Association of Lipid Profile with Type 2 Diabetes in First-Degree Relatives: A 14-Year Follow-Up Study in Iran
Purpose: Dyslipidemia is claimed to be associated with an increased risk of type 2 diabetes mellitus (T2DM). However, first-degree relatives (FDRs) of patients with T2DM are reported to be at higher risk. The aim of this study was to evaluate the association between serum lipid profile and T2DM incidence in FDRs.
Patients and methods: Information on 1222 T2DM FDRs during 14 years of follow-up was retrieved. All individuals were examined for diabetes status and dyslipidemia once a year. We used a Bayesian joint longitudinal-survival model to assess the association.
Results: Our data showed that a 10 mg/dL increase in triglycerides (TG), very-low-density lipoprotein (VLDL), and non-high-density lipoprotein (non-HDL) cholesterol levels during the follow-up period was associated with an increased risk of diabetes by 5%, 29%, and 6.6%, respectively. Moreover, for every one-unit increase in the TG to HDL ratio, the T2DM incidence increased by 35%. Subgroup analysis also showed that the increased risk of diabetes was significant only in female FDRs, so that a 10 mg/dL increase in TG and VLDL cholesterol level and a one-unit increase in TG to HDL ratio in female FDRs resulted in an increased risk of diabetes by 7.8%, 46%, and 64%, respectively. However, analysis of HDL, low-density lipoprotein (LDL), total cholesterol (TC), TC to HDL, and LDL to HDL cholesterol levels/ratios did not find any statistically significant associations.
Conclusion: Increases in TG, VLDL, non-HDL cholesterol level, and TG to HDL ratio are associated with an increased risk of T2DM in FDRs, especially in female FDRs.
Keywords: diabetes mellitus; joint model; longitudinal studies; survival.