Atherogenic dyslipidaemic profiles associated with the development of Type 2 diabetes: a 3.1-year longitudinal study
Article first published online: 26 JUL 2013
© 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK
Volume 31, Issue 1, pages 24–30, January 2014
How to Cite
Diabet. Med. 31, 24–30 (2014)
- Issue published online: 12 DEC 2013
- Article first published online: 26 JUL 2013
- Accepted manuscript online: 2 JUL 2013 11:01AM EST
- Manuscript Accepted: 27 JUN 2013
- Manuscript Revised: 8 JUN 2013
- Manuscript Received: 22 MAR 2013
While there is thought to be an association between glucose and lipid metabolism, it is largely unknown whether apolipoprotein B and non-high density lipoprotein (HDL) cholesterol are associated with the development of Type 2 diabetes. It is also unknown whether these atherogenic dyslipidaemic profiles have a stronger association with diabetes risk compared with conventional lipid measurements.
A total of 118 429 subjects without diabetes (70 980 men and 47 449 women), aged 17–90 years (mean age 39.6 years), were enrolled in this study and followed for a mean duration of 3.1 years.
Apolipoprotein B and non-HDL cholesterol levels showed a strong association with the development of Type 2 diabetes compared with conventional lipid measurements and their ratios [hazard ratio per 1 sd; 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 Type 2 diabetes developed more frequently as apolipoprotein B or non-HDL cholesterol levels increased across quartiles (both P < 0.001). In multivariate Cox regression analyses, both apolipoprotein B and non-HDL cholesterol were associated with the development of Type 2 diabetes, independent of other risk factor including age, sex, waist circumference, family history of diabetes, fasting serum glucose and insulin levels, HbA1c, systolic blood pressure and other conventional lipid measurements [hazard ratio per 1 sd; 1.14 (95% CI 1.11–1.18) and 1.13 (95% CI 1.10–1.16), respectively; both P < 0.001].
Atherogenic dyslipidaemia was more strongly associated with the development of Type 2 diabetes than conventional lipid measurements, and this effect was independent of other well-established risk factor for diabetes.