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Non-fasting and Fasting Triglyceride Levels and the Risk of Diabetes Mellitus: The Circulatory Risk in Communities
Jiaqi Li1, Hironori Imano1, Kazumasa Yamagishi2,3
1Department of Public Health, Kindai University Faculty of Medicine.
Journal of Atherosclerosis and Thrombosis
|July 15, 2026
Summary
Non-fasting triglyceride levels, like fasting levels, predict diabetes mellitus risk. Including triglyceride measurements in risk assessments offers modest but useful supplementary information for diabetes prediction, especially when samples are non-fasting.
Area of Science:
- Cardiology
- Endocrinology
- Preventive Medicine
Background:
- Non-fasting triglyceride measurements are increasingly used for atherosclerotic cardiovascular disease screening.
- Limited evidence exists on the predictive value of non-fasting triglycerides for diabetes mellitus.
- This study investigates the association between triglyceride levels and incident diabetes mellitus.
Purpose of the Study:
- To evaluate the predictive value of non-fasting triglyceride levels for incident diabetes mellitus.
- To compare the predictive utility of non-fasting versus fasting triglyceride levels.
- To assess the clinical utility of incorporating triglyceride levels into diabetes risk prediction models.
Main Methods:
- Prospective cohort study involving 7,673 individuals with non-fasting samples and 4,055 with fasting samples, aged 40-74, without prior diabetes.
- New diabetes mellitus cases identified using annual health checkup data.
- Cox proportional hazard models and decision curve analyses were employed to estimate hazard ratios and assess clinical utility.
Main Results:
- Over a median 13-year follow-up, diabetes developed in 727 participants with non-fasting samples and 444 with fasting samples.
- Both non-fasting and fasting triglyceride levels were positively associated with diabetes mellitus hazard (HRs for highest vs. lowest quartiles: 1.99 and 1.58, respectively), after adjusting for confounders.
- Adding triglyceride levels slightly improved 15-year diabetes risk prediction net benefit, with a marginally greater improvement under non-fasting conditions.
Conclusions:
- Both non-fasting and fasting triglyceride levels are associated with an increased risk of developing diabetes mellitus.
- Triglyceride measurements provide modest but potentially useful supplementary information for diabetes prediction.
- Non-fasting triglyceride measurements may offer a slight advantage over fasting measurements for diabetes risk assessment.
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