Background: In the population with diabetes mellitus (DM), the impact of age on the association between low density lipoprotein-cholesterol (LDL-C) level and cardiovascular disease (CVD) risk is unclear. Therefore, we conducted a cohort study to elucidate the relationship.
Methods: We assessed the 2009-2012 Korean National Health Screening and the National Health Insurance Service record, with follow up to primary outcome (myocardial infarction [MI] or stroke) or December 2018. Participants with a history of MI and stroke were excluded. Finally, 2,227,394 participants with DM were included. Participants were categorized based on baseline LDL-C level and age. Cox proportional hazard modeling was conducted with confounding factor adjustment. CVD risk of age <40, LDL-C <70mg/dL were set as a reference. In each age group, LDL-C <70mg/dL was set as a reference and subgroup analysis was done.
Results: The cut-off LDL-C value for increased MI risk were different in each age group (<40 year old, LDL-C ≥160mg/dL, HR 2.03, 95% CI 1.644-2.506; 40-49 year old, LDL-C <115 mg/dL, HR 1.245, 1.04-1.489; 50-59 year old, LDL-C <115 mg/dL, HR 1.21, 1.014-1.445; 60-69 year old, LDL-C <145mg/dL, HR 1.229, 1.022-1.479; ≥70year old group, LDL-C <100mg/dL, HR 1.238, 1.018-1.504). The cut-off LDL-C value for increased stroke risk were different in each age subgroup (<40 year old, LDL-C ≥160mg/dL, HR 1.395, 1.094-1.779; 40-49 year old, LDL-C <145 mg/dL, HR 1.13, 1.019-1.253; 50-59 year old, HR 1.079, 1.008-1.154, 60-69 year old, LDL-C <130mg/dL, HR 1.07, 1.022-1.119; ≥70year old; LDL-C <115mg/dL, HR 1.064, 1.019-1.112)
Conclusions: The impact of LDL-C on the risk of CVD varies according to the age of DM population.
W.Lee: None. E.Rhee: None. K.Han: None.
