Abstract
BackgroundThe magnitude and direction of association of low-density lipid cholesterol (LDL-C) with diabetes mellitus (DM) might differ by hypertensive status, but there is limited epidemiological evidence in China.MethodsWe examined the association between LDL-C levels and DM in 9892 participants with hypertension using logistic regression. Participants were stratified into three groups according to LDL-C levels (desirable, borderline high or high), then further divided into quartiles. Restricted cubic spline regression models, subgroup analysis and interaction tests were also conducted to evaluate the shape of association.ResultsAfter adjusting for covariates, lower LDL-C had a significant and inverse association with the likelihood of DM in all participants (OR: 0.944, 95% CI = 0.893, 0.998). In participants with desirable LDL-C concentrations (< 3.4 mmol/L), LDL-C protected against DM (OR = 1.240, 95% CI = 1.076, 1.429 per 1 mmol/L decrease). In participants with higher LDL-C concentrations (> 4.1 mmol/L), LDL-C increased the DM likelihood (OR = 1.536, 95% CI = 1.126, 2.096 per 1 mmol/L increase). Restricted cubic spline regression also found a U-shaped association between LDL-C levels and DM prevalence.ConclusionsThere was a U-shaped association between LDL-C levels and DM in Chinese patients with hypertension.
Highlights
The magnitude and direction of association of low-density lipid cholesterol (LDL-C) with diabetes mellitus (DM) might differ by hypertensive status, but there is limited epidemiological evidence in China
Participants’ height, weight, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), estimated glomerular filtration rate, and body mass index (BMI) were assessed. eGFR was calculated as 186 × Scr− 1.154 × age− 0.203 × 0.724 for women; Scr is serum creatinine
Participants with LDLC concentrations < 3.4 mmol/L were younger in age, had higher FBG, lower WC and SBP than participants in other two groups, and higher prevalence of DM or coronary artery disease (CAD)
Summary
The magnitude and direction of association of low-density lipid cholesterol (LDL-C) with diabetes mellitus (DM) might differ by hypertensive status, but there is limited epidemiological evidence in China. The number of adults with diabetes mellitus (DM) worldwide was estimated to be 366 million in 2011 and is expected to reach 552 million by 2030 [1, 2]. The International Diabetes Federation has estimated that 50% of adults with diabetes are undiagnosed [3]. DM is highly prevalent in China and is a great disease burden [4]. Lowering low-density lipoprotein cholesterol (LDL-C) has been considered to be essential in preventing cardiovascular disease [5]. Statin therapy has been associated with a slightly increased risk of DM. Liu et al Lipids in Health and Disease (2019) 18:163
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