Non-HDL Cholesterol Is Less Informative Than the Total-to-HDL Cholesterol Ratio in Predicting Cardiovascular Risk in Type 2 Diabetes

Abstract

The UKPDS Risk Engine encapsulates a parametric model to estimate the risk of CHD, defined as myocardial infarction or sudden cardiac death, derived from the UKPDS, with 53,000 patient-years of follow-up data (3). For this analysis, 4,540 of the 5,102 UKPDS patients were included, for whom sufficient data were available and whose characteristics have been previously reported (2). Briefly, the UKPDS recruited patients with newly diagnosed type 2 diabetes but no recent myocardial infarction or stroke. They were mean age 53 years (range 25–65), 58% male, 83% white-Caucasian, 10% Indian-Asian, 8% Afro-Caribbean, and 30% were smokers at study entry. Mean (±SD) HbA_1c, 1–2 years after study entry, was 6.7 ± 1.4%, systolic blood pressure was 136 ± 20 mmHg, total cholesterol was 5.4 ± 1.0 mmol/l, and HDL cholesterol was 1.1 ± 0.25 mmol/l. The UKPDS Risk Engine equation (2) includes the total-to-HDL cholesterol ratio and adjusts for age, duration of diabetes, sex, smoking, ethnic group, HbA_1c, and systolic blood pressure.