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Role of HDL Cholesterol and Estimates of HDL Particle Composition in Future Development of Type 2 Diabetes in the General Population:The PREVEND Study

By Ali Abbasi, Eva Corpeleijn, Ron T. Gansevoort, Rijk O. B. Gans, Hans L. Hillege, Ronald P. Stolk, Gerjan Navis, Stephan J. L. Bakker and Robin P. F. Dullaart


<p>Background and Aims: High-density lipoproteins (HDLs) may directly stimulate beta-cell function and glucose metabolism. We determined the relationships of fasting high-density lipoprotein cholesterol (HDL-C), plasma apolipoprotein (apo) A-I and apoA-II, and HDL-C-to-apoA-I and HDL-C-to-apoA-II ratios, as estimates of HDL particle composition, with incident type 2 diabetes mellitus.</p><p>Methods: A prospective study was carried out in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) cohort after exclusion of subjects with diabetes at baseline (n = 6820; age, 28-75 years). The association of HDL-related variables with incident type 2 diabetes was determined by multivariate logistic regression analyses.</p><p>Results: After a median follow-up of 7.7 years, 394 incident cases of type 2 diabetes mellitus were ascertained (5.8%). After adjustment for age, sex, family history of diabetes, body mass index, hypertension, alcohol, and smoking, odd ratios (ORs) for diabetes were 0.55 (95% confidence interval [CI], 0.47-0.64; P <.001), 0.81 (0.71-0.93; P = .002), 0.02 (0.01-0.06; P <.001), and 0.03 (0.01-0.060; P <.001) per 1-SD increase in HDL-C and apoA-I and in the HDL-C-to-apoA-I and the HDL-C-to-apoA-II ratios, respectively. In contrast, apoA-II was not related to incident diabetes (OR = 1.02; 95% CI, 0.90-1.16; P=0.71). The relationships of HDL-C and the ratios of HDL-C to apoA-I and HDL-C to apoA-II remained significant after further adjustment for baseline glucose and triglycerides (ORHDL = 0.74 [95% CI, 0.61-0.88], ORHDL/APOA-I = 0.14 [0.04-0.44], and ORHDL/APOA-II = 0.12 [0.04-0.36]; all P</p><p>Conclusions: Higher HDL-C, as well as higher HDL-C-to-apoA-I and HDL-C-to-apoA-II ratios are strongly and independently related to a lower risk of future type 2 diabetes.</p>

Year: 2013
DOI identifier: 10.1210/jc.2013-1680
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