Non‐high‐density lipoprotein cholesterol: High‐density lipoprotein cholesterol ratio is an independent risk factor for diabetes mellitus: Results from a population‐based cohort study

Abstract Background Dyslipidemia predicts the development and progression of diabetes. A higher non‐high‐density lipoprotein cholesterol (HDL‐C): HDL‐C ratio is reportedly associated with metabolic syndrome and insulin resistance, but its relationship with glycemic levels and diabetes remains unclear. Methods In all, 4882 subjects aged ≥40 years without diabetes and not using lipid‐lowering drugs were enrolled in the study. The non‐HDL‐C: HDL‐C ratio was log 10 transformed to achieve normal distribution. Multivariate logistic regression was used to investigate the association between the log 10 ‐transformed non‐HDL‐C: HDL‐C ratio and diabetes. Stratified analyses of the association by age, gender, and body mass index (BMI) were also performed. Results After 3 years of follow‐up, 704 participants developed diabetes. After adjustment for age, gender, current smoking, current drinking, physical activity, BMI, systolic blood pressure, and family history of diabetes, each 1‐SD increase in the log(non‐HDL‐C: HDL‐C ratio) was associated with higher fasting blood glucose (FPG) levels (β = 0.1; 95% confidence interval [CI] 0.1–0.1), 2‐h postload plasma glucose levels (2‐h glucose; β = 0.2; 95% CI 0.1–0.2), and risk of diabetes (odds ratio [OR] 1.1; 95% CI 1.0–1.2). In a multivariate model, subjects in the top quartile of non‐HDL‐C: HDL‐C ratio had higher FPG (β = 0.2; 95% CI 0.2–0.3), 2‐h glucose (β = 0.5; 95% CI 0.3–0.7) and HbA1c (β = 0.1; 95% CI 0.1–0.2) levels, and a 40% increased risk of diabetes (OR 1.4; 95% CI 1.1–1.8) than participants in the bottom quartile. Conclusions The non‐HDL‐C: HDL‐C ratio was found to be an independent risk factor for diabetes.