- Among patients with type 2 diabetes (T2D), high-density lipoprotein cholesterol (HDL) was not significantly associated with overall, cardiovascular, or cancer mortality.
- The results did show a significant U-shaped association with infectious disease mortality.
Why this matters
- The protective role of high HDL against cardiovascular disease (CVD) has been recently questioned, but limited data address its benefit or not in T2D.
- Retrospective population-based cohort study, 2113 patients with T2D attending an Italian diabetes clinic.
- Patients grouped by HDL tertiles, with middle used as reference.
- Funding: None.
- HDL tertile cut-offs were 37.5 mg/dL and 47.5 mg/dL for males and 41.5 mg/dL and 52.0 mg/dL for females.
- During the 14-year follow-up, 46.1% (973) died.
- Lower vs upper HDL tertiles did not differ (adjusted HRs; 95% CIs) in mortality from:
- All-causes: 1.12 (0.96-1.32) vs 1.11 (0.95-1.30).
- CVD: 0.97 (0.77-1.23) vs 0.94 (0.75-1.18).
- Cancer: 0.92 (0.67-1.25) vs 0.89 (0.66-1.21).
- Vs middle tertile, infectious disease mortality (adjusted HRs, 95% CIs) was significantly increased in:
- Low tertile: 2.62 (1.44-4.74).
- High tertile: 2.05 (1.09-3.85
- Increased risk for diabetes-related mortality in upper HDL tertile:
- Adjusted HR, 1.87 (95% CI, 1.10-3.15).
- Exclusion of 646 with baseline CVD did not significantly alter results.
- No data on inflammatory status, specific infectious diseases.
- Only baseline values collected.
- Possible residual confounding.