High LDL-C/HDL-C ratio may predict new-onset diabetes

An elevated ratio between low- and high-density lipoprotein cholesterol (LDL-C/HDL-C) appears to increase the risk of new-onset diabetes, reports a new China study.

Researchers conducted a retrospective cohort study on 116,661 adults (mean age, 44.07±12.93 years; 53.8 percent male) who were free of diabetes upon enrolment. The main outcome of interest was the development of new-onset diabetes, defined as fasting plasma glucose (FPG) ≥7.0 mmol/L, self-reported diagnosis, or treatment with insulin or other agents.

Participants were categorized according to quartiles of LDL-C/HDL-C ratio, and the median value at baseline for the overall cohort was 1.9836. Those in the top quartile were older, more predominantly male, and were more commonly smokers. LDL-C and triglycerides were also higher in this class, while HDL-C was lower.

Over a median follow-up of 2.98 years, 2,681 new cases of diabetes were reported, yielding an incidence rate of 2.3 percent. The crude incidence rates increased from the lowest to the highest quartiles of LDL-C/HDL-C ratio: 0.31 percent, 0.43 percent, 0.68 percent, and 0.88 percent, respectively.

Fully adjusted Cox regression analysis showed that patients in the highest quartile of LDL-C/HDL-C ratio were nearly twice as likely as their first-quartile counterparts to develop new-onset diabetes (hazard ratio [HR], 1.92, 95 percent confidence interval [CI], 1.43–2.59). Those in the third quartile had more than a 40-percent risk excess (HR, 1.42, 95 percent CI, 1.07–1.90).

“To the best of our knowledge, this is the first study investigating the relationship between LDL-C/HDL-C ratio and new-onset diabetes risk in Chinese population. This longitudinal study clearly demonstrated that as the LDL-C/HDL-C ratio increased, the incidence of new-onset diabetes became gradually more pronounced,” researchers said.