Key result
In male patients with type 2 diabetes, BMI exhibited an inverted U-shaped association with LDL cholesterol, increasing below a BMI of 26.08 (slope 2.38) and flattening or decreasing above it.
Why the study?
While a linear relationship between BMI and LDL-C has been reported in the normal population, evidence in diabetes patients has been limited by sample size.
What is the dose-response relationship between BMI and LDL-C in male and female patients with type 2 diabetes?
Observational (n=2,500)
No
What is the dose-response relationship between BMI and LDL-C in male and female patients with type 2 diabetes?
Effect estimate: Slope 2.38 (below breakpoint) and -0.36 (above breakpoint) (95% CI 1.06-3.70 and -1.20-0.48)
The relationship between BMI and LDL-C in type 2 diabetes is sex-specific, exhibiting an inverted U-shape in males but not females, suggesting different lipid metabolism dynamics across BMI categories.
Background: A data-based study reported the linear relationship between body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C) in a normal population. However, there were no studies giving the suggestion for diabetes patients limited by sample size. This study aimed to investigate the non-linear dose-response relationship between BMI and LDL-C in type 2 diabetes mellitus (T2DM). Method: The study participants registered at the National Metabolic Management Center (MMC) of Beijing Luhe hospital from June 2017 to June 2021. T2DM was diagnosed according to the 1999 World Organization criteria. The generalized additive models (GAMs) were used to investigate the non-linear association between BMI and LDL-C. The relationship between BMI and LDL-C was visualized via the smooth splines function plot by sex. Segmented regressions were fitted to calculate the slopes with different estimated breakpoints. Results: After data cleaning, a total of 2500 participants with T2DM aged 30 to 70 years were included in this study. Compared with females, the spline between BMI and LDL-C showed an Inverted U shape in males. In males, the slopes below and above the breakpoint (26.08. 95% CI: 24.13 to 28.03) were 2.38 (95%CI: 1.06, 3.70) and -0.36 (95%CI: -1.20, 0.48), respectively. Conclusion: There was an Inverted U shape association between BMI and LDL-C in male participants with T2DM, for which the LDL-C was increased with BMI in the lean population, while LDL-C gradually tended to be flat or even decreased in the obese population. However, the Inverted U-shape between BMI and LDL-C was not found in female patients with T2DM.
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Li et al. (2023) conducted an observational in Type 2 diabetes mellitus (n=2,500). Body mass index (BMI) was evaluated on LDL cholesterol level (Slope 2.38 (below breakpoint) and -0.36 (above breakpoint), 95% CI 1.06-3.70 and -1.20-0.48). In male patients with type 2 diabetes, BMI exhibited an inverted U-shaped association with LDL cholesterol, increasing below a BMI of 26.08 (slope 2.38) and flattening or decreasing above it.
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