Low HDL cholesterol is associated with the risk of stroke in elderly diabetic individuals: changes in the risk for atherosclerotic diseases at various ages.

Abstract

To clarify the relationship between lipid levels and ischemic heart disease (IHD) and cerebrovascular disease (CVD) in diabetic individuals. The Japan Cholesterol and Diabetes Mellitus Study is a prospective cohort study of 4,014 type 2 diabetic patients (1,936 women; mean +/- SD age 67.4 +/- 9.5 years). Lipid and glucose levels and other factors were investigated in relation to occurrence of IHD or CVD. IHD and CVD occurred in 1.59 and 1.43% of participants, respectively, over a 2-year period. The relation of lower HDL or higher LDL cholesterol to occurrence of IHD in subjects <65 years old was significant. Lower HDL cholesterol was also significantly related to CVD in subjects >or=65 years old and especially in those >75 years old (n = 1,016; odds ratio 0.511 [95% CI 0.239-0.918]; P < 0.05). Stepwise multiple regression analysis with onset of CVD as a dependent variable showed the same result. Lower HDL cholesterol is an important risk factor for not only IHD but also CVD, especially in diabetic elderly individuals.