Plasma Lipidomic Profiles Improve on Traditional Risk Factors for the Prediction of Cardiovascular Events in Type 2 Diabetes Mellitus
Primary result · CV events: prediction (C statistic)Result — go to the resultContinuous NRI 0.227 95% CI 0.219–0.235Authors' conclusion
The improvement in the prediction of cardiovascular events, above traditional risk factors, demonstrates the potential of plasma lipid species as biomarkers for cardiovascular risk stratification in diabetes mellitus.
Study context
- Population
- T2DM with ≥1 additional CV risk factor (35% history of macrovascular disease); 61% male, mean age 67 yearscase-cohort
- Participants
- 3,779 participants
- Comparison
- Base model plus lipid species vs base model
- Primary endpoint
- CV events (nonfatal MI, nonfatal stroke, CV death) and CV death
- Follow-up
- 5-year follow-up
Methodological detailscase-cohort, 5-fold cross-validation, external validation (LIPID trial subcohort), 310 plasma lipid species by targeted lipidomics (LC ESI-MS/MS); weighted Cox regression; models optimised with Akaike information criteria
- Case-cohort
- 5-fold cross-validation
- External validation (LIPID trial subcohort)
- 310 plasma lipid species by targeted lipidomics (LC ESI-MS/MS); weighted Cox regression; models optimised with Akaike information criteria
Primary result
CV events: prediction (C statistic)
Continuous NRI
0.227
95% CI 0.219–0.235
P < 0.0001 for C statistic increase
By group
Base model
0.680
C statistic · 95% CI 0.678–0.682
Base model + 7 lipid species
0.700
C statistic · 95% CI 0.698–0.702
As reported in the abstract
Further findings
| Outcome | Base model + 7 lipid species | Base model | Continuous NRI (95% CI) | P value | |
|---|---|---|---|---|---|
| CV death: prediction (C statistic), base model + 4 lipid speciesBase model + 4 lipid species vs Base model · P for C statistic increase | Not reported in the abstract | C statistic 0.740 (95% CI 0.738–0.742) | 0.328 (0.317–0.339) | P < 0.0001 for C statistic increase | Base model + 7 lipid species: not reported in the abstract |
- CV death: prediction (C statistic), base model + 4 lipid species: Base model + 4 lipid species C statistic 0.760 (95% CI 0.757–0.762)
Validation in T2DM subcohort of LIPID trial
- Results validated (n=511)
Original publication
Plasma Lipidomic Profiles Improve on Traditional Risk Factors for the Prediction of Cardiovascular Events in Type 2 Diabetes Mellitus. Circulation. Published 18 October 2016. doi:10.
Summarised from the published abstract; every number is checked against it