Atherogenic lipid parameters in people with normal glucose tolerance: implications from elevated 1-hour post-load plasma glucose.

IF 8.5 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Chunyu Yang, Xin Chai, Yachen Wang, Di Li, Dongli Zhu, Kaipeng Liang, Jinping Wang, Zhiwei Yang, Qiuhong Gong, Juan Zhang, Ruitai Shao
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引用次数: 0

Abstract

Background: Existing evidence suggests that elevated 1-hour post-load plasma glucose (1-h PG ≥ 8.6 mmol/L) during an oral glucose tolerance test (OGTT) is associated with atherogenic lipid parameters which are linked to an increased risk of cardiovascular disease (CVD). However, it remains unclear whether normal glucose tolerance (NGT) individuals with elevated 1-h PG (NGT-1hPG-high) should still be considered low-risk. Therefore, this study aims to demonstrate comprehensive lipid characteristics in individuals with different glycemic status stratified by 1-h PG, with a particular focus on those with NGT-1hPG-high.

Methods: This cross-sectional study included individuals aged 25-55 years with high-risk of diabetes from the Daqing Diabetes Prevention Study II (Daqing DPS-II). Individuals were categorized into different glycemic status based on the World Health Organization's 1999 criteria and the International Diabetes Federation's 2024 position statement on 1-h PG. Traditional (TC, TG, HDL-C, LDL-C) and non-traditional lipid parameters [ApoA-1, ApoB, sdLDL-C, Lp(a), non-HDL-C, remnant cholesterol (RC), ApoB/ApoA-1, LDL-C/ApoB] were measured. Dyslipidemia was defined according to the 2023 Chinese Guidelines for Lipid Management. The China-PAR equation was used to estimate 10-year CVD risk. Spearman's correlation coefficients were calculated to evaluate the correlation between lipid parameters and 10-year CVD risk. Logistic and multiple linear regression models were performed to assess the association between 1-h PG and dyslipidemia as well as lipid parameters adjusting for covariates.

Results: Among 2 469 individuals, 22.7% had NGT with normal 1-h PG (NGT-1hPG-normal), 19.9% had NGT-1hPG-high, 2.6% had prediabetes with normal 1-h PG (PDM-1hPG-normal), 34.2% had prediabetes with elevated 1-h PG (PDM-1hPG-high), and 20.6% had newly diagnosed diabetes. The prevalence of dyslipidemia did not significantly differ between NGT-1hPG-high and PDM-1hPG-high (OR = 1.13, 95%CI: 0.88-1.44, P > 0.05). Higher 1-h PG levels were consistently associated with an atherogenic lipid profile, characterized by increased TC, TG, LDL-C, ApoB, sdLDL-C, non-HDL-C, RC and ApoB/ApoA-1, along with decreased ApoA-1, HDL-C and LDL-C/ApoB (all P < 0.05). Among lipid parameters, TG, sdLDL-C, RC, ApoB/ApoA-1, LDL-C/ApoB and HDL-C showed the strongest correlation with 10-year CVD risk, with Spearman's correlation coefficients of 0.41, 0.38, 0.35, 0.31, - 0.37 and - 0.36, respectively. In the NGT-1hPG-high, TG, sdLDL-C, and ApoB/ApoA-1 levels were significantly higher, while HDL-C and LDL-C/ApoB levels were significantly lower compared to counterparts with NGT-1hPG-normal (all P < 0.05). Moreover, except for TG and RC (both P < 0.01), the majority of lipid parameter levels in NGT-1hPG-high did not significantly differ from those in PDM (all P > 0.05).

Conclusions: NGT-1hPG-high exhibited a similar atherogenic lipid profile to that observed in PDM. 1-h PG could serve as a potential indicator for the early identification of at-risk individuals who may otherwise go undetected among NGT population.

糖耐量正常人群的致动脉粥样硬化脂质参数:负荷后1小时血浆葡萄糖升高的影响
背景:现有证据表明,口服葡萄糖耐量试验(OGTT)期间1小时负荷后血浆葡萄糖升高(1小时PG≥8.6 mmol/L)与动脉粥样硬化性脂质参数相关,而脂质参数与心血管疾病(CVD)风险增加有关。然而,目前尚不清楚1小时PG升高(NGT- 1pg -high)的正常糖耐量(NGT)个体是否仍应被视为低风险。因此,本研究旨在展示不同血糖状态(1-h PG分层)个体的综合脂质特征,特别关注ngt - 1pg高的个体。方法:本横断面研究纳入了来自大庆糖尿病预防研究II (Daqing DPS-II)的25-55岁糖尿病高危人群。根据世界卫生组织1999年的标准和国际糖尿病联合会2024年关于1-h PG的立场声明,将个体分为不同的血糖状态,测量传统(TC、TG、HDL-C、LDL-C)和非传统脂类参数[ApoA-1、ApoB、sdLDL-C、Lp(a)、非HDL-C、残余胆固醇(RC)、ApoB/ApoA-1、LDL-C/ApoB]。根据《2023中国血脂管理指南》定义血脂异常。中国- par方程用于估计10年心血管疾病风险。计算Spearman相关系数,评估脂质参数与10年心血管疾病风险之间的相关性。采用Logistic和多元线性回归模型评估1-h PG与血脂异常之间的关系,并对协变量进行脂质参数调整。结果:2469例患者中,22.7%的患者NGT伴1小时PG正常(NGT- 1pg -normal), 19.9%的患者NGT- 1pg -high, 2.6%的患者糖尿病前期伴1小时PG正常(pdm - 1pg -normal), 34.2%的患者糖尿病前期伴1小时PG升高(pdm - 1pg -high), 20.6%的患者为新诊断的糖尿病。NGT-1hPG-high组与PDM-1hPG-high组血脂异常发生率无显著差异(OR = 1.13, 95%CI: 0.88-1.44, P < 0.05)。较高的1 h PG水平与动脉粥样硬化性脂质谱一致相关,其特征是TC、TG、LDL-C、ApoB、sdLDL-C、非HDL-C、RC和ApoB/ApoA-1升高,ApoA-1、HDL-C和LDL-C/ApoB降低(均P < 0.05)。结论:ngt - 1hpg高表现出与PDM相似的致动脉粥样硬化脂质谱。1-h PG可作为早期识别NGT人群中可能未被发现的高危个体的潜在指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cardiovascular Diabetology
Cardiovascular Diabetology 医学-内分泌学与代谢
CiteScore
12.30
自引率
15.10%
发文量
240
审稿时长
1 months
期刊介绍: Cardiovascular Diabetology is a journal that welcomes manuscripts exploring various aspects of the relationship between diabetes, cardiovascular health, and the metabolic syndrome. We invite submissions related to clinical studies, genetic investigations, experimental research, pharmacological studies, epidemiological analyses, and molecular biology research in this field.
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