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Topical Area: Aging and Chronic Disease

Aging and Chronic Disease (Poster Session)

(P23-015-23) Differences in HDL-Related Coronary Heart Disease Risk Between Individuals With and Without Diabetes: A Prospective Cohort Study

Monday, July 24, 2023
11:45 AM – 12:45 PM ET
Location: Poster Board 15

    Presenting Author(s)

  • Jun-Xiang Chen, MBBS (he/him/his)

    PhD candidate
    School of Public Health, Huazhong University of Science and Technology
    Wuhan, Hubei, China (People's Republic)

    • Co-Author(s)

  • QL

    Qi Lu, NA

    Huazhong University of Science and Technology, Tongji Medical College, School of Public Health
    Wuhan, Hubei, China (People's Republic)

  • GL

    Gang Liu

    Huazhong University of Science and Technology, Tongji Medical College, School of Public Health

  • AP

    An Pan, PhD

    Professor
    Huazhong University of Science and Technology, Tongji Medical College, School of Public Health
    Wuhan, Hubei, China (People's Republic)

Disclosure(s):
Jun-Xiang Chen, MBBS: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: High-density lipoprotein (HDL) could lose its atheroprotective functions (e.g., reverse cholesterol transport, anti-inflammation) in the presence of diabetes. This study sought to examine associations of HDL cholesterol (HDL-C) and HDL particle (HDL-P) subclasses with coronary heart disease (CHD) risk in individuals with and without diabetes.

Methods: This study included 393 516 participants (20 691 diabetes and 372 825 non-diabetes) with HDL-C measurements from the UK Biobank, among whom 108 071 (5730 diabetes and 102 341 non-diabetes) had HDL-P subclasses measurements. Restricted cubic splines cooperated with Cox model were used to estimate associations of HDL with CHD.

Results: Concentrations of HDL-C and HDL-P subclasses in individuals with diabetes were lower than those in individuals without diabetes (P < 0.001). During a median follow-up of 13.0 years, 3398 (16.4%) and 24 772 (6.6%) incident CHD events were identified for those with and without diabetes, respectively. The association between HDL-C and CHD was L-shape for individuals without diabetes, whereas U-shape for patients with diabetes (P for interaction between HDL-C and diabetes < 0.05). As for HDL-P subclasses, in individuals without diabetes, there was an inverted U-shaped association for very large HDL-P, a linear and negative association for large HDL-P, L-shaped associations for medium HDL-P and small HDL-P; however, in individuals with diabetes, linear and positive association was found for very large HDL-P (P for interaction < 0.05), null association for large HDL (P for interaction < 0.05), and L-shaped or weak U-shaped associations for medium HDL-P and small HDL-P.

Conclusions: Very high HDL-C levels were associated with higher CHD risk in patients with diabetes, but not in those without diabetes. Furthermore, smaller HDL-P at low levels was inversely, whereas very large HDL-P was positively associated with CHD risk in patients with diabetes. These data provide new insights into the modifying effect of diabetes on atheroprotective property of HDL.

Funding Sources: The National Natural Science Foundation of China