HDL cholesterol is an independent predictor of β‐cell function decline and incident type 2 diabetes: A longitudinal study

Abstract

Background: Experimental evidence indicates that high-density lipoprotein (HDL) may stimulate glucose uptake and improve β-cell function. The aim of this study was to evaluate whether lower levels of HDL may affect the risk to develop type 2 diabetes.Methods: Incident rate of type 2 diabetes and changes in insulin sensitivity and β-cell function over 5.5-year follow-up were examined in 670 non-diabetic subjects stratified in tertiles according to basal HDL levels.Results: As compared to the highest tertile of HDL, individuals with lower levels of HDL have an increased risk to develop type 2 diabetes independently from several cardiometabolic risk factors (odds ratio: 2.88, 95% confidence interval: 1.05-7.91), and exhibited a greater deterioration of β-cell function, estimated by the disposition index, over 5.5-year follow-up. Conversely, changes in Matsuda index of insulin sensitivity over the follow-up were not significantly different amongst the three HDL groups. In a multivariable regression analysis model including age, sex, waist circumference, triglycerides, total cholesterol, C-reactive protein, fasting and 2-hour postload glucose, family history of type 2 diabetes and smoking habit, HDL concentration at baseline was an independent predictor of β-cell function decline over the followup (β = .30, P = .0001). Mediation analysis showed that the association between lower HDL levels at baseline and increased risk of incident diabetes was mediated by β-cell function deterioration during the follow-up (t = −3.32, P = .001).Conclusions: Subjects with lower levels of HDL have an increased risk to develop type 2 diabetes likely due to a greater β-cell function decline over time.

The effect of probiotics, prebiotics or synbiotics on metabolic outcomes in individuals with diabetes: a systematic review and meta-analysis

“…A recent systematic review and meta-analysis investigated the predictive role of triacylglycerols as a risk factor for cardiovascular disease in people with type 2 diabetes and found that high serum triacylglycerol levels were associated with poor diabetes control and increased risk of cardiovascular disease [75]. Individuals with low levels of HDL-cholesterol have been reported to exhibit a deterioration in beta cell function [76], therefore decreasing triacylglycerol and increasing HDL-cholesterol levels with the use of probiotics, prebiotics or synbiotics may be helpful.…”

A short peptide of the C-terminal class Y helices of apolipoprotein A-I has preserved functions in cholesterol efflux and in vivo metabolic control

“…Collectively, the findings suggest that ApoA-I and HDL have novel and specific roles in the regulation of glucose control. This notion is further supported by a recent clinical study that concludes that individuals with low HDL levels have an increased risk to develop T2D due to a decline in beta cell function over time 17 .…”

Association between high-density lipoprotein cholesterol and type 2 diabetes mellitus among Chinese: the Beijing longitudinal study of aging

“…Another mouse model study determined the link between lower HDL-C and the decreased uptake of glucose by peripheral skeletal muscle owing to a decrease in mitochondrial respiratory function within these cells [ 32 ]. Some prior publications have found that the protective impact of HDL-C in the context of T2DM risk was linked to changes in the function of pancreatic β-cell cells [ 33 ]. Atherogenic dyslipidemia and associated insulin resistance are thought to be driven in large part by increased hepatic free fatty acid flux, [ 27 ] leading to the liver-mediated secretion of particles containing apo-B [ 34 ].…”