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KMID : 0388320230300010066
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Journal of Korean Academy of Fundamental Nursing
2023 Volume.30 No. 1 p.66 ~ p.77
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The Association between the Low-density Lipoprotein-Cholesterol to High-density Lipoprotein-Cholesterol Ratio and the Incidence of Type 2 Diabetes Mellitus in Korean Adults: A Secondary Data Analysis Using a Community-based Cohort Study in Korea
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Cha Bo-Kyoung
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Abstract
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Purpose: This study investigated the association between the low-density lipoprotein-cholesterol/high-densitylipoprotein-cholesterol (LDL-C/HDL-C) ratio and the incidence of diabetes in a Korean community-based cohort.
Methods: The participants were 7,653 adults aged 40-69 years without diabetes at baseline from Korean Genomeand Epidemiology Study who were followed up for 16 years biennially. These participants were categorized intofour groups (Q1-Q4) according to quartiles of LDL-C/HDL-C ratio at baseline. Significant differences in theprobability of diabetes-free survival curve were identified using the log-rank test in Kaplan-Meier analysis. Hazardratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regressionanalysis.
Results: In total, 1,833 (24.0%) participants newly developed diabetes. The overall incidence of diabeteswas 20.37 per 1,000 person-years (14.94, 17.12, 22.0, and 22.08 per 1,000 person-years for Q1, Q2, Q3, andQ4, respectively). The probability of diabetes-free survival was significantly different among the four groups(log-rank, x2=117.88, p<.001). Covariates included age, sex, triglyceride, fasting plasma glucose, homeostaticmodel assessment for insulin resistance index, hypertension, body mass index, family history of diabetes mellitus,smoking status, and alcohol use. Multivariate Cox proportional hazards regression showed that people with thehighest quartile of the LDL-C/HDL-C ratio had a 1.17 times higher (HR=1.17, 95% CI: 1.01~1.35, p=.038) risk ofdiabetes development than those in the lowest quartile after adjusting for covariates.
Conclusion: TheLDL-C/HDL-C ratio is an independent risk factor for diabetes development. Measuring and managing theLDL-C/HDL-C ratio is necessary for detecting individuals at high risk for developing diabetes.
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KEYWORD
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Cohort study, Diabetes mellitus, HDL Cholesterol, LDL Cholesterol, Triglyceride
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