Longitudinal triglyceride and HDL cholesterol, but not LDL cholesterol associated with the risk of incident type 2 diabetes: Evidence from a multi-trajectory analysis

IF 3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Annals of Epidemiology Pub Date : 2025-10-10 DOI:10.1016/j.annepidem.2025.10.007

Xue Tian , Shuohua Chen , Xue Xia , Qin Xu , Shouling Wu , Anxin Wang

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引用次数: 0

Abstract

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.

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纵向甘油三酯和高密度脂蛋白胆固醇，而非低密度脂蛋白胆固醇与2型糖尿病发生风险相关：来自多轨迹分析的证据

目的：关于脂质与2型糖尿病（T2DM）之间的关系，目前的研究结果并不一致，部分原因是忽略了脂质纵向模式的联合作用。本研究旨在探讨不同脂质联合多轨迹与2型糖尿病风险的关系。方法：我们从开滦研究中招募了71,043名无T2DM的参与者。采用基于组的多轨迹模型，建立了2006-2010年期间甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）的联合多轨迹，以预测2010-2019年期间T2DM的风险。结果在4年的暴露中，确定了5个不同的多轨迹组，在中位随访8.97年期间发生了6473例（9.11 %）T2DM事件。T2DM发生风险最高的是TG、LDL、HDL-C水平最高的第5组（风险比[HR]， 2.14； 95 %可信区间[CI]， 1.89 ~ 2.41），其次是HDL-C水平最低、TG、LDL- c水平最佳的第3组（风险比，1.39;95 % CI, 1.11 ~ 1.43）， LDL- c水平最高、TG、HDL-C水平最佳的第4组(风险比，1,26；95 % CI, 1.11-1.43)，与TG水平最低、LDL-C最佳升高和HDL-C高升高的2组相比。无论基线脂质水平如何，观察到的关联都存在。结论高升高的TG和低降低的HDL-C在T2DM的发生过程中发挥重要作用，而不是高升高的LDL-C，这有助于更好地了解T2DM的异质性风险，促进有针对性的预防计划。

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

Annals of Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.40

自引率

1.80%

发文量

207

审稿时长

59 days

期刊介绍： The journal emphasizes the application of epidemiologic methods to issues that affect the distribution and determinants of human illness in diverse contexts. Its primary focus is on chronic and acute conditions of diverse etiologies and of major importance to clinical medicine, public health, and health care delivery.