Hormonal
In overweight or obese individuals with type 2 diabetes, metabolic dyslipidemia (defined as high triglycerides and low HDL-C) is associated with a significantly higher risk of coronary artery disease and composite cardiovascular events, independent of LDL-C levels.
If you have Type 2 Diabetes and are overweight, your risk of heart disease is significantly higher if you have both high triglycerides and low HDL cholesterol, even if your LDL is normal. This risk exists independently of your LDL levels. You should discuss your triglyceride and HDL levels with your doctor as part of your cardiovascular risk assessment, not just your LDL.
Compared with patients with normal triglyceride and normal HDL, participants with metabolic dyslipidemia had higher risks of the composite CVD outcome (HR, 1.30; 95% CI, 1.03–1.63 [P=0.025]) and coronary artery disease events (HR, 1.48; 95% CI, 1.14–1.93 [P=0.003]) but not stroke.
Why this rating
Large sample size (n=4199), long follow-up (median 9.5 years), and multivariable adjustment, but it is an observational post-hoc analysis of a trial.
Source
Metabolic Dyslipidemia and Cardiovascular Outcomes in Type 2 Diabetes Mellitus: Findings From the Look AHEAD Study
Arnaud D. Kazé et al. · Journal of the American Heart Association · 2021
DOI 10.1161/jaha.120.016947
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