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Original Articles

Dyslipidemia and Hyperglycemia Predict Coronary Heart Disease Events in Middle-Aged Patients With NIDDM

  1. Seppo Lehto,
  2. Tapani Rönnemaa,
  3. Steven M Haffher,
  4. Kalevi Pyörälä,
  5. Veikko Kallio and
  6. Markku Laakso
  1. Department of Medicine, Kuopio University Hospital Kuopio
  2. Department of Medicine, Turku University Central Hospital Turku, Finland
  3. Social Insurance Institution Turku, Finland
  4. Department of Medicine, The University of Texas Health Science Center at San Antonio San Antonio, Texas
  1. Address correspondence and reprint requests to Dr. Markku Laakso, Professor and Chair, Department of Medicine, Kuopio University Hospital, SF-70210 Kuopio, Finland. markku.laakso{at}uku.fi.
Diabetes 1997 Aug; 46(8): 1354-1359. https://doi.org/10.2337/diab.46.8.1354
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Abstract

Patients with NIDDM are at increased risk for coronary heart disease (CHD). However, information on the predictive value of cardiovascular risk factors and the degree of hyperglycemia with respect to the risk for CHD in diabetic patients is still limited. Therefore, we carried out a prospective study on risk factors for CHD, including a large number of NIDDM patients. At baseline, risk factor levels of CHD were determined in 1,059 NIDDM patients (581 men and 478 women), aged from 45 to 64 years. These patients were followed up to 7 years with respect to CHD events. Altogether, 158 NIDDM patients (97 men [16.7%] and 61 women [12.8%]) died of CHD and 256 NIDDM patients (156 men [26.8%] and 100 women [20.9%]) had a serious CHD event (death from CHD or nonfatal myocardial infarction). A previous history of myocardial infarction, low HDL cholesterol level (<1.0 mmol/l), high non-HDL cholesterol (>5.2 mmol/l), high total triglyceride level (>2.3 mmol/l), and high fasting plasma glucose (>13.4 mmol/l) were associated with a twofold increase in the risk of CHD mortality or morbidity, independently of other cardiovascular risk factors. High calculated LDL cholesterol level (≥4.1 mmol/l) was significantly associated with all CHD events. The simultaneous presence of high fasting glucose (>13.4 mmol/l) with low HDL cholesterol, low HDL–to–total cholesterol ratio, or high total triglycerides further increased the risk for CHD events up to threefold. Our 7-year follow-up study provides evidence that dyslipidemia and poor glycemic control predict CHD mortality and morbidity in patients with NIDDM.

  • Received November 22, 1996.
  • Revision received March 28, 1997.
  • Accepted March 28, 1997.
  • Copyright © 1997 by the American Diabetes Association
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August 1997, 46(8)
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Dyslipidemia and Hyperglycemia Predict Coronary Heart Disease Events in Middle-Aged Patients With NIDDM
Seppo Lehto, Tapani Rönnemaa, Steven M Haffher, Kalevi Pyörälä, Veikko Kallio, Markku Laakso
Diabetes Aug 1997, 46 (8) 1354-1359; DOI: 10.2337/diab.46.8.1354

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Dyslipidemia and Hyperglycemia Predict Coronary Heart Disease Events in Middle-Aged Patients With NIDDM
Seppo Lehto, Tapani Rönnemaa, Steven M Haffher, Kalevi Pyörälä, Veikko Kallio, Markku Laakso
Diabetes Aug 1997, 46 (8) 1354-1359; DOI: 10.2337/diab.46.8.1354
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