Temporal trends in hyperlipidemia among adults with diabetes mellitus, 1999-2024: insights from the CDC WONDER...

Hyperlipidemia and diabetes mellitus (DM) often occur together, increasing the risk of cardiovascular disease and premature death. While both conditions have been studied separately, national trends in deaths related to their combination are not well understood. This study examines 25-year mortality trends associated with hyperlipidemia and DM among U.S. adults aged ≥25 years.

We analyzed the CDC WONDER Multiple Cause-of-Death database (1999-2024) to identify adult deaths with ICD-10 codes E78 (hyperlipidemia) and E10-E14 (DM) listed as underlying or contributing causes. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the direct method, standardized to the 2000 U S.

Joinpoint regression estimated annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CIs). Between 1999 and 2024, 595,203 deaths were attributed to hyperlipidemia with DM. AAMRs increased from 2.79 to 17.24, with an AAPC of 7.57 (95% CI: 6.28-9.19; p < 0.001). The fastest increase occurred from 1999 to 2004 (APC: 16.14), followed by a slower rise (APC: 5.52; p = 0.008). Mortality rates were consistently higher in men (12.22) than women (7.28) and in older adults (≥65 years: 37.88). Non-Hispanic American Indian/Alaskan Natives (13.16) and non-Hispanic Blacks (12.36) had the highest mean AAMRs. Regionally, the West (10.30) and Midwest (10.05) had the highest mean AAMRs, with the South demonstrating the fastest increase over time. Rural areas showed sharper increases than urban areas (AAPC: 8.96 vs. 8.00), though this urban-rural analysis was limited to 1999-2020 due to data availability.

Mortality due to hyperlipidemia and DM has increased substantially, especially among vulnerable subgroups, highlighting the need for targeted metabolic and equity-focused interventions.