Dataset Information

Low-density lipoprotein cholesterol : high-density lipoprotein cholesterol ratio is associated with incident diabetes in Chinese adults: A retrospective cohort study.

ABSTRACT:

Aims/introduction

Dyslipidemia plays a critical role in the pathogenesis of metabolic syndrome and diabetes. Evidence has increasingly shown that the ratio of low- to high-density lipoprotein cholesterol (LDL-C/HDL-C) is a novel marker for increased risk of insulin resistance and cardiovascular diseases. However, the correlation between the LDL-C/HDL-C ratio and diabetes risk is rarely reported. This is the first study to investigate the association between the LDL-C/HDL-C ratio and new-onset diabetes in a large community-based cohort.

Materials and methods

In this retrospective cohort study, a total of 116,661 adults without baseline diabetes were enrolled. Participants were stratified into four groups based on LDL-C/HDL-C ratio quartiles. The outcome of interest was new-onset diabetes.

Results

During a median follow-up period of 2.98 years, 2,681 (2.3%) new diabetes cases were recorded. The total cumulative incidence of diabetes progressively increased alongside LDL-C/HDL-C ratio quartiles (0.31, 0.43, 0.68 and 0.88%, respectively, P-value for trend <0.001). After adjusting for potential confounders, using the lowest quartile of the LDL-C/HDL-C ratio as the reference, the risk of diabetes increased with LDL-C/HDL-C ratio quartiles (P-value for trend <0.001); in particular, from the second to fourth quartile, hazard ratios were 1.18 (95% confidence interval 0.87-1.59), 1.42 (95% confidence interval 1.07-1.90) and 1.92 (95% confidence interval 1.43-2.59), respectively. The results were also robust to challenges in multiple sensitivity analyses.

Conclusions

Among the Chinese population, elevated LDL-C/HDL-C ratio might be an independent risk factor for new-onset diabetes.

SUBMITTER: Wei L

PROVIDER: S-EPMC7779276 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Low-density lipoprotein cholesterol : high-density lipoprotein cholesterol ratio is associated with incident diabetes in Chinese adults: A retrospective cohort study.

Wei Limin L Wei Meng M Chen Lei L Liang Shanshan S Gao Fanfan F Cheng Xin X Jiang Hongli H

Journal of diabetes investigation 20200707 1

<h4>Aims/introduction</h4>Dyslipidemia plays a critical role in the pathogenesis of metabolic syndrome and diabetes. Evidence has increasingly shown that the ratio of low- to high-density lipoprotein cholesterol (LDL-C/HDL-C) is a novel marker for increased risk of insulin resistance and cardiovascular diseases. However, the correlation between the LDL-C/HDL-C ratio and diabetes risk is rarely reported. This is the first study to investigate the association between the LDL-C/HDL-C ratio and new- ...[more]

PMID: 32506632

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Project description:BACKGROUND:Previous studies have revealed that triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) is one of major risk factors of insulin resistance and diabetes. However, study on the association between TG/HDL-C and diabetes mellitus (DM) risk is limited, especially in Chinese people. This study was undertaken to investigate the relationship between TG/HDL-C and incident of diabetes in a large cohort in Chinese population. METHODS:The present study was a retrospective cohort study. A total of 114,787 adults from Rich Healthcare Group in China, which includes all medical records for participants who received a health check from 2010 to 2016. The target independent variable and the dependent variable were triglyceride to high-density lipoprotein cholesterol ratio measured at baseline and incident of diabetes mellitus appeared during follow-up respectively. Covariates involved in this study included age, gender, body mass index, diastolic blood pressure, systolic blood pressure, fasting plasma glucose, total cholesterol, low density lipoprotein cholesterol, serum creatinine, smoking and drinking status and family history of diabetes. Cox proportional-hazards regression was used to investigate the association of TG/HDL-C and diabetes. Generalized additive models was used to identify non-linear relationships. Additionally, we also performed a subgroup analysis. It was stated that the data had been uploaded to the DATADRYAD website. RESULT:After adjusting age, gender, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol, serum creatinine, smoking and drinking status and family history of diabetes, result showed TG/HDL-C was positively associated with incident of diabetes mellitus (HR?=?1.159, 95%CI (1.104, 1.215)). A non-linear relationship was detected between TG/HDL-C and incident of diabetes, which had an inflection point of TG/HDL-C was 1.186. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 1.718(1.433,2.060) and 1.049(0.981,1.120), respectively. Subgroup analysis showed, the stronger association can be found in the population with fasting plasma glucose (FPG) <?6.1?mmol/L (P for interaction<?0.0001; HR?=?1.296 with FPG?<?6.1?mmol/L vs HR?= 1.051 with FPG???6.1?mmol/L).The same trend was also seen in the population with body mass index (BMI)(?18.5, <?24?kg/m2) (P for interaction?=?0.010,HR?=?1.324) and family history without diabetes(P for interaction?=?0.025, HR?=?1.170). CONCLUSION:TG/HDL-C is positively associated with diabetes risk. The relationship between TG/HDL-C and incident of diabetes is also non-linear. TG/HDL-C was strong positively related to incident of diabetes when TG/HDL-C is less than 1.186.

Project description:BackgroundEvidence about the relationship between triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio and prediabetes (Pre-DM) in Chinese non-obese people with a normal range of low-density lipoprotein cholesterol (LDL-c) is limited. Therefore, the present study was undertaken to explore the link of the TG/HDL-C ratio on Pre-DM among non-obese Chinese population with a normal range of LDL-c.MethodsThis study was a cross-sectional study that enrolled 153163 non-obese individuals with a normal range of low-density lipoprotein cholesterol in a Chinese hospital from January 2010 to December 2014. Logistic regression model, generalized additive model (GAM), smooth curve fitting and a series of sensitivity analyses was used to evaluate the association between TG/HDL-C ratio and Pre-DM.ResultThe prevalence of Pre-DM was 9.77%.The median TG/HDL-C ratio was 0.671 (interquartile range, 0.468-1.010). After adjusting covariates, the results showed that TG/HDL-C ratio was positively associated with Pre-DM ((OR = 1.185, 95%CI 1.145-1.226). In addition, the TG/HDL-C ratio level has a non-linear relationship with the incidence of Pre-DM, in which the inflection point was 1.617. The effect sizes (OR) on the left and right sides of the inflection point were 1.312 (95%CI 1.242-1.386) and 0.980 (95%CI 0.898-1.070), respectively. And the sensitive analysis demonstrated the robustness of the results. Subgroup analysis showed a stronger association between TG/HDL-C ratio and Pre-DM in females and the population with 30 years < age < 40 years, 18.5 kg/m2 < body mass index < 24 kg/m2, and ALT < 40U/L.ConclusionThis study demonstrates a positive and non-linear relationship between TG/HDL-C ratio and Pre-DM in Chinese non-obese people with a normal range of low-density lipoprotein cholesterol. TG/HDL-C ratio is strongly related to Pre-DM when TG/HDL-C ratio is less than 1.617. It makes sense to reduce the TG/HDL-C ratio level below the inflection point from a treatment perspective.

Dataset Information

Low-density lipoprotein cholesterol : high-density lipoprotein cholesterol ratio is associated with incident diabetes in Chinese adults: A retrospective cohort study.

Aims/introduction

Materials and methods

Results

Conclusions

Publications

Low-density lipoprotein cholesterol : high-density lipoprotein cholesterol ratio is associated with incident diabetes in Chinese adults: A retrospective cohort study.

Similar Datasets

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