TG与高密度脂蛋白胆固醇对2型糖尿病发病影响的前瞻性队列研究

  目的  评估TG、HDL-C及TG/HDL-C与2型糖尿病发病风险的关系。  方法  以“金昌队列”基线调查中30 546名未患2型糖尿病者为研究对象，运用Cox比例风险回归模型、限制性立方样条法估计TG、HDL-C及TG/HDL-C对2型糖尿病发病风险及剂量-反应关系。采用受试者工作特征曲线评估其对2型糖尿病发病风险的预测能力，确定最佳预测指标及其临界值。  结果  调整混杂因素后，在总人群中高TG、低HDL-C、高TG/HDL-C是2型糖尿病发病的危险因素，其发病风险比(hazard ratio, HR)分别为1.082(95% CI: 1.053~1.111, P < 0.001)、0.730(95% CI: 0.595~0.897, P=0.003)与1.061(95% CI: 1.038~1.085, P < 0.001)，且均存在一定的剂量-反应关系。TG/HDL-C预测价值高于TG和HDL-C，其曲线下面积分别为0.652、0.646、0.600，最佳临界值为1.14、1.67 mmol/L、1.40 mmol/L。  结论  高TG、低HDL-C及高TG/HDL-C是2型糖尿病发病的独立危险因素，TG/HDL-C对2型糖尿病发病的预测能力较强。

Association between triglyceride,high-density lipoprotein cholesterol and type 2 diabetes mellitus: a prospective cohort study

  Objective  To evaluate the association between triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C and the risk of type 2 diabetes (T2D).  Methods  A total of 30 546 people without T2D from the Jinchang cohort baseline survey were enrolled. Cox proportional hazards regression and restricted cubic spline were used to estimate the relationship between TG, HDL-C and TG/HDL-C on the risk and dose response of T2D. Receiver operating characteristic curve was conducted to evaluate the predictive ability on the risk of T2D, and determine the optimal predictive index and its critical value.  Results  After adjusting for confounding factors, high TG, low HDL-C and high TG/HDL-C in the general population were risk factors for T2D, with the HRs of 1.082 (95% CI: 1.053-1.111, P < 0.001), 0.730 (95% CI: 0.595-0.897, P=0.003) and 1.061(95% CI: 1.038-1.085, P < 0.001), respectively. The predictive value of TG/HDL-C was higher than those of TG and HDL-C, and their areas under the curve were 0.652, 0.646 and 0.600, respectively. The optimal cut-offs were 1.14, 1.67 mmol/L and 1.40 mmol/L for TG/HDL-C, TG and HDL-C.  Conclusions  High TG, low HDL-C and high TG/HDL-C are independent risk factors for the risk of T2D. TG/HDL-C has the strongest predictive ability on the incidence of T2D.