# Remnantcholesterol en ontsteking verklaren restrisico op perifeer vaatlijden bij diabetes type 2

*geplaatst 2026-11-12 · Cholesterol · Journal of the American Heart Association · doi 10.1161/JAHA.126.049813 · https://hartvaat.nl/2026/11/03/remnantcholesterol-en-ontsteking-verklaren-restrisico-op-perifeer-vaatlijden-bij/*

In een prospectieve cohortstudie onder 18.741 patiënten met diabetes type 2 op lipidendalingstherapie bleek een verhoogd remnantcholesterol en hsCRP-gehalte elk onafhankelijk geassocieerd met een hoger risico op incident perifeer vaatlijden. Patiënten met beide verhoogden waarden liepen het grootste risico; deze associaties bleven robuust na uitgebreide correcties voor covariaten en in sensitiviteit analyses. De bevindingen onderstrepen dat het restrisico op vaatcomplicaties verder gaat dan het behaalde LDL-C-niveau, wat pleit voor intensievere risicomanagement en mogelijke targeting van remnantlipoproteïnen en ontsteking in deze populatie.

## English: Residual Risk From Remnant Cholesterol and Inflammation Despite Lipid-Lowering Therapy and Association With Incident Peripheral Artery Disease in Type 2 Diabetes.

In a prospective cohort study of 18,741 patients with type 2 diabetes on lipid-lowering therapy, elevated remnant cholesterol and hsCRP levels were each independently associated with a higher risk of incident peripheral artery disease. Patients with concurrent elevations in both markers faced the greatest risk, and these associations remained robust after extensive multivariable adjustments and sensitivity analyses. The findings highlight substantial residual cardiovascular risk beyond achieved LDL-C levels, underscoring the need for broader risk management strategies that address remnant lipoproteins and systemic inflammation in diabetic patients.

## Abstract (original, from the publication)

BACKGROUND: Despite guideline-recommended lipid-lowering therapy, patients with type 2 diabetes retain a significant residual risk for peripheral artery disease (PAD). The contributions of remnant cholesterol (RC) and systemic inflammation in this treated population, particularly beyond achieved low-density lipoprotein cholesterol, remain incompletely understood. METHODS: This prospective cohort study included 18 741 participants with type 2 diabetes from the UK Biobank who were free of PAD and were on lipid-lowering therapy at baseline. Plasma RC and hsCRP (high-sensitivity C-reactive protein) levels were measured at baseline. Incident PAD was ascertained over a median follow-up of 13.6 years. Multivariable Cox models were used to estimate hazard ratios after adjustment for demographic, clinical, metabolic, and treatment-related covariates, including low-density lipoprotein cholesterol and baseline coronary artery disease. RESULTS: During follow-up, incident PAD occurred in 1223 participants (6.5%). Elevated RC and hsCRP levels were each independently linked to an increased risk of PAD. Participants with concurrent elevations in both RC and hsCRP exhibited the highest risk of incident PAD. These associations remained robust across multiple sensitivity analyses, including exclusion of participants with baseline coronary artery disease, removal of events within the initial 2-year follow-up, elimination of individuals with hsCRP >10 mg/L, competing-risk analyses accounting for death, and further adjustment for detailed lipid-lowering therapy categories. CONCLUSIONS: Among patients with type 2 diabetes receiving lipid-lowering therapy for primary prevention of PAD, elevated RC and systemic inflammation are independently and jointly associated with future PAD risk. These findings highlight substantial residual risk beyond managed low-density lipoprotein cholesterol and support the need for further strategies targeting both remnant lipoproteins and inflammation in this high-risk population.

Auteurs: Ruoxi Liao, Zhiwen Xiao, Chixiong Huang, Lin Chen, Ying Liu, Xiaomin Wei, Mingjue Li, Mengjia Shen, Zhiqi Hu, Jianping Bin

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Bron: Journal of the American Heart Association, https://doi.org/10.1161/JAHA.126.049813. Bijgewerkt 2026-11-05T02:42:54Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.