Relation of four nontraditional lipid profiles to diabetes in rural Chinese H-type hypertension population

Value of the triglyceride-glucose index and non-traditional blood lipid parameters in predicting metabolic syndrome in women with polycystic ovary syndrome

PURPOSE

Insulin resistance (IR) is common in patients with polycystic ovary syndrome (PCOS). Metabolic syndrome (MS) includes, inter alia, IR, hypertension, dyslipidemia, and disturbances in glucose metabolism. The triglyceride-glucose (TyG) index and non-traditional lipid parameters are strong predictors of IR and cardiovascular disease and can be considered as screening indicators for MS. This study aimed to evaluate the predictive potential of non-traditional lipid parameters and the TyG index to identify MS in PCOS.

METHODS

This cross-sectional study included 134 women diagnosed with PCOS (50 patients with comorbid MS and 84 patients without MS). Biochemical indices were collected, and triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC)/HDL-C, low-density lipoprotein cholesterol (LDL-C)/HDL-C, non-HDL-C, TyG, and TyG-BMI indices were calculated. Logistic regression analysis was used to compare and determine the association of the six parameters with MS, and the receiver operating characteristic (ROC) curve was used to evaluate the performance of each parameter in identifying MS in the PCOS population.

RESULTS

After adjusting for age and body mass index (BMI), TG/HDL-C, TC/HDL-C, LDL-C/HDL-C, non-HDL-C, TyG, and TyG-BMI were associated with MS (all P<0.05). The odds ratios were 4.075 (0.891, 1.107), 3.121 (1.844, 5.282), 3.106 (1.734, 5.561), 2.238 (1.302, 3.848), 13.422 (4.364, 41.282), and 1.102 (1.056, 1.150), respectively. TG/HDL-C, TC/HDL-C, LDL-C/HDL-C, non-HDL-C, TyG, and TyG-BMI are effective predictors of MS in PCOS, and their cut-off values can be used for the early detection of MS. TyG-BMI had the strongest performance in predicting MS (area under the curve 0.905, 95% CI 0.855-0.956), and its optimal critical value for predicting MS was 202.542.

CONCLUSIONS

TG/HDL-C, TC/HDL-C, LDL-C/HDL-C, non-HDL-C, TyG, and TyG-BMI are novel, clinically convenient and practical markers for the early identification of MS risk in PCOS patients.

The association of lipid ratios with hyperuricemia in a rural Chinese hypertensive population

Background

Current studies support lipid ratios [the total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio; the triglyceride (TG)/HDL-C ratio; the low-density lipoprotein cholesterol (LDL -C)/HDL-C ratio; and non-HDL-C] as reliable indicators of cardiovascular disease, stroke, and diabetes. However, whether lipid ratios could serve as markers for hyperuricemia (HUA) remains unclear due to limited research. This study aimed to explore the association between lipid ratios and HUA in hypertensive patients.

Methods

The data from 14,227 Chinese hypertensive individuals in the study were analyzed. Multiple logistic regression analysis and smooth curve fitting models examined the relationship between lipid ratios and HUA.

Results

The results showed positive associations between the lipid ratios and HUA (all P < 0.001). Furthermore, lipid ratios were converted from continuous variables to tertiles. Compared to the lowest tertile, the fully adjusted ORs (95 % CI) of the TC/HDL-C ratio, the TG/HDL-C ratio, the LDL-C/HDL-C ratio, and non-HDL-C in the highest tertile were 1.79 (1.62, 1.99), 2.09 (1.88, 2.32), 1.67 (1.51, 1.86), and 1.93 (1.74, 2.13), respectively (all P < 0.001).

Conclusions

The study suggested that high lipid ratios (TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio, and non-HDL-C) are associated with HUA in a Chinese hypertensive population. This study’s findings further expand the scope of the application of lipid ratios. These novel and essential results suggest that lipid ratio profiles might be potential and valuable markers for HUA.

Trial registration

No. ChiCTR1800017274. Registered July 20, 2018.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12944-021-01556-z.

Lp(a) and Apo-lipoproteins as predictors for micro- and macrovascular complications of diabetes: A case-cohort study

AIMS

To investigate the associations between Lp(a), Apo A1, Apo B, and Apo B/Apo A1 ratio with micro- and macrovascular complications of diabetes.

METHODS AND RESULTS

In this case-cohort study, 1057 patients with type 2 diabetes (T2DM) were followed in the diabetes clinic of Vali-Asr Hospital from 2014 to 2019. The association between serum Lp (a) and apolipoproteins with cardiovascular disease (CVD), neuropathy, and nephropathy were assessed by using binary regression analysis. The ROC curve analysis was used to evaluate the predictive properties of proteins. Youden index was used to calculate cutoff values. Among patients with T2DM, 242, 231, and 91 patients developed CVD, neuropathy, and nephropathy, respectively. The serum Lp (a) level was positively correlated with the development of all three. (P-values = 0.022, 0.042, and 0.038, respectively). The Apo A1 level was negatively correlated with nephropathy. Among the biomarkers, Lp(a) had the highest AUC for prediction of CVD, neuropathy, and nephropathy. Calculated cutoff values of Lp(a), and Apo A1 levels were higher than the standard cutoff values.

CONCLUSION

Serum level of Lp(a) is a predictor for CVD, neuropathy, and nephropathy. Based on the calculated cutoff values in patients with T2DM, we should consider diabetic complications at higher levels of Lp(a).

A retrospective cohort study of preoperative lipid indices and their impact on new-onset diabetes after liver transplantation

Background

The correlation between preoperative lipid profiles and new‐onset diabetes after transplantation (NODAT) remains relatively unexplored in liver transplant recipients (LTRs). Thus, we aimed to investigate the preoperative lipid profiles in Chinese LTRs and evaluate the different influences of preoperative total cholesterol, total triglycerides (TG), high‐density lipoprotein cholesterol, and low‐density lipoprotein cholesterol on the development of NODAT in both sexes.

Methods

A total of 767 Chinese LTRs from Zhongshan Hospital were retrospectively evaluated. NODAT was defined according to the American Diabetes Association guidelines; the relationship between each preoperative lipid index and NODAT development was analyzed separately in men and women.

Results

Pretransplant hypotriglyceridemia was observed in 35.72% of the total LTRs. In men, only the preoperative TG level was significantly associated with incident NODAT after adjusting for potential confounders (hazard ratio 1.37, 95% confidence interval 1.13‐1.66, P = .001). There was a nonlinear relationship between the preoperative TG level and NODAT risk. The risk of NODAT significantly increased with preoperative a TG level above 0.54 mmol/L (log‐likelihood ratio test, P = .043). In women, no significant association was observed.

Conclusion

Among male LTRs, a higher preoperative TG level, even at a low level within the normal range, was significantly and nonlinearly associated with an increased risk of NODAT.

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

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 (P_linear  = 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.