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Original article
Lipid profile and persistent lipid abnormalities in diabetic patients – a retrospective study
Perfil lipídico e persistência de anomalias lipídicas em doentes diabéticos – um estudo retrospetivo
Ana Margarida Monteiroa,
Corresponding author
, Isabel Palmab
a Department of Endocrinology, Hospital de Braga, Braga, Portugal
b Department of Endocrinology, Centro Hospitalar do Porto, Porto, Portugal
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Cardiovascular disease &#40;CVD&#41; is the leading cause of death among adult diabetic patients&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> Although the multifactorial etiology of atherosclerotic vascular disease&#44; dyslipidemia is a common and an important predictor of cardiovascular risk&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a> Dyslipidemia is usually present at diagnosis of type 2 diabetes and persists regardless of the treatment of hyperglycemia&#46; The main therapy goal in the management of dyslipidemia is to decrease the levels of LDL-cholesterol &#40;LDL-C&#41; and other apolipoprotein-B-containing lipoproteins&#44; which is primarily achieved with dietary modifications and statins&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Data from randomized controlled trials of statin therapy show highly significant reductions in the incidence of major CVD events in diabetic patients&#44; with or without established CVD&#46; Moreover&#44; the reductions in major CVD events are proportional to the reduction in LDL cholesterol&#46; Despite the widespread evidence of the benefits of lipid-lowering treatment&#44; particularly with statins&#44; for reducing cardiovascular disease and mortality in diabetic patients&#44; a considerable proportion of diabetic patients do not achieve the therapeutic goals in LDL cholesterol&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of this study is to characterize lipid profile of diabetic patients&#44; according the presence or absence of previous cardiovascular event and the evaluation of the suitability of the treatment with statins according to the cardiovascular profile&#46; Additionally&#44; our purpose is to determine in the statin-treated patients&#44; the prevalence of persistent lipid abnormalities&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Data sources and subjects</span><p id="par0020" class="elsevierStylePara elsevierViewall">This article describes an observational&#44; analytical and retrospective study of outpatient diabetic patients followed at Educational Therapy of Diabetes Consultation &#40;CTED&#41; in <span class="elsevierStyleItalic">Centro Hospitalar do Porto</span> &#40;CHP&#41;&#44; between June 2014 and June 2015&#46; CTED is a multidisplinary consultation composed of endocrinologists&#44; nurses&#44; nutritionists&#44; psychologists and podiatrists&#46; The main purpose of this consult is diabetes self-management education and support&#46; The patients are referenced to this consult by family physician or by another specialty consultation in HSA&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Outpatients eligible for inclusion were age &#8805;18 years old&#46; Patients were excluded if they were type 1 diabetic and if was impossible to obtain the file of the patient&#46; The source of information was electronic or paper file&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Data collection</span><p id="par0030" class="elsevierStylePara elsevierViewall">Data were collected from medical records and clinical examination at the time of the consults&#46; Demographics &#40;age and gender&#41; and anthropometric variables &#91;weight&#44; height and body mass index &#40;BMI&#41;&#93; were recorded at first visit&#44; as well as glycosylated hemoglobin &#40;DCA2000 method&#41;&#46; Lipid profile &#91;total cholesterol &#40;TC&#41;&#44; triglycerides &#40;TG&#41;&#44; LDL-C&#44; HDL-cholesterol &#40;HDL-C&#41; and apolipoprotein B &#40;apoB&#41;&#93; were obtained on the second visit&#46; The measurements were made in the same laboratory&#44; by standard hospital assays &#8211; CT&#44; HDL-C and TG through enzymatic methods &#40;Roche&#174;&#41; in freshly drawn lithium-heparin plasma samples&#46; The value of LDL-C was calculated using the Friedewald equation &#40;LDL-C<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>TC-HDL-C-&#91;TG&#47;5&#93;&#41;&#44; if TG levels &#60;400<span class="elsevierStyleHsp" style=""></span>mg&#47;dl and measured directly at higher levels&#46; Non-HDL cholesterol &#40;non HDL-C&#41; was also calculated &#40;TC-HDL-C&#41;&#46; Apolipoproteins were measured through immunoturbidimetric assays&#46; Because of its influence on lipid profile&#44; we excluded thyroid dysfunction in all patients through TSH measurement by electrochemiluminescence&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The presence of cardiovascular risk factors &#40;smoking&#44; hypertension&#44; dyslipidemia and physical inactivity&#41;&#44; of diabetic kidney disease and history of cardiovascular disease &#40;ischemic heart disease&#44; cerebrovascular disease and peripheral artery disease&#41; were registered&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Definition of dyslipidemia</span><p id="par0040" class="elsevierStylePara elsevierViewall">To determine the persistence of lipid abnormalities&#44; in terms of dyslipidemia treatment and goals of lipid levels&#44; it was applied the American Diabetes Association &#40;ADA&#41; recommendations of 2014&#46; Accordingly&#44; patients without overt CVD the goal of LDL-C is less than 100<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; and in individuals with overt CVD the goal of LDL-C is less than 70<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; Although the LDL-target statin therapy is the preferred strategy&#44; additional targets are triglyceride levels less than 150<span class="elsevierStyleHsp" style=""></span>mg&#47;dl and HDL-C superior to 40 or 50<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; in men and women&#44; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The lipid levels goals correspond to a range of values defined by an upper limit without a lower limit&#46; Although the term target is commonly used interchangeably&#44; achieving targets could result in the undertreatment of many patients who could benefit from having LDL-C&#44; triglyceride values below the target values or HDL-C above the target value&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">To analyze the suitability of the dose of statins were used the recommendations of the ADA in 2015&#46; Therefore&#44; diabetic patients were divided in groups considering the age and the presence or absence of overt CVD &#91;previous cardiovascular events or acute coronary syndromes&#93; and cardiovascular &#40;CV&#41; risk factors &#91;LDL<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; high blood pressure&#44; smoking&#44; overweight or obesity&#93;&#46; Patients of all ages with diabetes and overt CVD should be medicated with an high-dose statin&#46; Patients with diabetes under 40 years of age and with additional CVD risk factors&#44; it should be considered using moderate or high-dose statin&#46; For patients with diabetes aged 40&#8211;75 years without additional CVD risk factors&#44; it should be considered using moderate-dose statin&#46; For patients with diabetes aged 40&#8211;75 years with additional CVD risk factors&#44; it should be considered using high-dose statin&#46; For diabetics over 75 years old without additional CVD risk factors&#44; it should be considered using moderate-dose statin therapy&#46; And for patients over 75 years with additional CVD risk factors&#44; it should be considered using moderate or high-dose statin therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The statins were classified in high-intensity and moderate-intensity according to the potency for lowering LDL-C&#46; High-intensity statins lowers LDL-C by 50&#37; &#40;atorvastatin 40<span class="elsevierStyleHsp" style=""></span>mg&#44; atorvastatin 80<span class="elsevierStyleHsp" style=""></span>mg&#44; rosuvastatin 20<span class="elsevierStyleHsp" style=""></span>mg and rosuvastatin 40<span class="elsevierStyleHsp" style=""></span>mg&#41;&#46; Moderate-intensity statins lowers LDL-C 30&#8211;50&#37; &#40;atorvastatin 10<span class="elsevierStyleHsp" style=""></span>mg&#44; atorvastatin 20<span class="elsevierStyleHsp" style=""></span>mg&#44; rosuvastatin 5<span class="elsevierStyleHsp" style=""></span>mg&#44; rosuvastatin 10<span class="elsevierStyleHsp" style=""></span>mg&#44; simvastatin 20<span class="elsevierStyleHsp" style=""></span>mg&#44; simvastatin 40<span class="elsevierStyleHsp" style=""></span>mg&#44; pravastatin 40<span class="elsevierStyleHsp" style=""></span>mg&#44; pravastatin 80<span class="elsevierStyleHsp" style=""></span>mg&#44; lovastatin 40<span class="elsevierStyleHsp" style=""></span>mg&#44; fluvastatin XL 80<span class="elsevierStyleHsp" style=""></span>mg&#44; fluvastatin 40<span class="elsevierStyleHsp" style=""></span>mg bid&#44; pitavastatin 2<span class="elsevierStyleHsp" style=""></span>mg&#44; pitavastatin 4<span class="elsevierStyleHsp" style=""></span>mg&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0060" class="elsevierStylePara elsevierViewall">Continuous variables are expressed as the mean and standard deviation &#40;SD&#41; or median and interquartile range &#40;IQR&#41; &#40;25th&#8211;75th percentile&#41;&#44; according to the distribution of variables&#46; Age was the only continuous variable with a normal distribution and was expressed as mean and SD&#46; The others continuous variables had a non-normal distribution and were expressed as median and IQR&#46; Categorical variables are expressed as frequencies&#44; percentages and confidence interval of 95&#37; &#40;95&#37; CI&#41;&#46; Group comparisons were made using the Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test or the Wilcoxon rank-sum test for continuous variables and the chi-square &#40;<span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span>&#41; test for categorical variables&#46; Statistical significance was defined at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; Statistical analysis was performed using SPSS&#8482; software version 20&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">The study included 199 diabetic patients with a mean age of 59&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;6 years and with a preponderance &#40;56&#46;8&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>113&#41; of males&#46; In this population&#44; type 2 diabetes was the predominant type of diabetes &#40;94&#46;0&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>187&#41; and the median HbA1c were 8&#46;0&#37; IQR 2&#46;2&#46; The majority of these patients was overweight &#40;BMI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>25&#41; &#40;77&#46;0&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>131&#41; and had a sedentary lifestyle &#40;69&#46;4&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>136&#41;&#46; Also&#44; we found a high prevalence of dyslipidemia &#40;77&#46;7&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>153&#41; and hypertension &#40;70&#46;2&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>139&#41;&#46; More than a third &#40;33&#46;3&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>66&#41; had a previous cardiovascular event and 58&#46;6&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>109&#41; were treated with statins &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The study population was divided in two groups according to the presence or absence of previous cardiovascular event&#44; as shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; There were no differences between the groups in terms of age&#44; sex&#44; metabolic control &#40;HbA1c&#41; and prevalence of obesity&#46; The group of patients with previous cardiovascular events had higher prevalence of dyslipidemia &#40;87&#46;7 vs 72&#46;7&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#44; hypertension &#40;87&#46;9 vs 61&#46;4&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41; and was more frequently statin-treated &#40;87&#46;5 vs 43&#46;4&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The group of patients without overt CVD had higher TC &#40;178&#46;0 vs 157&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41;&#44; HDL-C &#40;51&#46;0 vs 43&#46;0<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41;&#44; LDL-C &#40;97&#46;0 vs 79&#46;0<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41; and non-HDL &#40;127&#46;0 vs 112&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41; and higher prevalence of patients who achieved HDL-C goals &#40;64&#46;3 vs 33&#46;3&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#44; as demonstrated in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; There were no statistical differences on the median of the triglycerides and of the apo-B&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">A strong and positive correlation between apo-B and non-HDL-C was verified &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;87&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The group of patients without overt CVD had significantly higher prevalence of patients that met the HDL-C goals &#40;64&#46;3 vs 33&#46;3&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46; Although&#44; we found no statistical difference on prevalence of patients that met the LDL-C and TG goals&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The study of suitability of the dose of the statin has shown that there were no differences between the groups &#40;14&#46;1 vs 6&#46;6&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;095&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">To evaluate the persistence of lipid abnormalities&#44; the patients were divided in statin-treated and non-statin treated&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">In statin-treated patients&#44; 13&#46;9&#37; were treated with statins with adequate potency to their cardiovascular profile&#46; There were no differences between the patients with and without overt CVD in the adequacy of statin treatment &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; Less than half &#40;46&#46;8&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>44&#41; failed to achieve the LDL-C goal&#46; Half &#40;51&#46;1&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>48&#41; and 35&#46;1&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#41; of these patients failed to achieve HDL-C and TG goals&#44; respectively&#46; Only 11&#46;7&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#41; of these patients achieved all three goals&#46; In this group of patients&#44; we found a statistically significant difference between those with and without cardiovascular disease in HDL-C median level &#40;43&#46;0 vs 50&#46;5&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41; and in the prevalence of patients reaching the target of HDL-C &#40;68&#46;1 vs 35&#46;4&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; There were no differences in the prevalence of patients who achieved LDL-C and triglyceride goals &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0105" class="elsevierStylePara elsevierViewall">As other similar published studies our study population included diabetic patients with a mean age in the sixties and with a high prevalence of overweight&#44; sedentary lifestyle&#44; dyslipidemia and hypertension&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">9&#44;10</span></a> Also&#44; we found an elevated prevalence of non-statin treated patients &#40;56&#46;8&#37;&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The group of patients without overt CVD was more frequently non-statin treated and had higher TC&#44; LDL-C&#44; HDL-C and non-HDL&#46; Also&#44; there was a trend for statistical significance to higher apo-B levels&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">In the Dyslipidemia International Study &#40;DYSIS&#41; the diabetics without a previous CVD also had higher LDL-C and HDL-C&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> Those facts may reflect better lipid-focused treatment in patients with a previous event of CVD&#46; The group of patients without previous CVD had significantly higher prevalence of patients that achieved the HDL-C goals&#44; and this is concordant with the findings of DYSIS&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> A higher level HDL-C in patients without overt CVD can be the reflection of their cardioprotective effect&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">In our study&#44; half of the statin-treated diabetic patients &#40;53&#46;2&#37;&#41; achieved LDL-C goals&#46; This finding is similar to the analysis of Leiter et al&#46; and Feher et al&#46;&#44; however are in contrast with the analysis of Silva et al&#46; of Portuguese subpopulation of the DYSIS &#40;77&#46;1&#37;&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">9&#8211;11</span></a> We verified that over one third &#40;35&#46;8&#37;&#41; did not achieved TG goals&#44; half &#40;51&#46;6&#37;&#41; did not achieved HDL-C goals and only a minority &#40;11&#46;7&#37;&#41; of patients achieved all three goals&#46; In the Portuguese subpopulation analysis of DYSIS the percentage of patients that not met the TG goals are similar &#40;41&#46;4&#37;&#41; but diverge on the percentage of patients that failed the HDL-C goal &#40;27&#46;7&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> In DYSIS&#44; a quarter &#40;25&#46;9&#37;&#41; of the diabetic patients and almost 20&#37; &#40;19&#46;9&#37;&#41; did not achieve TG and HDL-C goals&#44; respectively&#44; and 39&#37; of the patients achieve all goals&#46; <a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> Feher et al&#46; demonstrated that approximately half of the patients who received statin monotherapy attained the treatment goals for HDL-C and TG&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">When analyzing the suitability of the dose of the statin we verified that there were no differences between the groups&#44; although with a tendency to significance for the group with overt CVD&#46; This can be the expression&#44; again&#44; of a higher attention to lipid treatment in patients with a previous event of CVD&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The vast majority of patients were treated with a dose of statin non-adequate to their cardiovascular profile&#46; This observation must be analyzed very carefully because the study included patients observed from June 2014 to June 2015&#46; As this recommendations were published in November 2013 by the ACC&#47;AHH and adopted by ADA in January 2015&#44; we cannot make firm conclusions about the suitability of statins dose&#44; and this is a considerable limitation of the study&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Limitations</span><p id="par0135" class="elsevierStylePara elsevierViewall">This study reflects a small sample of patients evaluated in the CTED&#44; analyzed retrospectively and we did not evaluate long-term outcomes&#46; In addition&#44; we lack data of adherence to treatment regime or contraindications to statin therapy&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclusion</span><p id="par0140" class="elsevierStylePara elsevierViewall">Several clinical studies have demonstrated evidence supporting the beneficial effects of statins therapy in patients for both primary and secondary prevention of CVD events and death&#46; Also&#44; recommendations of treatment and management of dyslipidemia are wide spread to guide medical decision&#46; Despite those facts&#44; evidence has shown&#44; in concordance to our results&#44; a suboptimal use of lipid-modifying therapies and a substantial percentage of diabetic patients that do not achieve the therapeutic goals&#46; We emphasize that is necessary an effort to optimize the lipid profile of diabetic patients and&#44; consequently&#44; decrease the prevalence of CVD events in this population&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Ethical disclosures</span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Protection of human and animal subjects</span><p id="par0145" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Confidentiality of data</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Right to privacy and informed consent</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflicts of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The purposes of this study are the characterization the lipid profile and the suitability of the statins treatment according to the cardiovascular profile&#46; Also&#44; in statin-treated patients&#44; we aim to determine the prevalence of persistent lipid abnormalities&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Observational and retrospective study of outpatient diabetic patients of a hospital consultation&#44; between Jun&#47;2014 and Jun&#47;2015&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Of the 199 diabetic patients included&#44; 58&#46;6&#37; were treated with statins and only 13&#46;9&#37; were treated with statin dose adequate for its cardiovascular profile&#46; The patients without overt cardiovascular disease had higher total cholesterol &#40;178&#46;0 vs 157&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41;&#44; HDL-C &#40;51&#46;0 vs 43&#46;0<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41;&#44; LDL-C &#40;97&#46;0 vs 79&#46;0<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41; and non-HDL-C &#40;127&#46;0 vs 112&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41; and higher prevalence of patients who achieved HDL-C goals &#40;64&#46;3 vs 33&#46;3&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46; Almost half of statin-treated patients &#40;46&#46;8&#37;&#41; failed to achieve the LDL-C goals&#44; 35&#46;8&#37; and 51&#46;6&#37; failed the triglycerides and HDL-C goals&#44; respectively&#46; Only 11&#46;7&#37; achieved all three goals&#46; In statin-treated patients&#44; we found a statistically significant difference between patients with and without cardiovascular disease on the prevalence of patients reaching the target HDL-C &#40;68&#46;1 vs 35&#46;4&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; There were no differences in the prevalence of patients who achieved LDL-C and triglyceride goals&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion&#47;conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">There is a suboptimal utilization of statins and a substantial percentage of diabetic patients that do not achieve the therapeutic goals&#46; We emphasize the need for an effort to optimize the lipid profile of diabetics in order to contribute to reducing the prevalence of cardiovascular diseases in this population&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introdu&#231;&#227;o</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Os objetivos s&#227;o a caracteriza&#231;&#227;o do perfil lip&#237;dico e a avalia&#231;&#227;o do tratamento com estatinas de acordo com o perfil cardiovascular&#46; Adicionalmente&#44; pretendemos determinar preval&#234;ncias de anomalias lip&#237;dicas persistentes nos doentes tratados com estatinas&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiais e m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudo observacional e retrospetivo de diab&#233;ticos acompanhados numa consulta hospitalar entre 06&#47;2014 e 06&#47;2015&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Dos 199 doentes&#44; 58&#44;6&#37; estavam tratados com estatinas e 13&#44;9&#37; estavam tratados com doses de estatinas adequadas para o perfil cardiovascular&#46; Os doentes sem doen&#231;a cardiovascular &#40;DCV&#41; tinham n&#237;veis mais elevados de colesterol total &#40;178&#44;0 vs&#46; 157&#44;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#44; HDL-C &#40;51&#44;0 vs&#46; 43&#44;0<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41;&#44; LDL-C &#40;97&#44;0 vs&#46; 79&#44;0<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; e n&#227;o-HDL-C &#40;127&#44;0 vs&#46; 112&#44;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41; e uma maior preval&#234;ncia de doentes que alcan&#231;aram metas de HDL-C &#40;64&#44;3 vs&#46; 33&#44;3&#37;&#59; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46; Quase metade dos doentes tratados com estatinas &#40;46&#44;8&#37;&#41; n&#227;o atingiram o valor alvo de LDL-C&#44; 35&#44;8 e 51&#44;6&#37; falharam as metas de HDL-C e de triglicer&#237;deos&#44; respetivamente&#46; Apenas 11&#44;7&#37; atingiram todos os 3 objetivos&#46; Nos doentes tratados com estatinas&#44; encontramos diferen&#231;a estatisticamente significativa entre os doentes com e sem DCV&#44; sobre a preval&#234;ncia de atingimento do alvo HDL-C &#40;68&#44;1 vs&#46; 35&#44;4&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; N&#227;o houve diferen&#231;as na preval&#234;ncia de doentes que atingiram os objetivos de LDL-C e triglicer&#237;deos&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discuss&#227;o e conclus&#227;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Verifica-se uma utiliza&#231;&#227;o sub&#243;tima das estatinas e uma percentagem substancial de diab&#233;ticos que n&#227;o alcan&#231;am os objetivos terap&#234;uticos&#46; Salienta-se a necessidade de um esfor&#231;o para otimizar o perfil lip&#237;dico dos diab&#233;ticos de forma a contribuir para a diminui&#231;&#227;o da preval&#234;ncia de DCV nesta popula&#231;&#227;o&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introdu&#231;&#227;o"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Materiais e m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Discuss&#227;o e conclus&#227;o"
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        ]
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        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">BMI&#58; body mass index&#59; CAD&#58; coronary artery disease&#59; PAD&#58; peripheral artery disease&#59; T2DM&#58; type 2 diabetes mellitus&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Results&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age &#40;years&#41;&#44; mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Male&#44; &#37;&#44; &#40;95&#37; CI&#41;&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#46;8 &#40;47&#46;8&#8211;63&#46;1&#41; &#40;113&#47;199&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T2DM&#44; &#37;&#44; &#40;95&#37; CI&#41;&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">94&#46;0 &#40;89&#46;8&#8211;96&#46;8&#41; &#40;187&#47;199&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HbA1c &#40;&#37;&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;0&#59; 2&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Current smoker&#44; &#37;&#44; &#40;95&#37; CI&#41;&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46;7 &#40;3&#46;8&#8211;12&#46;7&#41; &#40;19&#47;196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sedentary lifestyle&#44; &#37;&#44; &#40;95&#37; CI&#41;&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69&#46;4 &#40;61&#46;1&#8211;75&#46;8&#41; &#40;136&#47;196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#46;7&#59; 6&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Overweight &#40;BMI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>25 and &#60;30&#41;&#44; &#37;&#44; &#40;95&#37; CI&#41;&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#46;2 &#40;30&#46;6&#8211;45&#46;9&#41; &#40;65&#47;170&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Obesity &#40;BMI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>30&#41;&#44; &#37;&#44; &#40;95&#37; CI&#41;&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#46;8 32&#46;5&#8211;47&#46;8&#41; &#40;66&#47;170&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dyslipidemia&#44; &#37;&#44; &#40;95&#37; CI&#41;&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&#46;7 &#40;75&#46;8&#8211;87&#46;9&#41; &#40;153&#47;197&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hypertension&#44; &#37;&#44; &#40;95&#37; CI&#41;&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#46;2 &#40;66&#46;2&#8211;80&#46;9&#41; &#40;139&#47;198&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CAD&#44; cerebrovascular disease and&#47;or PAD&#44; &#37;&#44; &#40;95&#37; CI&#41;&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#46;3 &#40;28&#46;0&#8211;42&#46;7&#41; &#40;66&#47;198&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Statin-treated&#44; &#37;&#44; &#40;95&#37; CI&#41;&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58&#46;6 &#40;54&#46;8&#8211;69&#46;4&#41; &#40;109&#47;186&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The characteristics of study population &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>199&#41;&#46;</p>"
        ]
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      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
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            "identificador" => "at2"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">BMI&#58; body mass index&#59; CAD&#58; coronary artery disease&#59; CVD&#58; cardiovascular disease&#59; PAD&#58; peripheral artery disease&#59; T2DM&#58; type 2 diabetes mellitus&#46;</p>"
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Overt CVD &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non-CVD &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>132&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">All &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>199&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> Value<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age &#40;years&#41;&#44; mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Male&#44; &#37;&#44; &#40;95&#37; CI&#41; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#46;5 &#40;37&#46;8&#8211;68&#46;2&#41; &#40;36&#47;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58&#46;3 &#40;44&#46;4&#8211;63&#46;9&#41; &#40;77&#47;132&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#46;8 &#40;47&#46;8&#8211;63&#46;1&#41; &#40;113&#47;199&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T2DM&#44; &#37;&#44; &#40;95&#37; CI&#41; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">98&#46;5 &#40;92&#46;5&#8211;100&#46;0&#41; &#40;65&#47;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91&#46;7 &#40;85&#46;9&#8211;96&#46;1&#41; &#40;121&#47;132&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">94&#46;0 &#40;89&#46;8&#8211;96&#46;8&#41; &#40;187&#47;199&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HbA1c &#40;&#37;&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;1&#59; 2&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;0&#59; 2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;0&#59; 2&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Current smoker&#44; &#37;&#44; &#40;95&#37; CI&#41; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;6 &#40;2&#46;5&#8211;21&#46;7&#41; &#40;7&#47;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46;2 &#40;2&#46;0&#8211;12&#46;1&#41; &#40;12&#47;130&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46;7 &#40;3&#46;8&#8211;12&#46;7&#41; &#40;19&#47;196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sedentary lifestyle&#44; &#37;&#44; &#40;95&#37; CI&#41; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&#46;2 &#40;69&#46;8&#8211;93&#46;0&#41; &#40;49&#47;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#46;9 &#40;57&#46;6&#8211;75&#46;3&#41; &#40;87&#47;130&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69&#46;4 &#40;61&#46;1&#8211;75&#46;8&#41; &#40;136&#47;196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#46;9&#59; 6&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#46;6&#59; 6&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#46;7&#59; 6&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Overweight &#40;BMI &#8805;25 and &#60;30&#41;&#44; &#37;&#44; &#40;95&#37; CI&#41; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#46;6 &#40;29&#46;7&#8211;57&#46;9&#41; &#40;27&#47;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#46;3 &#40;24&#46;2&#8211;43&#46;0&#41; &#40;37&#47;111&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#46;2 &#40;30&#46;6&#8211;45&#46;9&#41; &#40;65&#47;170&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Obesity &#40;BMI &#8805; 30&#41;&#44; &#37;&#44; &#40;95&#37; CI&#41; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&#46;4 &#40;32&#46;6&#8211;61&#46;4&#41; &#40;24&#47;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&#46;8 &#40;28&#46;6&#8211;47&#46;4&#41; &#40;42&#47;111&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#46;8 &#40;32&#46;5&#8211;47&#46;8&#41; &#40;66&#47;170&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dyslipidemia&#44; &#37;&#44; &#40;95&#37; CI&#41; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87&#46;7 &#40;81&#46;8&#8211;98&#46;0&#41; &#40;57&#47;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#46;7 &#40;68&#46;6&#8211;85&#46;0&#41; &#40;96&#47;132&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&#46;7 &#40;75&#46;8&#8211;87&#46;9&#41; &#40;153&#47;197&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hypertension&#44; &#37;&#44; &#40;95&#37; CI&#41; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87&#46;9 &#40;81&#46;8&#8211;98&#46;0&#41; &#40;58&#47;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&#46;4 &#40;56&#46;6&#8211;75&#46;2&#41; &#40;81&#47;132&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#46;2 &#40;66&#46;2&#8211;80&#46;9&#41; &#40;139&#47;198&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Statin-treated&#44; &#37;&#44; &#40;95&#37; CI&#41; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87&#46;5 &#40;85&#46;4&#8211;100&#46;0&#41; &#40;56&#47;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43&#46;4 &#40;36&#46;3&#8211;55&#46;8&#41; &#40;53&#47;122&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58&#46;6 &#40;54&#46;8&#8211;69&#46;4&#41; &#40;109&#47;186&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "identificador" => "tblfn0005"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Statistical significance&#58; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46;</p>"
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the groups&#58; with and without overt CVD&#46;</p>"
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        "etiqueta" => "Table 3"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">CVD&#58; cardiovascular disease&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Lipid profile&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Overt CVD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non-CVD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">All&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> Value<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total cholesterol &#40;mg&#47;dl&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">157&#46;5&#59; 51&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">178&#46;0&#59; 58&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">172&#46;5&#59; 58&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Triglycerides &#40;mg&#47;dl&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">129&#46;5&#59; 99&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">113&#46;0&#59; 82&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">117&#46;0&#59; 85&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HDL-C &#40;mg&#47;dl&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43&#46;0&#59; 14&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&#46;0&#59; 24&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#46;0&#59; 23&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LDL-C &#40;mg&#47;dl&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&#46;0&#59; 45&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&#46;0&#59; 50&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">89&#46;0&#59; 49&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Apo-B &#40;mg&#47;dl&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&#46;0&#59; 39&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">92&#46;0&#58; 33&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90&#46;0&#59; 33&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Non-HDL-C &#40;mg&#47;dl&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">112&#46;5&#59; 45&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">127&#46;0&#59; 53&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">117&#46;0&#59; 52&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patients at LDL-C goal&#44;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a> &#37;&#44; 95&#37; CI&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39&#46;6 &#40;24&#46;0&#8211;51&#46;2&#41; &#40;21&#47;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52&#46;2 &#40;39&#46;6&#8211;61&#46;2&#41; &#40;60&#47;115&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&#46;2 &#40;81&#47;168&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patients at TG goal&#44;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a> &#37;&#44; 95&#37; CI&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&#46;0 &#40;47&#46;9&#8211;76&#46;5&#41; &#40;34&#47;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#46;4 &#40;61&#46;1&#8211;80&#46;4&#41; &#40;81&#47;115&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#46;6 &#40;115&#47;170&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patients at HDL-C goal&#44;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">c</span></a> &#37;&#44; 95&#37; CI&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#46;3 &#40;18&#46;4&#8211;44&#46;9&#41; &#40;18&#47;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&#46;3 &#40;56&#46;5&#8211;76&#46;0&#41; &#40;74&#47;115&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#46;1 &#40;92&#47;170&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patients achieving all goals<br>&#40;LDL-C&#44; HDL-C and TG&#41;&#44; &#37;&#44; 95&#37; CI&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;7 &#40;0&#46;0&#8211;11&#46;4&#41; &#40;3&#47;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46;6 &#40;3&#46;2&#8211;14&#46;9&#41; &#40;11&#47;115&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;3 &#40;14&#47;168&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patients with adequate statin-treatment&#44; &#37;&#44; 95&#37; CI&#44; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#46;1 &#40;4&#46;5&#8211;23&#46;9&#41; &#40;9&#47;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;6 &#40;2&#46;1 &#8211; 12&#46;0&#41; &#40;8&#47;121&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46;1 &#40;17&#47;186&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;095&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "identificador" => "tblfn0010"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">LDL-C goal&#58; &#60;70<span class="elsevierStyleHsp" style=""></span>mg&#47;dl and &#60;100<span class="elsevierStyleHsp" style=""></span>mg&#47;dl in patients with and without overt CVD&#44; respectively&#46;</p>"
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              "identificador" => "tblfn0015"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">TG goal&#58; &#60;150<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46;</p>"
            ]
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              "identificador" => "tblfn0020"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">HDL-C goal&#58; &#62; 40 or 50<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; in men and women&#44; respectively&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Statistical significance&#58; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46;</p>"
            ]
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          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Lipid profile in diabetics with and without overt CVD&#46;</p>"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">CVD&#58; cardiovascular disease&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Lipid profile&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Statin-treated</th><th class="td" title="table-head  " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">p</span> Value<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Overt CVD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non-CVD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">All &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>109&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Adequate statin&#44; &#37; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#46;1 &#40;6&#46;5&#8211;26&#46;0&#41; &#40;9&#47;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46;5 &#40;3&#46;9&#8211;20&#46;8&#41; &#40;6&#47;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;9 &#40;5&#46;4&#8211;13&#46;4&#41; &#40;15&#47;108&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total cholesterol &#40;mg&#47;dl&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">156&#46;0&#59; 58&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">172&#46;0&#59; 53&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">162&#46;0&#59; 48&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Triglycerides &#40;mg&#47;dl&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">134&#46;0&#59; 96&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">126&#46;5&#59; 74&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">130&#46;0&#59; 84&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HDL-C &#40;mg&#47;dl&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43&#46;0&#59; 14&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#46;5&#59; 18&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45&#46;0&#59; 19&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LDL-C &#40;mg&#47;dl&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&#46;5&#59; 46&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&#46;5&#59; 45&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83&#46;0&#59; 48&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Apo-B &#40;mg&#47;dl&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&#46;0&#59; 39&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90&#46;0&#59; 25&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#46;0&#59; 30&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Non-HDL &#40;mg&#47;dl&#41;&#44; median&#59; IQR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">113&#46;0&#59; 50&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">115&#46;0&#59; 46&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">113&#46;0&#59; 48&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patients not at LDL-C goal&#44;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">a</span></a> &#37; &#40;95&#37; CI&#41; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#46;5 &#40;35&#46;7&#8211;67&#46;5&#41; &#40;26&#47;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&#46;5 &#40;24&#46;3 &#8211; 52&#46;4&#41; &#40;18&#47;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#46;8 &#40;33&#46;7&#8211;55&#46;4&#41; &#40;44&#47;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patients not at TG goal&#44;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">b</span></a> &#37; &#40;95&#37; CI&#41; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#46;3 &#40;24&#46;1&#8211;55&#46;6&#41; &#40;18&#47;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#46;3 &#40;20&#46;9&#8211;48&#46;4&#41; &#40;16&#47;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#46;8 &#40;26&#46;0&#8211;46&#46;9&#41; &#40;34&#47;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patients not at HDL-C goal<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a> &#37; &#40;95&#37; CI&#41; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#46;1 &#40;50&#46;0&#8211;79&#46;1&#41; &#40;32&#47;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#46;4 &#40;22&#46;0&#8211;50&#46;0&#41; &#40;17&#47;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&#46;6 &#40;39&#46;3&#8211;60&#46;9&#41; &#40;49&#47;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patients achieving all goals &#40;LDL-C&#44; HDL-C and TG&#41;&#44; &#37; &#40;n&#47;N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;5 &#40;0&#46;0&#8211;16&#46;7&#41; &#40;3&#47;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#46;7 &#40;6&#46;8&#8211;28&#46;0&#41; &#40;8&#47;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46;7 &#40;5&#46;7&#8211;19&#46;8&#41; &#40;11&#47;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "identificador" => "tblfn0030"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">LDL-C goal&#58; &#60;70<span class="elsevierStyleHsp" style=""></span>mg&#47;dl and &#60;100<span class="elsevierStyleHsp" style=""></span>mg&#47;dl in patients with and without overt CVD&#44; respectively&#46;</p>"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0040">HDL-C goal&#58; &#62; 40 or 50<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; in men and women&#44; respectively&#46;</p>"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0045">Statistical significance&#58; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46;</p>"
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Persistence of lipid abnormalities&#46;</p>"
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      "titulo" => "References"
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                  "contribucion" => array:1 [
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                        0 => array:2 [
                          "etal" => true
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                            0 => "S&#46;R&#46; Preis"
                            1 => "M&#46;J&#46; Pencina"
                            2 => "S&#46;J&#46; Hwang"
                            3 => "R&#46;B&#46; D&#8217;Agostino Sr&#46;"
                            4 => "P&#46;J&#46; Savage"
                            5 => "D&#46; Levy"
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                      "doi" => "10.1161/CIRCULATIONAHA.108.846519"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19581493"
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              "identificador" => "bib0065"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ESC Guidelines on diabetes&#44; pre-diabetes&#44; and cardiovascular diseases developed in collaboration with the EASD&#58; the Task Force on diabetes&#44; pre-diabetes&#44; and cardiovascular diseases of the European Society of Cardiology &#40;ESC&#41; and developed in collaboration with the European Association for the Study of Diabetes &#40;EASD&#41;"
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                            0 => "M&#46; Task Force"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/eht108"
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                        "tituloSerie" => "Eur Heart J"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lipid control in patients with diabetes mellitus"
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                        0 => array:2 [
                          "etal" => false
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/nrcardio.2011.23"
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diabetic dyslipidemia"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Wu"
                            1 => "K&#46;G&#46; Parhofer"
                            2 => "dyslipidemia&#46; Diabetic"
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                        ]
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                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
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                      "titulo" => "EUROASPIRE III&#58; a survey on the lifestyle&#44; risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries"
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                          "autores" => array:6 [
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                            1 => "D&#46; Wood"
                            2 => "G&#46; De Backer"
                            3 => "D&#46; De Bacquer"
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                        "tituloSerie" => "Eur J Cardiovasc Prevent Rehab&#58; Off J Eur Soc Cardiol&#44; Epidemiol Prevent Cardiac Rehabil Exerc Physiol"
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                        "volumen" => "16"
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                0 => array:2 [
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                      "titulo" => "Persistent lipid abnormalities in statin-treated patients and predictors of LDL-cholesterol goal achievement in clinical practice in Europe and Canada"
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                          "autores" => array:6 [
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos