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残余胆固醇升高增加 6 年内 2 型糖尿病发病风险。

Elevated remnant cholesterol increase 6-year type 2 diabetes mellitus onset risk.

机构信息

Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China.

Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China.

出版信息

Clin Chim Acta. 2023 Feb 15;541:117253. doi: 10.1016/j.cca.2023.117253. Epub 2023 Feb 14.

Abstract

AIM

To investigate the association of remnant cholesterol (RC) with future type 2 diabetes mellitus (T2DM) risk, and to assess the underlying impact of some recognized risk factors on it.

METHODS

A total of 11468 nondiabetic adults in rural China were recruited in 2007-2008 and followed up in 2013-2014. Logistic regression was used to assess the risk of incident T2DM by quartiles of baseline RC, estimating odds ratios (ORs) and 95% confidence intervals (CIs). Association of the combinations of RC and low-density lipoprotein cholesterol (LDL-C) with T2DM risk were further evaluated.

RESULTS

Multivariable adjusted OR (95% CI) for incident T2DM associated with quartile 4 versus quartile 1 of RC was 2.72 (2.05-3.62). Per 1-standard deviation (SD) increases in RC levels was associated with a 34% higher T2DM risk. However, gender modified the specific association (P < 0.05), with the association stronger among females. When combining the low LDL-C and low RC groups as reference, individuals with RC levels ≥ 0.56 mmol/L had more than a 2-fold T2DM risk, regardless of LDL-C level.

CONCLUSIONS

Elevated RC levels increase T2DM risk in rural Chinese populations. In those who cannot control their risk by lowering LDL-C levels, the goal of lipid-lowering therapy can be shifted to RC.

摘要

目的

探讨残余胆固醇(RC)与 2 型糖尿病(T2DM)发生风险的相关性,并评估一些公认的危险因素对其的潜在影响。

方法

本研究共纳入了 2007-2008 年期间在中国农村招募的 11468 名非糖尿病成年人,并于 2013-2014 年进行了随访。采用 logistic 回归评估基线 RC 四分位数与新发 T2DM 风险的关系,估计比值比(OR)和 95%置信区间(CI)。进一步评估 RC 与低密度脂蛋白胆固醇(LDL-C)组合与 T2DM 风险的关联。

结果

多变量校正后 RC 四分位数 4 与四分位数 1 相比,发生 T2DM 的 OR(95%CI)为 2.72(2.05-3.62)。RC 水平每增加 1 个标准差,T2DM 风险增加 34%。然而,性别修饰了特定的关联(P<0.05),RC 水平与 T2DM 风险的关联在女性中更强。当将低 LDL-C 和低 RC 组作为参考时,RC 水平≥0.56mmol/L 的个体无论 LDL-C 水平如何,T2DM 风险均增加了两倍以上。

结论

升高的 RC 水平增加了中国农村人群的 T2DM 风险。对于那些无法通过降低 LDL-C 水平控制风险的患者,降脂治疗的目标可以转移到 RC 上。

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