Meta-analysis of Atherogenic Index of Plasma and other lipid parameters in relation to risk of type 2 diabetes mellitus

AIMS

Diabetic dyslipidemia is one of important complication of type 2 diabetes mellitus (T2DM). Blood lipid parameters (e.g., triglyceride, TG; total cholesterol, TC; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C; Atherogenic Index of Plasma defined as lg(TG/HDL-C), AIP), are important indexes in predicting risk of T2DM. This study performed comprehensive meta-analyses to evaluate the powers of these indexes, especially for AIP, on predicting risk of T2DM.

METHODS

We searched PubMed Database, China National Knowledge Infrastructure (CNKI) and Wanfang Database in February 2014 to identify eligible studies. Case-control studies that have mean baseline values of AIP were included. Random-effect models were used to pool the summary standardized mean difference (SMD) in meta-analysis.

RESULTS

Fifteen eligible studies, with a total sample size of 4010, were included in meta-analysis. All these studies reported positive associations between AIP and T2DM. Moreover, the SMD for the AIP is 1.78 (95% confidence interval (CI): 1.04-2.52), which is higher than for other parameters (TG: 0.93, 95% CI: 0.78-1.09; TC: 0.46, 95% CI: 0.21-0.71; HDL-C: -0.89, 95% CI: -1.18 to -0.60; and LDL-C: 0.44, 95% CI: 0.11-0.77). Meta-analysis of association between BMI and T2DM gave a SMD of 0.85 (95% CI: 0.38 to 1.32).

CONCLUSIONS

The results suggest that lipid parameters have ability to reflect the risk of T2DM, but AIP may be more closely associated with the risk of T2DM. The current results suggest AIP may be used as a simple, easily calculated parameter in assessing the risk of T2DM.

Association between the triglyceride to high-density lipoprotein cholesterol ratio and type 2 diabetes mellitus in non-alcoholic fatty liver disease

This study evaluated the ability of the triglyceride (TG) to high-density lipoprotein cholesterol (TG/HDL-C) ratio to identify individuals at risk of type 2 diabetes mellitus (T2DM) in the non-alcoholic fatty liver disease (NAFLD) population. We retrospectively studied 4,769 patients with NAFLD from the Affiliated Hospital of Hangzhou Normal University (2020-2023). Binary logistic regression models were used to evaluate the association between the TG/HDL-C ratio and lipid parameters with T2DM. TG/HDL-C ratio was positively associated with T2DM in patients with NAFLD, with an odds ratio (OR) of 2.72 (95% confidence interval, 2.23-3.31, p < 0.001) for T2DM in the highest TG/HDL-C ratio quartile compared with the lowest one after adjusting for known confounders. The OR for the TG/HDL-C ratio had a stronger predictive value than those of TG, total cholesterol, HDL-C, and low-density lipoprotein cholesterol, indicating that the TG/HDL-C ratio could be a better discriminator of T2DM. The TG/HDL-C ratio better identifies potential risks of T2DM in individuals with NAFLD than individual lipid parameters. Therefore, clinicians should pay attention to individuals with high TG and low HDL-C levels during T2DM risk assessment in NAFLD cohorts.