A Cohort Study On The Relationship Between Serum Lipids And Glucose Metabolic Disorder

BackgroundThere was no cohort report on the relationship between serum lipids and abnormal glucose metabolism in a large sample of Mongolian population.ObjectiveTo explore the relationship between parameter of serum lipids(TC, TG, LDL-C and HDL-C) and abnormal glucose metabolism.Subjects and methods1. Baseline investigationTotal 32 villages in Kezuohou Banner and Naiman in Inner Mongolia were selected as the baseline surveys study field from 2002 to 2003. 2589 participants aged 20 years and older were recruited. Written informed consent was obtained for all study participants. They were administered interview using a standard questionnaire, and the related physical examination and blood samples collection were conducted by trained staffs.2. Follow-up surveyParticipants aged 20-65 and free of IFG and diabetes in baseline were re-investigated in 2013-2014. Survey items were as following: Information of human demography, history of disease and lifestyle were collected though the questionnaire. Medical examination. Examining fasting plasma glucose and conducting oral glucose tolerance test.3. Statistical analysisEpidata3.1 software was used to establish a database, and all questionnaires were input after checking by two individuals. All p-values were based on a 2-sided test and a significance level of 0.05, and statistical analysis was conducted using SAS 9.2 statistical software.Results1760 subjects were included in the data analysis. Among 1760 participants, 513 progressed to prediabetes and 157 were classified as having type 2 diabetes.1. The cumulative incidence of diabetes and prediabetes were 8.92% and 29.15%, and the incidence density were 81.97/10000 person-years and 267.85/10000 person-years, respectively. The cumulative incidence of abnormal glucose metabolism was 38.07% and the incidence density was 349.82/10000 person-years.2. The cumulative incidence of prediabetes and abnormal glucose metabolism in men and women, and total population increased with age(all P<0.05). The cumulative incidence of diabetes increased with age in women and total population(all P<0.05).3. Compared with normoglycaemia, participants with prediabetes had high level of baseline TC, TG and LDL-C. Participants with diabetes had higher level of TC, TG and LDL-C, and lower level of HDL-C. Compared with prediabetes, participants with diabetes had higher level of TG and lower level of HDL-C.4. Multivariate-adjusted OR(95%CI) of prediabetes in participants with TG>=1.34mmol/L was 1.589(1.110-2.273), compared with the reference group. The risk of prediabetes increased with the increasing TG level(trend P<0.05). Baseline levels of TC, HDL-C and LDL-C had no statistical difference with incidence of prediabetes, respectively(all P>0.05).5. In male, multivariate-adjusted ORs(95%CIs) of prediabetes in participants with TG in the third level was 1.939(1.124-3.343), compared with the reference group(all P<0.05). The risk of prediabetes increased with the increasing TG level(trend p<0.05).Baseline levels of TC,HDL-C and LDL-C had no statistical difference with incidence of prediabetes, respectively(all P>0.05). In female, after adjustment for multivariate, baseline levels of TC, TG, HDL-C and LDL-C had no statistical difference with incidence of prediabetes, respectively(all P>0.05).6. Multivariate-adjusted OR(95%CI) of diabetes in participants with TG>=1.34mmol/L was 2.240(1.242-4.041), compared with the reference group. The risk of diabetes increased with the increasing TG level(trend P<0.05). Multivariate-adjusted ORs(95%CIs) of diabetes in participants with HDL-C in the third and highest level were respectively 0.478(0.274-0.835) and 0.447(0.241-0.829), compared with the reference group(all P<0.05).The risk of diabetes decreased with the increasing HDL-C level(trend P<0.05). Baseline levels of TC and LDL-C had no statistical difference with incidence of diabetes, respectively(all P>0.05).7. In male, multivariate-adjusted OR(95%CI) of diabetes in participants with TG>=1.52mmol/L was 3.170(1.336-7.522), compared with the reference group. The risk of diabetes increased with the increasing TG level(trend P<0.05). Baseline levels of TC,HDL-C and LDL-C had no statistical difference with incidence of diabetes, respectively(all P>0.05).In female, multivariate-adjusted ORs(95%CIs) of diabetes in participants with HDL-C in the third and the highest were respectively 0.323(0.147-0.709) and 0.392(0.168-0.915), compared with the reference group. The risk of diabetes decreased with the increasing HDL-C level(trend P<0.05). Baseline levels of TC,TG and LDL-C had no statistical difference with incidence of diabetes, respectively(all P>0.05).8. Multivariate-adjusted OR(95%CI) of abnormal glucose metabolism in participants with TG>=1.34mmol/L was 1.722(1.237-2.397), compared with the reference group. The risk of abnormal glucose metabolism increased with the increasing TG level(trend P<0.05). Multivariate-adjusted OR(95%CI) of abnormal glucose metabolism in participants with HDL-C in the third level was 0.704(0.515- 0.960), compared with the reference group. The risk of abnormal glucose metabolism decreased with the increasing HDL-C level(trend P<0.05).9. In male, multivariate-adjusted ORs(95%CIs) of diabetes in participants with TG in the third and highest level were respectively 1.728(1.046-2.854) and 2.117(1.226-3.656), compared with the reference group. The risk of abnormal glucose metabolism increased with the increasing TG level in men(trend p<0.05). The risk of abnormal glucose metabolism decreased with the increasing HDL-C level in women(trend p<0.05).Conclusions1. There were high incidences of prediabetes, diabetes and abnormal glucose metabolism among Inner Mongolians. The cumulative incidences of prediabetes and diabetes as well as abnormal glucose metabolism were increased with age, and there was no statistical difference between male and female.2. The increasing of TG was associated with prediabetes, diabetes and abnormal glucose metabolism, respectively. The risk of prediabetes, diabetes and abnormal glucose metabolism increased with the increasing TG level. In male has reached the same conclusion, but not in the female.3. HDL-C is a protective factor for diabetes and abnormal glucose metabolism, and the risk of them increases with decreasing HDL-C level. Among the female, HDL-C is a protective factor for diabetes, and the risk of diabetes increase with decreasing HDL-C level. In male has not reached the same conclusion.