Association between preoperative lipid profiles and new‐onset diabetes after transplantation in Chinese kidney transplant recipients: A retrospective cohort study

Abstract

Background This study investigated the association between the preoperative lipid profiles and new‐onset diabetes after transplantation (NODAT) in Chinese kidney transplant recipients (KTRs). Methods In this study, of 1140 KTRs registered between January 1993 and March 2018 in Zhongshan Hospital, Fudan University, 449 were enrolled. Clinical data, obtained through a chart review of the patient records in the medical record system, were evaluated, and NODAT was diagnosed based on the American Diabetes Association guidelines. Multivariate Cox regression analysis was conducted to determine whether the preoperative lipid profiles in KTRs were independently associated with NODAT incidence. The preoperative lipid profiles were analyzed as continuous variables and grouped into tertiles. Smooth curve fitting was used to confirm the linear associations. Results During a median follow‐up of 28.03 (interquartile range 12.00–84.23) months, 104 of the 449 (23.16%) participants developed NODAT. The multivariate model analysis, adjusted for all potential covariates, showed that increased values of the following parameters were associated with NODAT (hazard ratio, 95% confidence interval): preoperative total cholesterol (TC; 1.25, 1.09–1.58, p = 0.0495), low‐density lipoprotein cholesterol (LDL‐C; 1.33, 1.02–1.75, p = 0.0352), non‐high‐density lipoprotein cholesterol (non‐HDL‐C; 1.41, 1.09–1.82, p = 0.0084), TC/HDL‐C (1.28, 1.06–1.54, p = 0.0109), and non‐HDL‐C/HDL‐C (1.26, 1.05–1.52, p = 0.0138). However, the association between the preoperative triglyceride, HDL‐C, or TG/HDL‐C and NODAT was not significant. Conclusions Preoperative TC, LDL‐C, non‐HDL‐C, TC/HDL‐C, and non‐HDL‐C/HDL‐C were independent risk factors for NODAT.

Association between non-high-density lipoprotein to high-density lipoprotein ratio and reversion to normoglycemia in people with impaired fasting glucose: a 5-year retrospective cohort study

“…However, previous research has indicated that the accumulation of excess cholesterol can lead to β-cell dysfunction, resulting in impaired glucose tolerance and compromised insulin secretion. Furthermore, deposition of cholesterol in the islets may contribute to increased aggregation of islet amyloid polypeptide and the formation of islet amyloid, further exacerbating β-cell dysfunction and impacting glucose regulation [ 23 – 26 , 56 ]. Therefore, it is plausible that the reduction in non-HDL-c/HDL-c ratio levels may have improved β-cell function, ultimately facilitating the reversal of IFG to normoglycemia.…”

“…Furthermore, an observational investigation has indicated that the non-HDL-c/HDL-c ratio outperforms other markers in predicting metabolic syndrome and insulin resistance [ 22 ]. Additionally, several recent studies have established a close association between the non-HDL-c/HDL-c ratio and the occurrence and progression of IFG and T2DM [ 23 – 26 ]. Moreover, a further study found that the non-HDL-c/HDL-c ratio serves as a superior marker for predicting diabetes risk compared to conventional lipid parameters in the general population [ 27 ].…”

Association of four lipid-derived indicators with the risk of developing type 2 diabetes: a Chinese population-based cohort study

“…Previous studies have demonstrated the association between lipids and T2D and the effectiveness of four lipid derivatives in predicting T2D risk [8][9][10][11][12]. However, the identification of the lipid derivative for predicting T2D risk in a clinical setting is still unclear.…”

“…High triglyceride (TG) and decreased high-density lipoprotein (HDL) are indicators of lipid metabolism disorders in T2D [7]. Furthermore, substantial evidence has shown [8][9][10][11][12] an association between lipid levels and T2D risk, and changes in lipid levels precede hyperglycemia [8,13]. In brief, an association was observed between alterations in lipid levels and the risk of developing T2D in the future.…”

Correlation between the triglyceride-to-high-density lipoprotein cholesterol ratio and other unconventional lipid parameters with the risk of prediabetes and Type 2 diabetes in patients with coronary heart disease: a RCSCD-TCM study in China

“…The reason may be that excess cholesterol accumulation leads to β-cell dysfunction, thereby impairing glucose tolerance and affecting insulin secretion. In addition, islet cholesterol deposition may lead to increased islet amyloid polypeptide aggregation and increased islet amyloid formation, further deteriorating beta-cell function and affecting glucose homeostasis [9][10][11][12]. More importantly, they are also considered to be more predictive of CHD than conventional lipid parameters.…”