{"title":"Association of remnant cholesterol with progression and regression of prediabetes in middle-aged and older adults: a nationwide cohort study.","authors":"Jinyan Jiang, Meichen Chen, Ran Li, Jifang Zhu, Fang Qin, Qian Peng","doi":"10.1007/s00592-024-02416-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The relationship between remnant cholesterol (RC) and outcome of patients with prediabetes remains unclear. This study aims to explore the association between dynamic changes in RC and progression to diabetes or regression to normal blood glucose in pre-diabetic population through a nationwide cohort study.</p><p><strong>Methods: </strong>Based on the China Health and Retirement Longitudinal Study (CHARLS), 2304 participants aged 45 years or older (58.60 ± 8.04 years) who participated in two surveys in 2011 and 2015 were included. Participants were divided into 3 groups according to the tertiles of dynamic changes in RC levels between the two surveys (Q1: ≤ - 1.59, Q2: - 1.59-12.73, Q3: ≥ 12.73, mmol/L). Multivariate Logistic regression models were used to analyze the association of the dynamic changes in RC and the progression and regression of prediabetes. Restricted cubic splines were used to analyze the dose-response relationship between RC and dynamic changes in RC and progression in the prediabetic population.</p><p><strong>Results: </strong>During follow-up, 522 (22.30%) participants developed diabetes, 1283 (54.8%) participants remained prediabetic, and 536 (22.9%) participants regressed to normoglycemia. Further analysis of dynamic changes in RC revealed that reducing RC levels during follow-up reduced the risk of developing diabetes (OR = 0.76, 95% CI: 0.58-0.99, P = 0.04). However, compared with people with increased RC levels, people with prediabetes and stable RC levels are more likely to return to normal blood glucose (OR = 1.45,95% CI: 1.12-1.88, P = 0.005). In the pre-diabetic population, there was non-linear dose-response relationship between the level of RC and dynamic change in RC and the risk of developing diabetes (P nonlinearity < 0.001).</p><p><strong>Conclusion: </strong>Our findings revealed a substantial and non-linear association between dynamic change in RC levels and the outcome of prediabetes. Decreased RC level were associated with reduced risk of progression to diabetes in prediabetes.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Diabetologica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00592-024-02416-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The relationship between remnant cholesterol (RC) and outcome of patients with prediabetes remains unclear. This study aims to explore the association between dynamic changes in RC and progression to diabetes or regression to normal blood glucose in pre-diabetic population through a nationwide cohort study.
Methods: Based on the China Health and Retirement Longitudinal Study (CHARLS), 2304 participants aged 45 years or older (58.60 ± 8.04 years) who participated in two surveys in 2011 and 2015 were included. Participants were divided into 3 groups according to the tertiles of dynamic changes in RC levels between the two surveys (Q1: ≤ - 1.59, Q2: - 1.59-12.73, Q3: ≥ 12.73, mmol/L). Multivariate Logistic regression models were used to analyze the association of the dynamic changes in RC and the progression and regression of prediabetes. Restricted cubic splines were used to analyze the dose-response relationship between RC and dynamic changes in RC and progression in the prediabetic population.
Results: During follow-up, 522 (22.30%) participants developed diabetes, 1283 (54.8%) participants remained prediabetic, and 536 (22.9%) participants regressed to normoglycemia. Further analysis of dynamic changes in RC revealed that reducing RC levels during follow-up reduced the risk of developing diabetes (OR = 0.76, 95% CI: 0.58-0.99, P = 0.04). However, compared with people with increased RC levels, people with prediabetes and stable RC levels are more likely to return to normal blood glucose (OR = 1.45,95% CI: 1.12-1.88, P = 0.005). In the pre-diabetic population, there was non-linear dose-response relationship between the level of RC and dynamic change in RC and the risk of developing diabetes (P nonlinearity < 0.001).
Conclusion: Our findings revealed a substantial and non-linear association between dynamic change in RC levels and the outcome of prediabetes. Decreased RC level were associated with reduced risk of progression to diabetes in prediabetes.
期刊介绍：
Acta Diabetologica is a journal that publishes reports of experimental and clinical research on diabetes mellitus and related metabolic diseases. Original contributions on biochemical, physiological, pathophysiological and clinical aspects of research on diabetes and metabolic diseases are welcome. Reports are published in the form of original articles, short communications and letters to the editor. Invited reviews and editorials are also published. A Methodology forum, which publishes contributions on methodological aspects of diabetes in vivo and in vitro, is also available. The Editor-in-chief will be pleased to consider articles describing new techniques (e.g., new transplantation methods, metabolic models), of innovative importance in the field of diabetes/metabolism. Finally, workshop reports are also welcome in Acta Diabetologica.
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