Capucine Bertrand1, Pierre-Jean Saulnier2,3,4, Louis Potier5,6,7, Mikaël Croyal8,9, Valentin Blanchard9, Elise Gand3, Stéphanie Ragot2,3,4, Fabrice Schneider2,10, Olivia Bocock1, Laurence Baillet-Blanco1, Gilberto Velho7, Michel Marre6,7,11, Ronan Roussel5,6,7, Vincent Rigalleau1,12,13, Samy Hadjadj14, Kamel Mohammedi15,16,17. 1. Département d'Endocrinologie, Diabétologie, Nutrition, Hôpital Haut-Lévêque, Pessac, Bordeaux, France. 2. UFR de Médecine et Pharmacie, Université de Poitiers, Poitiers, France. 3. CHU de Poitiers, Centre d'Investigation Clinique, Poitiers, France. 4. Inserm, CIC 1402, Poitiers, France. 5. Assistance Publique - Hôpitaux de Paris, Bichat Hospital, DHU FIRE, Département d'Endocrinologie, Diabétologie, Nutrition, Paris, France. 6. UFR de Médecine, Université de Paris, Paris, France. 7. Centre de Recherche des Cordeliers, Inserm, Sorbonne Université, Université de Paris, Paris, France. 8. INRA, CHU Nantes, UMR 1280, PhAN, IMAD, Nantes Université, Nantes, France. 9. CRNH-O, Mass Spectrometry Core Facility, Nantes, France. 10. Département de Chirurgie Vasculaire, CHU de Poitiers, Poitiers, France. 11. CMC Ambroise Paré, Neuilly-sur-Seine, France. 12. UFR de Médecine, Université de Bordeaux, Bordeaux, France. 13. Centre de Recherche Inserm - Université de Bordeaux U1219 'Bordeaux Population Health', Bordeaux, France. 14. Institut du Thorax, Inserm, CNRS, Université de Nantes, Nantes, France. 15. Département d'Endocrinologie, Diabétologie, Nutrition, Hôpital Haut-Lévêque, Pessac, Bordeaux, France. km.mmohammedi@gmail.com. 16. CMC Ambroise Paré, Neuilly-sur-Seine, France. km.mmohammedi@gmail.com. 17. Inserm U1034, Biologie des Maladies Cardiovasculaires, Bordeaux, France. km.mmohammedi@gmail.com.
Abstract
AIMS/HYPOTHESIS: The lipid profile has not been fully investigated in individuals with peripheral artery disease (PAD). We aimed to evaluate the relationship between plasma concentrations of lipoproteins and the prevalence of lower-limb PAD at baseline and its incidence during follow-up in people with type 2 diabetes. METHODS: Plasma concentrations of total cholesterol, HDL-cholesterol, triacylglycerol and apolipoprotein (Apo) A-I, ApoA-II, ApoB-100 and Apo(a) were measured at baseline using colorimetric or MS methods in the SURDIAGENE cohort. Total cholesterol/HDL-cholesterol ratio, non-HDL-cholesterol and LDL-cholesterol were estimated using computation formulas. Logistic and Cox proportional hazard regression models were fitted to estimate OR or HR, with related 95% CI, for baseline prevalence or incidence of major PAD (lower-limb amputation or requirement of revascularisation) during follow-up by increasing lipoprotein tertiles, after adjustment for key confounders. RESULTS: Among 1468 participants (women 42%, mean ± SD age 65 ± 11 years, duration of diabetes 14 ± 10 years at baseline), 129 (8.8%) had a baseline history of major PAD. Major PAD was less prevalent at baseline in the highest (vs lowest) tertile of HDL-cholesterol (OR 0.42 [95% CI 0.26, 0.71], p = 0.001) and ApoA-I (OR 0.39 [95% CI 0.23, 0.67], p = 0.0007), and more frequent in the highest tertile of total cholesterol/HDL-cholesterol ratio (OR 1.95 [95% CI 1.18, 3.24], p = 0.01). Among 1339 participants without a history of PAD at baseline, incident PAD occurred in 97 (7.2%) during a median (25th-75th percentile) duration of follow-up of 7.1 (4.4-10.7) years, corresponding to 9685 person-years and an incidence rate of 9.8 (95% CI 8.0, 12.0) per 1000 person-years. The risk of incident PAD was lower in the top (vs bottom) tertile of HDL-cholesterol (HR 0.54 [95% CI 0.30, 0.95], p = 0.03) or ApoA-I (HR 0.50 [95% CI 0.28, 0.86], p = 0.01) and higher in the top tertile of total cholesterol/HDL-cholesterol ratio (HR 2.81 [95% CI 1.61, 5.04], p = 0.0002) and non-HDL-cholesterol (HR 1.80 [95% CI 1.06, 3.12], p = 0.03). CONCLUSIONS/ INTERPRETATION: We reported independent associations between HDL-cholesterol, ApoA-I, total cholesterol/HDL-cholesterol ratio or non-HDL-cholesterol and the prevalence or the incidence of major PAD in people with type 2 diabetes. Our findings provide a picture of lipoprotein profile in people with type 2 diabetes. Graphical abstract.
AIMS/HYPOTHESIS: The lipid profile has not been fully investigated in individuals with peripheral artery disease (PAD). We aimed to evaluate the relationship between plasma concentrations of lipoproteins and the prevalence of lower-limb PAD at baseline and its incidence during follow-up in people with type 2 diabetes. METHODS: Plasma concentrations of total cholesterol, HDL-cholesterol, triacylglycerol and apolipoprotein (Apo) A-I, ApoA-II, ApoB-100 and Apo(a) were measured at baseline using colorimetric or MS methods in the SURDIAGENE cohort. Total cholesterol/HDL-cholesterol ratio, non-HDL-cholesterol and LDL-cholesterol were estimated using computation formulas. Logistic and Cox proportional hazard regression models were fitted to estimate OR or HR, with related 95% CI, for baseline prevalence or incidence of major PAD (lower-limb amputation or requirement of revascularisation) during follow-up by increasing lipoprotein tertiles, after adjustment for key confounders. RESULTS: Among 1468 participants (women 42%, mean ± SD age 65 ± 11 years, duration of diabetes 14 ± 10 years at baseline), 129 (8.8%) had a baseline history of major PAD. Major PAD was less prevalent at baseline in the highest (vs lowest) tertile of HDL-cholesterol (OR 0.42 [95% CI 0.26, 0.71], p = 0.001) and ApoA-I (OR 0.39 [95% CI 0.23, 0.67], p = 0.0007), and more frequent in the highest tertile of total cholesterol/HDL-cholesterol ratio (OR 1.95 [95% CI 1.18, 3.24], p = 0.01). Among 1339 participants without a history of PAD at baseline, incident PAD occurred in 97 (7.2%) during a median (25th-75th percentile) duration of follow-up of 7.1 (4.4-10.7) years, corresponding to 9685 person-years and an incidence rate of 9.8 (95% CI 8.0, 12.0) per 1000 person-years. The risk of incident PAD was lower in the top (vs bottom) tertile of HDL-cholesterol (HR 0.54 [95% CI 0.30, 0.95], p = 0.03) or ApoA-I (HR 0.50 [95% CI 0.28, 0.86], p = 0.01) and higher in the top tertile of total cholesterol/HDL-cholesterol ratio (HR 2.81 [95% CI 1.61, 5.04], p = 0.0002) and non-HDL-cholesterol (HR 1.80 [95% CI 1.06, 3.12], p = 0.03). CONCLUSIONS/ INTERPRETATION: We reported independent associations between HDL-cholesterol, ApoA-I, total cholesterol/HDL-cholesterol ratio or non-HDL-cholesterol and the prevalence or the incidence of major PAD in people with type 2 diabetes. Our findings provide a picture of lipoprotein profile in people with type 2 diabetes. Graphical abstract.
Authors: M Croyal; Z Kaabia; L León; S Ramin-Mangata; T Baty; F Fall; S Billon-Crossouard; A Aguesse; T Hollstein; D R Sullivan; E Nobecourt; G Lambert; M Krempf Journal: Diabetes Metab Date: 2017-05-09 Impact factor: 6.041
Authors: Thomas Mueller; Franz Hinterreiter; Christian Luft; Werner Poelz; Meinhard Haltmayer; Benjamin Dieplinger Journal: J Vasc Surg Date: 2014-01-03 Impact factor: 4.268
Authors: F Gerald R Fowkes; Diana Rudan; Igor Rudan; Victor Aboyans; Julie O Denenberg; Mary M McDermott; Paul E Norman; Uchechukwe K A Sampson; Linda J Williams; George A Mensah; Michael H Criqui Journal: Lancet Date: 2013-08-01 Impact factor: 79.321