coronary obstruction. Moreover, higher G-apoA1 and G-LDL-C levels were associated with an increased incidence of MACEs.
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Gu et al. (2026) conducted a cohort in Type 2 diabetes mellitus (n=3,292). Highest quartile of glycated LDL-C vs. Lowest quartile of glycated LDL-C was evaluated on Major adverse cardiovascular events (MACEs) (HR 2.798, 95% CI 2.053-3.812, p=<0.001). In patients with type 2 diabetes, the highest quartile of glycated LDL-C was associated with a significantly increased risk of major adverse cardiovascular events compared to the lowest quartile (HR 2.798).
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