459-P: Remnant Cholesterol and the Presence of Coronary Artery Disease Are Mutually Independent Predictors for the Development of Type 2 Diabetes Mellitus

Abstract

Remnant cholesterol is a predictor of cardiovascular event risk and is associated with the metabolic syndrome as well as with type 2 diabetes (T2DM). Whether this lipid parameter also predicts incident diabetes in subjects who do not yet have diabetes is less clear. We therefore prospectively recorded incident diabetes over 4 years in 864 consecutive nondiabetic Caucasian patients who underwent coronary angiography for the evaluation of established or suspected stable coronary artery disease (CAD). Diabetes was diagnosed according to ADA criteria. At baseline, 54.4% of our patients had significant CAD with lumen narrowing ≥50% at angiography; remnant cholesterol was significantly higher in patients with than in those without significant CAD (24±24 vs 19±18 mg/dl; p<0.001). During follow-up, diabetes was newly diagnosed in 87 patients, i.e. in 10.1% of the study population. Remnant cholesterol strongly predicted diabetes both univariately (OR 1.50 [1.23-1.82]; p<0.001) and after multivariate adjustment including both fasting glucose and HbA1c values (OR 1.47 [1.18-1.80]; p<0.001). When we further adjusted for the presence of significant CAD, remnant cholesterol remained predictive of incident diabetes (OR 1.43 [1.15-1.77]; p<0.001), while CAD predicted incident diabetes in this model independently of remnant cholesterol (OR 1.88 [1.17-3.00]; p=0.009). We conclude that remnant cholesterol and the presence of CAD are mutually independent predictors for the development of T2DM. Disclosure T. Plattner: None. A. Vonbank: None. A. Mader: None. L. Sprenger: None. M. Maechler: None. B. Larcher: None. A. Leiherer: None. A. Muendlein: None. H. Drexel: None. C.H. Saely: None.