School of Medicine, Nankai University, Tianjin, China.
Department of Endocrinology, First Medical Center of PLA General Hospital, Beijing, China.
J Diabetes. 2024 Aug;16(8):e13592. doi: 10.1111/1753-0407.13592.
Not many large-sample investigations are available that compare the potency of the relationship of remnant cholesterol (RC) and other lipid parameters with diabetes and prediabetes. The goals of our study are to discover the relationship between RC and prediabetes, diabetes, and insulin resistance (IR) and to investigate RC, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), TC/HDL-C, LDL-C/HDL-C, and TG/HDL-C, which are the lipid parameters that are most positively related to diabetes, prediabetes, and IR.
This research enrolled 36 684 subjects from China's eight provinces. We employed multiple logistic regression analysis for testing the relationship between lipid parameters and diabetes, prediabetes, and IR.
After adjusting for potential confounders, and comparing the results with other lipid parameters, the positive relationship between RC and diabetes (odds ratio [OR] 1.417, 95% confidence interval [CI]: 1.345-1.492), prediabetes (OR 1.555, 95% CI: 1.438-1.628), and IR (OR 1.488, 95% CI: 1.404-1.577) was highest. RC was still related to diabetes, prediabetes, and IR even when TG <2.3 mmol/L (diabetes: OR 1.256, 95% CI: 1.135-1.390; prediabetes: OR 1.503, 95% CI: 1.342-1.684; and IR: OR 1.278, 95% CI: 1.140-1.433), LDL-C <2.6 mmol/L (diabetes: OR 1.306, 95% CI: 1.203-1.418; prediabetes: OR 1.597, 95% CI: 1.418-1.798; and IR: OR 1.552, 95% CI: 1.416-1.701), or HDL-C ≥1 mmol/L (diabetes: OR 1.456, 95% CI: 1.366-1.550; prediabetes: OR 1.553, 95% CI: 1.421-1.697; and IR: OR 1.490, 95% CI: 1.389-1.598).
RC is more positively related to diabetes, prediabetes, and IR than conventional lipids and lipid ratios in the general population, the relationships between RC and diabetes, prediabetes, and IR are stable, even if HDL-C, LDL-C, or TG are at appropriate levels.
目前可用的大规模调查研究并不多，这些研究旨在比较残余胆固醇（RC）和其他脂质参数与糖尿病和糖尿病前期之间的关系。我们的研究目标是发现 RC 与糖尿病前期、糖尿病和胰岛素抵抗（IR）之间的关系，并研究 RC、高密度脂蛋白胆固醇（HDL-C）、非高密度脂蛋白胆固醇（non-HDL-C）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、TC/HDL-C、LDL-C/HDL-C 和 TG/HDL-C，这些参数与糖尿病前期、糖尿病和 IR 关系最密切。
本研究纳入了来自中国 8 个省份的 36684 名受试者。我们采用多因素 logistic 回归分析检测了血脂参数与糖尿病、糖尿病前期和 IR 之间的关系。
在调整了潜在混杂因素后，与其他脂质参数相比，RC 与糖尿病（比值比 [OR] 1.417，95%置信区间 [CI]：1.345-1.492）、糖尿病前期（OR 1.555，95%CI：1.438-1.628）和 IR（OR 1.488，95%CI：1.404-1.577）之间的正相关性最高。即使 TG<2.3mmol/L（糖尿病：OR 1.256，95%CI：1.135-1.390；糖尿病前期：OR 1.503，95%CI：1.342-1.684；IR：OR 1.278，95%CI：1.140-1.433）、LDL-C<2.6mmol/L（糖尿病：OR 1.306，95%CI：1.203-1.418；糖尿病前期：OR 1.597，95%CI：1.418-1.798；IR：OR 1.552，95%CI：1.416-1.701）或 HDL-C≥1mmol/L（糖尿病：OR 1.456，95%CI：1.366-1.550；糖尿病前期：OR 1.553，95%CI：1.421-1.697；IR：OR 1.490，95%CI：1.389-1.598）时，RC 与糖尿病、糖尿病前期和 IR 之间的关系仍然存在。
在一般人群中，RC 与传统脂质和脂质比值相比，与糖尿病、糖尿病前期和 IR 的相关性更显著，RC 与糖尿病、糖尿病前期和 IR 之间的关系是稳定的，即使 HDL-C、LDL-C 或 TG 处于适当水平。
