Trends in Apolipoprotein B, Non-High-Density Lipoprotein Cholesterol, Low-Density Lipoprotein Cholesterol, and Hemoglobin A1C Among US Adults with Diagnosed Diabetes, 2005-2018
Background: The control of blood glucose and atherogenic cholesterol particle concentrations is fundamental for patients with diabetes. The objective of this study was to examine trends in levels of apolipoprotein B (apo B), non-high-density lipoprotein (non-HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and hemoglobin A1c (A1C) and changes in the proportion of patients who achieved their glycemic and lipid goals between 2005 and 2018.Methods: We conducted a serial
... rial cross-sectional analysis of the US nationally representative data from the National Health and Nutrition Examination Surveys form 2005 through 2018. Results: In total, 5536 adults aged 20 years or older with diabetes were included (weighted mean age, 60.2 years; female, 50.1%). Among all adults with diabetes, the age-adjusted mean apo B levels did not decrease significantly from 2005 to 2016 (P =0.077). The age-adjusted mean non-HDL cholesterol levels reduced significantly (P =0.004) from 2005 to 2018. In 2017-2018, 55.3% of patients achieved the A1C goal of <7% and 43.8% achieved the non-HDL cholesterol goal of <130 mg/dl. In 2015-2016, 47.3% achieved the apo B goal of <90 mg/dL, 57.2% achieved the LDL cholesterol goal of <100 mg/dl, while 30.6% achieved all four glycemic and lipid goals. The success rates for achieving the goals of apo B, non-HDL cholesterol, and LDL cholesterol were higher in older compared with younger subjects, while white patients exhibited better glycemic control than Mexican Americans and non-Hispanic black patients.Conclusion: Among adults with diabetes, there was a significant reduction in non-HDL cholesterol level while there was no change in levels of apo B, LDL cholesterol or A1C over the past decade. Nevertheless, large percentages of adults with diabetes continue to have higher levels of apo B, non-HDL cholesterol, LDL cholesterol, and A1C.