Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China.
Lipids Health Dis. 2019 Jun 1;18(1):130. doi: 10.1186/s12944-019-1070-z.
Lipid ratios, for example total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) and triglyceride/high-density lipoprotein cholesterol (TG/HDL-C), are associated with type 2 diabetes mellitus (T2DM). However, the predictive values of lipid ratios in prediabetes remain unclear. The aims of this study were: 1) to investigate the association between lipid ratios and abnormal glucose tolerance; 2) to compare the predictive significance of lipid ratios with commonly used indicators of lipid variables in clinical practice in a Chinese population.
The cross-sectional study enrolled 2680 participants from the Health Promotion Center of the First Affiliated Hospital of Nanjing Medical University. All participants received a 75 g oral glucose tolerance test. Blood samples were obtained at baseline and 120 min after glucose ingestion. Participants were classified as normal glucose tolerance (NGT), impaired glucose regulation (IGR), and T2DM. The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression model. The receiver operating characteristic (ROC) curve was used to identify the cutoff points of lipid and lipid ratios. The area under the receiver operating characteristic curve (AUROC), sensitivity and specificity were calculated to estimate their diagnostic values.
TC, TG, TC/HDL-C, TG/HDL-C and non-HDL-C were significantly correlated with both prediabetes and T2DM after adjustment for other risk factors such as blood glucose, whereas LDL-C was only positively correlated with prediabetes. TG and TG/HDL-C showed higher diagnostic values for prediabetes and T2DM than TC, LDL-C, HDL-C, TC/HDL-C and non-HDL-C, with the AUC values over 0.70. For predicting prediabetes, the optimal cutoff point was 1.36 mmol/l for TG and 1.13 for TG/HDL-C. For predicting T2DM, the optimal cutoff point was 1.46 mmol/l for TG and 1.22 for TG/HDL-C.
Both TG and TG/HDL-C are promising biomarkers for distinguishing individuals with abnormal glucose tolerance, and can be used to predict prediabetes and T2DM in Chinese population.
血脂比值，如总胆固醇/高密度脂蛋白胆固醇（TC/HDL-C）和甘油三酯/高密度脂蛋白胆固醇（TG/HDL-C），与 2 型糖尿病（T2DM）相关。然而，脂类比值在糖尿病前期的预测价值尚不清楚。本研究的目的是：1）探讨血脂比值与糖代谢异常的关系；2）比较脂类比值与临床常用脂类变量指标在中国人中的预测意义。
这项横断面研究纳入了南京医科大学第一附属医院健康促进中心的 2680 名参与者。所有参与者均接受了 75g 口服葡萄糖耐量试验。在基线和葡萄糖摄入后 120 分钟采集血样。根据血糖情况将参与者分为正常糖耐量（NGT）、糖调节受损（IGR）和 T2DM。采用 logistic 回归模型估计比值比（OR）和 95%置信区间（CI）。采用受试者工作特征（ROC）曲线确定血脂和血脂比值的截断值。计算 ROC 曲线下面积（AUROC）、灵敏度和特异性，以评估其诊断价值。
调整血糖等其他危险因素后，TC、TG、TC/HDL-C、TG/HDL-C 和非 HDL-C 与糖尿病前期和 T2DM 均显著相关，而 LDL-C 仅与糖尿病前期呈正相关。与 TC、LDL-C、HDL-C、TC/HDL-C 和非 HDL-C 相比，TG 和 TG/HDL-C 对糖尿病前期和 T2DM 的诊断价值更高，AUC 值均超过 0.70。预测糖尿病前期时，TG 的最佳截断值为 1.36mmol/L，TG/HDL-C 的最佳截断值为 1.13。预测 T2DM 时，TG 的最佳截断值为 1.46mmol/L，TG/HDL-C 的最佳截断值为 1.22。
TG 和 TG/HDL-C 均是鉴别糖代谢异常个体的有前途的生物标志物，可用于预测中国人群的糖尿病前期和 T2DM。
