Dialysis Department of Nephrology Hospital, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Blood Transfusion Department, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
J Diabetes Investig. 2021 Jan;12(1):91-98. doi: 10.1111/jdi.13316. Epub 2020 Jul 7.
AIMS/INTRODUCTION: Dyslipidemia plays a critical role in the pathogenesis of metabolic syndrome and diabetes. Evidence has increasingly shown that the ratio of low- to high-density lipoprotein cholesterol (LDL-C/HDL-C) is a novel marker for increased risk of insulin resistance and cardiovascular diseases. However, the correlation between the LDL-C/HDL-C ratio and diabetes risk is rarely reported. This is the first study to investigate the association between the LDL-C/HDL-C ratio and new-onset diabetes in a large community-based cohort.
In this retrospective cohort study, a total of 116,661 adults without baseline diabetes were enrolled. Participants were stratified into four groups based on LDL-C/HDL-C ratio quartiles. The outcome of interest was new-onset diabetes.
During a median follow-up period of 2.98 years, 2,681 (2.3%) new diabetes cases were recorded. The total cumulative incidence of diabetes progressively increased alongside LDL-C/HDL-C ratio quartiles (0.31, 0.43, 0.68 and 0.88%, respectively, P-value for trend <0.001). After adjusting for potential confounders, using the lowest quartile of the LDL-C/HDL-C ratio as the reference, the risk of diabetes increased with LDL-C/HDL-C ratio quartiles (P-value for trend <0.001); in particular, from the second to fourth quartile, hazard ratios were 1.18 (95% confidence interval 0.87-1.59), 1.42 (95% confidence interval 1.07-1.90) and 1.92 (95% confidence interval 1.43-2.59), respectively. The results were also robust to challenges in multiple sensitivity analyses.
Among the Chinese population, elevated LDL-C/HDL-C ratio might be an independent risk factor for new-onset diabetes.
目的/引言：血脂异常在代谢综合征和糖尿病的发病机制中起着关键作用。越来越多的证据表明，低-高密度脂蛋白胆固醇（LDL-C/HDL-C）比值是胰岛素抵抗和心血管疾病风险增加的新标志物。然而，LDL-C/HDL-C 比值与糖尿病风险之间的相关性很少有报道。这是第一项在大型基于社区的队列中研究 LDL-C/HDL-C 比值与新发糖尿病之间关系的研究。
在这项回顾性队列研究中，共纳入了 116661 名基线无糖尿病的成年人。参与者根据 LDL-C/HDL-C 比值四分位组分为四组。主要结局是新发糖尿病。
在中位随访 2.98 年期间，记录到 2681 例（2.3%）新发糖尿病病例。随着 LDL-C/HDL-C 比值四分位组的升高，糖尿病的总累积发生率也逐渐增加（分别为 0.31%、0.43%、0.68%和 0.88%，趋势 P 值<0.001）。在校正潜在混杂因素后，以 LDL-C/HDL-C 比值最低四分位数为参照，糖尿病风险随 LDL-C/HDL-C 比值四分位组升高而增加（趋势 P 值<0.001）；特别是从第二到第四四分位组，风险比分别为 1.18（95%置信区间 0.87-1.59）、1.42（95%置信区间 1.07-1.90）和 1.92（95%置信区间 1.43-2.59）。在多种敏感性分析中，结果也是稳健的。
在中国人群中，升高的 LDL-C/HDL-C 比值可能是新发糖尿病的独立危险因素。
