Atherogenic dyslipidaemic profiles associated with the development of Type 2 diabetes: a 3.1-year longitudinal study

Abstract

AimsWhile there is thought to be an association between glucose and lipid metabolism, it is largely unknown whether apolipoproteinB and non-high density lipoprotein (HDL) cholesterol are associated with the development of Type2 diabetes. It is also unknown whether these atherogenic dyslipidaemic profiles have a stronger association with diabetes risk compared with conventional lipid measurements. MethodsA total of 118429 subjects without diabetes (70980 men and 47449 women), aged 17-90years (mean age 39.6years), were enrolled in this study and followed for a mean duration of 3.1years. ResultsApolipoproteinB and non-HDL cholesterol levels showed a strong association with the development of Type2 diabetes compared with conventional lipid measurements and their ratios [hazard ratio per 1sd; 1.39 (95%CI 1.37-1.42) and 1.38 (95%CI 1.35-1.40), respectively; both P<0.001]. The Kaplan-Meier survival curve demonstrated that Type2 diabetes developed more frequently as apolipoproteinB or non-HDL cholesterol levels increased across quartiles (both P<0.001). In multivariate Cox regression analyses, both apolipoproteinB and non-HDL cholesterol were associated with the development of Type2 diabetes, independent of other risk factor including age, sex, waist circumference, family history of diabetes, fasting serum glucose and insulin levels, HbA(1c), systolic blood pressure and other conventional lipid measurements [hazard ratio per 1sd; 1.14 (95%CI 1.11-1.18) and 1.13 (95%CI 1.10-1.16), respectively; both P<0.001]. ConclusionsAtherogenic dyslipidaemia was more strongly associated with the development of Type2 diabetes than conventional lipid measurements, and this effect was independent of other well-established risk factor for diabetes.