Atherosclerosis indexes and incident T2DM in middle-aged and older adults: evidence from a cohort study

Xin Wu; Yu Gao; Miyuan Wang; Hongye Peng; Di Zhang; Biyuan Qin; Liang Pan; Guolong Zhu

doi:10.1186/s13098-023-00992-4

Atherosclerosis indexes and incident T2DM in middle-aged and older adults: evidence from a cohort study

Diabetol Metab Syndr. 2023 Feb 17;15(1):23. doi: 10.1186/s13098-023-00992-4.

Authors

Xin Wu^#¹, Yu Gao^#², Miyuan Wang^#³, Hongye Peng⁴, Di Zhang⁵, Biyuan Qin⁶, Liang Pan⁷, Guolong Zhu⁸

Affiliations

¹ Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China.
² College of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.
³ School of Public Health, Huazhong University of Science and Technology, Wuhan, 430074, China.
⁴ Graduate School, Beijing University of Chinese Medicine, Beijing, 100029, China.
⁵ Chengdu University of Traditional Chinese Medicine, Sichuan, 610075, China.
⁶ Department of Science & Education, Deyang People's Hospital, Sichuan, 618000, China.
⁷ Phase 1 Clinical Trial Center, Deyang People's Hospital, Sichuan, 618000, China. pandruid@163.com.
⁸ College of Traditional Chinese Medicine, Three Gorges University & Yichang Hospital of Traditional Chinese Medicine, Hubei, 443003, China. 862218962@qq.com.

^# Contributed equally.

Abstract

Background: Type 2 diabetes mellitus (T2DM) is an expanding global health problem, requiring effective methods for predicting and diagnosing in its early stages of development. Previous studies reported the prognostic value of the atherosclerosis indexes in both cardiovascular diseases and T2DM. However, the predictive performance of Non-HDL-C, AI, AIP, TG/HDL-C and LCI indexes on the risk of T2DM remains unclear. This study aims to compare the five atherosclerosis indexes for predicting T2DM in middle-aged and elderly Chinese.

Methods: Data are collected from wave 2011 and wave 2015 of China Health and Retirement Longitudinal Study (CHARLS). Multi-variate logistic regression models were used to estimate odds ratio (OR) with 95% confidence interval (CI) of incident T2DM with five atherosclerosis indexes, and the restricted cubic splines were used to visualize the dose-response relationships. Receiver operating characteristic (ROC) curve was drawn and the areas under the curve (AUC) were used to compare the performance of the five atherosclerosis indexes in predicting T2DM.

Results: A total of 504 (10.97%) participants had T2DM. Multi-variate logistic regression analysis showed that five atherosclerosis indexes were associated with T2DM, with adjusted ORs (95% CIs) of 1.29 (1.15-1.45), 1.29 (1.18-1.42), 1.45 (1.29-1.62), 1.41 (1.25-1.59) and 1.34 (1.23-1.48) for each IQR increment in Non-HDL-C, TG/HDLC, AI, AIP and LCI, respectively. Restricted cubic spline regression showed a nonlinear correlation between five atherosclerosis indexes and the risk of T2DM (p for nonlinear < 0.001). According to the ROC curve analysis, LCI had the highest AUC (0.587 [0.574-0.600]).

Conclusion: We found that LCI, compared with other indexes, was a better predictor in the clinical setting for identifying individuals with T2DM in middle-aged and elderly Chinese. LCI monitoring might help in the early identification of individuals at high risk of T2DM.

Keywords: Atherosclerosis indexes; Cohort study; Insulin resistance; Lipid comprehensive index; Type 2 diabetes mellitus.