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Utility of non‐high‐density lipoprotein cholesterol in assessing incident type 2 diabetes risk
Author(s) -
Ley S. H.,
Harris S. B.,
Connelly P. W.,
Mamakeesick M.,
Gittelsohn J.,
Wolever T. M.,
Hegele R. A.,
Zinman B.,
Hanley A. J.
Publication year - 2012
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/j.1463-1326.2012.01607.x
Subject(s) - type 2 diabetes , high density lipoprotein , diabetes mellitus , cholesterol , medicine , endocrinology
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.