NMR-determined lipoprotein subclass profile predicts type 2 diabetes,☆☆

https://doi.org/10.1016/j.diabres.2008.11.007Get rights and content

Abstract

Aims

To determine whether nuclear magnetic resonance (NMR)-determined lipoprotein profiles predict type 2 diabetes.

Methods

Subjects were 813 male and female participants in the Melbourne Collaborative Cohort Study, aged 40–69 years at baseline (1990–1994), and with a baseline fasting plasma glucose <7.0 mmol/L. Incident type 2 diabetes was identified in 1994–1998 by self-report and confirmation from doctors. Eligible cases and a random group of controls were selected, with NMR data available for 59 cases and 754 non-cases.

Results

Concentration of very low density lipoprotein (VLDL) particles (positive) and high density lipoprotein (HDL) particle size (negative) were selected by stepwise regression as predictors of type 2 diabetes. These associations were independent of other non-lipid risk factors, but not plasma triglycerides. Factor analysis identified a factor from NMR variables, explaining 47% of their variation, and characterized by a positive correlation with VLDL, particularly large and medium sized; more low density lipoprotein (LDL) that were smaller; and relatively smaller, but not more HDL particles. This factor was positively associated with diabetes incidence, but not independently of triglycerides.

Conclusions

We identified an atherogenic NMR lipoprotein profile in people who developed diabetes, but this did not improve diabetes prediction beyond conventional triglyceride levels.

Section snippets

Subjects

The Melbourne Collaborative Cohort Study (MCCS) was established to study prospectively cancer and other lifestyle related diseases [11]. The MCCS recruited 17,049 males and 24,479 females, aged between 27 and 75 years at baseline, 99.3% of whom were aged 40–69 years. The study participants were recruited from the Melbourne metropolitan area from 1990 to 1994 via the Electoral Rolls, advertisements and community announcements in local media. Southern European migrants to Australia were

Subject characteristics

Data are available for 59 cases (57%) and 754 controls (94%). The only significant difference between people with NMR data and those without was that the controls with NMR data had a median age 5 years less than those without data. No differences by inclusion status were observed for BMI, insulin or conventional lipids within cases or controls.

Southern European migrants were over-represented among people who developed diabetes, who were also older, had higher fasting glucose and were more obese

Discussion

Our results are consistent with the IRAS study, showing atherogenic lipoprotein abnormalities in people who subsequently developed diabetes, and extend the findings to a group that were not deliberately selected for a high diabetes risk. Concentration of large VLDL particles and HDL particle size predicted diabetes incidence. For both, the associations were independent of non-lipid risk factors, but neither improved diabetes prediction beyond conventional triglyceride concentration adjusting

Conflict of interest statement

None.

Acknowledgements

This study was made possible by the contribution of many people, including the original investigators and the diligent team who recruited the participants and completed follow-up. We would like to express our gratitude to the many thousands of Melbourne residents who continue to participate in the study. We would particularly like to acknowledge Dr. Jim Otvos for the analysis of the NMR lipoprotein profiles.

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    Related data was previously presented at the Australasian Epidemiological Association Annual Conference, September 18–19, 2006, University of Melbourne, Melbourne, Australia.

    ☆☆

    This work was funded by VicHealth, The Cancer Council Victoria and the National Health and Medical Research Council (Grant Ids 124317, 126402, 126403, 180705, 180706, 194327, 209057, 251533).

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