Relationship Between Time‐Varying Achieved High‐Density Lipoprotein Cholesterol and Risk of Coronary Events Depends on Haptoglobin Phenotype Within the ACCORD Lipid Study
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Background The Hp (haptoglobin)2‐2 phenotype (~40% of people) is associated with dysfunctional high‐density lipoprotein (HDL) that is heavily oxidized in hyperglycemia, which may explain why raising HDL‐cholesterol (HDL‐C) does not reliably prevent coronary artery disease (CAD) in diabetes. Methods and Results In this observational study using longitudinal data from the ACCORD (Action to Control Cardiovascular Risk in Diabetes) lipid trial, time‐varying (achieved) HDL‐C updated at 4, 8, and 12 months, and annually thereafter over a mean of 4.7 years, was analyzed in relation to risk of CAD and secondary outcomes using Cox proportional hazards regression with time‐varying covariables among participants with (n=1781) and without (n=3191) the Hp2‐2 phenotype. HDL‐C did not differ between the phenotypes throughout the study. Having low HDL‐C (<40 mg/dL for male participants and <50 mg/dL for female participants) was associated with a greater risk of CAD compared with non‐low HDL‐C among participants with the non‐Hp2‐2 phenotype (hazard ratio [HR], 1.48 [95% CI, 1.18–1.87]) but not among the Hp2‐2 phenotype (HR, 0.97 [95% CI, 0.70–1.35]; P interaction=0.03). Similarly, an inverse relationship was observed between HDL‐C quintiles and CAD risk among participants without the Hp2‐2 phenotype, whereas no significant inverse relationship was observed among participants with the Hp2‐2 phenotype ( P interaction=0.38). Among the Hp2‐2 phenotype group, having low HDL‐C was associated with higher risk of CVD mortality (HR, 2.09 [95% CI, 1.05–4.13]), and compared with the lowest HDL‐C quintile, higher quintiles were associated with lower risk of CVD mortality and congestive heart failure. Conclusions Hp phenotype modified the association between HDL‐C and risk of CAD in the ACCORD lipid study, suggesting that HDL dysfunction in the Hp2‐2 phenotype may hinder CAD‐protective properties of HDL‐C.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it