Diabetes/metabolism research and reviews 2017 11 09() doi 10.1002/dmrr.2960
There are inconsistent findings regarding associations between triglyceride and cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM). This study aimed to test whether the association between triglyceride and CVD depends upon duration of diabetes.
From April 1, 2012 to June 30, 2012, we conducted a cross-sectional survey of 223612 patients with T2DM from 630 hospitals in China. CVD was defined as having either prior coronary heart disease or stroke or diabetes foot. Binary logistic regression was used to estimate odds ratios of triglyceride for CVD. Relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S) were used to estimate effect size of additive interaction between low triglyceride, i.e., <1.7 mmol/L, and duration of diabetes, i.e., ≥15 years. RESULTS
Among 223612 T2DM patients, 31898 (14.27%) suffered from CVD. Low triglyceride was associated with decreased risk of CVD (univariable OR:0.91, 95%CI: 0.88-0.93; multivariable OR:0.94, 95%CI: 0.92-0.97) among patients with <15 years of duration of diabetes but increased risk of CVD (univariable OR:1.12, 95%CI:1.04-1.21; multivariable OR:1.18, 95%CI: 1.09-1.27) among those patients with 15 and more years of duration of diabetes with significant additive interactions (RERI:0.39, 95%CI: 0.25-0.52; AP:0.20, 95%CI: 0.14-0.27; and S:1. 80, 95%CI: 1.43-2.28). CONCLUSIONS
Although high triglyceride was associated with increased risk of CVD in short-term T2DM, low triglyceride was associated with increased CVD risk in long-term T2DM. Low triglyceride may be a marker of CVD risk in Chinese patients with long-term T2DM.