Zheng Xiaowei, Jiang Minglan, Ren Xiao, Han Longyang
Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China.
Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China.
J Diabetes Complications. 2023 Jan;37(1):108360. doi: 10.1016/j.jdiacomp.2022.108360. Epub 2022 Nov 24.
The association between remnant cholesterol (RC) and diabetes remains unclear in Chinese.
We used the data of 9464 Chinese adults aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS). Estimated RC level was calculated as total cholesterol minus high-density lipoprotein cholesterol minus low-density lipoprotein cholesterol. Cox proportional hazard models and restricted cubic spline models were used to assess the relationships between RC and diabetes.
After 6 years of follow-up, a total of 777 respondents experienced new-onset diabetes. In multivariable-adjusted analyses, the adjusted hazard ratios (95 % confidence intervals) for the highest versus lowest quartile of RC was 1.45 (1.19-1.75) for risk of diabetes, and each 1-SD increase of RC (19.52 mg/dl) was associated with 9 % (HRs = 1.09; 1.03-1.15) increased risk of diabetes. There were also significant linear associations between RC level and diabetes (P for linearity <0.001).
Elevated RC levels were positively associated with increased risk of diabetes in Chinese adult population, suggesting that RC could be considered as a preferential predictor and treatment target of diabetes in Chinese population. Future prospective studies are needed to verify our findings and to assess the effect of RC-lowering interventions in diabetes prevention.
在中国人群中，残余胆固醇（RC）与糖尿病之间的关联仍不明确。
我们使用了来自中国健康与养老追踪调查（CHARLS）的9464名年龄≥45岁的中国成年人的数据。通过总胆固醇减去高密度脂蛋白胆固醇再减去低密度脂蛋白胆固醇来计算估计的RC水平。采用Cox比例风险模型和受限立方样条模型来评估RC与糖尿病之间的关系。
经过6年的随访，共有777名受访者出现新发糖尿病。在多变量调整分析中，RC最高四分位数与最低四分位数相比，糖尿病风险的调整后风险比（95%置信区间）为1.45（1.19 - 1.75），RC每增加1个标准差（19.52mg/dl），糖尿病风险增加9%（风险比=1.09；1.03 - 1.15）。RC水平与糖尿病之间也存在显著的线性关联（线性关系P<0.001）。
在中国成年人群体中，升高的RC水平与糖尿病风险增加呈正相关，这表明RC可被视为中国人群中糖尿病的优先预测指标和治疗靶点。未来需要前瞻性研究来验证我们的发现，并评估降低RC干预措施在糖尿病预防中的效果。
