Annals of epidemiology · 2025
Longitudinal triglyceride and HDL cholesterol, but not LDL cholesterol associated with the risk of incident type 2 diabetes: Evidence from a multi-trajectory analysis.
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Tian Xue, Chen Shuohua, Xia Xue, Xu Qin, Wu Shouling, Wang Anxin
Аннотация
PURPOSE: There are inconsistent findings regarding the associations between lipids and type 2 diabetes mellitus (T2DM), partially due to ignoring the joint effects of longitudinal patterns in lipids simultaneously. This study aimed to investigate the association of joint multi-trajectory of different lipids with the risk of type 2 diabetes.
METHODS: We enrolled 71,043 participants free of T2DM from the Kailuan study. Using group-based multi-trajectory modeling, joint multi-trajectory of triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) during 2006-2010 was developed to predict the risk of T2DM during 2010-2019.
RESULTS: Five distinct multi-trajectory groups were identified over 4-year exposure, and 6473 (9.11 %) cases of incident T2DM occurred during a median follow-up of 8.97 years. The highest risk of T2DM was observed in Group 5 with the highest level of TG, optimal-increasing LDL, and high-increasing HDL-C (hazard ratio [HR], 2.14; 95 % confidence interval [CI], 1.89-2.41), followed by Group 3 with the lowest level of HDL-C and an optimal TG and LDL-C (HR, 1.39; 95 % CI, 1.11-1.43), and Group 4 with the highest level of LDL-C, optimal-increasing TG and high-increasing HDL-C (HR, 1,26; 95 % CI, 1.11-1.43), compared to Group 2 with the lowest level of TG and optimal-increasing LDL-C and high-increasing HDL-C. The observed associations existed regardless of baseline lipid levels.
CONCLUSION: Our results showed the important role of high-increasing TG and low-decreasing HDL-C, rather than high-increasing LDL-C in the development of T2DM, which would help better understand the heterogeneous risk of T2DM and facilitate targeted prevention programs.
METHODS: We enrolled 71,043 participants free of T2DM from the Kailuan study. Using group-based multi-trajectory modeling, joint multi-trajectory of triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) during 2006-2010 was developed to predict the risk of T2DM during 2010-2019.
RESULTS: Five distinct multi-trajectory groups were identified over 4-year exposure, and 6473 (9.11 %) cases of incident T2DM occurred during a median follow-up of 8.97 years. The highest risk of T2DM was observed in Group 5 with the highest level of TG, optimal-increasing LDL, and high-increasing HDL-C (hazard ratio [HR], 2.14; 95 % confidence interval [CI], 1.89-2.41), followed by Group 3 with the lowest level of HDL-C and an optimal TG and LDL-C (HR, 1.39; 95 % CI, 1.11-1.43), and Group 4 with the highest level of LDL-C, optimal-increasing TG and high-increasing HDL-C (HR, 1,26; 95 % CI, 1.11-1.43), compared to Group 2 with the lowest level of TG and optimal-increasing LDL-C and high-increasing HDL-C. The observed associations existed regardless of baseline lipid levels.
CONCLUSION: Our results showed the important role of high-increasing TG and low-decreasing HDL-C, rather than high-increasing LDL-C in the development of T2DM, which would help better understand the heterogeneous risk of T2DM and facilitate targeted prevention programs.