Non-high-density lipoprotein cholesterol predicts cardiovascular risk better than remnant cholesterol in patients with type 2 diabetes mellitus
BackgroundCardiovascular disease (CVD) is a leading cause of morbidity in patients with type 2 diabetes mellitus (T2DM). Non-high-density lipoprotein cholesterol (non-HDL-c) and remnant cholesterol (RC) have emerged as promising markers of atherogenic risk, but their comparative predictive performan...
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| Language: | English |
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1551203/full |
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| author | Paul Nsiah Samuel Acquah Ansumana Sandy Bockarie George Adjei Ebenezer Aniakwaa-Bonsu Oksana Ryabinina |
| author_facet | Paul Nsiah Samuel Acquah Ansumana Sandy Bockarie George Adjei Ebenezer Aniakwaa-Bonsu Oksana Ryabinina |
| author_sort | Paul Nsiah |
| collection | DOAJ |
| description | BackgroundCardiovascular disease (CVD) is a leading cause of morbidity in patients with type 2 diabetes mellitus (T2DM). Non-high-density lipoprotein cholesterol (non-HDL-c) and remnant cholesterol (RC) have emerged as promising markers of atherogenic risk, but their comparative predictive performance remains uncertain, particularly in resource-limited settings.ObjectiveThis study evaluated the predictive value of non-HDL-c and RC for atherosclerotic cardiovascular disease (ASCVD) risk and associated inflammatory and metabolic disturbances in T2DM patients.MethodsA cross-sectional study was conducted among 154 T2DM patients attending the outpatient diabetic clinic at the Effia Nkwanta Regional Hospital, Ghana. Non-HDL-c and RC were calculated from fasting lipid profiles. The TyG index was used as a surrogate for insulin resistance. ASCVD risk was assessed using the Framingham risk score. Logistic regression and ROC analysis were performed to assess predictive utility. Subgroup analyses were conducted based on BMI, hypertension, and TyG index.ResultsNon-HDL-C was significantly associated with higher ASCVD risk and elevated hs-CRP and resistin levels, while RC showed weaker, non-significant associations. Non-HDL-c had a higher AUC (0.78 vs. 0.62), sensitivity, and specificity. Nearly half of participants (49.4%) had elevated TyG index (>8.7). Non-HDL-C consistently outperformed RC across subgroups.ConclusionNon-HDL-c is a stronger and more practical predictor of ASCVD risk than RC in T2DM patients, particularly in settings with limited access to advanced lipid testing. Its use alongside the TyG index offers a cost-effective approach for enhancing cardiovascular risk stratification in diabetes care. |
| format | Article |
| id | doaj-art-896feeff3a7247c8b0c041b5f6006fe5 |
| institution | OA Journals |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-896feeff3a7247c8b0c041b5f6006fe52025-08-20T02:37:46ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-06-011210.3389/fcvm.2025.15512031551203Non-high-density lipoprotein cholesterol predicts cardiovascular risk better than remnant cholesterol in patients with type 2 diabetes mellitusPaul Nsiah0Samuel Acquah1Ansumana Sandy Bockarie2George Adjei3Ebenezer Aniakwaa-Bonsu4Oksana Ryabinina5Department of Chemical Pathology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, GhanaDepartment of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, GhanaDepartment of Internal Medicine and Therapeutics, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, GhanaDepartment of Community Medicine, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, GhanaDepartment of Microbiology and Immunology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, GhanaDepartment of Chemical Pathology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, GhanaBackgroundCardiovascular disease (CVD) is a leading cause of morbidity in patients with type 2 diabetes mellitus (T2DM). Non-high-density lipoprotein cholesterol (non-HDL-c) and remnant cholesterol (RC) have emerged as promising markers of atherogenic risk, but their comparative predictive performance remains uncertain, particularly in resource-limited settings.ObjectiveThis study evaluated the predictive value of non-HDL-c and RC for atherosclerotic cardiovascular disease (ASCVD) risk and associated inflammatory and metabolic disturbances in T2DM patients.MethodsA cross-sectional study was conducted among 154 T2DM patients attending the outpatient diabetic clinic at the Effia Nkwanta Regional Hospital, Ghana. Non-HDL-c and RC were calculated from fasting lipid profiles. The TyG index was used as a surrogate for insulin resistance. ASCVD risk was assessed using the Framingham risk score. Logistic regression and ROC analysis were performed to assess predictive utility. Subgroup analyses were conducted based on BMI, hypertension, and TyG index.ResultsNon-HDL-C was significantly associated with higher ASCVD risk and elevated hs-CRP and resistin levels, while RC showed weaker, non-significant associations. Non-HDL-c had a higher AUC (0.78 vs. 0.62), sensitivity, and specificity. Nearly half of participants (49.4%) had elevated TyG index (>8.7). Non-HDL-C consistently outperformed RC across subgroups.ConclusionNon-HDL-c is a stronger and more practical predictor of ASCVD risk than RC in T2DM patients, particularly in settings with limited access to advanced lipid testing. Its use alongside the TyG index offers a cost-effective approach for enhancing cardiovascular risk stratification in diabetes care.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1551203/fullnon-high-density lipoprotein cholesterolremnant cholesteroltype 2 diabetes mellituscardiovascular riskinsulin resistanceatherogenic dyslipidemia |
| spellingShingle | Paul Nsiah Samuel Acquah Ansumana Sandy Bockarie George Adjei Ebenezer Aniakwaa-Bonsu Oksana Ryabinina Non-high-density lipoprotein cholesterol predicts cardiovascular risk better than remnant cholesterol in patients with type 2 diabetes mellitus Frontiers in Cardiovascular Medicine non-high-density lipoprotein cholesterol remnant cholesterol type 2 diabetes mellitus cardiovascular risk insulin resistance atherogenic dyslipidemia |
| title | Non-high-density lipoprotein cholesterol predicts cardiovascular risk better than remnant cholesterol in patients with type 2 diabetes mellitus |
| title_full | Non-high-density lipoprotein cholesterol predicts cardiovascular risk better than remnant cholesterol in patients with type 2 diabetes mellitus |
| title_fullStr | Non-high-density lipoprotein cholesterol predicts cardiovascular risk better than remnant cholesterol in patients with type 2 diabetes mellitus |
| title_full_unstemmed | Non-high-density lipoprotein cholesterol predicts cardiovascular risk better than remnant cholesterol in patients with type 2 diabetes mellitus |
| title_short | Non-high-density lipoprotein cholesterol predicts cardiovascular risk better than remnant cholesterol in patients with type 2 diabetes mellitus |
| title_sort | non high density lipoprotein cholesterol predicts cardiovascular risk better than remnant cholesterol in patients with type 2 diabetes mellitus |
| topic | non-high-density lipoprotein cholesterol remnant cholesterol type 2 diabetes mellitus cardiovascular risk insulin resistance atherogenic dyslipidemia |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1551203/full |
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