Abstract

BackgroundLipid accumulation product (LAP), a product of waist circumference (WC) and fasting triglycerides (TG), is a measure of lipid accumulation and an effective predictor of metabolic syndrome. This study aimed to evaluate the associations of LAP and its longitudinal transitions with type 2 diabetes mellitus (T2DM) among middle-aged and older Chinese.MethodsData were extracted from the China Health and Retirement Longitudinal Study (2011, 2013, 2015, and 2018). LAP was defined as (WC-65) ×TG for men, and (WC-58) ×TG for women. Participants were classified into high- and low-LAP groups at baseline, and subsequently into four transition patterns during 2011-2015: maintained-high, maintained-low, high-to-low, and low-to-high LAP. The longitudinal transition patterns of LAP on the development of T2DM were assessed by multivariable Cox frailty models.ResultsOverall, 7397 participants were included for analysis, among whom 849 (11.5%) developed T2DM between 2011 and 2018. Women with high-LAP levels at baseline presented a higher risk of T2DM (hazard ratios [HR]=1.37, 95% confidence interval [CI]: 1.07-1.77), while no significant association was found in men. Compared with women with maintained-low LAP pattern, those with transition patterns of low-to-high LAP and maintained-high LAP were at higher risk of T2DM (HR =1.99 and 1.98, both P<0.05); however, for men, the significantly positive association was only observed in maintained-high LAP transition pattern (HR=1.53, 95% CI: 1.04-2.23).ConclusionsElevated LAP levels and the transition patterns of maintained-high LAP and low-to-high LAP are significant risk factors for T2DM in women. Preventions are needed to combat T2DM at an early dyslipidemic stage.

Highlights

  • Diabetes mellitus (DM) is a disease of abnormal glucose metabolism that affects multiple organ systems

  • The baseline characteristics of the included participants stratified by gender, setting and Lipid accumulation product (LAP) transition pattern are shown in Table 1 and Table S4

  • In this prospective cohort study, we confirmed that higher LAP level was a significant risk factor for Type 2 diabetes mellitus (T2DM), especially in women

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Summary

Introduction

Diabetes mellitus (DM) is a disease of abnormal glucose metabolism that affects multiple organ systems. Type 2 diabetes mellitus (T2DM) accounts for over 90% of patients with DM, bringing profound psychological and physical distress to patients and putting a huge burden on health care systems [3]. The overall prevalence of T2DM in China increased sharply from 1.3% in 1980-1989 to 4.5% in 1990-1999, 6.8% in 2000-2009, and 8.7% in 2010-2014. Previous research estimated that by 2025, the prevalence of T2DM in China would increase to 12.5% [4], becoming a serious epidemic that produces considerable socioeconomic pressures on both individuals and the society. This study aimed to evaluate the associations of LAP and its longitudinal transitions with type 2 diabetes mellitus (T2DM) among middle-aged and older Chinese

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