Abstract 17244: Association of Remnant Lipoprotein Cholesterol, Type 2 Diabetes Mellitus, and Major Adverse Cardiovascular Events: Insights From the UK Biobank

Abstract

Background: Remnant lipoprotein-cholesterol (RLP-C) has emerged as a potential contributor to adverse cardiovascular events. While the association of low-density lipoprotein- cholesterol and atherosclerotic cardiovascular disease is well-established, the joint association of RLP-C and type 2 diabetes mellitus (T2DM) in driving major adverse cardiovascular events (MACE) remains less explored. Methods: We included a total of 118,004 participants from the UK Biobank with nuclear magnetic resonance-measured RLP-C. Participants were categorized into four groups based on their RLP-C levels and T2DM status: Group 1 (RLP-C below the median and no T2DM), Group 2 (RLP-C above the median and no T2DM), Group 3 (RLP-C below the median and T2DM), and Group 4 (RLP-C above the median and T2DM). Cox proportional hazards regression was employed to assess the association of these four categories with the time to incident MACE. The model was adjusted for age, sex, race, BMI, smoking, systolic blood pressure, anti-hypertensive and lipid-lowering therapy, and physical activity. Results: Our analysis revealed significant associations between RLP-C levels, T2DM, and the risk of MACE. Compared to the reference group (Group 1), Groups 2-4 had hazard ratio for the MACE outcome of 1.27 (95% CI: 1.18-1.37, p < .0001), 1.43 (95% CI: 1.29-1.59, p < .0001), and 2.04 (95% CI: 1.78-2.32, p < .0001), respectively (see Figure). Conclusion: This analysis from individuals in UK Biobank free from cardiovascular disease at baseline demonstrated a significant joint association between elevated RLP-C levels and T2DM, with the risk of major adverse cardiovascular events. Keywords: remnant lipoprotein cholesterol, type 2 diabetes mellitus, major adverse cardiovascular events, UK Biobank, nuclear magnetic resonance