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Chen W, Hu H, Cao C, Liu D, Han Y. Link between remnant cholesterol and the reversion to normoglycemia in Chinese adults with prediabetes: a 5-year cohort study. Sci Rep 2024; 14:18098. [PMID: 39103476 PMCID: PMC11300864 DOI: 10.1038/s41598-024-69169-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 08/01/2024] [Indexed: 08/07/2024] Open
Abstract
Despite the clear association between remnant cholesterol (RC)and diabetes risk, no study to date has examined the relationship between RC and reversal of prediabetes to normoglycemia. This retrospective cohort study included a total of 15,023 patients with prediabetes who underwent a physical examination between 2010 and 2016. The link between initial RC levels and the reversion from prediabetes to normoglycemia was analyzed using the Cox proportional-hazards regression model. Additionally, the study explored the possible relationship between RC and the probability of returning normoglycemia by applying Cox proportional hazards regression models with cubic spline functions. To address competing risks, a multivariate Cox regression analysis was undertaken, treating the onset of diabetes as a competing risk event for reversing prediabetes to normoglycemia. Additionally, the study incorporated extensive subgroup analyses alongside multiple sensitivity analyses, enhancing the reliability and robustness of the results. After adjusting for covariates, the findings indicated that RC was inversely associated with the likelihood of reverting to normoglycemia (per 5 mg/dL increase, HR = 0.918, 95% CI 0.909-0.927). The analysis also revealed a nonlinear relationship between RC and normoglycemia reversion, with an inflection point at 51.08 mg/dL. For RC values below this inflection point (RC < 50.08 mg/dL), the HR for the probability of returning to normoglycemia was 0.907 (95% CI 0.897-0.917 per 5 mg/dL). Additionally, the competing risks model demonstrated a negative relationship between RC and the reversal of prediabetes to normoglycemia (SHR = 0.92, 95% CI 0.91-0.93). Sensitivity analyses confirmed the robustness and stability of these results. This study demonstrated a negative and non-linear association between RC and the probability of reversion to normoglycemia in Chinese adults with prediabetes. By actively intervening to reduce RC levels, at least to below 51.08 mg/dL, further reduction of RC may significantly increase the probability of returning to normoglycemia from prediabetes.
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Affiliation(s)
- Weifeng Chen
- Department of General Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, 518000, Guangdong, China
| | - Dehong Liu
- Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong, China.
| | - Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong, China.
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Shao Y, Hu H, Cao C, Han Y, Wu C. Elevated triglyceride-glucose-body mass index associated with lower probability of future regression to normoglycemia in Chinese adults with prediabetes: a 5-year cohort study. Front Endocrinol (Lausanne) 2024; 15:1278239. [PMID: 38414822 PMCID: PMC10898590 DOI: 10.3389/fendo.2024.1278239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/16/2024] [Indexed: 02/29/2024] Open
Abstract
Objective Despite the clear association of TyG-BMI with prediabetes and the progression of diabetes, no study to date has examined the relationship between TyG-BMI and the reversal of prediabetes to normoglycemia. Methods 25,279 participants with prediabetes who had physical examinations between 2010 and 2016 were enrolled in this retrospective cohort study. The relationship between baseline TyG-BMI and regression to normoglycemia from prediabetes was examined using the Cox proportional hazards regression model in this study. Additionally, the nonlinear association between TyG-BMI and the likelihood of regression to normoglycemia was investigated using the Cox proportional hazards regression with cubic spline function. Competing risk multivariate Cox regression analysis was conducted, with progression to diabetes as a competing risk for prediabetes reversal to normoglycemia. Furthermore, subgroup analyses and a series of sensitivity analyses were performed. Results After adjusting for covariates, the results showed that TyG-BMI was negatively associated with the probability of returning to normoglycemia (per 10 units, HR=0.970, 95% CI: 0.965, 0.976). They were also nonlinearly related, with an inflection point for TyG-BMI of 196.46. The effect size (HR) for TyG-BMI to the right of the inflection point (TyG-BMI ≥ 196.46) and the probability of return of normoglycemia was 0.962 (95% CI: 0.954, 0.970, per 10 units). In addition, the competing risks model found a negative correlation between TyG-BMI and return to normoglycemia (SHR=0.97, 95% CI: 0.96-0.98). Sensitivity analyses demonstrated the robustness of our results. Conclusion This study demonstrated a negative and nonlinear relationship between TyG-BMI and return to normoglycemia in Chinese adults with prediabetes. Through active intervention, the combined reduction of BMI and TG levels to bring TyG-BMI down to 196.46 could significantly increase the probability of returning to normoglycemia.
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Affiliation(s)
- Yang Shao
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
- Liaoning Clinical Research Center for Laboratory Medicine, Shenyang, Liaoning, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Cen Wu
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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Mo Z, Hu H, Han Y, Cao C, Zheng X. Association between high-density lipoprotein cholesterol and reversion to normoglycemia from prediabetes: an analysis based on data from a retrospective cohort study. Sci Rep 2024; 14:35. [PMID: 38168464 PMCID: PMC10762102 DOI: 10.1038/s41598-023-50539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
The available evidence on the connection between high-density lipoprotein cholesterol (HDL-C) levels and the reversion from prediabetes (Pre-DM) to normoglycemia is currently limited. The present research sought to examine the connection between HDL-C levels and the regression from Pre-DM to normoglycemia in a population of Chinese adults. This historical cohort study collected 15,420 Pre-DM patients in China who underwent health screening between 2010 and 2016. The present research used the Cox proportional hazards regression model to investigate the connection between HDL-C levels and reversion from Pre-DM to normoglycemia. The Cox proportional hazards regression model with cubic spline functions and smooth curve fitting was employed to ascertain the nonlinear association between HDL-C and reversion from Pre-DM to normoglycemia. Furthermore, a set of sensitivity analyses and subgroup analyses were employed. Following the adjustment of covariates, the findings revealed a positive connection between HDL-C levels and the likelihood of reversion from Pre-DM to normoglycemia (HR 1.898, 95% CI 1.758-2.048, P < 0.001). Furthermore, there was a non-linear relationship between HDL-C and the reversion from Pre-DM to normoglycemia in both genders, and the inflection point of HDL-C was 1.540 mmol/L in males and 1.620 mmol/L in females. We found a strong positive correlation between HDL-C and the reversion from Pre-DM to normoglycemia on the left of the inflection point (Male: HR 2.783, 95% CI 2.373-3.263; Female: HR 2.217, 95% CI 1.802-2.727). Our sensitivity analysis confirmed the robustness of these findings. Subgroup analyses indicated that patients with SBP < 140 mmHg and ever smoker exhibited a more pronounced correlation between HDL-C levels and the reversion from Pre-DM to normoglycemia. In contrast, a less robust correlation was observed among patients with SBP ≥ 140 mmHg, current and never smokers. This study provides evidence of a positive and nonlinear association between HDL-C levels and the reversion from Pre-DM to normoglycemia in Chinese patients. Implementing intensified intervention measures to control the HDL-C levels of patients with Pre-DM around the inflection point may substantially enhance the likelihood of regression to normoglycemia.
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Affiliation(s)
- Zihe Mo
- Department of Physical Examination, DongGuan Tungwah Hospital, Dongguan, 523000, Guangdong Province, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, No.3002, Sungang West Road, Futian District, Shenzhen, 518000, Guangdong Province, China.
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Second People's Hospital, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong Province, China.
| | - Xiaodan Zheng
- Department of Neurology, Shenzhen Samii Medical Center, The Fourth People's Hospital of Shenzhen, No. 1 Jinniu West Road, Shijing Street, Pingshan District, Shenzhen, 518000, Guangdong Province, China.
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Mo Z, Han Y, Cao C, Huang Q, Hu Y, Yu Z, Hu H. Association between non-high-density lipoprotein to high-density lipoprotein ratio and reversion to normoglycemia in people with impaired fasting glucose: a 5-year retrospective cohort study. Diabetol Metab Syndr 2023; 15:259. [PMID: 38105214 PMCID: PMC10726583 DOI: 10.1186/s13098-023-01237-0] [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: 08/09/2023] [Accepted: 11/29/2023] [Indexed: 12/19/2023] Open
Abstract
OBJECTIVE The relationship between the non-high-density lipoprotein to high-density lipoprotein ratio (non-HDL-c/HDL-c ratio) and changes in glycemic status as well as the development of type 2 diabetes mellitus (T2DM) has been well established. However, there is a lack of evidence concerning the association between the non-HDL-c/HDL-c ratio and the reversal of normoglycemia in individuals with impaired fasting glucose (IFG). Therefore, this study aimed to examine the connection between the non-HDL-c/HDL-c ratio and the likelihood of reverting to normoglycemia among people with IFG. METHODS This retrospective cohort study examined data collected from 15,524 non-selective participants with IFG at the Rich Healthcare Group in China between January 2010 and 2016. The Cox proportional-hazards regression model was used to investigate the connection between the baseline non-HDL-c/HDL-c ratio and the probability of reverting to normoglycemia. We were able to discover the non-linear association between the non-HDL-c/HDL-c ratio and reversion to normoglycemia using a Cox proportional hazards regression model with cubical spline smoothing. We also performed several sensitivity and subgroup analyses. A competing risk multivariate Cox regression was utilized as well to examine the development to diabetes as a competing risk for the reversal of normoglycemic events. RESULTS In our study, a total of 15,524 individuals participated, with a mean age of 50.9 ± 13.5 years, and 64.7% were male. The average baseline non-HDL-c/HDL-c ratio was 2.9 ± 0.9. Over a median follow-up period of 2.9 years, we observed a reversion rate to normoglycemia of 41.8%. After adjusting for covariates, our findings revealed a negative association between the non-HDL-c/HDL-c ratio and the likelihood of reverting to normoglycemia (HR = 0.71, 95% CI 0.69-0.74). Notably, we identified a non-linear relationship between the non-HDL-c/HDL-c ratio and the probability of transitioning from IFG to normoglycemia. We found an inflection point at a non-HDL-c/HDL-c ratio of 3.1, with HRs of 0.63 (95% CI 0.69, 0.74) on the left side and 0.78 (95% CI 0.74, 0.83) on the right side of the point. Competing risks multivariate Cox's regression, sensitivity analysis, and subgroup analysis consistently supported our robust results. CONCLUSION Our study has revealed a negative and non-linear relationship between the non-HDL-c/HDL-c ratio and reversion to normoglycemia in Chinese people with IFG. Specifically, when the non-HDL-c/HDL-c ratio was below 3.1, a significant and negative association with reversion to normoglycemia was observed. Furthermore, keeping the non-HDL-c/HDL-c ratio below 3.1 significantly elevated the probability of returning to normoglycemia.
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Affiliation(s)
- Zihe Mo
- Department of Physical Examination, Dongguan Tungwah Hospital, No. 1 Dongcheng Road, Dongcheng Street, Dongguan, 523000, Guangdong, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong, China
- Department of Emergency, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, 518000, Guangdong, China
| | - Qingli Huang
- Department of Physical Examination, Dongguan Tungwah Hospital, No. 1 Dongcheng Road, Dongcheng Street, Dongguan, 523000, Guangdong, China
| | - Yanhua Hu
- College of Information Science and Engineering, Liuzhou Institute of Technology, No. 99, Xinliu Avenue, Yufeng District, Liuzhou, 545616, Guangxi Zhuang Autonomous Region, China.
| | - Zhiqun Yu
- Department of Physical Examination, Dongguan Tungwah Hospital, No. 1 Dongcheng Road, Dongcheng Street, Dongguan, 523000, Guangdong, China.
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People's Hospital, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong, China.
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong, China.
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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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