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残余胆固醇与糖尿病独立相关,即使传统脂质处于适当水平:来自 REACTION 研究的报告。

Remnant cholesterol is independently associated with diabetes, even if the traditional lipid is at the appropriate level: A report from the REACTION study.

机构信息

School of Medicine, Nankai University, Tianjin, China.

Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, China.

出版信息

J Diabetes. 2023 Mar;15(3):204-214. doi: 10.1111/1753-0407.13362. Epub 2023 Feb 5.

Abstract

BACKGROUND

The association between remnant cholesterol (RC) and diabetes remains unclear because of limited study and data. This study attempted to explore the association between RC and diabetes in a large sample, multicenter general population.

METHODS

The current study included 36 684 participants from eight provinces across China. Subjects were quartered according to the RC quartile. Logistic regression analysis was used to evaluate the association between RC and diabetes.

RESULTS

After adjusting for potential confounding factors, RC was still significantly associated with diabetes (Q4: odds ratio [OR]:1.147, 95% confidence interval [CI]: 1.049-1.254, p = .003). In addition, RC and diabetes were still significantly associated when triglycerides (TG) were <1.7 mmol/L (Q4: OR: 1.155, 95% CI: 1.005-1.327, p = .042), low-density lipoprotein cholesterol (LDL-C) <3.4 mmol/L (Q4: OR: 1.130, 95% CI: 1.011-1.264, p = .032), or HDL-C (high-density lipoprotein cholesterol) ≥1.0 mmol/L (Q4: OR: 1.116, 95% CI: 1.007-1.237, p = .037). In the stratification analysis, elevated RC was significantly associated with diabetes in subjects with systolic blood pressure (SBP) <140 mm Hg and diastolic blood pressure (DBP) <90 mm Hg, 60 ≤ estimated glomerular filtration rate (eGFR) ≤90 ml/min per 1.73 m , younger than 55 years old and female.

CONCLUSION

In the Chinese community, RC is significantly correlated with diabetes, even when TG, LDL-C, or HDL-C were controlled within the appropriate range recommended by the guidelines.

摘要

背景

由于研究和数据有限,残余胆固醇(RC)与糖尿病之间的关联仍不清楚。本研究试图在一个大型、多中心的一般人群样本中探索 RC 与糖尿病之间的关联。

方法

本研究纳入了来自中国八个省份的 36684 名参与者。受试者按 RC 四分位数进行四分位分组。采用 logistic 回归分析评估 RC 与糖尿病之间的关系。

结果

在调整了潜在混杂因素后,RC 与糖尿病仍呈显著相关(Q4:比值比[OR]:1.147,95%置信区间[CI]:1.049-1.254,p=0.003)。此外,当甘油三酯(TG)<1.7mmol/L(Q4:OR:1.155,95%CI:1.005-1.327,p=0.042)、低密度脂蛋白胆固醇(LDL-C)<3.4mmol/L(Q4:OR:1.130,95%CI:1.011-1.264,p=0.032)或高密度脂蛋白胆固醇(HDL-C)≥1.0mmol/L(Q4:OR:1.116,95%CI:1.007-1.237,p=0.037)时,RC 与糖尿病仍呈显著相关。在分层分析中,在收缩压(SBP)<140mmHg 和舒张压(DBP)<90mmHg、60≤估算肾小球滤过率(eGFR)≤90ml/min/1.73m2、年龄<55 岁和女性的受试者中,升高的 RC 与糖尿病显著相关。

结论

在中国人群中,RC 与糖尿病显著相关,即使 TG、LDL-C 或 HDL-C 控制在指南推荐的适当范围内也是如此。

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