Factors Associated With Residual Hyperlipidemia Among Statin-Treated Adults With Diabetes and Atherosclerotic Cardiovascular Disease: A Cross-Sectional Analysis of National Health and Nutrition Examination Survey 2005 to 2018.

BACKGROUND

Residual hyperlipidemia remains a concern among statin-treated individuals with diabetes and atherosclerotic cardiovascular disease, despite established lipid-lowering strategies. Persistent elevation of atherogenic lipoproteins contributes to continued cardiovascular risk in this population.

OBJECTIVE

This study aimed to identify the demographic and clinical factors associated with residual hyperlipidemia among statin-treated adults with diabetes and atherosclerotic cardiovascular disease in the United States.

METHODS

This cross-sectional study used data from the National Health and Nutrition Examination Survey 2005 to 2018. The study included adults aged 18 years and older with diabetes, atherosclerotic cardiovascular disease, and statin use. Residual hyperlipidemia was defined using non-high-density lipoprotein cholesterol greater than or equal to 100 mg/dL as a proxy for low-density lipoprotein cholesterol targets. Survey-weighted descriptive analyses and multivariable logistic regression were performed to assess associations.

RESULTS

A total of 464 participants were included, representing a weighted population of 2,179,930. Residual hyperlipidemia was common in this group. Higher body mass index was associated with increased odds of residual hyperlipidemia (aOR=1.06; 95% CI: 1.02-1.10; p=0.006), while increasing age was associated with lower odds (aOR=0.94; 95% CI: 0.91-0.97; p=0.001). Other demographic and clinical variables were not significantly associated.

CONCLUSION

Residual hyperlipidemia remains prevalent among high-risk individuals despite statin therapy. These findings support the need for broader lipid assessment and targeted strategies to address persistent lipid abnormalities.