High triglycerides increase risk for lower-extremity amputation in diabetics
MedWire News: Diabetic patients who have high levels of triglycerides are at increased risk for lower-extremity amputation (LEA), report US researchers.
One of the most severe consequences of the microvascular complications experienced by many patients with diabetes is LEA, making early risk prediction highly desirable.
Intensive glucose control has been found to reduce the risk for microvascular complications to a certain extent, but LEA is still experienced by a considerable number of diabetic patients, suggesting the involvement of other factors.
Brian Callaghan (University of Michigan, Ann Arbor) and colleagues therefore investigated links between triglyceride levels and long-term risk for LEA in 28,701 diabetic patients.
The patients, most of whom had Type 2 diabetes, were from the Kaiser Permanente Medical Care Program and had their triglyceride levels measured on enrollment. They were then followed up for 10 years for incidence of LEA.
Callaghan and team found that compared with patients with triglyceride levels below 150 mg/dl, those with triglyceride levels of 150-199, 200-499, and 500 mg/dl or over had significant 10%, 27%, and 65% increased 10-year risks for LEA, respectively, after adjusting for possible confounders.
Of note, low-density and high-density lipoprotein cholesterol levels were not significantly related to LEA risk, whereas older age, longer duration of diabetes, and having a higher-than-target glycated hemoglobin level (above 7%) were associated with increased LEA risk.
"More research is necessary to define a causal role of triglyceride levels on amputation risk in diabetic patients," write the investigators in the journal Diabetes Care.
"Based on this current robust cohort study, such research should be a priority," they conclude.
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By Helen Albert