ArticleBMC medicine2024
The association of HDL-cholesterol levels with incident major adverse cardiovascular events and mortality in 0.6 million individuals with type 2 diabetes: a population-based retrospective cohort study.
Article in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Incidence and predictors of diabetic kidney disease among type 2 diabetes mellitus adult patients in Ethiopia: a systematic review and meta-analysis.BMC endocrine disorders · 2025Pooled it
- The relationship between pulse wave velocity and microvascular complications in patients with diabetes mellitus: a cross-sectional study.Irish journal of medical science · 2026Article
- Brain care score and retinal health: structural and metabolic insights from the UK Biobank.GeroScience · 2026Article
- Revealing the Link Between Exposure to Per- and Polyfluoroalkyl Substances (PFAS) and Stroke: A Comprehensive Epidemiological and Network Toxicology Perspective.Cardiovascular toxicology · 2026Article
- Type 2 Diabetes Is Associated With Increased Complications and Mortality After Hip Fracture in Older Adults Aged 60 Years or Older.Diabetes, obesity & metabolism · 2026Article
- Biology of HDL: From Structural Heterogeneity to Dysfunctional Remodeling in Cardiovascular Disease and Comorbidities.Antioxidants (Basel, Switzerland) · 2026Review
- Dose-response relationships of normal blood lipid levels in metabolic and endocrine diseases: mechanistic similarities, differences, and functional insights.Frontiers in endocrinology · 2026Review
- Joint assessment of white blood cell-to-HDL cholesterol ratio and waist-to-height-hemoglobin A1c for cardiometabolic multimorbidity risk: a prospective cohort study and cross-sectional study.Frontiers in nutrition · 2026Article
- High-density lipoprotein cholesterol levels and prognosis in non-ischemic dilated cardiomyopathy.Frontiers in endocrinology · 2026Article
- Risk factor control in relation to mortality and life expectancy among people with type 2 diabetes: results from 3 nationwide cohort studies.Military Medical Research · 2025Article
- HDL-C and systemic inflammatory response index mediate the association between visceral adipose tissue and risk of cardiovascular disease among young and middle-aged adults with prediabetes or diabetes: a national cohort study.Journal of translational medicine · 2025Article
- Association Between Neutrophil-to-HDL Ratio and Full-Spectrum Dysglycemia: Insights from a Large Middle Eastern Population Study.Healthcare (Basel, Switzerland) · 2025Article
- Nonlinear association between high-density lipoprotein cholesterol and carotid atherosclerosis risk in patients with type 2 diabetes: a retrospective analysis from China.European journal of medical research · 2025Article
- Machine learning-based integration of pericoronary adipose tissue and clinical risk factors for cardiovascular risk prediction in type 2 diabetes: a retrospective cohort study.European journal of medical research · 2025Article
- The role of the advanced lung cancer inflammation index (ALI) in the risk of liver fibrosis and mortality among US adult MAFLD patients: a cross-sectional study of NHANES 1999-2018.BMC gastroenterology · 2025Article
- Relationship between novel inflammatory markers derived from high-sensitivity C-reactive protein and heart failure: a cross-sectional study.BMC cardiovascular disorders · 2025Article
- Independent and joint associations of glucose modified by high-density lipoprotein cholesterol with mortality in heart failure patients: evidence from the Jiangxi, China cohort.Frontiers in endocrinology · 2025Article
- Independent and combined associations of high-density lipoprotein cholesterol-modified triglyceride-glucose index with all-cause and cardiovascular mortality in patients with acute decompensated heart failure.Frontiers in endocrinology · 2025Article
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10 authors.
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Abstract
backgroundHigh levels of high-density lipoprotein cholesterol (HDL-C) are previously considered protective against cardiovascular diseases (CVD), but recent studies suggest an increased risk of adverse events at very high HDL-C levels in the general population. It remains to be elucidated such a relationship in diabetes, a condition with high cardiovascular risks. We examined the association of HDL-C levels with the risk of major adverse cardiovascular events (MACE) and mortality in type 2 diabetes.
methodsThis retrospective cohort study identified individuals with type 2 diabetes who had HDL-C records (2008-2020) from the electronic health record database of the Hong Kong Hospital Authority. They were classified into three groups based on their first-recorded HDL-C levels following diabetes diagnosis: low (≤ 40 mg/dL), medium (> 40 and ≤ 80 mg/dL) and high HDL-C (> 80 mg/dL) groups. The primary outcome was incident MACE (composite of myocardial infarction, stroke, heart failure, and cardiovascular mortality). Cox regression model and restricted cubic spline analysis were employed to assess the relationship between HDL-C and adverse outcomes.
resultsAmong 596,943 individuals with type 2 diabetes included, 168,931 (28.30%), 412,863 (69.16%), and 15,149 (2.54%) were classified as low HDL-C, medium HDL-C, and high HDL-C groups, respectively. Over a median follow-up of 79.5 months, both low and high HDL-C groups had higher risk of incident MACE compared to the medium HDL-C group (HR 1.24, 95% CI 1.23-1.26, P < 0.001; HR 1.09, 95% CI 1.04-1.13, P < 0.001). The spline curves revealed a U-shaped association between HDL-C levels and incident MACE (non-linear p < 0.001). Similar U-shaped relationship was observed for all-cause and non-cardiovascular mortality.
conclusionsOur study demonstrated a U-shaped association between HDL-C levels and incident MACEs and all-cause and non-cardiovascular mortality in individuals with type 2 diabetes, highlighting the need for mechanistic studies on the adverse outcomes seen at high HDL-C levels in type 2 diabetes.
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