The association between lipid ratios and type 2 diabetes mellitus in middle-aged and older Chinese adults: A nationwide prospective cohort study (STROBE).

Type 2 diabetes mellitus (T2DM), as a noncommunicable chronic disease, poses a significant threat to human health. This study aims to investigate the relationship between lipid ratios and T2DM. The China Health and Retirement Longitudinal Study served as the data source for this research. The associations between lipid ratios - specifically, the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR), remnant cholesterol to high-density lipoprotein cholesterol (RC/HDL-C) ratio, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio, and low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio - and T2DM were analyzed using logistic regression analysis. Restricted cubic splines were employed to explore potential nonlinear relationships. Receiver operating characteristic analysis was utilized to assess the predictive value of lipid ratios for T2DM. A total of 7199 participants were included in this study. After adjusting for various factors, a positive association was identified between NHHR, RC/HDL-C ratio, TC/HDL-C ratio, TG/HDL-C ratio, and LDL-C/HDL-C ratio, with odds ratios of 3.34, 2.45, 3.34, 2.75, and 2.92, respectively. Nonlinear relationships were observed between NHHR, RC/HDL-C ratio, TC/HDL-C ratio, TG/HDL-C ratio, and LDL-C/HDL-C ratio and the incidence of T2DM. This study demonstrates that lipid ratios are associated with an increased risk of T2DM. This result provides a basis for the early identification of T2DM and identify novel targets for its prevention and early intervention.