Lipid profile analyses of patients with and without type-2 diabetes in a cardiac rehabilitation population

Funding Acknowledgements

Type of funding sources: None.

Introduction

Type 2 diabetes mellitus (T2DM) can double your risk of coronary artery disease (CAD). SGLT2 inhibitors reduce all-cause mortality for patients with T2DM and CAD, targeting metabolic syndrome components like HbA1c, blood pressure and weight. Lipid profiles are intrinsically linked to obesity however the secondary effects of SGLT2 inhibitors remain unclear, with studies showing a rise in HDLc and LDLc with these medications.

Propose

To compare the effect of cardiac rehabilitation and guideline directed statin therapy on lipid panels of those with diabetes to those without, and to conduct a sub-analysis on SGLT2 inhibited patients to assess for increased HDLc and LDLc.

Methods

We retrospectively reviewed our cardiac rehab records. Data was collected on sequential patients over age 18 who completed cardiac rehab, until 90 diabetics and 90 non-diabetics were identified. Statistical analyses performed using SPSS v.26.

Results

Diabetics had significantly lower total cholesterol, HDL and LDL prior to commencing rehab (Table 1). Diabetics also showed less reduction in total cholesterol and LDL than non-diabetics. Groups had similar follow-up time and anti-lipid therapy. N = 12 (13.3%) diabetics were on SGLT2 inhibitors. This group showed the greatest mean increase of HDL and lowest mean decrease of LDL levels, however, did start with the lowest initial lipid levels.

Conclusions

Diabetics had lower LDL and HDL prior to rehab, which may have led to reduced change in their profiles compared to non-diabetics. Interestingly however, patients on SGLT2 inhibitors showed a trend towards least reduction in mean LDL and the greatest increase in mean HDL compared to other diabetics.

Table 1 Category(Lipids in mmol/L) Non-Diabetics, n = 90 (Mean ± SD) Diabetics, n = 90 (Mean ± SD) p-value SGLT2 cohort, n = 12 (Mean ± SD) Age (Years) 66.1 ± 8.73 67.73 ± 8.88 0.21 66.41 ± 7.8 Max. statin (%) 92.2% 90% 0.16 100% Pre-Total Chol. 4.21 ± 1.29 3.57 ± 0.9 <0.01* 3.36 ± 0.62 Pre-Triglyceride 1.6 ± 0.85 1.87 ± 1.02 0.054 1.63 ± 0.6 Pre-HDL 1.33 ± 0.48 1.12±.029 <0.001* 1.03 ± 0.22 Pre-LDL 2.14 ± 1.03 1.68 ± 0.93 0.002* 1.60 ± 0.57 Change- Total Chol. -0.75 ± 1.13 -0.26 ± 0.09 0.9 -0.09 ± 0.45 Change-HDL -0.01 ± 0.42 +0.03 ± 0.19 0.33 +0.19 ± 0.13 Change- LDL -0.61 ± 0.96 -0.28 ± 0.75 0.01* -0.24 ± 0.63 Lipids rechecked (months) 8.4 ± 0.25 7.9 ± 0.26 0.14 8.25 ± 2.26 Pre-intervention lipid profiles, followed by change in levels over time. *Denotes significance.

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