The relationship between high-density lipoprotein cholesterol (HDL-C) and glycosylated hemoglobin in diabetic patients aged 20 or above: a cross-sectional study

Rui Huang,Yuhua Lei,Li Yan

doi:10.1186/s12902-021-00863-x

Abstract

AimThe incidence rate of diabetes is increasing year by year, seriously threatening human health. As a predictor of glycemic control, glycated hemoglobin is reported to be related to various complications and prognoses of diabetes. Besides, HDL-C dyslipidemia is a component of metabolic syndrome and may be related to various cardiovascular and cerebrovascular diseases. The principal objective of this project was to investigate the relationship between HDL-C and glycosylated hemoglobin in adult diabetic patients.MethodsA total of 3171 adult diabetic patients aged 20 years and above were included in the present study from the National Health and Nutrition Examination Survey (NHANES). HDL-C and glycosylated hemoglobin were regarded as independent and dependent variables, respectively. EmpowerStats software and R (version 3.4.3) were used to examine the association between HDL-C and glycosylated hemoglobin.ResultsHDL-C was inversely associated with glycohemoglobin after adjusting for other covariates (β = − 0.004, 95% CI:− 0.008 to − 0.000, p = 0.044). Race/ethnicity and age were considered the most prominent interactive factors that affect the relationship between HDL and glycosylated hemoglobin by the interaction analysis. A U-shaped association was detected between HDL-C and glycosylated hemoglobin for people of other race/ethnicity or aged 60 and above, which had an inflection point of HDL-C at 60 mg/dL. In contrast, we observed an inverted U-shaped distribution between HDL-C and glycosylated hemoglobin in people under 40 with point of inflection located at 60 mg/dL as well.ConclusionsHDL-C in diabetic patients is inversely associated with glycosylated hemoglobin and may be relevant to glycemic control. However, a U-shaped relationship was also observed in a certain kind of people, which implied that, though HDL-C is considered as metabolism and anti-atherogenic property, for diabetics, it is not the higher, the better.

Highlights

Diabetes Mellitus (DM) is a complex chronic disease characterized by high prevalence, morbidity, and excess mortality, especially in the middle-aged and elderly
High-density lipoprotein cholesterol (HDL-C) in diabetic patients is inversely associated with glycosylated hemoglobin and may be relevant to glycemic control
A U-shaped relationship was observed in a certain kind of people, which implied that, though HDL-C is considered as metabolism and anti-atherogenic property, for diabetics, it is not the higher, the better

Summary

Introduction

Diabetes Mellitus (DM) is a complex chronic disease characterized by high prevalence, morbidity, and excess mortality, especially in the middle-aged and elderly. Various approaches have been used in managing DM, the primary goal is to achieve and maintain optimal glycemic control and delay the onset of diabetes-related complications such as cardiovascular diseases, renal insufficiency, peripheral neuropathy, macrovascular and microvascular disorders. Extensive research has shown that glycosylated hemoglobin or HbA1C is recognized as a pivotal sign to evaluate the long-term serum glucose control and complications of diabetes currently, which is unlikely to be supplanted in the short term [3,4,5,6,7]. According to a recent report, the variability of HbA1c in diabetic patients is related to cardiovascular events and all-cause mortality, and high HbA1c is independently associated with an increased risk of microvascular complications [10]. Consistent with this research, other studies found that high HbA1c was associated with increased cardiovascular death [11] and metabolic syndrom [12, 13]

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