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- Title
Utility of non-high-density lipoprotein cholesterol in assessing incident type 2 diabetes risk.
- Authors
Ley, S. H.; Harris, S. B.; Connelly, P. W.; Mamakeesick, M.; Gittelsohn, J.; Wolever, T. M.; Hegele, R. A.; Zinman, B.; Hanley, A. J.
- Abstract
Aims: Traditional lipid indices have been associated with type 2 diabetes, but limited data are available regarding non-high-density lipoprotein (non-HDL) cholesterol. In view of recent guidelines for the clinical management of dyslipidemia recommending the monitoring of non-HDL cholesterol as a secondary target after achieving the low-density lipoprotein (LDL) cholesterol goal, we aimed to assess the association of non-HDL cholesterol with incident type 2 diabetes and compare its utility as a risk predictor with traditional lipid variables in Aboriginal Canadians. Methods: Of 606 diabetes-free participants at baseline, 540 (89.1%) returned for 10-year follow-up assessments. Baseline anthropometry, blood pressure, fasting insulin and serum lipids were measured. Fasting and 2-h postload glucose were obtained at baseline and follow-up to determine the incidence of type 2 diabetes. Results: The cumulative incidence of type 2 diabetes was 17.5%. Higher non-HDL cholesterol, total-to-HDL cholesterol ratio, apolipoprotein B, triglyceride and LDL cholesterol and lower HDL cholesterol concentrations were individually associated with incident type 2 diabetes in univariate analyses (all p < 0.05). Non-HDL cholesterol was a superior determinant of incident diabetes compared with LDL cholesterol (comparing C-statistics of univariate models p = 0.01) or HDL cholesterol (p = 0.004). With multivariate adjustment including waist circumference, non-HDL cholesterol remained associated with incident diabetes [odds ratio (OR) 1.42 (95% confidence interval, CI 1.07-1.88)], while LDL cholesterol and HDL cholesterol became non-significant. Conclusions: Non-HDL cholesterol was associated with incident type 2 diabetes and was superior to LDL cholesterol as a risk predictor in this population. Further studies are required to establish the utility of non-HDL cholesterol in non-Aboriginal populations.
- Subjects
CANADA; CHOLESTEROL; LIPOPROTEINS; TYPE 2 diabetes; DISEASE management; DYSLIPIDEMIA; ABORIGINAL Canadians
- Publication
Diabetes, Obesity & Metabolism, 2012, Vol 14, Issue 9, p821
- ISSN
1462-8902
- Publication type
Article
- DOI
10.1111/j.1463-1326.2012.01607.x