Lipids as the link between central obesity and diabetes: perspectives from mediation analysis

Abstract Background Central obesity is a well-recognized risk factor for diabetes, yet the potential role of lipids in the diabetes risk associated with central obesity remains unclear. This study aimed to explore the possible mediating role of 11 lipid parameters [high-density lipoprotein cholester...

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Main Authors: Song Lu, Maobin Kuang, Jiajun Qiu, Wenjuan Li, Min Zhang, Guotai Sheng, Yang Zou, Xiaoping Peng
Format: Article
Language:English
Published: BMC 2024-10-01
Series:BMC Endocrine Disorders
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Online Access:https://doi.org/10.1186/s12902-024-01764-5
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author Song Lu
Maobin Kuang
Jiajun Qiu
Wenjuan Li
Min Zhang
Guotai Sheng
Yang Zou
Xiaoping Peng
author_facet Song Lu
Maobin Kuang
Jiajun Qiu
Wenjuan Li
Min Zhang
Guotai Sheng
Yang Zou
Xiaoping Peng
author_sort Song Lu
collection DOAJ
description Abstract Background Central obesity is a well-recognized risk factor for diabetes, yet the potential role of lipids in the diabetes risk associated with central obesity remains unclear. This study aimed to explore the possible mediating role of 11 lipid parameters [high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), non-high-density lipoprotein cholesterol (Non-HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), remnant cholesterol (RC), and ratios of Non-HDL-C/HDL-C, RC/HDL-C, LDL/HDL-C, TG/HDL-C, TC/HDL-C] in the association of central obesity with diabetes risk. Methods We utilized data from 15,453 participants in the NAGALA longitudinal cohort to assess the association of baseline central obesity indicators [waist-height ratio (WHtR), waist circumference (WC)] and the 11 lipid parameters with diabetes risk. Mediation analysis models were constructed to explore the mediating role of lipid parameters in the association of WC/WHtR with diabetes. Results Confirmatory associative analysis using multivariable Cox regression showed that, except for Non-HDL-C, TC and LD-C, the remaining eight lipid parameters were significantly associated with WC/WHtR and diabetes risk. Mediation analysis indicated that TG, RC, HDL-C, and lipid ratios such as Non-HDL-C/HDL-C ratio, RC/HDL-C ratio, TG/HDL-C ratio, TC/HDL-C ratio and LDL/HDL-C ratio are potential lipids affecting the diabetes risk related to central obesity. Among these, the RC/HDL-C ratio seemed to contribute the most in the WC/WHtR-related diabetes risk association, with a mediation percentage of about 37%. Additionally, lipid ratio parameters appeared to play a more mediating role in the association of central obesity-related diabetes risk than individual lipids. Conclusions In central obesity-related diabetes risk, most lipids, especially lipid ratio parameters, play a significant mediating role. Given these findings, we advocate for increased efforts in multifactorial risk monitoring and joint management of diabetes. The evaluation of lipids, particularly lipid ratio parameters, may be holds substantial value in the prevention and management of diabetes risk under close monitoring of central obesity.
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spelling doaj-art-423d6f0b68fa4b8db045bfd8b0fffd842025-08-20T02:18:28ZengBMCBMC Endocrine Disorders1472-68232024-10-0124111510.1186/s12902-024-01764-5Lipids as the link between central obesity and diabetes: perspectives from mediation analysisSong Lu0Maobin Kuang1Jiajun Qiu2Wenjuan Li3Min Zhang4Guotai Sheng5Yang Zou6Xiaoping Peng7Department of Cardiology, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang UniversityState Key Laboratory of Food Science and Resources, Nanchang UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanchang UniversityJiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical CollegeJiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical CollegeDepartment of Cardiology, The First Affiliated Hospital of Nanchang UniversityAbstract Background Central obesity is a well-recognized risk factor for diabetes, yet the potential role of lipids in the diabetes risk associated with central obesity remains unclear. This study aimed to explore the possible mediating role of 11 lipid parameters [high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), non-high-density lipoprotein cholesterol (Non-HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), remnant cholesterol (RC), and ratios of Non-HDL-C/HDL-C, RC/HDL-C, LDL/HDL-C, TG/HDL-C, TC/HDL-C] in the association of central obesity with diabetes risk. Methods We utilized data from 15,453 participants in the NAGALA longitudinal cohort to assess the association of baseline central obesity indicators [waist-height ratio (WHtR), waist circumference (WC)] and the 11 lipid parameters with diabetes risk. Mediation analysis models were constructed to explore the mediating role of lipid parameters in the association of WC/WHtR with diabetes. Results Confirmatory associative analysis using multivariable Cox regression showed that, except for Non-HDL-C, TC and LD-C, the remaining eight lipid parameters were significantly associated with WC/WHtR and diabetes risk. Mediation analysis indicated that TG, RC, HDL-C, and lipid ratios such as Non-HDL-C/HDL-C ratio, RC/HDL-C ratio, TG/HDL-C ratio, TC/HDL-C ratio and LDL/HDL-C ratio are potential lipids affecting the diabetes risk related to central obesity. Among these, the RC/HDL-C ratio seemed to contribute the most in the WC/WHtR-related diabetes risk association, with a mediation percentage of about 37%. Additionally, lipid ratio parameters appeared to play a more mediating role in the association of central obesity-related diabetes risk than individual lipids. Conclusions In central obesity-related diabetes risk, most lipids, especially lipid ratio parameters, play a significant mediating role. Given these findings, we advocate for increased efforts in multifactorial risk monitoring and joint management of diabetes. The evaluation of lipids, particularly lipid ratio parameters, may be holds substantial value in the prevention and management of diabetes risk under close monitoring of central obesity.https://doi.org/10.1186/s12902-024-01764-5LipidsRC/HDL-C ratioCentral obesityDiabetes
spellingShingle Song Lu
Maobin Kuang
Jiajun Qiu
Wenjuan Li
Min Zhang
Guotai Sheng
Yang Zou
Xiaoping Peng
Lipids as the link between central obesity and diabetes: perspectives from mediation analysis
BMC Endocrine Disorders
Lipids
RC/HDL-C ratio
Central obesity
Diabetes
title Lipids as the link between central obesity and diabetes: perspectives from mediation analysis
title_full Lipids as the link between central obesity and diabetes: perspectives from mediation analysis
title_fullStr Lipids as the link between central obesity and diabetes: perspectives from mediation analysis
title_full_unstemmed Lipids as the link between central obesity and diabetes: perspectives from mediation analysis
title_short Lipids as the link between central obesity and diabetes: perspectives from mediation analysis
title_sort lipids as the link between central obesity and diabetes perspectives from mediation analysis
topic Lipids
RC/HDL-C ratio
Central obesity
Diabetes
url https://doi.org/10.1186/s12902-024-01764-5
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AT wenjuanli lipidsasthelinkbetweencentralobesityanddiabetesperspectivesfrommediationanalysis
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