The Ability of Baseline Triglycerides and Total Cholesterol Concentrations to Predict Incidence of Type 2 Diabetes Mellitus in Chinese Men and Women: A Longitudinal Study in Qingdao, China

Abstract

Objective: The purpose of this study was to assess the association between triglycerides (TG), total cholesterol (TC) at baseline, and type 2 diabetes mellitus (T2DM) incidence in a general Chinese population. Further, it aimed to evaluate the ability of TG and TC to predict T2DM incidence.

Methods: Qingdao Diabetes Prevention Program participants recruited between 2006 and 2009 were followed up in 2012-2015. TG, TC, and T2DM status were measured. Cox proportional hazards models were used to estimate the association between TG, TC, and T2DM incidence. The receiver operating characteristic (ROC) curve was used to evaluate the ability of TG and TC to identify T2DM participants.

Results: The incidence of T2DM significantly increased with TG in women and TC in both men and women (Ptrend < 0.05). Univariate Cox regression indicated that higher TG {borderline high TG [hazards ratio (HR): 2.05; 95% confidence interval (CI): 1.40, 3.00] and hypertriglyceridemia [HR: 2.64; 95% CI: 1.68, 4.15]} and TC [hypercholesterolemia (HR: 2.05; 95% CI: 1.43, 2.95)] were significantly associated with increased risk of T2DM incidence in women but not in men. Multivariate Cox regression showed that hypertriglyceridemia in women (HR: 1.78, 95% CI: 1.07, 2.97), borderline high TC in men (HR: 1.61, 95% CI: 1.04, 2.48), and hypercholesterolemia in women (HR: 1.68, 95% CI: 1.81, 2.61) had a higher significant risk of T2DM incidence. The optimal cutoff values of TG were > 1.15 and > 1.23 mmol/L in men and women, respectively. For TC, they were > 5.17 and > 5.77 mmol/L in men and women, respectively. The area under the ROCs of TG and TC were 0.54 (0.51-0.57) and 0.55 (0.52-0.58), respectively, in men, and 0.60 (0.58-0.62) and 0.59 (0.56-0.61), respectively, in women.

Conclusion: Elevated TG and TC were risk factors for T2DM incidence. However, no predictive capacity was found for both factors to identify T2DM incidence in Chinese men and women. Hence, TG and TC levels in both Chinese men and women might be used for decreasing the incidence of T2DM but no clinical predictive capacity for T2DM.

Keywords: Adult onset type 2 diabetes mellitus; Total cholesterol; Triglycerides.