Different Associations between Lipid Levels and Risk for Heart Failure according to Diabetes Progression

Area of Science:

• Cardiovascular Medicine
• Endocrinology
• Public Health

Background:

• The association between circulating lipid levels and heart failure (HF) risk is debated.
• Type 2 diabetes mellitus (T2DM) complicates this relationship, with duration and treatment potentially modifying risk.

Purpose of the Study:

• To investigate the association between lipid profiles and incident HF in individuals with T2DM.
• To determine if diabetes duration or antidiabetic medication regimens modify this association.

Main Methods:

• A large cohort (n=2,439,978) from the Korean National Health Information Database (2015-2016).
• Subjects stratified by diabetes duration (new-onset, <5, 5-10, ≥10 years) and antidiabetic medication count.
• Incident HF identified via ICD-10 code I50 during hospitalization; risk analyzed using Cox proportional hazard models.

Main Results:

• An inverse association between LDL-C and HF risk was seen in new-onset diabetes (lower risk with higher LDL-C).
• J-shaped associations were observed in long-standing diabetes, with higher HF risk at LDL-C ≥160 mg/dL.
• Similar patterns emerged for total cholesterol, non-HDL-C, and across different antidiabetic medication groups.

Conclusions:

• Lipid level associations with HF risk differ based on diabetes progression.
• Disease duration is a critical factor influencing the lipid-HF relationship in T2DM patients.