Low-density lipoprotein cholesterol predicts coronary artery calcification events in patients with type 2 diabetes: a longitudinal study
Abstract Background Coronary Artery Calcification (CAC) is a major risk factor for various cardiovascular diseases. Low-Density Lipoprotein Cholesterol (LDL-C) is a significant factor in atherosclerotic cardiovascular diseases and is usually elevated in patients with Type 2 Diabetes Mellitus (T2DM)....
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BMC
2025-02-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | https://doi.org/10.1186/s13098-025-01625-8 |
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| author | Zhi Zou Yongbing Sun Lijun Zou Yang Zhou Xinbei Lin Jing Zhou Zhonglin Li Xiaoling Wu Ling Wang Xiaodong Li Yong Wang Yangxi Hu Fengli Li Jiancheng Zhang Yongli Li |
| author_facet | Zhi Zou Yongbing Sun Lijun Zou Yang Zhou Xinbei Lin Jing Zhou Zhonglin Li Xiaoling Wu Ling Wang Xiaodong Li Yong Wang Yangxi Hu Fengli Li Jiancheng Zhang Yongli Li |
| author_sort | Zhi Zou |
| collection | DOAJ |
| description | Abstract Background Coronary Artery Calcification (CAC) is a major risk factor for various cardiovascular diseases. Low-Density Lipoprotein Cholesterol (LDL-C) is a significant factor in atherosclerotic cardiovascular diseases and is usually elevated in patients with Type 2 Diabetes Mellitus (T2DM). However, the association between LDL-C levels and incident CAC in asymptomatic T2DM patients remains unclear. Methods This study is a single-center retrospective cohort study conducted from January 2018 to December 2023, including 2,631 asymptomatic T2DM patients who underwent regular health screenings. All participants were confirmed to be free of CAC at baseline by computed tomography (CT). Based on baseline LDL-C levels, participants were divided into three groups (T1: 0.66–2.43 mmol/L; T2: 2.44–3.18 mmol/L; T3: 3.19–7.21 mmol/L). The follow-up endpoint was the occurrence of incident CAC, with a total follow-up period of 72 months. Kaplan-Meier survival curves were used for analysis, followed by log-rank tests. Univariate and multivariate Cox proportional hazards regression models were employed to investigate the relationship between LDL-C and incident CAC, and subgroup analysis was performed to test the robustness of the LDL-C and CAC relationship. Results During a median follow-up period of 29.9 months, 885 (33.64%) participants developed incident CAC occurred. The cumulative incidence of incident CAC increased progressively with higher LDL-C levels (log-rank test, P < 0.001). After adjusting for confounding factors, multivariable Cox proportional hazards regression results showed a significant association between LDL-C and incident CAC (hazard ratio [HR], 1.77; 95% confidence interval [CI], 1.64–1.92). When LDL-C was treated as a categorical variable, elevated levels in T2 (adjusted HR, 1.62; 95% CI, 1.36–1.93; P < 0.001) and T3 (adjusted HR, 3.38; 95% CI, 2.84–4.03; P < 0.001) were significantly associated with the risk of incident CAC. Additionally, subgroup analysis demonstrated a consistent association between LDL-C and incident CAC. Conclusion High LDL-C levels are associated with incident CAC in asymptomatic T2DM patients, suggesting that LDL-C may be useful for risk stratification in this population. |
| format | Article |
| id | doaj-art-cd12dcd255e942d3856bc53342dc195c |
| institution | OA Journals |
| issn | 1758-5996 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj-art-cd12dcd255e942d3856bc53342dc195c2025-08-20T02:13:10ZengBMCDiabetology & Metabolic Syndrome1758-59962025-02-011711910.1186/s13098-025-01625-8Low-density lipoprotein cholesterol predicts coronary artery calcification events in patients with type 2 diabetes: a longitudinal studyZhi Zou0Yongbing Sun1Lijun Zou2Yang Zhou3Xinbei Lin4Jing Zhou5Zhonglin Li6Xiaoling Wu7Ling Wang8Xiaodong Li9Yong Wang10Yangxi Hu11Fengli Li12Jiancheng Zhang13Yongli Li14Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou UniversityHenan Provincial People’s Hospital, People’s Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityHenan Provincial People’s Hospital, People’s Hospital of Zhengzhou UniversityHenan Provincial People’s Hospital, People’s Hospital of Zhengzhou UniversityHenan Provincial Research Center of Clinical Medicine of Nephropathy, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s HospitalHenan Provincial People’s Hospital, People’s Hospital of Zhengzhou UniversityDepartment of Nuclear Medicine, Henan Provincial People’s HospitalHenan Provincial People’s Hospital, People’s Hospital of Zhengzhou UniversityHenan Provincial People’s Hospital, People’s Hospital of Zhengzhou UniversityHenan Provincial People’s HospitalCentral Hospital of Zhengzhou UniversityCentral Hospital of Zhengzhou UniversityDepartment of Gastrointestinal Surgery, Henan Provincial People’s HospitalDepartment of Health Management, Chronic Health Management Laboratory, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou UniversityAbstract Background Coronary Artery Calcification (CAC) is a major risk factor for various cardiovascular diseases. Low-Density Lipoprotein Cholesterol (LDL-C) is a significant factor in atherosclerotic cardiovascular diseases and is usually elevated in patients with Type 2 Diabetes Mellitus (T2DM). However, the association between LDL-C levels and incident CAC in asymptomatic T2DM patients remains unclear. Methods This study is a single-center retrospective cohort study conducted from January 2018 to December 2023, including 2,631 asymptomatic T2DM patients who underwent regular health screenings. All participants were confirmed to be free of CAC at baseline by computed tomography (CT). Based on baseline LDL-C levels, participants were divided into three groups (T1: 0.66–2.43 mmol/L; T2: 2.44–3.18 mmol/L; T3: 3.19–7.21 mmol/L). The follow-up endpoint was the occurrence of incident CAC, with a total follow-up period of 72 months. Kaplan-Meier survival curves were used for analysis, followed by log-rank tests. Univariate and multivariate Cox proportional hazards regression models were employed to investigate the relationship between LDL-C and incident CAC, and subgroup analysis was performed to test the robustness of the LDL-C and CAC relationship. Results During a median follow-up period of 29.9 months, 885 (33.64%) participants developed incident CAC occurred. The cumulative incidence of incident CAC increased progressively with higher LDL-C levels (log-rank test, P < 0.001). After adjusting for confounding factors, multivariable Cox proportional hazards regression results showed a significant association between LDL-C and incident CAC (hazard ratio [HR], 1.77; 95% confidence interval [CI], 1.64–1.92). When LDL-C was treated as a categorical variable, elevated levels in T2 (adjusted HR, 1.62; 95% CI, 1.36–1.93; P < 0.001) and T3 (adjusted HR, 3.38; 95% CI, 2.84–4.03; P < 0.001) were significantly associated with the risk of incident CAC. Additionally, subgroup analysis demonstrated a consistent association between LDL-C and incident CAC. Conclusion High LDL-C levels are associated with incident CAC in asymptomatic T2DM patients, suggesting that LDL-C may be useful for risk stratification in this population.https://doi.org/10.1186/s13098-025-01625-8Coronary artery calcificationLow-density lipoprotein cholesterolType 2 diabetes mellitusKaplan-Meier survival curves |
| spellingShingle | Zhi Zou Yongbing Sun Lijun Zou Yang Zhou Xinbei Lin Jing Zhou Zhonglin Li Xiaoling Wu Ling Wang Xiaodong Li Yong Wang Yangxi Hu Fengli Li Jiancheng Zhang Yongli Li Low-density lipoprotein cholesterol predicts coronary artery calcification events in patients with type 2 diabetes: a longitudinal study Diabetology & Metabolic Syndrome Coronary artery calcification Low-density lipoprotein cholesterol Type 2 diabetes mellitus Kaplan-Meier survival curves |
| title | Low-density lipoprotein cholesterol predicts coronary artery calcification events in patients with type 2 diabetes: a longitudinal study |
| title_full | Low-density lipoprotein cholesterol predicts coronary artery calcification events in patients with type 2 diabetes: a longitudinal study |
| title_fullStr | Low-density lipoprotein cholesterol predicts coronary artery calcification events in patients with type 2 diabetes: a longitudinal study |
| title_full_unstemmed | Low-density lipoprotein cholesterol predicts coronary artery calcification events in patients with type 2 diabetes: a longitudinal study |
| title_short | Low-density lipoprotein cholesterol predicts coronary artery calcification events in patients with type 2 diabetes: a longitudinal study |
| title_sort | low density lipoprotein cholesterol predicts coronary artery calcification events in patients with type 2 diabetes a longitudinal study |
| topic | Coronary artery calcification Low-density lipoprotein cholesterol Type 2 diabetes mellitus Kaplan-Meier survival curves |
| url | https://doi.org/10.1186/s13098-025-01625-8 |
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