Abstract 5530: Predominant Types of Dyslipidemia in U.S. Adults with Coronary Heart Disease and Diabetes
Background: The prevalence of isolated (one lipid disorder) and mixed (≥2 lipid disorders) dyslipidemia has not been well-chararacterized, particularly among patients with coronary heart disease (CHD) and type 2 diabetes mellitus (DM). We examined the association between types of dyslipidemia and CHD or DM among a representative sample of US adults.
Methods: We studied 2,827 adults with complete lipid data for LDL-C, HDL-C and triglycerides (TG) representing 126 million US adults in the National Health and Nutrition Examination Survey (NHANES) 2003–2004. We determined the prevalence of elevated LDL-C (as per NCEP guidelines), low HDL-C (<40 mg/dL for men and <50 mg/dL for women) and/or elevated TG (≥200 mg/dL) among those with CHD (n=134) or DM (n=277). Multivariate logistic regression examined the association between CHD or DM and types of dyslipidemia while controlling for clinical and demographic characteristics.
Results: Overall, 74% with CHD and 80% of those with DM had ≥1 lipid disorder. Among CHD patients, 60%, 27% and 27% had elevated LDL-C, low HDL-C and elevated TG respectively, while 20% had 2 lipid disorders and 10% had all 3. Among DM patients, 65%, 40% and 22% had elevated LDL-C, low HDL-C, and elevated TG respectively, while 29% had 2 lipid disorders and 10% had all 3. Compared to those with no lipid disorder, the odds of CHD were 4–6 times greater with elevated LDL-C combined with elevated TG regardless of HDL-C. In contrast, the odds of DM were the greatest in those with elevated LDL-C and low HDL-C regardless of TG. Other types of dyslipidemia were less strongly or not associated with CHD or DM (Table⇓).
Conclusions: In this representative sample of US adults, CHD was most closely associated with elevated LDL-C combined with elevated TG regardless of HDL-C levels, while DM was most closely associated with elevated LDL-C and low HDL-C regardless of TG levels. These differences should be considered when choosing therapies for dyslipidemia in patients with CHD and DM.