Abstract Aims Oxidised lipoproteins—including oxidised high‐density lipoprotein cholesterol (ox‐HDL‐C), oxidised low‐density lipoprotein cholesterol (ox‐LDL‐C) and oxidised lipoprotein(a) ox‐Lp(a)—are emerging biomarkers of oxidative stress and vascular inflammation. However, their roles in glycometabolic disorders and the progression from prediabetes to type 2 diabetes mellitus (T2DM) remain poorly defined. To prospectively assess the associations between plasma ox‐HDL‐C, ox‐LDL‐C and ox‐Lp(a) levels and the future risk of T2DM among individuals with prediabetes. Materials and Methods This multi‐centre, prospective cohort study enrolled 3056 participants, including 1521 individuals with prediabetes who were followed for 5 years. Baseline levels of ox‐HDL‐C, ox‐LDL‐C and ox‐Lp(a) were quantified using ELISA. Glycaemic indices, insulin resistance markers and β‐cell function were assessed. Associations with incident T2DM were evaluated using logistic regression, Cox proportional hazards models and restricted cubic spline analyses. Results Elevated baseline levels of ox‐HDL‐C, ox‐LDL‐C and ox‐Lp(a) were independently associated with increased odds and hazard ratios for progression from prediabetes to T2DM. These associations were dose‐dependent and remained significant across sex‐specific subgroups. Additionally, oxidised lipoproteins correlated positively with FBG, HbA1c and HOMA‐IR, and negatively with HOMA‐β and HOMA‐IS, suggesting a relationship with β‐cell dysfunction and insulin resistance. Conclusions Ox‐HDL‐C, ox‐LDL‐C and ox‐Lp(a) are independent, dose‐dependent predictors of T2DM development in individuals with prediabetes. Their close association with impaired β‐cell function highlights their potential utility in early risk stratification and targeted prevention strategies for T2DM.
Gu et al. (Mon,) studied this question.