Seo In-Ho, Son Da-Hye, Lee Hye Sun, Lee Yong-Jae
Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea.
Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea.
Transl Res. 2022 May;243:52-59. doi: 10.1016/j.trsl.2021.12.008. Epub 2021 Dec 31.
Non-HDL cholesterol is a simple measure to analyze the total amount of proatherogenic lipoproteins in the blood and to predict development of cardiovascular disease. However, it is unclear whether non-HDL cholesterol has a relationship with incident type 2 diabetes. This study aimed to evaluate the association between non-HDL cholesterol and incident type 2 diabetes with a large-sample, community-based Korean cohort over a 12-year period. Among the 10,038 total participants, 7608 (3662 men and 3946 women) without diabetes were selected from the Korean Genome and Epidemiology Study (KoGES). Their non-HDL cholesterol level was divided into quartiles. The hazard ratios (HRs) with 95% confidence intervals (CIs) for incident type 2 diabetes were calculated using multivariate Cox proportional hazards regression models after adjusting for potentially confounding variables. In total, 1442 individuals (18.9%: 1442 of 7608) developed type 2 diabetes during the 12-year follow up period, with an incident rate of 3.0-5.0. Compared to the reference first quartile, the HRs (95% CIs) of incident type 2 diabetes for the second, third, and fourth quartiles increased in a dose-response manner after adjusting for potentially confounding variables, including the HOMA-IR marker. Non-HDL cholesterol level at baseline could be a future predictor of type 2 diabetes even when prior glucose or insulin (HOMA-IR) levels are normal.
非高密度脂蛋白胆固醇是一种用于分析血液中促动脉粥样硬化脂蛋白总量以及预测心血管疾病发生的简单指标。然而,尚不清楚非高密度脂蛋白胆固醇与2型糖尿病的发生是否存在关联。本研究旨在通过一项基于韩国社区的大样本队列研究,评估非高密度脂蛋白胆固醇与12年间2型糖尿病发病之间的关联。在总共10,038名参与者中,从韩国基因组与流行病学研究(KoGES)中选取了7608名(3662名男性和3946名女性)无糖尿病患者。他们的非高密度脂蛋白胆固醇水平被分为四分位数。在对潜在混杂变量进行调整后,使用多变量Cox比例风险回归模型计算2型糖尿病发病的风险比(HRs)及其95%置信区间(CIs)。在12年的随访期内,共有1442人(18.9%:7608人中的1442人)患上了2型糖尿病,发病率为3.0 - 5.0。在对包括HOMA-IR标志物在内的潜在混杂变量进行调整后,与作为参考的第一四分位数相比,第二、第三和第四四分位数的2型糖尿病发病HRs(95% CIs)呈剂量反应关系增加。即使既往血糖或胰岛素(HOMA-IR)水平正常,基线时的非高密度脂蛋白胆固醇水平仍可能是2型糖尿病未来的预测指标。