Association between glycated hemoglobin and lipid parameters at the time of type 2 diabetes mellitus diagnosis: evidence from a regional population

Background and objectives Type 2 diabetes mellitus (T2DM) is associated with lipid abnormalities that increase cardiovascular risk; however, evidence regarding this relationship at diagnosis is limited. This study aimed to examine the association between glycated hemoglobin (HbA1c) and lipid parameters at the time of T2DM diagnosis. Methods A retrospective cross-sectional study included 3,501 newly diagnosed T2DM patients treated within the Riojano Health Service between 2019 and 2025. Multiple linear regression was used to assess associations between HbA1c and lipid parameters. The study was approved by the Research Ethics Committee of La Rioja (CEImLAR, PI 778). Results HbA1c was positively associated with total cholesterol (TC) (β = 4.25, p < 0.001) and triglycerides (TG) (β = 15.65, p < 0.001) and negatively associated with high-density lipoprotein cholesterol (HDL-C) (β = −1.40, p < 0.001) in multiple linear regression adjusted for age, sex, and body mass index (BMI). No significant association was found between HbA1c and low-density lipoprotein cholesterol (LDL-C) (β = 1.67, p = 0.080). Conclusion At diagnosis, higher HbA1c levels were independently associated with a more atherogenic lipid profile—higher TC and TG, and lower HDL-C—highlighting the importance of early metabolic assessment and comprehensive cardiovascular risk management.