Lipids as the link between central obesity and diabetes: perspectives from mediation analysis.

IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM BMC Endocrine Disorders Pub Date : 2024-10-28 DOI:10.1186/s12902-024-01764-5
Song Lu, Maobin Kuang, Jiajun Qiu, Wenjuan Li, Min Zhang, Guotai Sheng, Yang Zou, Xiaoping Peng
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Abstract

Background: Central obesity is a well-recognized risk factor for diabetes, yet the potential role of lipids in the diabetes risk associated with central obesity remains unclear. This study aimed to explore the possible mediating role of 11 lipid parameters [high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), non-high-density lipoprotein cholesterol (Non-HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), remnant cholesterol (RC), and ratios of Non-HDL-C/HDL-C, RC/HDL-C, LDL/HDL-C, TG/HDL-C, TC/HDL-C] in the association of central obesity with diabetes risk.

Methods: We utilized data from 15,453 participants in the NAGALA longitudinal cohort to assess the association of baseline central obesity indicators [waist-height ratio (WHtR), waist circumference (WC)] and the 11 lipid parameters with diabetes risk. Mediation analysis models were constructed to explore the mediating role of lipid parameters in the association of WC/WHtR with diabetes.

Results: Confirmatory associative analysis using multivariable Cox regression showed that, except for Non-HDL-C, TC and LD-C, the remaining eight lipid parameters were significantly associated with WC/WHtR and diabetes risk. Mediation analysis indicated that TG, RC, HDL-C, and lipid ratios such as Non-HDL-C/HDL-C ratio, RC/HDL-C ratio, TG/HDL-C ratio, TC/HDL-C ratio and LDL/HDL-C ratio are potential lipids affecting the diabetes risk related to central obesity. Among these, the RC/HDL-C ratio seemed to contribute the most in the WC/WHtR-related diabetes risk association, with a mediation percentage of about 37%. Additionally, lipid ratio parameters appeared to play a more mediating role in the association of central obesity-related diabetes risk than individual lipids.

Conclusions: In central obesity-related diabetes risk, most lipids, especially lipid ratio parameters, play a significant mediating role. Given these findings, we advocate for increased efforts in multifactorial risk monitoring and joint management of diabetes. The evaluation of lipids, particularly lipid ratio parameters, may be holds substantial value in the prevention and management of diabetes risk under close monitoring of central obesity.

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血脂是中心性肥胖与糖尿病之间的联系:中介分析的视角。
背景:中心性肥胖是公认的糖尿病风险因素,但血脂在与中心性肥胖相关的糖尿病风险中的潜在作用仍不清楚。本研究旨在探讨 11 种血脂参数(高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、非高密度脂蛋白胆固醇(Non-HDL-C)低密度脂蛋白胆固醇 (LDL-C)、甘油三酯 (TG)、残余胆固醇 (RC) 以及非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇、RC/高密度脂蛋白胆固醇、低密度脂蛋白/高密度脂蛋白胆固醇、TG/高密度脂蛋白胆固醇、TC/高密度脂蛋白胆固醇的比率]等 11 项血脂参数在中心性肥胖与糖尿病风险的关联中的作用。方法:我们利用 NAGALA 纵向队列中 15,453 名参与者的数据,评估了基线中心性肥胖指标[腰高比(WHtR)、腰围(WC)]和 11 项血脂参数与糖尿病风险的关系。建立了中介分析模型,以探讨血脂参数在腰围/腰围比与糖尿病的关联中的中介作用:结果:使用多变量考克斯回归进行的确证关联分析表明,除非高密度脂蛋白胆固醇(Non-HDL-C)、总胆固醇(TC)和低密度脂蛋白胆固醇(LD-C)外,其余8个血脂参数与体重/体重指数和糖尿病风险显著相关。中介分析表明,TG、RC、HDL-C 以及非 HDL-C/HDL-C 比值、RC/HDL-C 比值、TG/HDL-C 比值、TC/HDL-C 比值和 LDL/HDL-C 比值等血脂比率是影响中心性肥胖相关糖尿病风险的潜在血脂参数。其中,RC/HDL-C 比值似乎在与 WC/WHtR 相关的糖尿病风险关联中贡献最大,调解比例约为 37%。此外,与单个血脂相比,血脂比率参数似乎在中心性肥胖相关糖尿病风险关联中发挥着更大的中介作用:结论:在中枢性肥胖相关糖尿病风险中,大多数血脂,尤其是血脂比率参数,起着重要的中介作用。鉴于这些发现,我们主张加大多因素风险监测和糖尿病联合管理的力度。在密切监测中心性肥胖的情况下,评估血脂,尤其是血脂比率参数,对预防和管理糖尿病风险具有重要价值。
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来源期刊
BMC Endocrine Disorders
BMC Endocrine Disorders ENDOCRINOLOGY & METABOLISM-
CiteScore
4.40
自引率
0.00%
发文量
280
审稿时长
>12 weeks
期刊介绍: BMC Endocrine Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of endocrine disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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