Association between non-traditional lipid-inflammatory parameters and incident diabetes: a national prospective
Jie Hua1,2, Qingqing Jiang1,2, Shiyi Cao3
1School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Qiaokou District, Wuhan, Hubei, 430030, China.
Background:
Non-traditional lipid indices are diabetes risk factors, but their combined effects with inflammatory markers remain unclear. The present study systematically investigated and compared the associations between eight non-traditional lipid-inflammatory parameters and new-onset diabetes.
Methods:
Data were obtained from the 2011-2020 China Health and Retirement Longitudinal Study. The lipid-inflammatory parameters were created by integrating non-traditional lipid indices and high-sensitivity C-reactive protein (hsCRP). Cox regression and restricted cubic spline models examined the associations of baseline and cumulative lipid-inflammatory parameters with diabetes risk. Time-dependent receiver operating characteristic analyses evaluated the predictive performance of these parameters. Mediation analyses explored the reciprocal links between non-traditional lipid indices, hsCRP, and diabetes risk.
Results:
The study enrolled 7,356 participants, with 1,173 (15.95%) developing diabetes over a median follow-up period of 9 years. In the multivariable-adjusted model, individuals with higher baseline and cumulative non-traditional lipid-inflammatory parameter levels had an elevated risk of developing diabetes, especially for lipoprotein combined index (LCI)-hsCRP (hazard ratio [HR] = 2.03, 95% confidence interval [CI]: 1.70-2.41). All lipid-inflammatory parameters were nonlinearly associated with diabetes risk. The area under the curve (AUC) values for the eight lipid-inflammatory parameters ranged from 0.595 to 0.619, with LCI-hsCRP exhibiting the highest predictive value (AUC = 0.619, 95% CI: 0.597-0.640). The results were consistent across sensitivity and subgroup analyses. Mediation analyses showed significant bidirectional mediation between non-traditional lipid indices and hsCRP for diabetes.
Conclusions:
Elevated baseline and cumulative non-traditional lipid-inflammatory parameter levels are linked to a higher risk of incident diabetes, with LCI-hsCRP showing the highest predictive value.
Clinical Trial Number:
Not applicable.
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