Whereas elevated LDL-C is a major risk factor for CAD, the inverse association between HDL-C levels and risk of CAD is well-known. Although insulin resistance and glucose intolerance are associated with low HDL-C levels, it is not clear whether the association of LDL-C with CAD differs depending on glucose status and HDL-C values. We examined associations of LDL-C with new-onset CAD according to HDL-C and glucose status using a nationwide claims database on 600,6individuals during 2008-20with no history of CAD. Cox proportional hazards model identified risks of CAD events among combinations of tertiles of HDL-C and sextiles of LDL-C according to glucose status. During a mean follow-up period of 5.6 years, 2,391 CAD events occurred. CAD risk increased from lower LDL-C levels accompanied by lower HDL-C levels regardless of glucose status (Table) . Compared with the highest tertile of HDL-C and lowest sextile of LDL-C, groups with the highest tertile of HDL-C and highest sextile of LDL-C and the lowest tertile of HDL-C and highest sextile of LDL-C had approximately 4-fold and 9-fold, respectively, increased risks of CAD regardless of glucose status. Despite the necessity of a lower LDL-C target for people with than without diabetes, our results demonstrated that the necessity of modulating the LDL-C target according to HDL-C levels is not affected by concomitant diabetes.
M.H.Yamada: None.
