Association Between Simple, Combined Lipid Markers and 20-year Cumulative Incidence of Type 2 Diabetes: the ATTICA Cohort Study (2002-2022)

Overview

Journal Lipids Health Dis

Publisher Biomed Central

Specialties Biochemistry
Endocrinology

Date 2024 Dec 20

PMID 39707372

Authors

Ioanna Kechagia

Fotios Barkas

Evangelos Liberopoulos

Christina Chrysohoou

Petros P Sfikakis

Costas Tsioufis

Christos Pitsavos

Demosthenes Panagiotakos

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study was to evaluate the association between simple, combined lipid biomarkers, and 20-year cumulative incidence of new type 2 diabetes mellitus (T2DM) among adults participating in the ATTICA cohort study (2002-2022).

Methods: The present analysis included data from 2000 individuals free of T2DM at baseline (age 43 ± 13 years; 51% women). Sociodemographic, anthropometric, lifestyle, clinical, and biochemical parameters were collected at baseline and follow-up examinations; combined lipid markers were evaluated.

Results: The 20-year cumulative incidence of T2DM was 26.3% (95%CI 24.4, 28.3%). All, simple and combined lipid markers were independently associated with new T2DM onset. The accuracy of simple and combined markers was approximately 75%, without any significant differences between simple and combined indices. The additive correct classification gain of lipid markers to glucose metabolism indices on 20-year new T2DM cumulative incidence varied between 0.9% for cardiometabolic index to 10.6% for LDL-cholesterol.

Conclusions: Lipid profile is associated with the long-term onset of T2DM. Evaluated through simple or combined markers, lipid profiles can be utilized for identifying and improving risk stratification in individuals at high risk for T2DM, while also enhancing the effectiveness of primary prevention measures and public health strategies.

References

Zhu X, Deng F, Lei S . Meta-analysis of Atherogenic Index of Plasma and other lipid parameters in relation to risk of type 2 diabetes mellitus. Prim Care Diabetes. 2014; 9(1):60-7. DOI: 10.1016/j.pcd.2014.03.007. View

Robertson R, Porte Jr D . The glucose receptor. A defective mechanism in diabetes mellitus distinct from the beta adrenergic receptor. J Clin Invest. 1973; 52(4):870-6. PMC: 302334. DOI: 10.1172/JCI107251. View

Lee J, Chang P, Zhang Y, Kizer J, Best L, Howard B . Triglyceride and HDL-C Dyslipidemia and Risks of Coronary Heart Disease and Ischemic Stroke by Glycemic Dysregulation Status: The Strong Heart Study. Diabetes Care. 2017; 40(4):529-537. PMC: 5360283. DOI: 10.2337/dc16-1958. View

Wondmkun Y . Obesity, Insulin Resistance, and Type 2 Diabetes: Associations and Therapeutic Implications. Diabetes Metab Syndr Obes. 2020; 13:3611-3616. PMC: 7553667. DOI: 10.2147/DMSO.S275898. View

Han M, Li Q, Qie R, Guo C, Zhou Q, Tian G . Association of non-HDL-C/HDL-C ratio and its dynamic changes with incident type 2 diabetes mellitus: The Rural Chinese Cohort Study. J Diabetes Complications. 2020; 34(12):107712. DOI: 10.1016/j.jdiacomp.2020.107712. View

Wang Y, Zhang X, Li Y, Gui J, Mei Y, Yang X . Obesity- and lipid-related indices as a predictor of type 2 diabetes in a national cohort study. Front Endocrinol (Lausanne). 2024; 14:1331739. PMC: 10864443. DOI: 10.3389/fendo.2023.1331739. View

Katsouyanni K, Rimm E, Gnardellis C, Trichopoulos D, Polychronopoulos E, Trichopoulou A . Reproducibility and relative validity of an extensive semi-quantitative food frequency questionnaire using dietary records and biochemical markers among Greek schoolteachers. Int J Epidemiol. 1997; 26 Suppl 1:S118-27. DOI: 10.1093/ije/26.suppl_1.s118. View

Panagiotakos D, Pitsavos C, Stefanadis C . Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutr Metab Cardiovasc Dis. 2006; 16(8):559-68. DOI: 10.1016/j.numecd.2005.08.006. View

Zheng D, Li H, Ai F, Sun F, Singh M, Cao X . Association between the triglyceride to high-density lipoprotein cholesterol ratio and the risk of type 2 diabetes mellitus among Chinese elderly: the Beijing Longitudinal Study of Aging. BMJ Open Diabetes Res Care. 2020; 8(1). PMC: 7206911. DOI: 10.1136/bmjdrc-2019-000811. View

10.

Bommer C, Sagalova V, Heesemann E, Manne-Goehler J, Atun R, Barnighausen T . Global Economic Burden of Diabetes in Adults: Projections From 2015 to 2030. Diabetes Care. 2018; 41(5):963-970. DOI: 10.2337/dc17-1962. View

11.

. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2023; 402(10397):203-234. PMC: 10364581. DOI: 10.1016/S0140-6736(23)01301-6. View

12.

Chen Z, Hu H, Chen M, Luo X, Yao W, Liang Q . Association of Triglyceride to high-density lipoprotein cholesterol ratio and incident of diabetes mellitus: a secondary retrospective analysis based on a Chinese cohort study. Lipids Health Dis. 2020; 19(1):33. PMC: 7057518. DOI: 10.1186/s12944-020-01213-x. View

13.

. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2000; 284(23):3043-5. View

14.

Okunogbe A, Nugent R, Spencer G, Powis J, Ralston J, Wilding J . Economic impacts of overweight and obesity: current and future estimates for 161 countries. BMJ Glob Health. 2022; 7(9). PMC: 9494015. DOI: 10.1136/bmjgh-2022-009773. View

15.

Golabi P, Paik J, Kumar A, Al Shabeeb R, Eberly K, Cusi K . Nonalcoholic fatty liver disease (NAFLD) and associated mortality in individuals with type 2 diabetes, pre-diabetes, metabolically unhealthy, and metabolically healthy individuals in the United States. Metabolism. 2023; 146:155642. DOI: 10.1016/j.metabol.2023.155642. View

16.

Kechagia I, Tsiampalis T, Damigou E, Barkas F, Anastasiou G, Kravvariti E . Long-Term Adherence to the Mediterranean Diet Reduces 20-Year Diabetes Incidence: The ATTICA Cohort Study (2002-2022). Metabolites. 2024; 14(4). PMC: 11051724. DOI: 10.3390/metabo14040182. View

17.

Wakabayashi I, Daimon T . The "cardiometabolic index" as a new marker determined by adiposity and blood lipids for discrimination of diabetes mellitus. Clin Chim Acta. 2014; 438:274-8. DOI: 10.1016/j.cca.2014.08.042. View

18.

Tan M, Weng L, Yang Z, Zhu S, Wu S, Su J . The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio with type 2 diabetes mellitus: recent findings from NHANES 2007-2018. Lipids Health Dis. 2024; 23(1):151. PMC: 11106869. DOI: 10.1186/s12944-024-02143-8. View

19.

Sheng G, Liu D, Kuang M, Zhong Y, Zhang S, Zou Y . Utility of Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio in Evaluating Incident Diabetes Risk. Diabetes Metab Syndr Obes. 2022; 15:1677-1686. PMC: 9166911. DOI: 10.2147/DMSO.S355980. View

20.

Lopez-Jaramillo P, Gomez-Arbelaez D, Martinez-Bello D, Abat M, Alhabib K, Avezum A . Association of the triglyceride glucose index as a measure of insulin resistance with mortality and cardiovascular disease in populations from five continents (PURE study): a prospective cohort study. Lancet Healthy Longev. 2022; 4(1):e23-e33. DOI: 10.1016/S2666-7568(22)00247-1. View