{"title":"血脂是肾功能与糖尿病风险之间缺失的一环吗？基于队列研究的中介分析的启示。","authors":"Xiaomin Liang, Haofei Hu, Ying Li, Shuiqing Gui","doi":"10.2147/JMDH.S544229","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Both renal function impairment and lipid abnormalities are recognized risk factors for diabetes. However, the potential mediating role of lipid parameters in the relationship between renal function and diabetes risk remains unexplored. This study aimed to investigate whether and to what extent lipid parameters mediate the association between renal function and diabetes risk.</p><p><strong>Patients and methods: </strong>We conducted a cohort study including adults from 32 sites across 11 Chinese cities between 2010 and 2016. Renal function was assessed by estimated glomerular filtration rate (eGFR). Lipid parameters included triglyceride glucose (TyG), triglyceride glucose- body mass index (TyG-BMI), triglyceride/ high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic index of plasma (AIP). Cox proportional hazards models were used to examine the relationship between eGFR and diabetes risk. Subgroup analyses were performed to identify potential effect modifiers. Mediation analyses quantified the proportion of eGFR's effect on diabetes risk mediated through each lipid parameter.</p><p><strong>Results: </strong>Among 115,488 participants (54.07% male, mean age 44.12 ± 12.95 years) followed for 3.10 ± 0.95 years, 2659 (2.30%) developed diabetes. After multivariable adjustment, higher eGFR was inversely associated with diabetes risk (HR=0.98, 95% CI: 0.98-0.98). This association was more pronounced in females, participants <60 years, those with BMI <25 kg/m², SBP <140 mmHg, non-smokers, non-drinkers, ALT <40 U/L, and AST <40 U/L. Mediation analyses revealed that TyG, TyG-BMI, TG/HDL-c, and AIP mediated 23.14%, 21.05%, 3.54%, and 12.49% of the eGFR-diabetes relationship, respectively.</p><p><strong>Conclusion: </strong>Reduced renal function, as indicated by lower eGFR, is associated with increased diabetes risk. This relationship is partially mediated through lipid metabolism pathways, suggesting lipid may represent a missing link between renal function and diabetes risk.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"5635-5649"},"PeriodicalIF":2.4000,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423442/pdf/","citationCount":"0","resultStr":"{\"title\":\"Is Lipid a Missing Link Between Renal Function and Diabetes Risk? Insights from a Mediation Analysis Based on the Cohort Study.\",\"authors\":\"Xiaomin Liang, Haofei Hu, Ying Li, Shuiqing Gui\",\"doi\":\"10.2147/JMDH.S544229\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Both renal function impairment and lipid abnormalities are recognized risk factors for diabetes. However, the potential mediating role of lipid parameters in the relationship between renal function and diabetes risk remains unexplored. This study aimed to investigate whether and to what extent lipid parameters mediate the association between renal function and diabetes risk.</p><p><strong>Patients and methods: </strong>We conducted a cohort study including adults from 32 sites across 11 Chinese cities between 2010 and 2016. Renal function was assessed by estimated glomerular filtration rate (eGFR). Lipid parameters included triglyceride glucose (TyG), triglyceride glucose- body mass index (TyG-BMI), triglyceride/ high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic index of plasma (AIP). Cox proportional hazards models were used to examine the relationship between eGFR and diabetes risk. Subgroup analyses were performed to identify potential effect modifiers. Mediation analyses quantified the proportion of eGFR's effect on diabetes risk mediated through each lipid parameter.</p><p><strong>Results: </strong>Among 115,488 participants (54.07% male, mean age 44.12 ± 12.95 years) followed for 3.10 ± 0.95 years, 2659 (2.30%) developed diabetes. After multivariable adjustment, higher eGFR was inversely associated with diabetes risk (HR=0.98, 95% CI: 0.98-0.98). This association was more pronounced in females, participants <60 years, those with BMI <25 kg/m², SBP <140 mmHg, non-smokers, non-drinkers, ALT <40 U/L, and AST <40 U/L. Mediation analyses revealed that TyG, TyG-BMI, TG/HDL-c, and AIP mediated 23.14%, 21.05%, 3.54%, and 12.49% of the eGFR-diabetes relationship, respectively.</p><p><strong>Conclusion: </strong>Reduced renal function, as indicated by lower eGFR, is associated with increased diabetes risk. This relationship is partially mediated through lipid metabolism pathways, suggesting lipid may represent a missing link between renal function and diabetes risk.</p>\",\"PeriodicalId\":16357,\"journal\":{\"name\":\"Journal of Multidisciplinary Healthcare\",\"volume\":\"18 \",\"pages\":\"5635-5649\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-09-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423442/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Multidisciplinary Healthcare\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/JMDH.S544229\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Multidisciplinary Healthcare","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/JMDH.S544229","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Is Lipid a Missing Link Between Renal Function and Diabetes Risk? Insights from a Mediation Analysis Based on the Cohort Study.
Purpose: Both renal function impairment and lipid abnormalities are recognized risk factors for diabetes. However, the potential mediating role of lipid parameters in the relationship between renal function and diabetes risk remains unexplored. This study aimed to investigate whether and to what extent lipid parameters mediate the association between renal function and diabetes risk.
Patients and methods: We conducted a cohort study including adults from 32 sites across 11 Chinese cities between 2010 and 2016. Renal function was assessed by estimated glomerular filtration rate (eGFR). Lipid parameters included triglyceride glucose (TyG), triglyceride glucose- body mass index (TyG-BMI), triglyceride/ high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic index of plasma (AIP). Cox proportional hazards models were used to examine the relationship between eGFR and diabetes risk. Subgroup analyses were performed to identify potential effect modifiers. Mediation analyses quantified the proportion of eGFR's effect on diabetes risk mediated through each lipid parameter.
Results: Among 115,488 participants (54.07% male, mean age 44.12 ± 12.95 years) followed for 3.10 ± 0.95 years, 2659 (2.30%) developed diabetes. After multivariable adjustment, higher eGFR was inversely associated with diabetes risk (HR=0.98, 95% CI: 0.98-0.98). This association was more pronounced in females, participants <60 years, those with BMI <25 kg/m², SBP <140 mmHg, non-smokers, non-drinkers, ALT <40 U/L, and AST <40 U/L. Mediation analyses revealed that TyG, TyG-BMI, TG/HDL-c, and AIP mediated 23.14%, 21.05%, 3.54%, and 12.49% of the eGFR-diabetes relationship, respectively.
Conclusion: Reduced renal function, as indicated by lower eGFR, is associated with increased diabetes risk. This relationship is partially mediated through lipid metabolism pathways, suggesting lipid may represent a missing link between renal function and diabetes risk.
期刊介绍：
The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.
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