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Original Article
Cardiovascular Risk/Epidemiology
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Mean and Variability of Lipid Measurements and Risk for Development of Subclinical Left Ventricular Diastolic Dysfunction
Jiyun Park, Mira Kang, Jiyeon Ahn, Min Young Kim, Min Sun Choi, You-Bin Lee, Gyuri Kim, Kyu Yeon Hur, Jae Hyeon Kim, Jeong Hoon Yang, Sang-Man Jin
Diabetes Metab J. 2022;46(2):286-296.   Published online November 22, 2021
DOI: https://doi.org/10.4093/dmj.2021.0080
  • 6,032 View
  • 202 Download
  • 2 Web of Science
  • 4 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Subclinical left ventricular diastolic dysfunction (LVDD) is an emerging consequence of increased insulin resistance, and dyslipidemia is one of the few correctable risk factors of LVDD. This study evaluated the role of mean and visit-to-visit variability of lipid measurements in risk of LVDD in a healthy population.
Methods
This was a 3.7-year (interquartile range, 2.1 to 4.9) longitudinal cohort study including 2,817 adults (median age 55 years) with left ventricular ejection fraction >50% who underwent an annual or biannual health screening between January 2008 and July 2016. The mean, standard deviation (SD), coefficient of variation (CV), variability independent of the mean (VIM), and average real variability of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein B (apoB), non-HDL-C, and triglycerides were obtained from three to six measurements during the 5 years preceding the first echocardiogram.
Results
Among the 2,817 patients, 560 (19.9%) developed LVDD. The mean of no component of lipid measurements was associated with risk of LVDD. CV (hazard ratio [HR], 1.35; 95% confidence interval [CI], 1.10 to 1.67), SD (HR, 1.27; 95% CI, 1.03 to 1.57), and VIM (HR, 1.26; 95% CI, 1.03 to 1.55) of LDL-C and all the variability parameters of apoB were significantly associated with development of LVDD. The association between CV-LDL and risk of LVDD did not have significant interaction with sex, increasing/decreasing trend at baseline, or use of stain and/or lipid-modifying agents.
Conclusion
The variability of LDL-C and apoB, rather than their mean, was associated with risk for LVDD.

Citations

Citations to this article as recorded by  
  • Greater variability in HDL-C was associated with an increased risk of cognitive decline in the middle- and elderly Chinese: A cohort study
    Lili Luo, Wei Feng, Mei Mei, Xue Tian, Yuhan Zhao, Lulu Liu, Zemeng Zhao, Hui Luo, Xiuhua Guo, Lixin Tao, Xiangtong Liu, Xiaonan Wang, Yanxia Luo
    Archives of Gerontology and Geriatrics.2024; 125: 105503.     CrossRef
  • Lipid Variability Induces Endothelial Dysfunction by Increasing Inflammation and Oxidative Stress
    Marie Rhee, Joonyub Lee, Eun Young Lee, Kun-Ho Yoon, Seung-Hwan Lee
    Endocrinology and Metabolism.2024; 39(3): 511.     CrossRef
  • Separate and Joint Associations of Remnant Cholesterol Accumulation and Variability With Carotid Atherosclerosis: A Prospective Cohort Study
    Jinqi Wang, Rui Jin, Xiaohan Jin, Zhiyuan Wu, Haiping Zhang, Ze Han, Zongkai Xu, Yueruijing Liu, Xiaoyu Zhao, Xiuhua Guo, Lixin Tao
    Journal of the American Heart Association.2023;[Epub]     CrossRef
  • Variability of Metabolic Risk Factors: Causative Factor or Epiphenomenon?
    Hye Jin Yoo
    Diabetes & Metabolism Journal.2022; 46(2): 257.     CrossRef
Review
Diabetic Cardiomyopathy.
Sung Ai Kim, Jong Won Ha
Korean Diabetes J. 2009;33(1):9-12.   Published online February 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.1.9
  • 2,100 View
  • 20 Download
AbstractAbstract PDF
Cardiovascular disease is the most common cause of death in patients with diabetes mellitus (DM). In particular, the focus of many studies has been on ischemic heart disease, as it is a eading cause of death in diabetic patients. However, independent of coronary artery disease, DM can also lead to cardiac structural and functional changes, supporting the presence of diabetic cardiomyopathy. The pathologic mechanismin the development of diabetic cardiomyopathy is multifactorial including metabolic disturbance, myocardial fibrosis, microvascular disease, and autonomic dysfunction. Functionally, diabetic patients have a higher prevalence of LV (left ventricle) diastolic dysfunction. Because most diabetic patients with early myocardial disease have a wide spectrum of diastolic dysfunction at rest, assessment of LV functional reserve during exercise is helpful for early identification of myocardial dysfunction. Recent research has demonstrated that LV diastolic functional reserve (DFR) assessed by diastolic stress echocardiography was significantly reduced in patients with DM, compared with a control group, suggesting DFR might be an early indicator of diabetic cardiomyopathy. Glycemic control might be the most important and basic therapeutic strategy for preventing the development of diabetic cardiomyopathy. However, more extensive studies are needed to garner further evidence of preventive and therapeutic strategies of diabetic cardiomyopathy.

Diabetes Metab J : Diabetes & Metabolism Journal
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