On-Target Low-Density Lipoprotein Cholesterol in Adults with Diabetes Not at High Cardiovascular Disease Risk Predicts Greater Mortality, Independent of Early Deaths or Frailty
2024

Low LDL Cholesterol in Adults with Diabetes Linked to Higher Mortality

Sample size: 2098 publication 10 minutes Evidence: moderate

Author Information

Author(s): Bruna C. Chwal, Rodrigo C. P. dos Reis, Maria I. Schmidt, Antonio L. P. Ribeiro, Sandhi M. Barreto, Rosane H. Griep, Paulo A. Lotufo, Bruce B. Duncan

Primary Institution: Universidade Federal do Rio Grande do Sul

Hypothesis

Does low-density lipoprotein cholesterol (LDL-C) predict all-cause mortality in adults with diabetes not at high cardiovascular risk?

Conclusion

Lower LDL-C levels in adults with diabetes not at high cardiovascular risk are associated with greater mortality, independent of early deaths or frailty.

Supporting Evidence

  • Participants with LDL-C < 100 mg/dL had a 67% greater mortality risk compared to those with LDL-C between 100 and 130 mg/dL.
  • The risk was 127% greater for those with LDL-C < 70 mg/dL.
  • Mortality risk was highest in individuals aged 60 or older with low LDL-C levels.
  • Low LDL-C levels were associated with more deaths from cancer.

Takeaway

If you have diabetes but aren't at high risk for heart problems, having low cholesterol might actually be bad for you and could lead to a higher chance of dying.

Methodology

The study followed 2098 participants from the ELSA-Brasil cohort over 10.3 years, analyzing the relationship between LDL-C levels and all-cause mortality.

Potential Biases

Potential biases include selective recruitment and the observational nature of the study.

Limitations

The study's findings may not be generalizable to populations with high cardiovascular risk or those outside Brazil.

Participant Demographics

Participants were middle-aged and elderly Brazilian adults, with a mean age of 55.6 years; 53% were men and 44.3% self-identified as white.

Statistical Information

P-Value

p ≤ 0.001

Confidence Interval

95%CI 1.21–2.30

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3390/jcm13247667

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