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Xu G, Song J. The Association Between the Triglyceride to High-Density Lipoprotein Cholesterol Ratio and the Incidence of Type 2 Diabetes Mellitus in the Japanese Population. Metab Syndr Relat Disord 2024. [PMID: 38593410 DOI: 10.1089/met.2023.0314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Abstract Aims: To explore whether the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) was independently associated with the risk of incident type 2 diabetes mellitus (T2DM) in a large Japanese cohort. Methods: A secondary analysis was performed using open-access data from a retrospective cohort study. A total of 12,716 eligible participants who had standard medical examinations at the Murakami Memorial Hospital were included in this study. New-onset T2DM was the main outcome during follow-up. The risk of T2DM based on the TG/HDL-C ratio was evaluated using Cox regression analysis and Kaplan-Meier analysis. Subgroup analysis was performed to understand further the significance of the TG/HDL-C ratio in particular populations. To assess the potential of the TG/HDL-C ratio for predicting T2DM, a receiver operating characteristic (ROC) analysis was performed. Results: One hundred fifty new-onset T2DM cases were observed during a median follow-up of 5.39 years. The incidence of T2DM increased with a rise in the TG/HDL-C ratio based on the Kaplan-Meier curves (P < 0.0001). After controlling for potential confounding variables, the TG/HDL-C ratio was positively related to incidence of T2DM (hazard ratio = 1.08, 95% confidence interval: 1.01-1.15, P = 0.0239). In subgroup analysis, those with a body mass index of ≥18.5 and <24 kg/m2 showed a significantly positive relationship. The area under the ROC curve for the TG/HDL-C ratio as a T2DM predictor was 0.684. The optimal TG/HDL-C ratio cutoff value for T2DM was 1.609, with a sensitivity of 54.7% and a specificity of 73.6%. Conclusion: The authors' results showed a significant relationship between the TG/HDL-C ratio and the incidence of T2DM in the Japanese population.
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Affiliation(s)
- Guojuan Xu
- Department of Cardiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jing Song
- Department of Cardiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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Jiang L, Li L, Xu Z, Tang Y, Zhai Y, Fu X, Liu D, Wu Q. Non-linear associations of atherogenic index of plasma with prediabetes and type 2 diabetes mellitus among Chinese adults aged 45 years and above: a cross-sectional study from CHARLS. Front Endocrinol (Lausanne) 2024; 15:1360874. [PMID: 38628590 PMCID: PMC11018972 DOI: 10.3389/fendo.2024.1360874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 03/13/2024] [Indexed: 04/19/2024] Open
Abstract
Background Dyslipidemia is strongly associated with the development of prediabetes and type 2 diabetes mellitus (T2DM). The atherogenic index of plasma (AIP), as a comprehensive index for assessing lipid metabolism, has received extensive attention from researchers in recent years. However, there are relatively few studies exploring the relationships between AIP and the risk of prediabetes and T2DM in the Chinese population. This study focuses on exploring the relationships of AIP with the risk of prediabetes and T2DM in the Chinese population. Methods We conducted an analysis of the public data from the China Health and Retirement Longitudinal Study (CHARLS), involving a total of 12,060 participants aged 45 years and above in China. The study explored the relationships of AIP with prediabetes and T2DM risk through multivariate logistic regression, subgroup analysis, smooth curve fitting, and threshold effect analysis. Results After adjusting for potential confounding factors, we observed positive associations between AIP and the risk of prediabetes [odds ratio (OR) = 1.75, 95% confidence interval (CI): 1.49-2.06] and T2DM (OR = 2.91, 95% CI: 2.38-3.57). Participants with higher AIP levels demonstrated a significantly elevated risk of prediabetes (OR = 1.52, 95% CI: 1.33-1.74) and T2DM (OR = 2.28, 95% CI: 1.92-2.71) compared to those with lower AIP levels. AIP showed consistent correlations with prediabetes and T2DM risk in different subgroups. The results showed the non-linear relationships between AIP and risk of prediabetes and T2DM, with inflection points at 0.29 and -0.04, respectively. When AIP > 0.29, there was a positive association between AIP and the risk of prediabetes (OR = 2.24, 95% CI: 1.67-3.00, p < 0.0001). Similarly, when AIP > -0.04, AIP was positively associated with the risk of T2DM (OR = 3.33, 95% CI: 2.67-4.16, p < 0.0001). Conclusions This study demonstrated non-linear positive associations of AIP with the risk of prediabetes and T2DM among participants ≥ 45 years of age in China.
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Affiliation(s)
- Luqing Jiang
- Department of Laboratory Medicine, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Lei Li
- Department of Laboratory Medicine, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Zichen Xu
- Department of Laboratory Medicine, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Yu Tang
- Department of Laboratory Medicine, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Ying Zhai
- Department of Laboratory Medicine, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Xia Fu
- Department of Laboratory Medicine, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Daoqin Liu
- Department of Kidney Medicine, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Qiwen Wu
- Department of Laboratory Medicine, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
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Liu C, Yang H, Yang J, Wang H. Correlation analysis of diabetes based on Copula. Front Endocrinol (Lausanne) 2024; 15:1291895. [PMID: 38419954 PMCID: PMC10899488 DOI: 10.3389/fendo.2024.1291895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/24/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction The ratio of Triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) is a crucial indicator for diabetes diagnosis. Methods This study utilizes the Copula function to model and fit the non-linear correlation among fasting blood glucose (Glu), glycosylated hemoglobin (HbA1C), and TG/HDL-C in patients with diabetes. The Copula function chosen for this study includes the two-dimensional Archimedes and Elliptical distribution family, as well as the multidimensional Vine Copula function, for fitting the data. The evaluation of the fitting effect is performed using the mean absolute error (MAE) and mean square error (MSE). Results The results indicate that the Clayton Copula exhibits the highest effectiveness in fitting the pairwise relationship between Glu and TG/HDL-C, as well as HbA1C and TG/HDL-C, displaying the smallest fitting error. Additionally, the Vine Copula function produces a satisfactory fit for the relationship among all three indicators. Compared to linear analysis methods, the Copula function more accurately depicts the correlation among these three types of indicators. Discussion Moreover, our findings indicate a stronger correlation in the lower tail between Glu and HbA1C, as well as TG/HDL-C, suggesting that the Copula function provides greater accuracy and applicability in depicting the relationship among these indicators. As a result, it can offer a more precise auxiliary diagnosis and serve as a valuable reference in clinical judgment.
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Affiliation(s)
- Chang Liu
- College of Science, Beijing Forestry University, Beijing, China
| | - Hu Yang
- College of Science, Beijing Forestry University, Beijing, China
| | - Junjie Yang
- State Key Laboratory of Vegetation and Environmental Change, Institute of Botany, Chinese Academy of Sciences, Beijing, China
| | - Hongqing Wang
- College of Science, Beijing Forestry University, Beijing, China
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Yuan L, Verhoeven A, Blomberg N, van Eyk HJ, Bizino MB, Rensen PCN, Jazet IM, Lamb HJ, Rabelink TJ, Giera M, van den Berg BM. Ethnic Disparities in Lipid Metabolism and Clinical Outcomes between Dutch South Asians and Dutch White Caucasians with Type 2 Diabetes Mellitus. Metabolites 2024; 14:33. [PMID: 38248836 PMCID: PMC10819672 DOI: 10.3390/metabo14010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/26/2023] [Accepted: 12/30/2023] [Indexed: 01/23/2024] Open
Abstract
Type 2 diabetes mellitus (T2DM) poses a higher risk for complications in South Asian individuals compared to other ethnic groups. To shed light on potential mediating factors, we investigated lipidomic changes in plasma of Dutch South Asians (DSA) and Dutch white Caucasians (DwC) with and without T2DM and explore their associations with clinical features. Using a targeted quantitative lipidomics platform, monitoring over 1000 lipids across 17 classes, along with 1H NMR based lipoprotein analysis, we studied 51 healthy participants (21 DSA, 30 DwC) and 92 T2DM patients (47 DSA, 45 DwC) from the MAGNetic resonance Assessment of VICTOza efficacy in the Regression of cardiovascular dysfunction in type 2 dIAbetes mellitus (MAGNA VICTORIA) study. This comprehensive mapping of the circulating lipidome allowed us to identify relevant lipid modules through unbiased weighted correlation network analysis, as well as disease and ethnicity related key mediatory lipids. Significant differences in lipidomic profiles, encompassing various lipid classes and species, were observed between T2DM patients and healthy controls in both the DSA and DwC populations. Our analyses revealed that healthy DSA, but not DwC, controls already exhibited a lipid profile prone to develop T2DM. Particularly, in DSA-T2DM patients, specific lipid changes correlated with clinical features, particularly diacylglycerols (DGs), showing significant associations with glycemic control and renal function. Our findings highlight an ethnic distinction in lipid modules influencing clinical outcomes in renal health. We discover distinctive ethnic disparities of the circulating lipidome and identify ethnicity-specific lipid markers. Jointly, our discoveries show great potential as personalized biomarkers for the assessment of glycemic control and renal function in DSA-T2DM individuals.
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Affiliation(s)
- Lushun Yuan
- Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (L.Y.); (P.C.N.R.); (T.J.R.)
- Department of Internal Medicine, Division of Nephrology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Aswin Verhoeven
- Center for Proteomics and Metabolomics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (A.V.); (N.B.); (M.G.)
| | - Niek Blomberg
- Center for Proteomics and Metabolomics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (A.V.); (N.B.); (M.G.)
| | - Huub J. van Eyk
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (H.J.v.E.); (I.M.J.)
| | - Maurice B. Bizino
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (M.B.B.); (H.J.L.)
| | - Patrick C. N. Rensen
- Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (L.Y.); (P.C.N.R.); (T.J.R.)
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (H.J.v.E.); (I.M.J.)
| | - Ingrid M. Jazet
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (H.J.v.E.); (I.M.J.)
| | - Hildo J. Lamb
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (M.B.B.); (H.J.L.)
| | - Ton J. Rabelink
- Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (L.Y.); (P.C.N.R.); (T.J.R.)
- Department of Internal Medicine, Division of Nephrology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Martin Giera
- Center for Proteomics and Metabolomics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (A.V.); (N.B.); (M.G.)
| | - Bernard M. van den Berg
- Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (L.Y.); (P.C.N.R.); (T.J.R.)
- Department of Internal Medicine, Division of Nephrology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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Huang Z, Han Y, Hu H, Cao C, Liu D, Wang Z. Triglyceride to high-density lipoprotein cholesterol ratio is associated with regression to normoglycemia from prediabetes in adults: a 5-year cohort study in China. J Transl Med 2023; 21:868. [PMID: 38037094 PMCID: PMC10688482 DOI: 10.1186/s12967-023-04752-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023] Open
Abstract
OBJECTIVE The current body of evidence on the association between the ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDL-c) and the reversal of prediabetes to normoglycemia remains limited. The aim of this study is to investigate the association between TG/HDL-c and the reversion to normoglycemia in patients with prediabetes. METHODS This retrospective cohort study included 15,107 individuals with prediabetes from 32 Chinese districts and 11 cities who completed health checks from 2010 to 2016. The Cox proportional-hazards regression model examined baseline TG/HDL-c and reversion to normoglycemia from prediabetes. Cox proportional hazards regression with cubic spline functions and smooth curve fitting determined the non-linear connection between TG/HDL-c and reversion to normoglycemia. We also ran sensitivity and subgroup analysis. By characterizing progression to diabetes as a competing risk for the reversal of prediabetes to normoglycemic event, a multivariate Cox proportional hazards regression model with competing risks was created. RESULTS Upon adjusting for covariates, the findings indicate a negative association between TG/HDL-c and the likelihood of returning to normoglycemia (HR = 0.869, 95%CI:0.842-0.897). Additionally, a non-linear relationship between TG/HDL-c and the probability of reversion to normoglycemia was observed, with an inflection point of 1.675. The HR on the left side of the inflection point was 0.748 (95%CI:0.699, 0.801). The robustness of our results was confirmed through competing risks multivariate Cox's regression and a series of sensitivity analyses. CONCLUSION The present study reveals a negative and non-linear correlation between TG/HDL-c and the reversion to normoglycemia among Chinese individuals with prediabetes. The findings of this study are anticipated to serve as a valuable resource for clinicians in managing dyslipidemia in prediabetic patients. Interventions aimed at reducing the TG/HDL-c ratio through the reduction of TG or elevation of HDL-c levels may substantially enhance the likelihood of achieving normoglycemia in individuals with prediabetes.
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Affiliation(s)
- Zhiqiang Huang
- Department of Emergency, Futian District, Shenzhen Second People's Hospital, No. 3002 Sungang Road, Shenzhen, 518000, Guangdong Province, China
| | - Yong Han
- Department of Emergency, Futian District, Shenzhen Second People's Hospital, No. 3002 Sungang Road, Shenzhen, 518000, Guangdong Province, China
| | - Haofei Hu
- Department of Nephrology, Guangdong Province, Shenzhen Second People's Hospital, Shenzhen, 518000, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Dehong Liu
- Department of Emergency, Futian District, Shenzhen Second People's Hospital, No. 3002 Sungang Road, Shenzhen, 518000, Guangdong Province, China.
| | - Zhibin Wang
- Department of Emergency, Futian District, Shenzhen Second People's Hospital, No. 3002 Sungang Road, Shenzhen, 518000, Guangdong Province, China.
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González-Salvatierra S, García-Fontana B, Martínez-Heredia L, Lacal J, Andújar-Vera F, Sanabria-de la Torre R, Moratalla-Aranda E, Lozano-Alonso S, García-Fontana C, Muñoz-Torres M. Exploring the role of osteoglycin in type 2 diabetes: implications for insulin resistance and vascular pathophysiology. Am J Physiol Endocrinol Metab 2023; 325:E649-E660. [PMID: 37819194 PMCID: PMC10874653 DOI: 10.1152/ajpendo.00320.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/05/2023] [Indexed: 10/13/2023]
Abstract
Osteoglycin, a fundamental proteoglycan within the vascular extracellular matrix, is expressed in vascular smooth muscle cells (VSMCs). Type 2 diabetes (T2D) is associated with cardiovascular disease (CVD) but the role of osteoglycin in the development of CVD is controversial to date. Therefore, our aims are to determine and compare the level of osteoglycin in T2D patients with/without CVD versus control subjects both at serum and vascular tissue and to analyze in vitro role of osteoglycin in VSMCs under calcified conditions. For this, serum osteoglycin levels were determined by enzyme-linked immunosorbent assay (ELISA) in 117 controls and 129 patients with T2D (46 with CVD and 83 without CVD), revealing a significant increase in patients with T2D compared with controls. Osteoglycin level was not an estimator of CVD but correlated with markers of insulin resistance (triglycerides and triglycerides/high-density lipoprotein cholesterol index) in patients with T2D. At the vascular level, osteoglycin expression was assessed by RT-qPCR and immunohistochemistry, and no significant differences were observed between calcified arteries from patients with T2D and noncalcified arteries from controls. In vitro experiments using VSMCs (mock and overexpressing osteoglycin) under calcifying conditions were performed to analyze the osteoglycin function. The overexpression of osteoglycin in VMSCs under calcifying conditions revealed an increase of cell proliferation without effect on apoptosis and an upregulation of the expression of autotaxin (ATX) involved in inflammatory processes. In conclusion, osteoglycin could play a role in glycemic homeostasis, being a potential biomarker of insulin resistance in patients with T2D. Furthermore, osteoglycin could indirectly participate in the development of atherosclerosis through its regulatory effect on ATX and by proliferating VSMCs.NEW & NOTEWORTHY This study uncovers an increase of serum osteoglycin levels in patients with type 2 diabetes, which does not appear to be associated with the development of atherosclerosis, but rather with insulin resistance in this population. Overexpression of osteoglycin increased proliferation and upregulated the expression of autotaxin in vascular smooth muscle cells within calcified environments. Osteoglycin could be a biomarker of insulin resistance for type 2 diabetes and could be indirectly involved in the development of atherosclerosis.
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Affiliation(s)
- Sheila González-Salvatierra
- Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain
- Endocrinology and Nutrition Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain
- Department of Biochemistry and Molecular Biology II, University of Granada, Granada, Spain
| | - Beatriz García-Fontana
- Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain
- Endocrinology and Nutrition Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES) Institute of Health Carlos III, Madrid, Spain
- Department of Cell Biology, University of Granada, Granada, Spain
| | | | - Jesus Lacal
- Laboratory of Functional Genetics of Rare Diseases, Department of Microbiology and Genetics, University of Salamanca (USAL), Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Francisco Andújar-Vera
- Bioinformatic Research Service, Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain
- Department of Computer Science and Artificial Intelligence, University of Granada, Granada, Spain
- Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI Institute), Granada, Spain
| | - Raquel Sanabria-de la Torre
- Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain
- Department of Biochemistry, Molecular Biology III and Immunology, University of Granada, Granada, Spain
| | - Enrique Moratalla-Aranda
- Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain
- Nuclear Medicine Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - Silvia Lozano-Alonso
- Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain
- Angiology and Vascular Surgery Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - Cristina García-Fontana
- Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain
- Endocrinology and Nutrition Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES) Institute of Health Carlos III, Madrid, Spain
| | - Manuel Muñoz-Torres
- Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain
- Endocrinology and Nutrition Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES) Institute of Health Carlos III, Madrid, Spain
- Department of Medicine, University of Granada, Granada, Spain
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Song B, Wang K, Lu W, Zhao X, Yao T, Liu T, Gao G, Fan H, Liu C. A U-shaped association between the triglyceride to high-density lipoprotein cholesterol ratio and the risk of incident type 2 diabetes mellitus in Japanese men with normal glycemic levels: a population-based longitudinal cohort study. Front Endocrinol (Lausanne) 2023; 14:1180910. [PMID: 37810876 PMCID: PMC10552638 DOI: 10.3389/fendo.2023.1180910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Background Several studies have verified that a high baseline TG/HDL-C ratio is a risk factor for incident type 2 diabetes mellitus (T2DM). However, for low baseline TG/HDL-C levels, the findings were inconsistent with ours. In addition, the association between baseline TG/HDL-C ratio and the risk of incident T2DM in Japanese men with normal glycemic levels is unclear. As a result, our study further investigated the relationship between baseline TG/HDL-C and the risk of incident T2DM in Japanese men with normal glycemic levels. Methods This was a secondary longitudinal cohort study. We selected 7,684 male participants between 2004 and 2015 from the NAGALA database. A standardized Cox regression model and two piecewise Cox regression models were used to explore the relationship between the baseline high-density lipoprotein cholesterol ratio (TG/HDL-C) and incident T2DM. Results During a median follow-up of 2,282 days, 162 men developed incident T2DM. In the adjusted model, the baseline TG/HDL-C ratio was strongly associated with the risk of incident T2DM, and no dose-dependent positive association was observed between the baseline TG/HDL-C ratio and incidence of T2DM throughout the baseline TG/HDL-C quartiles. Two-piecewise linear regression analysis showed a U-shaped association between baseline TG/HDL-C ratio and incidence of incident T2DM. A baseline TG/HDL-C ratio below 1.188 was negatively associated with incident T2DM (H.R. = 0.105, 95% CI = 0.025, 0.451; P = 0.002). In contrast, a baseline TG/HDL-C ratio >1.188 was positively associated with incident T2DM (H.R. = 1.248, 95% CI = 1.113, 1.399; P<0.001). The best TG/HDL-C threshold for predicting incident T2DM was 1.8115 (area under the curve, 0.6837). Conclusion A U-shaped relationship between baseline TG/HDL-C ratio and incident T2DM in Japanese men with normal glycemic levels was found.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Chengyun Liu
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Xie X, Liao J, Huang C, Li X, Cao Q, Kong L, Okamura T, Hashimoto Y, Obora A, Kojima T, Fukui M, Hamaguchi M, Luo Z, Qin Y, Liang X, Xuan X. U-shaped association between triglyceride and risk of incident diabetes in normoglycemic males with NAFLD: A population-base cohort study. Int J Med Sci 2023; 20:1417-1424. [PMID: 37790852 PMCID: PMC10542184 DOI: 10.7150/ijms.83371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 08/01/2023] [Indexed: 10/05/2023] Open
Abstract
Background: Serum triglyceride (TG) was an important biomarker for nonalcoholic fatty liver disease (NAFLD), and the association between TG and incident type 2 diabetes mellitus is still under debate with some studies suggesting that elevated TG increase the risk of incident T2DM while others indicative of a negative relationship. These controversial findings may be partially due to the inclusion of the participants with NAFLD. The association between TG and incident type 2 diabetes mellitus in people with NAFLD remained unclear. Therefore, this study aimed to characterize the relationship between the baseline TG levels and incident type 2 diabetes mellitus in a male Japanese cohort with NAFLD. Methods: A total of 1221 males with NAFLD were enrolled from the Nagala (NAFLD in the Gifu Area Longitudinal analysis) study conducted from 2004 to 2015. Cox proportional hazards models were performed to examine the relationship between baseline TG concentration and incident type 2 diabetes mellitus. A two-piecewise linear regression model was explored to evaluate the threshold effect of the baseline TG levels on type 2 diabetes mellitus incidence by using a smoothing function. Results: During a median follow-up of 6.05 years, 39 males with NAFLD at baseline developed type 2 diabetes mellitus. The risk of incident type 2 diabetes mellitus was significantly associated with baseline TG concentration in males with NAFLD after fully adjustment for confounders, with per 10 mg/dl elevation in TG levels increasing the risk of incident diabetes by 8.5% (HR=1.085, CI=1.039-1.132; P<0.001). However, no typical dose-dependent positive association between type 2 diabetes mellitus incidence and the TG levels was observed across the TG tertiles. Interestingly, a U-shaped association between TG concentration and risk of incident type 2 diabetes mellitus was revealed by the two-piecewise linear regression analysis. Baseline TG concentration lower than the threshold values (TG <53mg/dl) were negatively associated with risk of incident type 2 diabetes mellitus. With each 10mg/dl increase in baseline TG levels, the risk of incident type 2 diabetes mellitus decreased by nearly 59% (HR=0.413, 95% CI=0.220-0.778). In contrast, when TG levels were higher than the threshold values (TG>53mg/dl), the risk of incident diabetes increased 9.1% with every 10mg TG elevation (HR=1.091, 95% CI=1.046-1.137). Conclusions: A U-shaped relationship was observed between baseline TG levels and incident type 2 diabetes mellitus in a male normoglycemic Japanese population with NAFLD, although extrapolation of the finding to other populations should be made with caution.
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Affiliation(s)
- Xuemei Xie
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jixiang Liao
- Transplant Medical Center, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, China
- Guangxi Key Laboratory of Organ Donation and Transplantation, Nanning, Guangxi 530007, China
- Guangxi Transplantation Medicine Research Center of Engineering Technology, Nanning, Guangxi 530007, China
| | - Chenghu Huang
- Department of Endocrinology, Bishan Hospital of Chongqing, Bishan, Chongqing, China
| | - Xiaowei Li
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Qiuli Cao
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Lijuan Kong
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Akihiro Obora
- Department of Gastroenterology, Asahi University Hospital, 3-23, Hashimoto-cho, Gifu, Japan
| | - Takao Kojima
- Department of Gastroenterology, Asahi University Hospital, 3-23, Hashimoto-cho, Gifu, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Zuojie Luo
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yingfen Qin
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xinghuan Liang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiuping Xuan
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Tian Y, Shi D, Liao H, Lu B, Pang Z. The role of Huidouba in regulating skeletal muscle metabolic disorders in prediabetic mice through AMPK/PGC-1α/PPARα pathway. Diabetol Metab Syndr 2023; 15:145. [PMID: 37391779 DOI: 10.1186/s13098-023-01097-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 05/23/2023] [Indexed: 07/02/2023] Open
Abstract
Prediabetes is a transitional state between normal blood glucose levels and diabetes, but it is also a reversible process. At the same time, as one of the most important tissues in the human body, the metabolic disorder of skeletal muscle is closely related to prediabetes. Huidouba (HDB) is a clinically proven traditional Chinese medicine with significant effects in regulating disorders of glucose and lipid metabolism. Our study aimed to investigate the efficacy and mechanism of HDB in prediabetic model mice from the perspective of skeletal muscle. C57BL/6J mice (6 weeks old) were fed a high-fat diet (HFD) for 12 weeks to replicate the prediabetic model. Three concentrations of HDB were treated with metformin as a positive control. After administration, fasting blood glucose was measured as an indicator of glucose metabolism, as well as lipid metabolism indicators such as total triglyceride (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), free fatty acid (FFA), and lactate dehydrogenase (LDH). Muscle fat accumulation and glycogen accumulation were observed. The protein expression levels of p-AMPK, AMPK, PGC-1α, PPAR-α, and GLUT-4 were detected. After HDB treatment, fasting blood glucose was significantly improved, and TG, LDL-C, FFA, and LDH in serum and lipid accumulation in muscle tissue were significantly reduced. In addition, HDB significantly upregulated the expression levels of p-AMPK/AMPK, PGC-1α, PPAR-α, and GLUT-4 in muscle tissue. In conclusion, HDB can alleviate the symptoms of prediabetic model mice by promoting the AMPK/PGC-1α/PPARα pathway and upregulating the expression of GLUT-4 protein.
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Affiliation(s)
- Yu Tian
- School of Pharmacy, Minzu University of China, Beijing, PR China
- Key Laboratory of Ethnomedicine, Minzu University of China), Ministry of Education, Beijing, PR China
| | - Dongxu Shi
- School of Pharmacy, Minzu University of China, Beijing, PR China
- Key Laboratory of Ethnomedicine, Minzu University of China), Ministry of Education, Beijing, PR China
| | - Haiying Liao
- School of Pharmacy, Minzu University of China, Beijing, PR China
- Key Laboratory of Ethnomedicine, Minzu University of China), Ministry of Education, Beijing, PR China
| | - Binan Lu
- School of Pharmacy, Minzu University of China, Beijing, PR China.
- Key Laboratory of Ethnomedicine, Minzu University of China), Ministry of Education, Beijing, PR China.
| | - Zongran Pang
- School of Pharmacy, Minzu University of China, Beijing, PR China.
- Key Laboratory of Ethnomedicine, Minzu University of China), Ministry of Education, Beijing, PR China.
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10
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Yin B, Wu Z, Xia Y, Xiao S, Chen L, Li Y. Non-linear association of atherogenic index of plasma with insulin resistance and type 2 diabetes: a cross-sectional study. Cardiovasc Diabetol 2023; 22:157. [PMID: 37386500 PMCID: PMC10311747 DOI: 10.1186/s12933-023-01886-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/12/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Although there is numerous evidence on the epidemiological risk factors for insulin resistance (IR)-related metabolic diseases, there is still insufficient evidence to explore the non-linear association of Atherogenic Index of Plasma (AIP) with IR. Therefore, we aimed to elucidate the non-linear relationship between AIP and IR and type 2 diabetes (T2D). METHODS This cross-sectional study was conducted in the National Health and Nutrition Survey (NHANES) from 2009 to 2018. A total of 9,245 participants were included in the study. The AIP was calculated as log10 (triglycerides/high-density lipoprotein cholesterol). The outcome variables included IR and T2D defined by the 2013 American Diabetes Association guidelines. The weighted multivariate linear regression, weighted multivariate logistic regression, subgroup analysis, generalized additive model, smooth fitting curve and two-part logistic regression were adopted to reveal the relationship of AIP with IR and T2D. RESULTS After adjustment for age, gender, race, education level, smoking status, alcohol consumption, vigorous/moderate physical activity, body mass index, waist circumference and hypertension, we found that AIP was positively associated with fasting blood glucose (β = 0.08, 95% CI: 0.06, 0.10), glycosylated hemoglobin (β = 0.04, 95% CI: 0.39, 0.58), fasting serum insulin (β = 4.26, 95% CI: 3.73, 4.79), and homeostasis model assessment of insulin resistance (β = 0.22, 95% CI: 0.18, 0.25). Further studies found that AIP was associated with increased risk of IR (OR = 1.29, 95% CI: 1.26-1.32) and T2D (OR = 1.18, 95% CI: 1.15-1.22). However, the positive association between AIP and IR or T2D was more significant in female than in male (IR: P for interaction = 0.0135; T2D: P for interaction = 0.0024). A non-linear and inverse L-shaped association was found between AIP and IR, while a J-shaped association was found between AIP and T2D. In patients with - 0.47 < AIP < 0.45, increased AIP was significantly associated with increased risk of IR and T2D. CONCLUSIONS AIP showed an inverse L-shaped association with IR and a J-shaped association with T2D, indicating that AIP should be reduced to a certain level to prevent IR and T2D.
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Affiliation(s)
- Bei Yin
- Department of Traditional Chinese Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, China
| | - Zihong Wu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610000, China
| | - Yaqing Xia
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital, Guangzhou University of Chinese Medicine), Guangzhou, 510000, China
| | - Shunqiang Xiao
- Department of Traditional Chinese Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, China
| | - Lingling Chen
- Department of Traditional Chinese Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, China.
| | - Yousheng Li
- Department of Traditional Chinese Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, China.
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11
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Wang H, Wang C, Xuan X, Xie Z, Qiu Y, Qin H, Xiaoning Z. Association between triglyceride to high-density lipoprotein cholesterol ratio and type 2 diabetes risk in Japanese. Sci Rep 2023; 13:3719. [PMID: 36878958 PMCID: PMC9988840 DOI: 10.1038/s41598-022-25585-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/01/2022] [Indexed: 03/08/2023] Open
Abstract
Abnormal lipid metabolism is known to increases the risk for metabolic diseases, such as type 2 diabetes mellitus(T2DM). The relationship between baseline ratio of triglyceride to HDL cholesterol (TG/HDL-C) and T2DM in Japanese adults was investigated in this study. Our secondary analysis included 8419 male and 7034 female Japanese subjects who were free of diabetes at baseline. The correlation between baseline TG/HDL-C and T2DM was analyzed by a proportional risk regression model, the nonlinear correlation between baseline TG/HDL-C and T2DM was analyzed by a generalized additive model (GAM), and the threshold effect analysis was performed by a segmented regression model. We conducted subgroup analyses in different populations. During the median 5.39 years follow-up, 373 participants, 286 males and 87 females, developed diabetes mellitus. After full adjustment for confounders, the baseline TG/HDL-C ratio positively correlated with the risk of diabetes (hazard ratio 1.19, 95% confidence interval 1.09-1.3), and smoothed curve fitting and two-stage linear regression analysis revealed a J-shaped relationship between baseline TG/HDL-C and T2DM. The inflection point for baseline TG/HDL-C was 0.35. baseline TG/HDL-C > 0.35 was positively associated with the development of T2DM (hazard ratio 1.2, 95% confidence interval 1.10-1.31). Subgroup analysis showed no significant differences in the effect between TG/HDL-C and T2DM in different populations. A J-shaped relationship was observed between baseline TG/HDL-C and T2DM risk in the Japanese population. When TG/HDL-C was higher than 0.35, there was a positive relationship between baseline TG/HDL-C and the incidence of diabetes mellitus.
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Affiliation(s)
- Huijuan Wang
- Department of Respiratory, The First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China.,Department of General Medicine, Guilin People's Hospital, The Fifth Affiliated Hospital of Guilin Medical University, Guilin, 541002, People's Republic of China
| | - Changming Wang
- Department of Respiratory Medicine, Guilin People's Hospital, The Fifth Affiliated Hospital of Guilin Medical University, Guilin, 541002, People's Republic of China
| | - Xiuping Xuan
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
| | - Zhouni Xie
- Department of General Medicine, Guilin People's Hospital, The Fifth Affiliated Hospital of Guilin Medical University, Guilin, 541002, People's Republic of China
| | - Yuanyuan Qiu
- Department of General Medicine, Guilin People's Hospital, The Fifth Affiliated Hospital of Guilin Medical University, Guilin, 541002, People's Republic of China
| | - Huiping Qin
- Department of Respiratory Medicine, Guilin People's Hospital, The Fifth Affiliated Hospital of Guilin Medical University, Guilin, 541002, People's Republic of China
| | - Zhong Xiaoning
- Department of Respiratory, The First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China.
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12
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Yuan L, Liu J, Huang Z, Zhao Y, Feng Y, Yang X, Hu H, Zhang J, Li T, Li Y, Wu Y, Li X, Huang H, Hu F, Hu D, Zhang M. Elevated remnant cholesterol increase 6-year type 2 diabetes mellitus onset risk. Clin Chim Acta 2023; 541:117253. [PMID: 36796575 DOI: 10.1016/j.cca.2023.117253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
AIM To investigate the association of remnant cholesterol (RC) with future type 2 diabetes mellitus (T2DM) risk, and to assess the underlying impact of some recognized risk factors on it. METHODS A total of 11468 nondiabetic adults in rural China were recruited in 2007-2008 and followed up in 2013-2014. Logistic regression was used to assess the risk of incident T2DM by quartiles of baseline RC, estimating odds ratios (ORs) and 95% confidence intervals (CIs). Association of the combinations of RC and low-density lipoprotein cholesterol (LDL-C) with T2DM risk were further evaluated. RESULTS Multivariable adjusted OR (95% CI) for incident T2DM associated with quartile 4 versus quartile 1 of RC was 2.72 (2.05-3.62). Per 1-standard deviation (SD) increases in RC levels was associated with a 34% higher T2DM risk. However, gender modified the specific association (Pinteraction < 0.05), with the association stronger among females. When combining the low LDL-C and low RC groups as reference, individuals with RC levels ≥ 0.56 mmol/L had more than a 2-fold T2DM risk, regardless of LDL-C level. CONCLUSIONS Elevated RC levels increase T2DM risk in rural Chinese populations. In those who cannot control their risk by lowering LDL-C levels, the goal of lipid-lowering therapy can be shifted to RC.
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Affiliation(s)
- Lijun Yuan
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Jiong Liu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Zelin Huang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yifei Feng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xingjin Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Huifang Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Jinli Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Tianze Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Li
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Yuying Wu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Xi Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Hao Huang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Fulan Hu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Dongsheng Hu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Ming Zhang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China.
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13
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Yang G, Schooling CM. Investigating sex-specific associations of lipid traits with type 2 diabetes, glycemic traits and sex hormones using Mendelian randomization. Cardiovasc Diabetol 2023; 22:3. [PMID: 36624450 PMCID: PMC9830908 DOI: 10.1186/s12933-022-01714-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 12/01/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Low-density lipoprotein (LDL)-cholesterol is positively associated with cardiovascular disease (CVD) and inversely associated with type 2 diabetes, which could detract from lipid modification. Here, we examined whether lipid traits potentially relevant to CVD aetiology, i.e. apolipoprotein B (apoB), triglycerides (TG) and lipoprotein(a) [Lp(a)] exhibited the same associations. We investigated sex-specifically, including the role of sex hormones, because sex disparities exist in lipid profile and type 2 diabetes. We also replicated where possible. METHODS We used Mendelian randomization (MR) to examine sex-specific associations of apoB, TG and Lp(a) with type 2 diabetes, HbA1c, fasting insulin, fasting glucose, testosterone and estradiol in the largest relevant sex-specific genome-wide association studies (GWAS) in people of European ancestry and replicated where possible. We also assessed sex-specific associations of liability to type 2 diabetes with apoB, TG and Lp(a). RESULTS Genetically predicted apoB and Lp(a) had little association with type 2 diabetes or glycemic traits in women or men. Genetically predicted higher TG was associated with higher type 2 diabetes risk [odds ratio (OR) 1.44 per standard deviation (SD), 95% confidence interval (CI) 1.26 to 1.65], HbA1c and fasting insulin specifically in women. Higher TG was associated with lower testosterone in women and higher testosterone in men, but with lower estradiol in men and women. Genetic liability to type 2 diabetes was associated with higher TG in women, and possibly with lower apoB in men. CONCLUSIONS Lipid traits potentially relevant to CVD aetiology do not exhibit contrasting associations with CVD and type 2 diabetes. However, higher TG is associated with higher type 2 diabetes risk and glycemic traits, which in turn further increases TG specifically in women, possibly driven by sex hormones.
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Affiliation(s)
- Guoyi Yang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
- Graduate School of Public Health and Health Policy, City University of New York, New York, USA.
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Type 2 Diabetes Related Mitochondrial Defects in Peripheral Mononucleated Blood Cells from Overweight Postmenopausal Women. Biomedicines 2023; 11:biomedicines11010121. [PMID: 36672627 PMCID: PMC9855941 DOI: 10.3390/biomedicines11010121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/24/2022] [Accepted: 12/30/2022] [Indexed: 01/05/2023] Open
Abstract
Type 2 diabetes (T2D) is a multisystem disease that is the subject of many studies, but the earliest cause of the disease has yet to be elucidated. Mitochondrial impairment has been associated with diabetes in several tissues. To extend the association between T2D and mitochondrial impairment to blood cells, we investigated T2D-related changes in peripheral mononucleated blood cells’ (PBMCs) mitochondrial function in two groups of women (CTRL vs. T2D; mean age: 54.1 ± 3.8 vs. 60.9 ± 4.8; mean BMI 25.6 ± 5.2 vs. 30.0 ± 5), together with a panel of blood biomarkers, anthropometric measurements and physiological parameters (VO2max and strength tests). Dual-energy X-ray absorptiometry (DXA) scan analysis, cardio-pulmonary exercise test and blood biomarkers confirmed hallmarks of diabetes in the T2D group. Mitochondrial function assays performed with high resolution respirometry highlighted a significant reduction of mitochondrial respiration in the ADP-stimulated state (OXPHOS; −30%, p = 0.006) and maximal non-coupled respiration (ET; −30%, p = 0.004) in PBMCs samples from the T2D group. The total glutathione antioxidant pool (GSHt) was significantly reduced (−38%: p = 0.04) in plasma samples from the T2D group. The fraction of glycated hemoglobin (Hb1Ac) was positively associated with markers of inflammation (C-reactive protein-CRP r = 0.618; p = 0.006) and of dyslipidemia (triglycerides-TG r = 0.815; p < 0.0001). The same marker (Hb1Ac) was negatively associated with mitochondrial activity levels (OXPHOS r = −0.502; p = 0.034; ET r = −0.529; p = 0.024). The results obtained in overweight postmenopausal women from analysis of PBMCs mitochondrial respiration and their association with anthropometric and physiological parameters indicate that PBMC could represent a reliable model for studying T2D-related metabolic impairment and could be useful for testing the effectiveness of interventions targeting mitochondria.
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15
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Causal Association of Obesity and Dyslipidemia with Type 2 Diabetes: A Two-Sample Mendelian Randomization Study. Genes (Basel) 2022; 13:genes13122407. [PMID: 36553674 PMCID: PMC9777695 DOI: 10.3390/genes13122407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
Recent studies have suggested an association between obesity and dyslipidemia in the development of type 2 diabetes (T2D). The purpose of this study was to explore the causal effects of obesity and dyslipidemia on T2D risk in Asians. Two-sample Mendelian randomization (MR) analyses were performed to assess genetically predicted obesity using body mass index (BMI) and dyslipidemia using high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), total cholesterol (TCHL), and triglycerides (TG) versus T2D susceptibility using genome-wide association study (GWAS) results derived from the summary statistics of Biobank Japan (n = 179,000) and DIAbetes Meta-ANalysis of Trans-Ethnic association studies (n = 50,533). The MR analysis demonstrated evidence of a causal effect of higher BMI on the risk of T2D (odds ratio (OR) > 1.0, p < 0.05). In addition, TG showed a protective effect on the risk of T2D (ORs 0.68-0.85). However, HDL, LDL, and TCHL showed little genetic evidence supporting a causal association between dyslipidemia and T2D. We found strong genetic evidence supporting a causal association of BMI with T2D. Although HDL, LDL, and TCHL did not show a causal association with T2D, TG had a causal relationship with the decrease of T2D. Although it was predicted that TG would be linked to a higher risk of T2D, it actually exhibited a paradoxical protective effect against T2D, which requires further investigation.
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16
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Zhou Y, Yang G, Qu C, Chen J, Qian Y, Yuan L, Mao T, Xu Y, Li X, Zhen S, Liu S. Predictive performance of lipid parameters in identifying undiagnosed diabetes and prediabetes: a cross-sectional study in eastern China. BMC Endocr Disord 2022; 22:76. [PMID: 35331213 PMCID: PMC8952267 DOI: 10.1186/s12902-022-00984-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/08/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Dyslipidaemia is a risk factor for abnormal blood glucose. However, studies on the predictive values of lipid markers in prediabetes and diabetes simultaneously are limited. This study aimed to assess the associations and predictive abilities of lipid indices and abnormal blood glucose. METHODS A sample of 7667 participants without diabetes were enrolled in this cross-sectional study conducted in 2016, and all of them were classified as having normal glucose tolerance (NGT), prediabetes or diabetes. Blood glucose, blood pressure and lipid parameters (triglycerides, TG; total cholesterol, TC; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C; non-high-density lipoprotein cholesterol, non-HDL-C; and triglyceride glucose index, TyG) were evaluated or calculated. Logistic regression models were used to analyse the association between lipids and abnormal blood glucose. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to assess the discriminatory power of lipid parameters for detecting prediabetes or diabetes. RESULTS After adjustment for potential confounding factors, the TyG was the strongest marker related to abnormal blood glucose compared to other lipid indices, with odds ratios of 2.111 for prediabetes and 5.423 for diabetes. For prediabetes, the AUCs of the TG, TC, HDL-C, LDL-C, TC/HDL-C, TG/HDL-C, non-HDL-C and TyG indices were 0.605, 0.617, 0.481, 0.615, 0.603, 0.590, 0.626 and 0.660, respectively, and the cut-off points were 1.34, 4.59, 1.42, 2.69, 3.39, 1.00, 3.19 and 8.52, respectively. For diabetes, the AUCs of the TG, TC, HDL-C, LDL-C, TC/HDL-C, TG/HDL-C, non-HDL-C and TyG indices were 0.712, 0.679, 0.440, 0.652, 0.686, 0.692, 0.705, and 0.827, respectively, and the cut-off points were 1.35, 4.68, 1.42, 2.61, 3.44, 0.98, 3.13 and 8.80, respectively. CONCLUSIONS The TyG, TG and non-HDL-C, especially TyG, are accessible biomarkers for screening individuals with undiagnosed diabetes.
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Affiliation(s)
- Yimin Zhou
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China
| | - Guoping Yang
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Chen Qu
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Jiaping Chen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China
| | - Yinan Qian
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China
| | - Lei Yuan
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China
| | - Tao Mao
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Yan Xu
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Xiaoning Li
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Shiqi Zhen
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China.
| | - Sijun Liu
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China.
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Li X, Xue Y, Dang Y, Liu W, Wang Q, Zhao Y, Zhang Y. Association of Non-Insulin-Based Insulin Resistance Indices with Risk of Incident Prediabetes and Diabetes in a Chinese Rural Population: A 12-Year Prospective Study. Diabetes Metab Syndr Obes 2022; 15:3809-3819. [PMID: 36530590 PMCID: PMC9756794 DOI: 10.2147/dmso.s385906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Three non-insulin-based insulin resistance (IR) indices, ie, triglyceride-glucose (TyG) index, triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, and metabolic score for IR (METS-IR), were considered powerful and simplified alternatives for IR. However, evidence for the association between the three IR indices and incident type 2 diabetes mellitus (T2DM), especially impaired fasting glucose (IFG), remains limited. Therefore, this study aimed to explore the association among IR indices, incident IFG, and T2DM in a rural population cohort. METHODS We analyzed data from 2209 adults (aged 24-75 years) at baseline and from 1205 normoglycemic participants who were followed up. Cox proportional hazards models were used to evaluate the associations between the three indices and IFG or T2DM. Restricted cubic spline curves based on the Cox regression model were used to examine the association between baseline indices and incident T2DM. RESULTS For the baseline data, logistic analyses demonstrated that the TyG index, TG/HDL-C ratio, and METS-IR had a significantly positive correlation with IFG or T2DM after multivariable adjustment. During a median follow-up of 12.17 years, 157 incident cases of IFG and 97 incident cases of T2DM were noted. The risk of T2DM, but not IFG, was strongly associated with the baseline TyG index in the adjusted model, and participants with the TyG index in the third tertile had a higher risk of developing T2DM (adjusted hazards ratio, 2.84; 95% confidence intervals, 1.26-6.37; p for trend <0.001) than those in the lowest tertile (reference). Moreover, a linear relationship was observed between the TyG index and T2DM incidence. The TG/HDL-C ratio and METS-IR had no significant relationship with the risk of IFG or T2DM. CONCLUSION The TyG index is more useful than the TG/HDL-C ratio and METS-IR in predicting T2DM in the normoglycemic population.
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Affiliation(s)
- Xiaoxia Li
- Department of Epidemiology and Health Statistics, School of Public Health and Management of Ningxia Medical University, Yinchuan, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health and Management of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Yixuan Xue
- Department of Epidemiology and Health Statistics, School of Public Health and Management of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Yuanyuan Dang
- Department of Epidemiology and Health Statistics, School of Public Health and Management of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Wanlu Liu
- Department of Epidemiology and Health Statistics, School of Public Health and Management of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Qingan Wang
- Department of Epidemiology and Health Statistics, School of Public Health and Management of Ningxia Medical University, Yinchuan, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health and Management of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Yi Zhao
- Department of Epidemiology and Health Statistics, School of Public Health and Management of Ningxia Medical University, Yinchuan, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health and Management of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Yuhong Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management of Ningxia Medical University, Yinchuan, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health and Management of Ningxia Medical University, Yinchuan, People’s Republic of China
- Correspondence: Yuhong Zhang, Department of Epidemiology and Health Statistics School of Public Health and Management, Ningxia Medical University, 1160 Shengli Street, Xingqing District, Yinchuan, 750004, People’s Republic of China, Tel +86951-6980144, Fax +86951-6980144, Email
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Qie R, Li Q, Zhao Y, Han M, Liu D, Guo C, Zhou Q, Tian G, Huang S, Wu X, Zhang Y, Qin P, Li H, Wang J, Cheng R, Lin J, Sun X, Wu Y, Li Y, Yang X, Zhao Y, Feng Y, Zhang M, Hu D. Association of hypertriglyceridemic waist-to-height ratio and its dynamic status with risk of type 2 diabetes mellitus: The Rural Chinese Cohort Study. Diabetes Res Clin Pract 2021; 179:108997. [PMID: 34371063 DOI: 10.1016/j.diabres.2021.108997] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/25/2021] [Accepted: 08/04/2021] [Indexed: 11/29/2022]
Abstract
AIMS To evaluate the risk of type 2 diabetes mellitus (T2DM) in a prospective study with hypertriglyceridemic waist-to-height ratio (HWHtR) and its dynamic status. METHODS We collected data for 12,248 participants ≥18 years in this study. Cox's proportional-hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for T2DM risk by baseline HWHtR. Multiple logistic regression analysis was used to estimate odds ratios (ORs) and 95% CIs for T2DM risk by transformation in HWHtR. RESULTS We identified 839 T2DM cases during a median follow-up of 5.92 years. Compared with normal TG level and normal WHtR, T2DM risk was increased with high TG level and high WHtR (aHR 2.04, 95% CI 1.49-2.79). Similar results were observed in subgroup analyses by sex and age. During follow-up, T2DM risk was increased with stable high TG level and high WHtR (aOR 4.45, 95% CI 2.76-7.17) compared with stable normal TG level and normal WHtR. The results above were robust in sensitivity analyses. CONCLUSIONS HWHtR phenotype and its dynamic status were associated with risk of T2DM. Our study suggests that primary prevention and avoiding the appearance of the HWHtR phenotype in the rural Chinese population may reduce the T2DM risk.
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Affiliation(s)
- Ranran Qie
- Department of Endocrinology, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, PR China.; Study Team of Shenzhen's Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Quanman Li
- Department of Endocrinology, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, PR China.; Study Team of Shenzhen's Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yang Zhao
- Study Team of Shenzhen's Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Minghui Han
- Study Team of Shenzhen's Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Dechen Liu
- Study Team of Shenzhen's Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Chunmei Guo
- Study Team of Shenzhen's Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Qionggui Zhou
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Gang Tian
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Shengbing Huang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xiaoyan Wu
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yanyan Zhang
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Pei Qin
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Honghui Li
- Study Team of Shenzhen's Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Jian Wang
- Study Team of Shenzhen's Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Ruirong Cheng
- Study Team of Shenzhen's Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Jinchun Lin
- Study Team of Shenzhen's Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Xizhuo Sun
- Study Team of Shenzhen's Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yuying Wu
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yang Li
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Xingjin Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yifei Feng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Ming Zhang
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Dongsheng Hu
- Department of Endocrinology, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, PR China.; Study Team of Shenzhen's Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
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Peng J, Zhao F, Yang X, Pan X, Xin J, Wu M, Peng YG. Association between dyslipidemia and risk of type 2 diabetes mellitus in middle-aged and older Chinese adults: a secondary analysis of a nationwide cohort. BMJ Open 2021; 11:e042821. [PMID: 34035089 PMCID: PMC8154929 DOI: 10.1136/bmjopen-2020-042821] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
AIMS To evaluate the type 2 diabetes mellitus (T2DM) risk of individuals with different types of dyslipidaemia and compare the predictive value of distinct lipid parameters in predicting T2DM. METHODS We conducted a secondary analysis of data from the China Health and Retirement Longitudinal Study (CHARLS). 17 708 individuals over 45 years old were interviewed, and 11 847 blood samples were collected at the baseline survey (2011-2012). Outcome of T2DM was confirmed during two follow-up surveys (2013-2014 and 2015-2016). The HRs and 95% CI of T2DM associated with dyslipidaemia were estimated by Cox proportional hazards regressions model. The discriminatory value of eight lipid parameters were compared by the area under the receiver operating characteristic (ROC) curve (AUC). RESULTS A total of 7329 participants were enrolled in our analysis; during the mean follow-up time of 3.4 years, 387 (5.28%) participants developed new-onset diabetes. Compared with participants in normal lipid levels, the T2DM risk of those with hypercholesterolaemia, hypertriglyceridaemia and low high-density lipoprotein cholesterol (HDL-C) were significantly increased (HRs (95% CI) were 1.48 (1.11 to 1.96), 1.92 (1.49 to 2.46) and 1.67 (1.35 to 2.07), respectively). The AUCs of non-HDL-C (0.685, 95% CI 0.659 to 0.711), triglyceride (TG) (0.684, 95% CI 0.658 to 0.710), total cholesterol (TC)/HDL-C (0.685, 95% CI 0.659 to 0.712) and TG/HDL-C (0.680, 95% CI 0.654 to 0.706) were significantly (p<0.005) larger than that of other lipid parameters. CONCLUSION Middle-aged and elderly adults with hypertriglyceridaemia, hypercholesterolaemia and low HDL-C were at higher risk for developing diabetes. Non-HDL-C, TG, TC/HDL and TG/HDL have greater performance than other lipid parameters in predicting T2DM incidence.
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Affiliation(s)
- Jieru Peng
- Department of Medical Records Statistics, Chengdu Women and Children' s Central Hospital, School of medicine, University of Electronic Science and Technology, Chengdu, Sichuan, China
| | - Fei Zhao
- Department of Infection Control, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China
| | - Xue Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiongfei Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jue Xin
- Department of Medical Records Statistics, Chengdu Women and Children' s Central Hospital, School of medicine, University of Electronic Science and Technology, Chengdu, Sichuan, China
| | - Mengjun Wu
- Department of Anesthesiology, Chengdu Women and Children' s Central Hospital, School of medicine, University of Electronic Science and Technology, Chengdu, Sichuan, China
| | - Yong G Peng
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA
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20
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Liu Y, Gong R, Luo G, Li J, Li Q, Yang L, Wei X. Associations of Triglycerides/High-Density Lipoprotein Cholesterol Ratio With Insulin Resistance, Impaired Glucose Tolerance, and Diabetes in American Adults at Different Vitamin D3 Levels. Front Endocrinol (Lausanne) 2021; 12:735736. [PMID: 35185778 PMCID: PMC8854269 DOI: 10.3389/fendo.2021.735736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 12/24/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Previous studies have shown that vitamin D3 (VD3) may be a protective factor for diabetes mellitus (DM), while triglycerides/high-density lipoprotein (TG/HDL) may be a risk factor for diabetes. However, no existing study has elucidated the interaction between TG/HDL and VD3. Therefore, this work aimed to investigate the relationships of TG/HDL with insulin resistance (IR), impaired glucose tolerance (IGT), and DM at different VD3 levels. METHODS With the use of the data from five National Health and Nutrition Examination Survey (NHANES) cycles, a total of 2,929 males and 3,031 females were divided into 4 groups according to their VD3 levels. Logistic regression was performed to observe the associations of TG/HDL ratio with IR, IGT, and DM in different groups. RESULTS The relationships of TG/HDL with IR, IGT, and DM showed a threshold effect, with the cutoff values of 1.094, 1.51, and 1.11, respectively. On both sides of the cutoff values, the correlation was first weakened and then enhanced with the increase in VD3 levels. CONCLUSION TG/HDL is a risk factor for IR, IGT, and DM. Both too low and too high levels of VD3 can strengthen this association, whereas keeping VD3 at a reasonable level helps to reduce the associations of TG/HDL with IR, IGT, and DM.
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Affiliation(s)
- Yuanyuan Liu
- Medical College of Qinghai University, Xining, China
- Endocrinology Department, Qinghai Provincial People’s Hospital, Xining, China
| | - Rongpeng Gong
- Medical College of Qinghai University, Xining, China
| | - Gang Luo
- College of Eco-environmental Engineering, Qinghai University, Xining, China
| | - Jinxia Li
- Medical College of Qinghai University, Xining, China
- Endocrinology Department, Qinghai Provincial People’s Hospital, Xining, China
| | - Qidan Li
- Medical College of Qinghai University, Xining, China
| | - Lixin Yang
- Medical College of Qinghai University, Xining, China
- Endocrinology Department, Qinghai Provincial People’s Hospital, Xining, China
- *Correspondence: Lixin Yang, ; Xiaoxing Wei,
| | - Xiaoxing Wei
- Medical College of Qinghai University, Xining, China
- College of Eco-environmental Engineering, Qinghai University, Xining, China
- *Correspondence: Lixin Yang, ; Xiaoxing Wei,
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21
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Zhang Y, Qin P, Lou Y, Zhao P, Li X, Qie R, Wu X, Han M, Huang S, Zhao Y, Liu D, Wu Y, Li Y, Yang X, Zhao Y, Feng Y, Wang C, Ma J, Peng X, Chen H, Zhao D, Xu S, Wang L, Luo X, Zhang M, Hu D, Hu F. Association of TG/HDLC ratio trajectory and risk of type 2 diabetes: A retrospective cohort study in China. J Diabetes 2020; 13:402-412. [PMID: 33074586 DOI: 10.1111/1753-0407.13123] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/20/2020] [Accepted: 10/15/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The association of ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDL-C ratio) change trajectory with risk of type 2 diabetes mellitus (T2DM) remains unknown. The aim of this study was to evaluate the association between risk of T2DM and TG/HDL-C ratio change trajectory. METHODS A total of 18 444 participants aged 18-80 years old were included in this cohort study. Linear regression and quadratic regression models were used to determine the TG/HDL-C ratio change trajectory. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between TG/HDL-C ratio change trajectory and probability of T2DM. RESULTS T2DM developed in 714 participants during a median follow-up of 5.74 years (92 076.23 person-years of follow-up). After adjusting for baseline potential confounders, odds of T2DM were greater for participants with the increasing, U-shape, bell-shape, and other shape change vs decreasing change (adjusted OR [aOR] 2.01, 95% CI 1.42-2.81; 1.56, 1.15-2.13; 1.60, 1.17-2.20; and 1.49, 1.13-2.00, respectively). The results were robust in the sensitivity analyses on excluding baseline participants with T2DM. Moreover, the associations remained significant with male sex, age <60 years and body mass index <24 kg/m2 . CONCLUSIONS This retrospective study revealed increased probability of T2DM with increasing, U-shape, bell-shape, and other-shape TG/HDL-C ratio change trajectories, especially with male sex, age <60 years and body mass index <24 kg/m2 .
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Affiliation(s)
- Yanyan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Pei Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Yanmei Lou
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, People's Republic of China
| | - Ping Zhao
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, People's Republic of China
| | - Xue Li
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, People's Republic of China
| | - Ranran Qie
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Xiaoyan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Minghui Han
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Shengbing Huang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Dechen Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yuying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Yang Li
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Xingjin Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yifei Feng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Changyi Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Jianping Ma
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Xiaolin Peng
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Hongen Chen
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Dan Zhao
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Shan Xu
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Li Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Xinping Luo
- School of Basic Medicine, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Ming Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Fulan Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
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Lim TK, Lee HS, Lee YJ. Triglyceride to HDL-cholesterol ratio and the incidence risk of type 2 diabetes in community dwelling adults: A longitudinal 12-year analysis of the Korean Genome and Epidemiology Study. Diabetes Res Clin Pract 2020; 163:108150. [PMID: 32305400 DOI: 10.1016/j.diabres.2020.108150] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 04/07/2020] [Indexed: 12/16/2022]
Abstract
AIMS Serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio is known to be associated with cardiometabolic diseases. This study is aimed to evaluate the association between the TG/HDL-C ratio and incident type 2 diabetes with a large-sample, community-based Korean cohort over 12 years. METHODS Among 10,038 participants, a total of 8655 participants aged 40 to 69 years without diabetes were selected from the Korean Genome and Epidemiology Study (KoGES). The baseline TG/HDL-C ratio was divided into quartiles. Newly developed type 2 diabetes was defined by any of the following: a fasting plasma glucose level ≥ 126 mg/dL; a glucose level ≥ 200 mg/dL 2-hours after a 75 g oral glucose tolerance test; an HbA1c ≥ 6.5%; or treatment with anti-diabetic therapy. The hazard ratios (HRs) with 95% confidence intervals (CIs) for incident type 2 diabetes were calculated using multivariate Cox proportional hazards regression models after adjusting for potentially confounding variables. RESULTS During the 12-year follow-up period, type 2 diabetes developed in 1437 subjects (16.6%, 1437/8655), with incidence rate of 2.8-5.0 (over 2 years). Compared to the reference first quartile, the HRs (95% CIs) of incident type 2 diabetes in the second, third, and fourth quartiles increased in a dose-response manner after adjusting for potentially confounding variables. CONCLUSIONS High TG/HDL-C ratio at baseline may be a useful surrogate indicator of future incident type 2 diabetes.
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Affiliation(s)
- Tae-Kyeong Lim
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Wang Y, Yuan JM, Pan A, Koh WP. Tissue inhibitor matrix metalloproteinase 1 and risk of type 2 diabetes in a Chinese population. BMJ Open Diabetes Res Care 2020; 8:e001051. [PMID: 32303531 PMCID: PMC7199153 DOI: 10.1136/bmjdrc-2019-001051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/18/2020] [Accepted: 03/24/2020] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION The non-invasive enhanced liver fibrosis (ELF) score-comprising tissue inhibitor of matrix metalloproteinases-1 (TIMP1), hyaluronic acid (HA) and amino-terminal propeptide of type III procollagen (PIIINP)-has been shown to accurately predict fibrosis stages among patients with non-alcoholic fatty liver disease (NAFLD). However, no study has examined whether the ELF score or its components would also be predictive of type 2 diabetes, which commonly coexists and shares the same pathogenic abnormalities with NAFLD. Therefore, we prospectively investigated their associations with type 2 diabetes risks for the first time. RESEARCH DESIGN AND METHODS The ELF score was measured among 254 type 2 diabetes cases and 254 age-matched and sex-matched controls nested within the prospective Singapore Chinese Health Study. Cases had hemoglobin A1c (HbA1c) levels <6.5% at blood collection (1999-2004) and reported to have diabetes during follow-up II (2006-2010). Controls had HbA1c levels <6.0% at blood-taking and remained free of diabetes at follow-up II. Multivariable conditional logistic regression models were used to assess the ELF-diabetes association. RESULTS Higher TIMP1 levels were associated with increased type 2 diabetes risk, and the OR comparing the highest versus lowest quartiles was 2.56 (95% CI 1.23 to 5.34; p trend=0.035). However, ELF score, PIIINP and HA were not significantly associated with type 2 diabetes risks. CONCLUSIONS Higher TIMP1 levels, but not ELF score, PIIIMP and HA, were associated with increased type 2 diabetes risk in Chinese adults. Our results suggested that elevated TIMP1 levels may contribute to the type 2 diabetes development through pathways other than liver fibrosis.
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Affiliation(s)
- Yeli Wang
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Jian-Min Yuan
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Woon-Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Liu XY, Wu QY, Chen ZH, Yan GY, Lu Y, Dai HJ, Li Y, Yang PT, Yuan H. Elevated triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio increased risk of hyperuricemia: a 4-year cohort study in China. Endocrine 2020; 68:71-80. [PMID: 31940133 DOI: 10.1007/s12020-019-02176-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 12/26/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Previous studies revealed that high serum uric acid (SUA) levels correlated with increased triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio. However, evidence is lacking regarding whether TG/HDL-C is an independent risk factor or just a simple marker of hyperuricemia. We aimed to investigate the relationship between TG/HDL-C and the risk of hyperuricemia in Chinese population. METHODS This retrospective cohort study involved 15,198 subjects (43.14 ± 13.13 years, 54.9% men) who were free of hyperuricemia at baseline. The association between TG/HDL-C and the risk of hyperuricemia, in the total sample and stratified by subgroups, was examined by multiple logistic regression analyses. RESULTS During 4 years follow-up, hyperuricemia occurred in 2365 (15.6%) participants. The cumulative incidence of hyperuricemia was significantly elevated with increasing TG/HDL-C quartiles (5.9, 10.8, 18.4, and 27.5%, respectively). After multivariate adjustment, the odds ratio for hyperuricemia in the highest compared with the lowest quartile of TG/HDL-C was 1.80 (95% confidence interval [CI] 1.49, 2.18), and each SD increment of TG/HDL-C ratio caused a 10% additional risk for hyperuricemia. Moreover, subgroup analyses showed that the association between TG/HDL-C and the risk of hyperuricemia was more pronounced in women and normal-weight adults. The results were consistent when analyses were restricted to participants without metabolic syndrome. CONCLUSIONS TG/HDL-C ratio was positively related to the risk of hyperuricemia in Chinese population, particularly in women and normal-weight individuals. These findings suggested the potential of TG/HDL-C ratio to serve as an independent risk indicator in the prevention of hyperuricemia.
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Affiliation(s)
- Xin-Yao Liu
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Qiao-Yu Wu
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Zhi-Heng Chen
- Department of Health Examination Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Guang-Yu Yan
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Yao Lu
- Key Laboratory of Medical Information Research, Central South University, Changsha, Hunan, PR China
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Hai-Jiang Dai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Ying Li
- Department of Health Examination Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Ping-Ting Yang
- Department of Health Examination Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Hong Yuan
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, PR China.
- Key Laboratory of Medical Information Research, Central South University, Changsha, Hunan, PR China.
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, PR China.
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Chen Z, Hu H, Chen M, Luo X, Yao W, Liang Q, Yang F, Wang X. Association of Triglyceride to high-density lipoprotein cholesterol ratio and incident of diabetes mellitus: a secondary retrospective analysis based on a Chinese cohort study. Lipids Health Dis 2020; 19:33. [PMID: 32131838 PMCID: PMC7057518 DOI: 10.1186/s12944-020-01213-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/24/2020] [Indexed: 01/06/2023] Open
Abstract
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.
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Affiliation(s)
- Zhuangsen Chen
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong Province, China.,Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China.,Shenzhen University Health Science Center, Shenzhen, 518000, Guangdong Province, China
| | - Haofei Hu
- Shenzhen University Health Science Center, Shenzhen, 518000, Guangdong Province, China.,Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China.,Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Miaoling Chen
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong Province, China.,Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China.,Shenzhen University Health Science Center, Shenzhen, 518000, Guangdong Province, China
| | - Xueying Luo
- Department of Plastic and reconstructive, Shenzhen People's Hospital, Shenzhen, 518000, Guangdong, China
| | - Weili Yao
- Department of Endocrinology, Shenzhen Longhua District People's Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Qian Liang
- Department of Endocrinology, Shenzhen People's Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Fan Yang
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong Province, China.,Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China.,Shenzhen University Health Science Center, Shenzhen, 518000, Guangdong Province, China
| | - Xinyu Wang
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong Province, China. .,Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China. .,Shenzhen University Health Science Center, Shenzhen, 518000, Guangdong Province, China.
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Hajian-Tilaki K, Heidari B, Bakhtiari A. Triglyceride to high-density lipoprotein cholesterol and low-density lipoprotein cholestrol to high-density lipoprotein cholesterol ratios are predictors of cardiovascular risk in Iranian adults: Evidence from a population-based cross-sectional study. CASPIAN JOURNAL OF INTERNAL MEDICINE 2020; 11:53-61. [PMID: 32042387 PMCID: PMC6992727 DOI: 10.22088/cjim.11.1.53] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 08/08/2019] [Accepted: 09/21/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND The superiority of TG/HDL-C and LDL-C/HDL-C ratios in predicting CVD risk is a matter of debates. Thus, the objective of this study was to compare TG/HDL-C and LDL-C to HDL-C ratios in predicting the risk of CVD events. METHODS In a population-based cross-sectional study, 567 representative participants aged 40 years or older were entered in the study in Babol, North of Iran. The demographic data, anthropometric measures, and the cardio metabolic risk factors were measured. The individual risk of CVD events was assessed by ACC/AHA risk model. ROC analysis was applied to estimate the diagnostic accuracy and the optimal cut-off points of TG/HDL-C and LDL-C/HDL-C ratios. RESULTS The AUC of TG/HDL-C and LDL-C/HDL-C ratios were rather similar and both parameters significantly predicted CVD risk in men comparably, and TG/HDL-C at optimal cutoff point of 3.6 produced 75% sensitivity and 39% specificity. However,in women TG/HDL-C with AUC of 0.65( p=0.091) at optimal cutoff value of 3.4 produced a sensitivity of 82% and specificity of 51%. The LDL-C/HDL-C ratio had no discriminative ability in predicting CVD risk in women. The adjusted OR of TG/HDL-C at 2nd quartile was significant (OR=3.22, 95% CI:1.25-8.29) and a greater association was found with 3rd and 4rth quartiles. CONCLUSION Both TG/HDL-C and LDL-C/HDL-C ratios comparably predict CVD risk in men, whereas in women only TG/ HDL-C is a significant predictor but not LDL-C/HDL-C.
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Affiliation(s)
- Karimollah Hajian-Tilaki
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Behzad Heidari
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Afsaneh Bakhtiari
- Department of Midwifery, Babol University of Medical Sciences, Babol, Iran
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Qin H, Chen Z, Zhang Y, Wang L, Ouyang P, Cheng L, Zhang Y. Triglyceride to high-density lipoprotein cholesterol ratio is associated with incident diabetes in men: A retrospective study of Chinese individuals. J Diabetes Investig 2020; 11:192-198. [PMID: 31145539 PMCID: PMC6944823 DOI: 10.1111/jdi.13087] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/04/2019] [Accepted: 05/25/2019] [Indexed: 02/05/2023] Open
Abstract
AIMS/INTRODUCTION Dyslipidemia is commonly present in type 2 diabetes mellitus patients. Recently, the triglyceride : high-density lipoprotein cholesterol (TG/HDL-C) ratio, a novel parameter of lipid abnormality, has been seen as an independent predictor for incident diabetes. However, the correlation of the TG/HDL-C ratio with incident diabetes in the Chinese population and how this relationship is impacted by sex have been rarely studied. In the present study, the correlation of the TG/HDL-C ratio with incident diabetes is investigated between different sexes of the Chinese population. MATERIALS AND METHODS A total of 116,855 participants who were free of diabetes at baseline were enrolled in the study. The participants were grouped by the median value (0.82) of the TG/HDL-C ratio. Then, participants were further analyzed according to their sex. Cumulative incidence and person-years incidence were used to express the incidence rate. The predictive value of the TG/HDL-C ratio for incident diabetes was probed by the Cox regression proportional hazards model. RESULTS The mean age of the participants was 44.1 ± 12.9 years, and 53% of participants (n = 62,868) were the men. A total of 2,685 incident diabetes cases occurred during the 3.1 years of the median follow-up period. The cumulative incidence in total incident diabetes patients, men and women was 2.30% (2.21-2.38%), 3.01% (2.87-3.14%) and 1.47% (1.37-1.57%), respectively. After the adjustment of multivariate factors, the multivariate Cox regression analysis results showed that a higher TG/HDL-C ratio was the independent predictive factor of incident diabetes in men (hazard ratio 1.30, 95% confidence interval 1.03-1.64), compared with women (hazard ratio 0.85, 95% confidence interval 0.53-1.38). CONCLUSIONS Among the Chinese population, the TG/HDL-C ratio is an independent predictor for incident diabetes in male patients.
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Affiliation(s)
- Hailun Qin
- Department of CardiologyThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
- Cardiovascular LaboratoryCentre for Translational MedicineThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
| | - Zekai Chen
- Department of CardiologyThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
- Cardiovascular LaboratoryCentre for Translational MedicineThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
| | - Yunzhang Zhang
- Department of CardiologyThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
- Cardiovascular LaboratoryCentre for Translational MedicineThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
| | - Lingyu Wang
- Department of CardiologyThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
- Cardiovascular LaboratoryCentre for Translational MedicineThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
| | - Piao Ouyang
- Department of CardiologyThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
- Cardiovascular LaboratoryCentre for Translational MedicineThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
| | - Lan Cheng
- Department of CardiologyThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
- Cardiovascular LaboratoryCentre for Translational MedicineThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
| | - Yonggang Zhang
- Department of CardiologyThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
- Cardiovascular LaboratoryCentre for Translational MedicineThe Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdongChina
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Li X, Su T, Xiao H, Gao P, Xiong C, Liu J, Zou H. Association of the HDL-c Level with HsCRP, IL-6, U-NAG, RBP and Cys-C in Type 2 Diabetes Mellitus, Hypertension, and Chronic Kidney Disease: An Epidemiological Survey. Diabetes Metab Syndr Obes 2020; 13:3645-3654. [PMID: 33116716 PMCID: PMC7568590 DOI: 10.2147/dmso.s265735] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/10/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To explore the association between the anti-inflammatory and renal protective roles of high-density lipoprotein cholesterol (HDL-c) and its different levels in type 2 diabetes mellitus (T2D), hypertension (HTN), and chronic kidney disease (CKD) and to lay a theoretical basis for precise, maximum-benefit HDL-c-raising therapy for patients with these diseases. PATIENTS AND METHODS A total of 2127 participants (195 with T2D, 618 with HTN, 162 with CKD, and 1152 controls) were selected and divided into four groups according to their baseline HDL-c level, namely, low HDL-c (L-HDL-c, ≤1.03 mmol/L), medium HDL-c (M-HDL-c, 1.04-1.55 mmol/L), high HDL-c (H-HDL-c, 1.56-2.05 mmol/L) and extremely high HDL-c (E-HDL-c, ≥ 2.06 mmol/L). Serum and morning urine samples were collected to analyze the correlation between high-sensitivity C-reactive protein (HsCRP), interleukin-6 (IL-6), urine n-acetyl-β-d-glucosidase (U-NAG), retinol binding protein (RBP), and cystatin c (Cys-C) levels with the HDL-c levels. RESULTS The HDL-c levels of patients with T2D, HTN and CKD were universally lower than those in the control group in both sexes (p<0.05), while male patients also manifested a lower level of HDL-c than female patients. However, although they had lower values of the renal impairment index, female patients were found to have anomalously higher amounts of proinflammatory cytokines. In addition, the correlations between HsCRP and RBP levels and HDL-c levels were most significant in patients with HTN (p<0.05), whereas in patients with T2D and CKD, such relevance was less significant. CONCLUSION Existence of substantial differences in HDL-c levels between different types of disease and sex highlighted that a higher HDL level does not always predict a better clinical outcome of patients. Moreover, we found that both HsCRP and RBP correlated negatively with HDL-c in HTN patients, indicating that monitoring HsCRP and RBP may serve as indicators for therapeutic efficacy of HDL-c-raising medications in HTN patients.
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Affiliation(s)
- Xiaolin Li
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
- Department of Endocrinology, Hunan University of Medicine, Huaihua 418000, Hunan, People’s Republic of China
| | - Ting Su
- Guangdong Provincial Key Laboratory of Proteomics, School of Basic Medical Sciences, Southern Medical University, Guangzhou510515, People’s Republic of China
| | - Hua Xiao
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Peichun Gao
- School of Public Health, Southern Medical University, Guangzhou510080, People’s Republic of China
| | - Chongxiang Xiong
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Jinghua Liu
- Guangdong Provincial Key Laboratory of Proteomics, School of Basic Medical Sciences, Southern Medical University, Guangzhou510515, People’s Republic of China
- Correspondence: Jinghua Liu Guangdong Provincial Key Laboratory of Proteomics, School of Basic Medical Sciences, Southern Medical University, Guangzhou510515, People’s Republic of ChinaTel +86 20 61648392Fax +86 20 61648231 Email
| | - Hequn Zou
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
- Hequn ZouDepartment of Nephrology, The Third Affiliated Hospital, Southern Medical University, 183 Zhongshan Dadao, Tianhe District, Guangzhou510630, People’s Republic of ChinaTel +86 20 62784393Fax +86 20 62784399 Email
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Zhao J, Zhang Y, Wei F, Song J, Cao Z, Chen C, Zhang K, Feng S, Wang Y, Li WD. Triglyceride is an independent predictor of type 2 diabetes among middle-aged and older adults: a prospective study with 8-year follow-ups in two cohorts. J Transl Med 2019; 17:403. [PMID: 31801571 PMCID: PMC6894231 DOI: 10.1186/s12967-019-02156-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 11/25/2019] [Indexed: 12/17/2022] Open
Abstract
Background Although there is abundant evidence indicating the connection between triglyceride and type 2 diabetes mellitus (T2DM), few reports or cohort studies confirm that high TG concentration may predict the incidence of T2DM independently. Thus, we studied the association between triglyceride (TG) and T2DM in a male-dominated, middle and older aged cohort, Tianjin General Hospital Cohort. And we further verified our results in the China Health and Retirement Longitudinal Study (CHARLS). Methods We conducted an 8-year retrospective cohort study (2009–2017) with 7241 participants who were free from T2DM at baseline. Three groups were constructed based on baseline TG levels (normal, borderline-high, and high). We used a Cox proportional hazards model to evaluate the relationship between TG and T2DM after adjusting for possible risk factors. A Kaplan–Meier survival analysis was performed to compare the incidence of T2DM among subjects in each TG group. We also tested the association between TG and T2DM in the CHARLS cohort. Results In Tianjin General Hospital Cohort, 7241 participants (male 75.8%, female 24.2%) were included, mean age was 61.49 ± 13.85 years at baseline. The cumulative incidence of T2DM in our cohort study was 8.6% (9.2% in men and 6.6% in women). Compared with the normal TG group, the hazard ratios in the borderline and high group were 1.30 (95% CI 1.04–1.62) and 1.54 (95% CI 1.24–1.90). The Kaplan–Meier survival analysis indicated that higher TG levels may predict higher onset of T2DM. These results were verified in the CHARLS cohort, the hazard ratio with T2DM (95% CI) for logTG was 3.94 (2.64–5.87). Conclusions Our findings suggest that the TG level may be an independent risk factor and predictor for T2DM.
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Affiliation(s)
- Jing Zhao
- Department of Genetics, College of Basic Medical Sciences, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Yuan Zhang
- Department of Genetics, College of Basic Medical Sciences, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Fengjiang Wei
- Department of Genetics, College of Basic Medical Sciences, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Jiani Song
- Department of Genetics, College of Basic Medical Sciences, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Zhi Cao
- College of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Chen Chen
- Tianjin General Hospital, Tianjin Medical University, 154 Anshan Road, Tianjin, 300052, People's Republic of China
| | - Kai Zhang
- Tianjin General Hospital, Tianjin Medical University, 154 Anshan Road, Tianjin, 300052, People's Republic of China
| | - Shuzhi Feng
- Tianjin General Hospital, Tianjin Medical University, 154 Anshan Road, Tianjin, 300052, People's Republic of China.
| | - Yaogang Wang
- College of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China.
| | - Wei-Dong Li
- Department of Genetics, College of Basic Medical Sciences, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China.
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Zhou T, Liu X, Liu Y, Li X. Meta-analytic evaluation for the spatio-temporal patterns of the associations between common risk factors and type 2 diabetes in mainland China. Medicine (Baltimore) 2019; 98:e15581. [PMID: 31096461 PMCID: PMC6531165 DOI: 10.1097/md.0000000000015581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 04/12/2019] [Accepted: 04/15/2019] [Indexed: 01/19/2023] Open
Abstract
There is a dearth of accurate information about the associations between risk factors and type 2 diabetes in mainland China. We conducted a systematic review and meta-analysis to explore the spatio-temporal patterns of the associations between common risk factors and type 2 diabetes in adults at least 18 years old in mainland China.We searched English and Chinese databases from January 1st, 1997 to December 31st, 2017 for relevant observational studies. Overall and stratification analyses including secular trends and temporal distributions were conducted, odds ratio (OR) and 95% confidence interval (CI) were calculated by applying random-effects model.Thirty-five studies were included. Type 2 diabetes was positively associated with a family history of type 2 diabetes (OR 2.89, 95%CI 2.38-3.49), hypertension (OR 2.73, 95%CI 2.25-3.36), central obesity (OR 2.28, 95%CI 1.94-2.68), dyslipidemia (OR 2.23, 95%CI 1.70-2.91), hypertriglyceridemia (OR 2.18, 95%CI 1.64-2.92), general obesity (OR 1.90, 95%CI 1.66-2.18), hypercholesterolemia (OR 1.65, 95%CI 1.32-2.06), smoking (OR 1.26, 95%CI 1.13-1.40), and drinking (OR 1.20, 95%CI 1.05-1.36), whereas a negative association with female gender (OR 0.87, 95%CI 0.78-0.97) existed. Except for female gender and drinking, the pooled effects of temporal and spatial stratification for the other five risk factors were consistent with the above results. For temporal stratification, the ORs of general obesity increased gradually during the periods of 1992 to 2005, 2006 to 2010, and 2011 to 2017, while the ORs of a family history declined. For regional stratification, the magnitudes of ORs for hypertension, dyslipidemia, and hypercholesterolemia in northern areas were larger than that in southern areas, while opposite situation occurred for a family history. Except for the factor a family history, provincial results for the other nine risk factors differed from the overall results and among provinces.Effect differences existed for modifiable and non-modifiable risk factors in secular trends and regional distribution, which is of potential public health importance for type 2 diabetes prevention.
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Affiliation(s)
- Ting Zhou
- Department of Epidemiology and Biostatistics
| | - Xiang Liu
- Department of Health and Social Behavior, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | | | - Xiaosong Li
- Department of Epidemiology and Biostatistics
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Cheng C, Liu Y, Sun X, Yin Z, Li H, Zhang M, Zhang D, Wang B, Ren Y, Zhao Y, Liu D, Zhou J, Liu X, Liu L, Chen X, Liu F, Zhou Q, Hu D. Dose-response association between the triglycerides: High-density lipoprotein cholesterol ratio and type 2 diabetes mellitus risk: The rural Chinese cohort study and meta-analysis. J Diabetes 2019; 11:183-192. [PMID: 30091266 DOI: 10.1111/1753-0407.12836] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/10/2018] [Accepted: 08/02/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND High triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) levels are traditional risk factors for type 2 diabetes mellitus (T2DM). This study evaluated the dose-response relationship between the TG/HDL-C ratio and T2DM risk. METHODS The study included 11 946 adults without baseline diabetes from the Rural Chinese Cohort Study. Cox proportional hazards regression was used to investigate the association between the TG/HDL-C ratio and T2DM. The dose-response relationship was evaluated by restricted cubic spline analysis. In addition, pooled odds ratios (OR) were calculated with a random-effects model in a meta-analysis including the present study and another three eligible articles. RESULTS During 2007-14, 618 patients with T2DM were identified (9.68/1000 person-years). People in the highest TG/HDL-C ratio quartile had a higher T2DM risk than those in the lowest quartile (adjusted hazard ratio [aHR] 2.11, 95% confidence interval [CI] 1.55-2.86); however, the association between the TG/HDL-C ratio and T2DM was stronger in females than males (aHR 1.27 [95% CI 1.16-1.39; and 1.19 [95% CI 1.04-1.37], respectively). In body mass index-specific analysis, the association was stronger in normal weight than overweight/obese people. The dose-response meta-analysis showed that a 1-unit increment in the TG/HDL-C ratio increased the T2DM risk by 28% (95% CI 20%-36%), with a positive linear relationship (Plinear = 0.326). CONCLUSIONS The TG/HDL-C ratio was an independent risk factor of T2DM, especially in females, and linearly increased the risk of T2DM; thus, it may be a useful indicator to identify future T2DM.
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Affiliation(s)
- Cheng Cheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yu Liu
- The Affiliated Luohu Hospital of Shenzhen, University Health Sciences Center, Shenzhen, China
| | - Xizhuo Sun
- The Affiliated Luohu Hospital of Shenzhen, University Health Sciences Center, Shenzhen, China
| | - Zhaoxia Yin
- The Affiliated Luohu Hospital of Shenzhen, University Health Sciences Center, Shenzhen, China
| | - Honghui Li
- The Affiliated Luohu Hospital of Shenzhen, University Health Sciences Center, Shenzhen, China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Dongdong Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Bingyuan Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Yongcheng Ren
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Dechen Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Junmei Zhou
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Xuejiao Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Leilei Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xu Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Feiyan Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Qionggui Zhou
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
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Wang Y, Sun L, Lin X, Yuan JM, Koh WP, Pan A. Retinol binding protein 4 and risk of type 2 diabetes in Singapore Chinese men and women: a nested case-control study. Nutr Metab (Lond) 2019; 16:3. [PMID: 30651745 PMCID: PMC6329092 DOI: 10.1186/s12986-018-0329-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/18/2018] [Indexed: 01/21/2023] Open
Abstract
Background Although retinol binding protein 4 (RBP4) has been implicated in insulin resistance in experimental studies, the association between RBP4 and risk of type 2 diabetes remains unclear. We assessed this association in a Chinese population, and pooled our results with those from two prior studies. Methods Plasma RBP4 levels were measured among 571 incident type 2 diabetes cases and 571 controls nested within the Singapore Chinese Health Study. All participants were free of diabetes, cancer and cardiovascular disease at blood collection (1999–2004). Incident cases of physician-diagnosed diabetes were self-reported at subsequent interviews (2006–2010). Results Plasma RBP4 levels were significantly higher in men than women, and the respective median values were 30 (interquartile range: 24–35) μg/mL and 25 (interquartile range: 21–31) μg/mL, respectively. With adjustment for diabetes risk factors, compared to the lowest quartile, the odds ratio (OR) and confidence interval (CI) for risk of type 2 diabetes associated with the highest quartile of RBP4 levels were 1.23 (0.73–2.07; P-trend = 0.14) in all subjects, 0.63 (0.27–1.45; P-trend = 0.65) in men, and 2.29 (1.05–5.00; P-trend = 0.018) in women. The difference in the risk estimates between men and women was statistically significant (P-interaction = 0.032). When we pooled our results with two prior studies, ORs (95% CIs) comparing high versus low category of RBP4 was 1.01 (0.70–1.46; I2 = 8.2%; P-heterogeneity = 0.34) in men, and 1.73 (1.28–2.33; I2 = 0%; P-heterogeneity = 0.80) in women. Conclusions Increased plasma RBP4 levels were associated with higher risk of type 2 diabetes in women but not in men. Electronic supplementary material The online version of this article (10.1186/s12986-018-0329-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yeli Wang
- 1Health Services and Systems Research, Duke-NUS Medical School, Singapore, 169857 Singapore
| | - Liang Sun
- 2CAS Key Laboratory of Nutrition, Metabolism and Food safety, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031 China
| | - Xu Lin
- 2CAS Key Laboratory of Nutrition, Metabolism and Food safety, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031 China
| | - Jian-Min Yuan
- 3Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, 15232 PA USA.,4Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, 15261 PA USA
| | - Woon-Puay Koh
- 1Health Services and Systems Research, Duke-NUS Medical School, Singapore, 169857 Singapore.,5Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549 Singapore
| | - An Pan
- 6Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 Hubei Province China
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Shi WR, Wang HY, Chen S, Guo XF, Li Z, Sun YX. Estimate of prevalent diabetes from cardiometabolic index in general Chinese population: a community-based study. Lipids Health Dis 2018; 17:236. [PMID: 30314516 PMCID: PMC6186046 DOI: 10.1186/s12944-018-0886-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 10/03/2018] [Indexed: 12/21/2022] Open
Abstract
Background Cardiometabolic index (CMI) defines adiposity based on triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio and waist-to-height ratio (WHtR). This newly proposed metric has been used to detect multiple cardiovascular risk factors, but data relative to diabetes in the general population are lacking. This study aims to validate CMI’s utility of discriminating diabetes and compares it with other indexes among general Chinese population. Methods Analyses were based on a cross-sectional study of 11,478 participants that underwent assessment of metabolic and anthropometric parameters in rural areas of northeastern China in 2013. CMI was calculated by TG/HDL-C × WHtR. Multivariate logistic regressions were performed to clarify CMI’s association with diabetes, ROC analyses were engaged to investigate CMI’s discriminating ability for diabetes. Results The prevalence of diabetes was 9.93% in males while 10.76% in females, and increased with CMI’s increment. After full adjustment, each SD increment of CMI had odds ratios (ORs) for diabetes of 1.471 (1.367–1.584) and 1.422 (1.315–1.539) in females and males, respectively. Compared with bottom categories of CMI, the top quartiles had ORs of 3.736 (2.783–5.015) in females and 3.697 (2.757–4.958) in males. The ROC results showed an excellent discriminating power of CMI (AUC: 0.702 for females, 0.664 for males). Conclusions An increasing CMI was correlated with higher odds of diabetes, supporting CMI as a useful and economic measure to screen and quantify diabetes in general Chinese population. Monitoring and promoting achievement of dyslipidemia and abdominal obesity based on CMI may improve subclinical and cardiovascular outcomes.
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Affiliation(s)
- Wen-Rui Shi
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Hao-Yu Wang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Shuang Chen
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Xiao-Fan Guo
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Ying-Xian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.
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Khaloo P, Hasheminia M, Tohidi M, Abdi H, Mansournia MA, Azizi F, Hadaegh F. Impact of 3-year changes in lipid parameters and their ratios on incident type 2 diabetes: Tehran lipid and glucose study. Nutr Metab (Lond) 2018; 15:50. [PMID: 30008790 PMCID: PMC6042239 DOI: 10.1186/s12986-018-0287-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 07/05/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND To examine the impact of changes in all lipid measures including total cholesterol (TC), log-transformed triglycerides (Ln-TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), non-HDL-C, TC/HDL-C and Ln TG/HDL-C, over an approximate 3 year duration, on incident type 2 diabetes (T2DM). METHODS A total of 5474 participants, mean age 41.3 years, without prevalent diabetes at baseline or the first follow-up were entered into the study. The association of lipid changes between baseline and the first follow-up i.e., between 1999-2002 and 2002-2005 for those entered in the first phase (n = 4406) and between 2002-2005 and 2005-2008 for participants recruited in the second phase (n = 1068) with incident T2DM over the follow-up period was assessed, using multivariate Cox proportional hazard analysis. RESULTS During a median follow-up of 8.9 years after the second lipid measurements, 577 incident cases of T2DM occurred. After adjustment for a wide variety of confounders and body mass index (BMI) change, each 1-SD increase in TC, Ln-TG, HDL-C, LDL-C, non-HDL-C, Ln-TG/HDL-C and TC/HDL-C was associated with 12, 14, 0.86, 12, 16, 15 and 13% risk for T2DM, respectively (all p-values < 0.05). However, after further adjustment for fasting plasma glucose (FPG) change, the risk disappeared for all lipid measures, excluding HDL-C [hazard ratio (HR): 0.84 (0.76-0.93)], Ln-TG/HDL-C [1.14 (1.04-1.25)] and TC/HDL-C [1.12 (1.04-1.21)]. CONCLUSIONS Three year changes in all lipid parameters, after adjustment for known risk factors of T2DM and BMI changes, were associated with incident T2DM. The independent risk of HDL-C and its ratios remained even after adjustment for FPG changes.
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Affiliation(s)
- Pegah Khaloo
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Number 24, Yemen Street, Shahid Chamran Highway, P.O. Box: 19395-4763, Tehran, Iran
| | - Mitra Hasheminia
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Number 24, Yemen Street, Shahid Chamran Highway, P.O. Box: 19395-4763, Tehran, Iran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Number 24, Yemen Street, Shahid Chamran Highway, P.O. Box: 19395-4763, Tehran, Iran
| | - Hengameh Abdi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Number 24, Yemen Street, Shahid Chamran Highway, P.O. Box: 19395-4763, Tehran, Iran
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Bouhajja H, Kacem FH, Abdelhedi R, Ncir M, Dimitrov JD, Marrakchi R, Jamoussi K, Rebai A, El Feki A, Abid M, Ayadi H, Kaveri SV, Mnif-Feki M, Bougacha-Elleuch N. Potential Predictive Role of Lipid Peroxidation Markers for Type 2 Diabetes in the Adult Tunisian Population. Can J Diabetes 2018; 42:263-271. [PMID: 28734952 DOI: 10.1016/j.jcjd.2017.06.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/02/2017] [Accepted: 06/15/2017] [Indexed: 12/29/2022]
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Bouhajja H, Abdelhedi R, Amouri A, Hadj Kacem F, Marrakchi R, Safi W, Mrabet H, Chtourou L, Charfi N, Fourati M, Bensassi S, Jamoussi K, Abid M, Ayadi H, Mnif-Feki M, Bougacha-Elleuch N. Potential role of liver enzyme levels as predictive markers of glucose metabolism disorders in a Tunisian population. Can J Physiol Pharmacol 2018. [PMID: 29527933 DOI: 10.1139/cjpp-2017-0579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The relationship between liver enzymes and T2D risk is inconclusive. We aimed to evaluate the association between liver markers and risk of carbohydrate metabolism disorders, as well as their discriminatory power, for T2D prediction. This cross-sectional study enrolled 216 participants classified as normoglycemic, prediabetic, newly diagnosed diabetics, and diagnosed diabetics. All participants underwent anthropometric and biochemical measurements. The relationship between hepatic enzymes and glucose metabolism markers was evaluated by analyses of covariance. The associations between liver enzymes and incident carbohydrate metabolism disorders were analyzed through logistic regression and their discriminatory capacity to predict T2D by ROC analysis. High AP, ALT, γGT, and AST levels were independently related to decreased insulin sensitivity. Interestingly, a higher AP level was significantly associated with an increased risk of prediabetes (p = 0.017), newly diagnosed diabetes (p = 0.004), and T2D (p = 0.007). An elevated γGT level was an independent risk factor for T2D (p = 0.032) and undiagnosed T2D (p = 0.010) in prediabetic and normoglycemic subjects, respectively. In ROC analysis, AP was a powerful predictor of incident diabetes and significantly improved T2D prediction. Liver enzymes within the normal range, specifically AP levels, are associated with increased risk of carbohydrate metabolism disorders and significantly improved T2D prediction.
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Affiliation(s)
- Houda Bouhajja
- a Unit of Obesity and Metabolic Syndrome, Department of Endocrinology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Rania Abdelhedi
- b Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, Sfax, Tunisia
| | - Ali Amouri
- c Department of Gastroenterology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Faten Hadj Kacem
- a Unit of Obesity and Metabolic Syndrome, Department of Endocrinology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Rim Marrakchi
- d Biochemistry Laboratory, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Wajdi Safi
- a Unit of Obesity and Metabolic Syndrome, Department of Endocrinology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Houcem Mrabet
- a Unit of Obesity and Metabolic Syndrome, Department of Endocrinology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Lassaad Chtourou
- c Department of Gastroenterology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Nadia Charfi
- a Unit of Obesity and Metabolic Syndrome, Department of Endocrinology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Mouna Fourati
- a Unit of Obesity and Metabolic Syndrome, Department of Endocrinology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Salwa Bensassi
- a Unit of Obesity and Metabolic Syndrome, Department of Endocrinology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Kamel Jamoussi
- d Biochemistry Laboratory, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Mohamed Abid
- a Unit of Obesity and Metabolic Syndrome, Department of Endocrinology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Hammadi Ayadi
- b Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, Sfax, Tunisia
| | - Mouna Mnif-Feki
- a Unit of Obesity and Metabolic Syndrome, Department of Endocrinology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Noura Bougacha-Elleuch
- e Laboratory of Molecular and Functional Genetics, Faculty of Sciences of Sfax, University of Sfax, Tunisia
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Zhang M, Zhou J, Liu Y, Sun X, Luo X, Han C, Zhang L, Wang B, Ren Y, Zhao Y, Zhang D, Liu X, Hu D. Risk of type 2 diabetes mellitus associated with plasma lipid levels: The rural Chinese cohort study. Diabetes Res Clin Pract 2018; 135:150-157. [PMID: 29155120 DOI: 10.1016/j.diabres.2017.11.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 06/08/2017] [Accepted: 11/10/2017] [Indexed: 11/30/2022]
Abstract
AIM To investigate the association of type 2 diabetes mellitus (T2DM) risk and plasma lipid levels in rural Chinese. METHODS Each lipid variable was divided into quartiles and dichotomized by clinical cutoff points. Cox proportional-hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of T2DM risk and plasma lipid levels and explore the interaction between plasma lipid levels and other risk factors. RESULTS 11,929 participants were included in the analysis. We documented 720 incident cases of T2DM over 70,720.84 person-years of follow-up, for an incidence of 10.18/1,000 person-years. In the multivariable-adjusted model, risk of T2DM was increased with the highest versus lowest quartiles of total cholesterol (TC) and triglycerides (TG) levels and TC/high-density lipoprotein-cholesterol (HDL-C) and TG/HDL-C ratios. The HRs (95% CIs) for the fourth quartiles, for example, were 1.34 (1.03-1.74), 2.32 (1.73-3.13), 1.66 (1.23-2.25), and 1.84 (1.38-2.45), respectively. In addition, risk of T2DM was increased with high TG level and TC/HDL-C and TG/HDL-C ratios by clinical cutoffs. The HRs (95% CIs) were 1.50 (1.25-1.80), 1.24 (1.03-1.48), and 1.44 (1.18-1.75), respectively. Risk of T2DM was associated with interactions between all lipid variables and age and BMI. TG level and TG/HDL-C ratio additionally interacted with gender (all Pinteraction < 0.0001). CONCLUSIONS Risk of T2DM was increased with elevated serum levels of TC and TG and TC/HDL-C and TG/HDL-C ratios and also with interactions between high TC and TG levels and TC/HDL-C and TG/HDL-C ratios and age and BMI in a rural Chinese population.
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Affiliation(s)
- Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Shenzhen 518060, Guangdong, China
| | - Junmei Zhou
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Shenzhen 518060, Guangdong, China
| | - Yu Liu
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, 47 Youyi Road, Shenzhen 518001, Guangdong, China
| | - Xizhuo Sun
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, 47 Youyi Road, Shenzhen 518001, Guangdong, China
| | - Xinping Luo
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Shenzhen 518060, Guangdong, China
| | - Chengyi Han
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Shenzhen 518060, Guangdong, China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou 450001, Henan, China
| | - Lu Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Shenzhen 518060, Guangdong, China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou 450001, Henan, China
| | - Bingyuan Wang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Shenzhen 518060, Guangdong, China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou 450001, Henan, China
| | - Yongcheng Ren
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Shenzhen 518060, Guangdong, China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou 450001, Henan, China
| | - Yang Zhao
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Shenzhen 518060, Guangdong, China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou 450001, Henan, China
| | - Dongdong Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Shenzhen 518060, Guangdong, China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou 450001, Henan, China
| | - Xuejiao Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Shenzhen 518060, Guangdong, China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou 450001, Henan, China
| | - Dongsheng Hu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Shenzhen 518060, Guangdong, China.
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Wang H, Guo X, Chen Y, Li Z, Xu J, Sun Y. Relation of four nontraditional lipid profiles to diabetes in rural Chinese H-type hypertension population. Lipids Health Dis 2017; 16:199. [PMID: 29020963 PMCID: PMC5637264 DOI: 10.1186/s12944-017-0590-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/04/2017] [Indexed: 01/09/2023] Open
Abstract
Background Mounting evidence suggested that nontraditional lipid profiles have been recognized as a reliable indicator for unfavorable cardiovascular events. The purpose of this study was to explore the role of nontraditional lipid profiles as potential clinical indices for the assessment of prevalent diabetes in rural Chinese H-type hypertension population. Methods During 2012 to 2013, we conducted a large cross-sectional study of 2944 H-type hypertension participants (≥35 years of age) from rural areas in northeast China. Subjects underwent accurate assessment of lipid profiles, fasting plasma glucose (FPG), homocysteine (Hcy) according to standard protocols. Results The proportion of diabetes showed a graded and linear increase across the quartiles for all four nontraditional lipid parameters. Nontraditional lipid variables were independent determinants of FPG, and its correlation for TG/HDL-C was strongest, whether potential confounders were adjusted or not. Multivariable logistic regression analysis established that the highest triglycerides (TG)/ high-density lipoprotein cholesterol (HDL-C) quartile manifested the largest ORs of prevalent diabetes (OR: 3.275, 95%CI: 2.109–5.087) compared with the lowest quartile. The fully adjusted ORs (95%CI) were 2.753 (1.783–4.252), 2.178 (1.415–2.351), 1.648 (1.097–2.478) for the top quartile of total cholesterol (TC)/HDL-C, low-density lipoprotein cholesterol (LDL-C)/HDL-C, and non-high-density lipoprotein cholesterol (non-HDL-C), respectively. On the basis of the area under receiver-operating characteristic curve (AUC), TG/HDL-C showed the optimal discriminating power for diabetes (AUC: 0.684, 95% CI: 0.650–0.718). Conclusions Nontraditional lipid profiles (TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C) were all consistently and independently correlated with prevalent diabetes among the H-type hypertension population in rural China. TG/HDL-C was prone to be more profitable in assessing the risk of prevalent diabetes and should be encouraged as an effective clinical tool for monitoring and targeted intervention of diabetes in H-type hypertension adults.
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Affiliation(s)
- Haoyu Wang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yintao Chen
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Jiaqi Xu
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China.
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