Impact of 3-year changes in lipid parameters and their ratios on incident type 2 diabetes: Tehran lipid and glucose stud
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RESEARCH
Open Access
Impact of 3-year changes in lipid parameters and their ratios on incident type 2 diabetes: Tehran lipid and glucose study Pegah Khaloo1,2, Mitra Hasheminia2, Maryam Tohidi2, Hengameh Abdi3, Mohammad Ali Mansournia4, Fereidoun Azizi3 and Farzad Hadaegh2*
Abstract Background: To examine the impact of changes in all lipid measures including total cholesterol (TC), log-transformed triglycerides (Ln-TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), non-HDL-C, TC/HDL-C and Ln TG/HDL-C, over an approximate 3 year duration, on incident type 2 diabetes (T2DM). Methods: A total of 5474 participants, mean age 41.3 years, without prevalent diabetes at baseline or the first follow-up were entered into the study. The association of lipid changes between baseline and the first follow-up i.e., between 1999–2002 and 2002–2005 for those entered in the first phase (n = 4406) and between 2002–2005 and 2005–2008 for participants recruited in the second phase (n = 1068) with incident T2DM over the follow-up period was assessed, using multivariate Cox proportional hazard analysis. Results: During a median follow-up of 8.9 years after the second lipid measurements, 577 incident cases of T2DM occurred. After adjustment for a wide variety of confounders and body mass index (BMI) change, each 1-SD increase in TC, Ln-TG, HDL-C, LDL-C, non-HDL-C, Ln-TG/HDL-C and TC/HDL-C was associated with 12, 14, 0.86, 12, 16, 15 and 13% risk for T2DM, respectively (all p-values < 0.05). However, after further adjustment for fasting plasma glucose (FPG) change, the risk disappeared for all lipid measures, excluding HDL-C [hazard ratio (HR): 0.84 (0.76–0.93)], Ln-TG/HDL-C [1.14 (1.04–1.25)] and TC/HDL-C [1.12 (1.04–1.21)]. Conclusions: Three year changes in all lipid parameters, after adjustment for known risk factors of T2DM and BMI changes, were associated with incident T2DM. The independent risk of HDL-C and its ratios remained even after adjustment for FPG changes. Keywords: Dyslipidemia, Type 2 diabetes, Triglycerides, LDL-C, HDL-C, Total cholesterol
Background Prevalence of type 2 diabetes (T2DM) is fast increasing as a result of changes in lifestyle, physical inactivity, nutrition transition and a steep increase in obesity [1]. It is assumed that by the year 2045, over 629 million people worldwide will suffer from diabetes, of which over 13% (82 million) will be from the Middle East region [2, 3]. * Correspondence: [email protected] 2 Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Number 24, Yemen Street, Shahid Chamran Highway, P.O. Box: 19395-4763, Tehran, Iran Full list of author information is available at the end of the article
The annual incidence of T2DM is estimated to be over 1% in Iranian population [4]. Numerous studies have discussed the role of potential risk factors including high-risk ethnicity, physical inactivity, obesity, history of cardiovascular disease (CVD),
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