Diabetes, Metabolic Syndrome and Obesity (May 2022)
Utility of Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio in Evaluating Incident Diabetes Risk
Abstract
Guotai Sheng,1,* Dingyang Liu,1,* Maobin Kuang,1,* Yanjia Zhong,2 Shuhua Zhang,3 Yang Zou3 1Cardiology Department, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Provincial, 330006, People’s Republic of China; 2Endocrinology Department, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, 330006, People’s Republic of China; 3Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Provincial, People’s Republic of China*These authors have contributed equally to this workCorrespondence: Yang Zou, Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Provincial, People’s Republic of China, Email [email protected]: Diabetes is one of the most prevalent chronic diseases in the world, and its prevalence is expected to rise further. To help understand the utility of the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) in diabetes prevention, this large-scale longitudinal cohort study aims to explore the association of NHHR with diabetes risk and compare it as a risk predictor with conventional lipid parameters.Patients and Methods: This observational study extracted data from the NAGALA longitudinal cohort study conducted in Japan between 2004 and 2015. Multivariate Cox regression analysis was used to evaluate the association between NHHR and the risk of diabetes. The dose–response relationship was analyzed by restricted cubic spline (RCS) regression and the potential risk threshold was estimated. The receiver operator characteristic curve (ROC) was used to analyze and calculate the predictive value and optimal threshold of NHHR and other conventional lipids for new-onset diabetes.Results: Of the 15,464 people aged 18– 79, 373 (2.41%) were diagnosed with new-onset diabetes during the study period, with a median age of 46 years. The sensitivity analysis based on multivariate adjustment showed that the independent positive correlation between diabetes and NHHR was stable in different populations. RCS and ROC analysis indicated that the association between NHHR and diabetes was non-linear, and the NHHR was a better marker for predicting diabetes risk than other conventional lipid parameters; Additionally, it is worth noting that an NHHR of approximately 2.74 may be the optimal threshold for intervention in diabetes risk.Conclusion: In the general population, NHHR is a better marker for predicting diabetes risk than conventional lipid parameters, and an NHHR of about 2.74 may be the optimal threshold for assessing diabetes risk.Keywords: non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol, diabetes, longitudinal cohort, operator characteristic curve
