BACKGROUND The aim of the present study was to identify a threshold for the cholesterol level at which the risk of cardiovascular disease (CVD) begins to increase in people with type 2 diabetes mellitus (DM). METHODS Using the Korean National Health Insurance Service database, 2,077,135 people aged ≥ 40 years with type 2 DM who underwent regular health checks between 2009 and 2012 were included. Subjects with previous CVD were excluded. Cox regression analyses were performed to estimate the risk of CVD for each low-density lipoprotein cholesterol (LDL-C) group using the < 70 mg/dL as the reference group. RESULTS There were 78,560 cases of stroke (3.91%), and 50,791 myocardial infarction (MI, 2.53%) during a median follow-up of 7.1 years. Among participants not taking statins, LDL-C levels of 130-159 mg/dL and ≥ 160 mg/dL were significantly associated with the risk of MI: the hazard ratios (HRs) (95% confidence interval) were 1.19 (1.14-1.25) and 1.53 (1.46-1.62), respectively. Among participants taking statins, all categories of LDL-C level ≥ 70 mg/dL were significantly associated with increased risk of stroke and MI. CONCLUSIONS We identified an increased risk of CVD in people with an LDL-C level ≥ 130 mg/dL among individuals with type 2 DM not taking statins. The risk of CVD was significantly higher in those taking statins with an LDL-C level ≥ 70 mg/dL.

中文翻译：

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患有 2 型糖尿病且无心血管疾病的韩国人的胆固醇水平和心血管疾病的发展。


背景本研究的目的是确定 2 型糖尿病 (DM) 患者心血管疾病 (CVD) 风险开始增加的胆固醇水平阈值。方法 使用韩国国民健康保险服务数据库，纳入 2009 年至 2012 年间定期接受健康检查的 2,077,135 名年龄 ≥ 40 岁的 2 型糖尿病患者。先前患有CVD的受试者被排除在外。使用 < 70 mg/dL 作为参考组，进行 Cox 回归分析来估计每个低密度脂蛋白胆固醇 (LDL-C) 组的 CVD 风险。结果 在中位随访 7.1 年期间，共有 78,560 例中风病例（3.91%）和 50,791 例心肌梗塞病例（MI，2.53%）。在未服用他汀类药物的参与者中，130-159 mg/dL 和 ≥ 160 mg/dL 的 LDL-C 水平与 MI 风险显着相关：风险比 (HR)（95% 置信区间）为 1.19 (1.14-1.25) ）和 1.53（1.46-1.62）。在服用他汀类药物的参与者中，所有类别的 LDL-C 水平≥ 70 mg/dL 均与中风和 MI 风险增加显着相关。结论 我们发现，在未服用他汀类药物的 2 型糖尿病患者中，LDL-C 水平≥ 130 mg/dL 的患者发生 CVD 的风险增加。服用他汀类药物且 LDL-C 水平≥ 70 mg/dL 的患者发生 CVD 的风险显着更高。