中国人群高密度脂蛋白胆固醇与 2 型糖尿病的相关性：北京老龄化纵向研究。
Association between high-density lipoprotein cholesterol and type 2 diabetes mellitus among Chinese: the Beijing longitudinal study of aging.
机构信息
Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China.
Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
出版信息
Lipids Health Dis. 2021 Jul 17;20(1):71. doi: 10.1186/s12944-021-01499-5.
BACKGROUND
Some previous studies on different populations have yielded inconsistent findings with respect to the relationship between levels of high-density lipoprotein cholesterol (HDL-C) and future type 2 diabetes mellitus (T2DM) incidence. This study was designed to gain further insight into this relationship through a cohort study with a 25-year follow-up duration.
METHODS
In total, 1462 individuals that were 55 years of age or older and were free of T2DM at baseline were enrolled in the present study. T2DM incidence among this study population was detected through self-reported diagnoses or the concentration of fasting plasma glucose. The data were derived from nine surveys conducted from 1992 to 2017. The correlation between HDL-C levels and the T2DM risk was assessed through Cox proportional-hazards model and proportional hazards model for the sub-distribution with time-dependent variables.
RESULTS
Over the follow-up period, 120 participants were newly diagnosed with new-onset T2DM. When research participants were separated into four groups on the basis for quartiles of their levels of HDL-C measured at baseline, and incidence of diabetes declined with higher baseline HDL-C levels at 12.60, 9.70, 5.38, and 5.22 per 1000 person-years, respectively. Adjusted hazard ratios (HRs) were 0.98 (95% confidence interval [CI]: 0.62-1.55), 0.48 (95% CI: 0.27-0.85) and 0.44 (95% CI: 0.25-0.80) for individuals with HDL-C levels within the 1.15-1.39, 1.40-1.69, and ≥ 1.70 mmol/L ranges relative to participants with HDL-C levels < 1.15 mmol/L. Multiple sensitivity analyses similarly revealed reduced risk of diabetes incidence with increased HDL-C levels. Incorporating the levels of HDL-C into a multivariate model significantly enhanced the overall power of the predictive model (P values were 0.0296, 0.0011, respectively, for 5- and 10-year risk of diabetes).
CONCLUSIONS
Levels of HDL-C were independently and negatively associated with the risk of the new-onset T2DM among middle-aged and elderly Chinese.
背景
一些针对不同人群的先前研究在高密度脂蛋白胆固醇（HDL-C）水平与未来 2 型糖尿病（T2DM）发病风险之间的关系方面得出了不一致的结果。本研究旨在通过一项随访时间长达 25 年的队列研究，进一步深入了解这种关系。
方法
本研究共纳入 1462 名年龄在 55 岁及以上且基线时无 T2DM 的个体。通过自我报告的诊断或空腹血浆葡萄糖浓度来检测该研究人群中的 T2DM 发病率。这些数据来自于 1992 年至 2017 年进行的 9 项调查。通过 Cox 比例风险模型和时依变量的比例风险模型评估 HDL-C 水平与 T2DM 风险之间的相关性。
结果
在随访期间，有 120 名参与者被新诊断为新发 T2DM。当研究参与者根据基线时 HDL-C 水平的四分位数将其分为四组时，随着基线 HDL-C 水平的升高，糖尿病的发病率分别下降至每 1000 人年 12.60、9.70、5.38 和 5.22 例。调整后的危险比（HRs）分别为 0.98（95%置信区间[CI]：0.62-1.55）、0.48（95%CI：0.27-0.85）和 0.44（95%CI：0.25-0.80），分别对应于 HDL-C 水平在 1.15-1.39、1.40-1.69 和≥1.70 mmol/L 范围内的个体与 HDL-C 水平<1.15 mmol/L 的个体。多项敏感性分析同样表明，随着 HDL-C 水平的升高，糖尿病发病风险降低。将 HDL-C 水平纳入多变量模型可显著提高预测模型的整体效能（对于 5 年和 10 年糖尿病发病风险，P 值分别为 0.0296 和 0.0011）。
结论
在中老年中国人中，HDL-C 水平与新发 T2DM 的风险呈独立且负相关。
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