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
Summary
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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