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Very Low LDL-C Linked with Type 2 Diabetes

PLoS Med; ePub 2018 Aug 28; Feng, et al

Very low low-density lipoprotein cholesterol (LDL-C) concentrations occurring in the absence of statin treatment were significantly associated with type 2 diabetes mellitus (T2DM) risk, according to a recent study. Researchers used electronic health records (EHRs) to compare the risk of T2DM in a cross-sectional study among individuals with very low (≤60 mg/dl, n= 8,943) and normal (90–130 mg/dl, n=71,343) LDL-C levels. They used a 2-phase approach: In 1/3 of the sample (discovery) they used T2DM phenome-wide association study codes (phecodes) to identify cases and controls, and in the remaining 2/3 (validation) they identified T2DM cases and controls using a validated algorithm. They found:

  • In the discovery cohort, phecodes related to T2DM were significantly more frequent in the very low LDL-C group.
  • In the validation cohort (n=33,039), the risk of T2DM was increased in the very low compared to normal LDL-C group.
  • The association between low LDL-C levels and T2DM was significant in males and females; in normal weight, overweight, and obese categories; and in individuals with LDL-C < 40 mg/dl and LDL-C 40–60 mg/dl.
Citation:

Feng QP, Wei W-Q, Chung CP, et al. Relationship between very low low-density lipoprotein cholesterol concentrations not due to statin therapy and risk of type 2 diabetes: A US-based cross-sectional observational study using electronic health records. [Published online ahead of print August 28, 2018]. PLoS Med. doi:10.1371/journal.pmed.1002642.

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