Remnant cholesterol tied to CVD death in patients with T2D, CKD, diabetic nephropathy

Remnant cholesterol (C) appears predictive of mortality due to cardiovascular disease (CVD) among patients with type 2 diabetes (T2D), chronic kidney disease (CKD) stage 3 to 5, and incident diabetic nephropathy (DN), suggests a study.

In addition, the interaction of remnant-C and low-density lipoprotein (LDL)-C correlates with the highest risk of CVD mortality.

In the study, the authors determine the baseline lipid profile and searched for deaths with CVD within 2 years of baseline among 2,282 adults enrolled between 1 January 2015 and 31 December 2016, who had T2D, CKD stage 3 to 5, and newly diagnosed DN.

The associations between lipids, particularly remnant-C concentration (either as continuous or categorical variables), and CVD mortality risk were analysed using adjusted logistic regression models.

Multivariable-adjusted analyses revealed the association of LDL-C (odds ratio [OR] per 10 mg/dL, 1.022, 95 percent confidence interval [CI], 1.017–1.026), high-density lipoprotein (HDL)-C (OR, 0.929 per 5 mg/dL, 95 percent CI, 0.922–0.936), non–HDL-C (OR, 1.024 per 10 mg/dL, 95 percent CI, 1.021–1.028), and remnant-C (OR, 1.115 per 10 mg/dL, 95 percent CI, 1.103–1.127), but not triglycerides, with CVD mortality.

Atherogenic dyslipidaemia (triglycerides >150 mg/dL [1.69 mmol/L] and HDL-C <40 mg/dL in men or <50 mg/dL in women) also correlated with CVD mortality (OR, 1.073, 95 percent CI, 1.031–1.116).

Notably, remnant-C ≥30 mg/dL differentiated patients at greater risk of CVD mortality from those with lower concentrations, particularly for interaction with LDL-C level >100 mg/dL. Patients with higher levels of both remnant-C and LDL-C (OR, 1.696, 95 percent CI, 1.613–1.783) were at greatest risk of death with CVD.