The Relationship Between Low-Density Lipoprotein Cholesterol Levels and Cardiovascular Risk in Koreans With and...

Area of Science:

• Cardiology
• Endocrinology
• Public Health

Background:

• Low-density lipoprotein cholesterol (LDL-C) is a key cardiovascular disease (CVD) risk factor.
• Specific LDL-C thresholds for CVD risk assessment in non-diabetic populations are not well-defined.
• Understanding these thresholds is crucial for effective CVD prevention strategies.

Purpose of the Study:

• To investigate the association between LDL-C levels and CVD risk in Koreans.
• To compare CVD risk in individuals with and without diabetes based on LDL-C levels.
• To evaluate the impact of statin therapy on LDL-C-related CVD risk stratified by diabetes status.

Main Methods:

• Nationwide cohort study of 4,668,406 individuals without prior CVD.
• Categorization into six LDL-C groups (<70, 70-99, 100-129, 130-159, 160-189, ≥190 mg/dL).
• Multivariable Cox proportional hazards models used to estimate hazard ratios, adjusting for covariates.

Main Results:

• LDL-C levels ≥100 mg/dL were significantly associated with increased CVD risk across all participants.
• In statin users without diabetes, CVD risk increased from LDL-C ≥130 mg/dL.
• In statin users with diabetes, CVD risk increased from LDL-C ≥100 mg/dL.

Conclusions:

• Individuals without diabetes should aim for LDL-C control below 100 mg/dL.
• Glycemic status influences LDL-C thresholds for CVD risk, particularly with statin use.
• Individualized LDL-C management strategies considering diabetes status are essential.