Remnant cholesterol, but not other traditional lipids or lipid ratios, is independently and positively related to future diabetes risk in Chinese general population: A 3 year cohort study

AimsVery few cohort studies are available about the relation between remnant cholesterol (RC) and diabetes. Based on a prospective cohort survey, this research aimed at investigating if high RC was related to a future diabetes risk in the Chinese population, as well as to compare the association between RC, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG), TG/HDL-C, LDL-C/HDL-C, TC/HDL-C, and non-high-density lipoprotein cholesterol (non-HDL-C), and future diabetes risk.Materials and Methods6,700 baseline normoglycemic participants of the REACTION study's Beijing center were recruited in 2011-2012 and followed up in 2015. Multivariate Cox regression analyses were performed to explore the relationship of RC, HDL-C, LDL-C, TC, TG, LDL-C/HDL-C, TG/HDL-C, TC/HDL-C, and non-HDL-C and a future diabetes risk.ResultsAfter potential confounders were adjusted for, only RC (HR 1.134, 95% CI 1.016-1.267, P = 0.025) was positively related to a future diabetes risk, and only HDL-C (HR 0.728, 95% CI 0.578-0.918, P = 0.007) was negatively related to a future diabetes risk. The rest of the lipid parameters were not related to a future risk of diabetes. Sensitivity and stratification analyses revealed that the relation between RC and future diabetes risk was stable. RC and future diabetes risk were still positively correlated even when the HDL-C was >= 1.04 mmol/L (HR 1.167, 95% CI 1.050-1.297, P = 0.004).ConclusionsIt was RC, but not other lipid parameters, that was independently and positively related to a future risk of diabetes among the Chinese general population. Moreover, the relationship between RC and diabetes risk was stable, even with appropriate levels of HDL-C. The first cohort survey of the Chinese general population that compared the correlation between RC and conventional lipids and lipid ratios with a future diabetes risk. Among RC, traditional lipids and lipid ratios, only RC was positively associated with a future diabetes risk, only HDL-C was negatively associated with a future diabetes risk, and the other lipid parameters (LDL-C, TC, TG, non-HDL-C, TG/HDL-C, TC/HDL-C, and LDL-C/HDL-C) were not associated with a future diabetes risk. RC was associated with a future diabetes risk even when HDL-C, which is protective of a future diabetes risk, was controlled within appropriate ranges. The relationship between RC and a future diabetes risk is stable in the Chinese general population. image