Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Diabetes Research and Care, Capital Medical University, Beijing, China.
Front Endocrinol (Lausanne). 2023 Jul 7;14:1180012. doi: 10.3389/fendo.2023.1180012. eCollection 2023.
A data-based study reported the linear relationship between body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C) in a normal population. However, there were no studies giving the suggestion for diabetes patients limited by sample size. This study aimed to investigate the non-linear dose-response relationship between BMI and LDL-C in type 2 diabetes mellitus (T2DM).
The study participants registered at the National Metabolic Management Center (MMC) of Beijing Luhe hospital from June 2017 to June 2021. T2DM was diagnosed according to the 1999 World Organization criteria. The generalized additive models (GAMs) were used to investigate the non-linear association between BMI and LDL-C. The relationship between BMI and LDL-C was visualized via the smooth splines function plot by sex. Segmented regressions were fitted to calculate the slopes with different estimated breakpoints.
After data cleaning, a total of 2500 participants with T2DM aged 30 to 70 years were included in this study. Compared with females, the spline between BMI and LDL-C showed an Inverted U shape in males. In males, the slopes below and above the breakpoint (26.08. 95% CI: 24.13 to 28.03) were 2.38 (95%CI: 1.06, 3.70) and -0.36 (95%CI: -1.20, 0.48), respectively.
There was an Inverted U shape association between BMI and LDL-C in male participants with T2DM, for which the LDL-C was increased with BMI in the lean population, while LDL-C gradually tended to be flat or even decreased in the obese population. However, the Inverted U-shape between BMI and LDL-C was not found in female patients with T2DM.
一项基于数据的研究报告了正常人群中体重指数（BMI）与低密度脂蛋白胆固醇（LDL-C）之间的线性关系。然而，由于样本量有限，对于糖尿病患者，并没有研究给出建议。本研究旨在探讨 2 型糖尿病（T2DM）患者 BMI 与 LDL-C 之间的非线性剂量反应关系。
研究对象为 2017 年 6 月至 2021 年 6 月在北京陆和医院国家代谢管理中心（MMC）注册的患者。T2DM 按照 1999 年世界卫生组织标准诊断。采用广义加性模型（GAMs）探讨 BMI 与 LDL-C 之间的非线性关联。通过性别特异性平滑样条函数图来直观显示 BMI 与 LDL-C 之间的关系。拟合分段回归以计算具有不同估计断点的斜率。
经过数据清理，本研究共纳入 2500 名年龄在 30-70 岁之间的 T2DM 患者。与女性相比，男性 BMI 与 LDL-C 之间的样条呈倒 U 型。在男性中，低于和高于拐点（26.08，95%CI：24.13-28.03）的斜率分别为 2.38（95%CI：1.06-3.70）和-0.36（95%CI：-1.20-0.48）。
T2DM 男性患者 BMI 与 LDL-C 之间呈倒 U 型关联，在偏瘦人群中，LDL-C 随 BMI 增加而升高，而在肥胖人群中，LDL-C 逐渐趋于平稳甚至降低。然而，在女性 T2DM 患者中，并未发现 BMI 与 LDL-C 之间的倒 U 型关系。
