Does high cholesterol predict additional diabetes risk in Turkish women and men who have abdominal obesity?

Details

This prospective observational study investigated whether high cholesterol interacting with abdominal obesity (AO) predicted Type 2 diabetes differently in women and men. It followed a representative sample of 3,048 Turkish adults aged ≥28 years who were free of diabetes at baseline.

The thresholds for AO were ≥95 cm in men and ≥91 cm in women; the threshold for high cholesterol was ≥5.2 mmol/L. Diabetes was diagnosed using American Diabetes Association criteria. Participants were divided into four baseline groups: Group I had neither AO nor high cholesterol (33.3%); Group II had AO only (27.6%); Group III had high cholesterol only (17.8%); and Group IV had both (21.3%).

Over a mean follow-up of 5.9 years, diabetes developed in 103 women and 116 men. In age-adjusted logistic regression comparing the four groups, with AO alone as the reference, the reported relative risk for having both AO and high cholesterol was 1.88 in women (95% confidence interval 1.14–3.09) and 1.29 in men, with the men's estimate not statistically significant. The abstract also reported that women were predicted to be 1.46 times more likely to develop diabetes. High cholesterol alone did not differ significantly from having neither condition in its ability to predict diabetes.

Multiple logistic regression identified elevated low-density lipoprotein cholesterol (LDL-C), defined as ≥3.4 mmol/L, as the component of high cholesterol associated with diabetes. Identifying 48 participants with familial-combined hyperlipidemia phenotypes could not, by itself, account for most women with both central obesity and high cholesterol who developed diabetes.

The authors suggested that diminished effectiveness of insulin resistance in centrally obese Turkish women, but not men, might predispose them to elevated LDL concentrations, while other features of visceral adiposity still predispose them to diabetes. This was a proposed explanation. Their overall conclusion was that elevated LDL-C interacts with AO in Turkish women in association with greater development of diabetes.