Key result
Higher non-fasting triglycerides linked to ~18% higher incident diabetes risk in normal-BMI adults.
Why the study?
Although lipid levels are typically measured in fasting individuals, non-fasting lipid measurements play an important role in predicting future diabetes mellitus. The relative predictive efficacy of lipid variables according to fasting status and body mass index category needed comparison.
Do fasting and non-fasting triglyceride levels predict incident diabetes mellitus across body mass index categories in nondiabetic Japanese adults?
Cohort (n=127,176)
Do fasting and non-fasting triglyceride levels predict incident diabetes mellitus across body mass index categories in nondiabetic Japanese adults?
Both fasting and non-fasting triglyceride levels in men and non-fasting triglyceride levels in women independently predict incident diabetes mellitus even among individuals with a normal BMI, supporting the clinical utility of convenient non-fasting lipid measurements for diabetes risk stratification.
Non-fasting triglycerides may predict diabetes risk in normal-BMI adults; extends prior observations but leaves open added value for risk stratification.
AIM: The levels of lipids, especially triglycerides (TG), and obesity are associated with diabetes mellitus (DM). Although typically measured in fasting individuals, non-fasting lipid measurements play an important role in predicting future DM. This study compared the predictive efficacy of lipid variables according to the fasting status and body mass index (BMI) category. METHODS: Data were collected for 39,196 nondiabetic men and 87,980 nondiabetic women 40-79years of age who underwent health checkups in Ibaraki-Prefecture, Japan in 1993 and were followed through 2007. The hazard ratios (HRs) for DM in relation to sex, the fasting status and BMI were estimated using a Cox proportional hazards model. RESULTS: A total of 8,867 participants, 4,012 men and 4,855 women, developed DM during a mean follow-up of 5.5 years. TG was found to be an independent predictor of incident DM in both fasting and non-fasting men and non-fasting women. The multivariable-adjusted HR for DM according to the TG quartile (Q) 4 vs. Q1 was 1.18 (95% confidence interval (CI): 1.05, 1.34) in the non-fasting men with a normal BMI (18.5-24.9). This trend was also observed in the non-fasting women with a normal BMI. That is, the multivariable-adjusted HRs for DM for TG Q2, Q3 and Q4 compared with Q1 were 1.07 (95% CI: 0.94, 1.23), 1.17 (95%CI: 1.03, 1.34) and 1.48 (95%CI: 1.30, 1.69), respectively. CONCLUSIONS: The fasting and non-fasting TG levels in men and non-fasting TG levels in women are predictive of future DM among those with a normal BMI. Clinicians must pay attention to those individuals at high risk for DM.
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Fujihara et al. (2014) conducted a cohort in Incident diabetes mellitus in nondiabetic adults (n=127,176). Elevated triglyceride levels (highest quartile Q4 vs lowest quartile Q1, by fasting status and BMI category) vs. Lowest quartile (Q1) of triglyceride levels was evaluated on Incident diabetes mellitus (defined as fasting plasma glucose >=7.0 mmol/L, non-fasting plasma glucose >=11.1 mmol/L, and/or initiation of treatment for diabetes mellitus) (HR 1.18, 95% CI 1.05-1.34, p=<0.01). Higher non-fasting triglycerides (Q4 vs Q1) independently predicted incident diabetes in normal-BMI men (HR 1.18, 95% CI 1.05-1.34) and women (HR 1.48, 95% CI 1.30-1.69).
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