- Cardiovascular Risk/Epidemiology
- Myocardial Infarction, Stroke, and All-Cause Mortality according to Low-Density Lipoprotein Cholesterol Level in the Elderly, a Nationwide Study
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You-Bin Lee, Minji Koo, Eunjin Noh, Soon Young Hwang, Jung A Kim, Eun Roh, So-hyeon Hong, Kyung Mook Choi, Sei Hyun Baik, Geum Joon Cho, Hye Jin Yoo
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Diabetes Metab J. 2022;46(5):722-732. Published online March 8, 2022
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DOI: https://doi.org/10.4093/dmj.2021.0225
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Abstract
PDFSupplementary MaterialPubReader ePub
- Background
We assessed the myocardial infarction (MI), stroke, and all-cause death risks during follow-up according to the low-density lipoprotein cholesterol (LDL-C) levels among older adults.
Methods The Korean National Health Insurance Service datasets (2002 to 2020) were used for this population-based cohort study. The hazards of MI, stroke, and all-cause mortality during follow-up were analyzed according to LDL-C level in individuals aged ≥65 years without baseline cardiovascular diseases (n=1,391,616).
Results During a mean 7.55 years, 52,753 MIs developed; 84,224 strokes occurred over a mean 7.47 years. After a mean 8.50 years, 233,963 died. A decrease in LDL-C was associated with lower hazards of MI and stroke. The decreased hazard of stroke in lower LDL-C was more pronounced in statin users, and individuals with diabetes or obesity. The hazard of all-cause death during follow-up showed an inverted J-shaped pattern according to the LDL-C levels. However, the paradoxically increased hazard of mortality during follow-up in lower LDL-C was attenuated in statin users and individuals with diabetes, hypertension, or obesity. In statin users, lower LDL-C was associated with a decreased hazard of mortality during follow-up.
Conclusion Among the elderly, lower LDL-C was associated with decreased risks of MI and stroke. Lower LDL-C achieved by statins in the elderly was associated with a decreased risk of all-cause death during follow-up, suggesting that LDL-C paradox for the premature death risk in the elderly should not be applied to statin users. Intensive statin therapy should not be hesitated for older adults with cardiovascular risk factors including diabetes.
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Citations
Citations to this article as recorded by
- Combination of low- or moderate-intensity statin and ezetimibe vs. high-intensity statin monotherapy on primary prevention of cardiovascular disease and all-cause death: a propensity-matched nationwide cohort study
Ji Eun Jun, In-Kyung Jeong, Kyu Jeong Ahn, Ho Yeon Chung, You-Cheol Hwang European Journal of Preventive Cardiology.2024; 31(10): 1205. CrossRef - Associations of Low-density Lipoprotein Cholesterol With All-cause and Cause-specific Mortality in Older Adults in China
Wenqing Ni, Yuebin Lv, Xueli Yuan, Yan Zhang, Hongmin Zhang, Yijing Zheng, Xiaoming Shi, Jian Xu The Journal of Clinical Endocrinology & Metabolism.2024;[Epub] CrossRef - Risk Factors of Acute Ischemic Stroke and Mortality Among Adults With Endocardial Fibroelastosis
Talal Warsi, Kamleshun Ramphul, Mansimran Singh Dulay, Saddam Jeelani, Renuka Verma, Nomesh Kumar, Jasninder Singh Dhaliwal, Caleb Carver, Hemamalini Sakthivel, Syed Khurram Mushtaq Gardezi, Saurabh Deshpande, Akil A. Sherif, Alexander Liu, Raheel Ahmed The Neurologist.2024; 29(6): 317. CrossRef - A Look at Primary and Secondary Prevention in the Elderly: The Two Sides of the Same Coin
Maurizio Giuseppe Abrignani, Fabiana Lucà, Vincenzo Abrignani, Giuseppe Pelaggi, Alessandro Aiello, Furio Colivicchi, Francesco Fattirolli, Michele Massimo Gulizia, Federico Nardi, Paolo Giuseppe Pino, Iris Parrini, Carmelo Massimiliano Rao Journal of Clinical Medicine.2024; 13(15): 4350. CrossRef - Contradictions in traditional ideas about atherosclerosis and the efficacy of lipid-lowering therapy. Promising directions
A. P. Vasiliev, N. N. Streltsova Сибирский научный медицинский журнал.2024; 44(4): 38. CrossRef - The relationship of low-density lipoprotein cholesterol and all-cause or cardiovascular mortality in patients with type 2 diabetes: a retrospective study
Chin-Huan Chang, Shu-Tin Yeh, Seng-Wei Ooi, Chung-Yi Li, Hua-Fen Chen PeerJ.2023; 11: e14609. CrossRef - ERCC1 polymorphism and its expression associated with ischemic stroke in Chinese population
Xiao-Dong Deng, Jian-Lin Ke, Tai-Yu Chen, Qin Gao, Zhuo-Lin Zhao, Wei Zhang, Huan Liu, Ming-Liang Xiang, Li-Zhen Wang, Ying Ma, Yun Liu Frontiers in Neurology.2023;[Epub] CrossRef - New, Novel Lipid-Lowering Agents for Reducing Cardiovascular Risk: Beyond Statins
Kyuho Kim, Henry N. Ginsberg, Sung Hee Choi Diabetes & Metabolism Journal.2022; 46(4): 517. CrossRef - Association between the Diabetes Drug Cost and Cardiovascular Events and Death in Korea: A National Health Insurance Service Database Analysis
Seung Min Chung, Ji-In Lee, Eugene Han, Hyun-Ae Seo, Eonju Jeon, Hye Soon Kim, Ji Sung Yoon Endocrinology and Metabolism.2022; 37(5): 759. CrossRef
- Metabolic Risk/Epidemiology
- Age- and Sex-Related Differential Associations between Body Composition and Diabetes Mellitus
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Eun Roh, Soon Young Hwang, Jung A Kim, You-Bin Lee, So-hyeon Hong, Nam Hoon Kim, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Hye Jin Yoo
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Diabetes Metab J. 2021;45(2):183-194. Published online June 16, 2020
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DOI: https://doi.org/10.4093/dmj.2019.0171
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Graphical Abstract
Abstract
PDFSupplementary MaterialPubReader ePub
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Background
The age- and sex-related differences on the impacts of body composition on diabetes mellitus (DM) remain uncertain.
Methods
The fourth and fifth Korea National Health and Nutrition Examination Survey included 15,586 subjects over 30 years of age who completed dual-energy X-ray absorptiometry. We conducted a cross-sectional study to investigate whether muscle mass index (MMI), defined as appendicular skeletal muscle divided by body mass index (BMI), and fat mass index (FMI), defined as trunk fat mass divided by BMI, were differently associated with DM according to age and sex.
Results
In multivariate logistic regression, the risk for DM significantly increased across quartiles of FMI in men aged ≥70. Meanwhile, MMI showed a protective association with DM in men of the same age. The odds ratios (ORs) for the highest quartile versus the lowest quartile of FMI and MMI were 3.116 (95% confidence interval [CI], 1.405 to 6.914) and 0.295 (95% CI, 0.157 to 0.554), respectively. In women, the ORs of DM was significantly different across FMI quartiles in those over age 50. The highest quartile of FMI exhibited increased ORs of DM in subjects aged 50 to 69 (OR, 1.891; 95% CI, 1.229 to 2.908) and ≥70 (OR, 2.275; 95% CI, 1.103 to 4.69) compared to lowest quartile. However, MMI was not significantly associated with DM in women of all age groups.
Conclusion
Both FMI and MMI were independent risk factors for DM in men aged 70 years or more. In women over 50 years, FMI was independently associated with DM. There was no significant association between MMI and DM in women.
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Citations
Citations to this article as recorded by
- Research Progress on Correlation between Body Composition Changes and Disease Pro-gression of Type 2 Diabetes
敏 张 Advances in Clinical Medicine.2024; 14(03): 936. CrossRef - Low Skeletal Muscle Mass Accompanied by Abdominal Obesity Additively Increases the Risk of Incident Type 2 Diabetes
Ji Eun Jun, Seung-Eun Lee, You-Bin Lee, Gyuri Kim, Sang-Man Jin, Jae Hwan Jee, Jae Hyeon Kim The Journal of Clinical Endocrinology & Metabolism.2023; 108(5): 1173. CrossRef - Is imaging-based muscle quantity associated with risk of diabetes? A meta-analysis of cohort studies
Shanhu Qiu, Xue Cai, Yang Yuan, Bo Xie, Zilin Sun, Tongzhi Wu Diabetes Research and Clinical Practice.2022; 189: 109939. CrossRef - Whole and segmental body composition changes during mid-follicular and mid-luteal phases of the menstrual cycle in recreationally active young women
Şükran Nazan Koşar, Yasemin Güzel, Mehmet Gören Köse, Ayşe Kin İşler, Tahir Hazır Annals of Human Biology.2022; 49(2): 124. CrossRef - Body Composition and Diabetes
Hye Jin Yoo The Journal of Korean Diabetes.2021; 22(4): 238. CrossRef
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