中国人群中独立于低密度脂蛋白胆固醇的基线残余胆固醇与新诊断糖尿病的关联。
Association of baseline remnant cholesterol independent of LDL-cholesterol with newly diagnosed diabetes in the Chinese population.
作者信息
Yang Yulu, Li Xuehan, Huang Jianwu, Wu Jiacheng, Wang Yalei, Chen Hao, Qiu Zhihua, Zhou Zihua
机构信息
Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Engineering Research Center for Immunological Diagnosis and Therapy of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Biomol Biomed. 2025 Apr 26;25(6):1408-1417. doi: 10.17305/bb.2024.11167.
Remnant cholesterol (RC) is highly regarded in the cardiovascular field; however, its relationship with new-onset diabetes remains unclear. This study aimed to investigate the relationship between RC and the risk of developing diabetes, as well as its interaction with low-density lipoprotein cholesterol (LDL-c). This was a secondary analysis of a retrospective cohort study based on a Chinese population. A multivariate Cox proportional hazards regression was initially employed to assess the relationship between RC and newly diagnosed diabetes. This was followed by a subgroup analysis to explore intergroup heterogeneity. A clinical prediction model was then developed. Finally, the study further analyzed the interactions between LDL-c and RC. After adjusting for confounding factors, RC was significantly associated with an increased risk of diabetes (HR = 1.46, 95% confidence interval [CI] 1.36-1.57). Furthermore, this relationship was nonlinear, with an inflection point of 0.48 identified through the piecewise model. Subgroup analysis indicated that the association was more pronounced in individuals under 60 years and those with a body mass index < 24 kg/m2 (P for interaction = 0.0004, <0.0001, respectively). RC proved to be a more effective predictor of diabetes compared to other lipid profiles, and the clinical prediction model was successfully constructed. Notably, individuals in the low LDL-c/high RC group were found to have a 1.41-fold (95% CI 1.281.55) greater risk compared to those in the low LDL-c/low RC group. Significant correlations were observed between baseline RC levels and the risk of new-onset diabetes. Elevated RC was a strong predictor of diabetes risk, irrespective of LDL-c levels.
残余胆固醇(RC)在心血管领域备受关注;然而,其与新发糖尿病之间的关系仍不明确。本研究旨在探讨RC与糖尿病发生风险之间的关系,以及其与低密度脂蛋白胆固醇(LDL-c)的相互作用。这是一项基于中国人群的回顾性队列研究的二次分析。最初采用多变量Cox比例风险回归来评估RC与新诊断糖尿病之间的关系。随后进行亚组分析以探索组间异质性。然后建立了一个临床预测模型。最后,该研究进一步分析了LDL-c与RC之间的相互作用。在调整混杂因素后,RC与糖尿病风险增加显著相关(HR = 1.46,95%置信区间[CI] 1.36 - 1.57)。此外,这种关系是非线性的,通过分段模型确定的拐点为0.48。亚组分析表明,这种关联在60岁以下个体和体重指数<24 kg/m²的个体中更为明显(交互作用P值分别为0.0004、<0.0001)。与其他血脂指标相比,RC被证明是糖尿病更有效的预测指标,并且成功构建了临床预测模型。值得注意的是,低LDL-c/高RC组个体的风险比低LDL-c/低RC组个体高1.41倍(95% CI 1.28 - 1.55)。观察到基线RC水平与新发糖尿病风险之间存在显著相关性。无论LDL-c水平如何,RC升高都是糖尿病风险的有力预测指标。