Among adults with heterozygous familial hypercholesterolemia, there was a 5.7% prevalence of type 2 diabetes, with rates as high as 29.9% in the Eastern Mediterranean region, according to a recent study.
In the cross-sectional study involving 24,784 adults with familial hypercholesterolemia (FH) from 44 countries, researchers examined the prevalence of type 2 diabetes (T2D) in relation to age, body mass index (BMI), and lipid-lowering medications. Conducted by the European Atherosclerosis Society Familial Hypercholesterolemia Studies Collaboration, the study reported an overall T2D prevalence of 5.7%, with 4.1% in the genetically confirmed FH cohort. Significant regional variation was observed, with the highest prevalence in the Eastern Mediterranean (29.9%), followed by South-East Asia and the Americas.
Eighty percent, or 19,818 participants, received a diagnosis of heterozygous FH confirmed through genetic testing. The average age of the cohort was 46.95 years (SD 16.03), with 54% identifying as female and 46% as male.
The findings, published in The Lancet Endocrinology & Diabetes, indicated that advancing age, elevated BMI, and the use of lipid-lowering medication were associated with an increased risk of developing T2D. Specifically, individuals aged 55 to 98 years, those categorized as obese, and those on statin therapy had a significantly higher risk, with odds ratios as high as 74.42 (95% CI 47.04–117.73) compared to the lowest risk group. Conversely, non-obese individuals receiving statins demonstrated a lower risk compared to their obese counterparts but still had a significantly elevated risk (OR 24.42 [15.57–38.31]) relative to the baseline group.
These results indicate that heterozygous FH does not provide a protective effect against T2D, with obesity being the strongest risk factor. Researchers highlighted the potential benefits of incorporating lifestyle interventions alongside lipid-lowering therapies to manage diabetes risk, considering the established role of statins in reducing cardiovascular disease.
Full disclosures can be found in the published study.