Association of apolipoprotein Cs with new-onset type 2 diabetes mellitus: findings from the Chinese multi-provincial cohort study.

Abstract

OBJECTIVES:

Apolipoprotein Cs (apoCs), especially apoC-II and apoC-III, as the components of triglyceride-rich lipoproteins, play a key role in the pathophysiology of diabetes. However, prospective studies examining direct associations between apoCs and diabetes are not reproducible. The aim of this study was to evaluate the impact of apoCs on the risk of developing diabetes in a middle-aged population, and to explore possible mediators responsible for the relationship between apoCs and diabetes.

DESIGN:

Prospective cohort study.

SETTING:

Community-based study carried out in Beijing.

METHODS:

ApoCs were measured in 1085 participants aged 45-74 years and free of type 2 diabetes mellitus (T2DM) at baseline from the Chinese Multi-Provincial Cohort Study-Beijing Project. Multivariate logistic regression was performed to examine the association of apoCs with a 5-year risk of new-onset T2DM. The impacts of triglycerides, insulin and high-sensitivity C reactive protein (hs-CRP) on the association between apoC-III and the risk of T2DM were explored by a mediation test.

RESULTS:

During the 5 years of follow-up, 97 (8.9%) participants developed T2DM. ApoC-III was significantly associated with the risk of developing T2DM after multivariable adjustment (OR=1.40; 95% CI 1.07 to 1.82). This association was mainly mediated by triglyceride levels with a significant indirect effect (OR 1.61; 95% CI 1.19 to 2.18), followed by hs-CRP and insulin.

CONCLUSIONS:

Our findings demonstrated that higher serum apoC-III was independently associated with increased 5-year risk of new-onset T2DM in the Chinese population, and triglyceride plays a crucial role in mediating this relationship. More attention should be paid to preventive strategies of T2DM targeting apoC-III.

• Authors: Jiangtao Li, Dong Zhao, Jing Liu, Miao Wang, Jiayi Sun, Jun Liu, Yan Li, Qiuju Deng, Yue Qi
• Journal: BMJ open (BMJ Open) Vol. 11 Issue 11 Pg. e052388 (11 16 2021) ISSN: 2044-6055 [Electronic] England
• PMID: 34785554 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Apolipoprotein C-III
• Triglycerides

Topics

• Apolipoprotein C-III
• China (epidemiology)
• Diabetes Mellitus, Type 2 (epidemiology)
• Humans
• Middle Aged
• Prospective Studies
• Risk Factors
• Triglycerides