Changes in triglycerides and high-density lipoprotein cholesterol may precede peripheral insulin resistance, with 2-h insulin partially mediating this unidirectional relationship: a prospective cohort studyReportar como inadecuado




Changes in triglycerides and high-density lipoprotein cholesterol may precede peripheral insulin resistance, with 2-h insulin partially mediating this unidirectional relationship: a prospective cohort study - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Cardiovascular Diabetology

, 15:154

First Online: 04 November 2016Received: 13 July 2016Accepted: 26 October 2016

Abstract

BackgroundResults of longitudinal researches regarding the temporal relationship between dyslipidemia and insulin resistance IR are inconsistent. This study assessed temporal relationships of blood lipids with IR and determined whether there are any mediating effects existed in these temporal relationships.

MethodsThis study examined a longitudinal cohort of 3325 subjects aged 20–74 years from China with an average of 4.2 years follow-up. Measurements of fasting blood lipids, as well as fasting and 2-h serum glucose and insulin, were obtained at two time points. The Gutt index and HOMA-IR were calculated as indicators of peripheral IR and hepatic IR. A cross-lagged path analysis was performed to examine the temporal relationships between blood lipids and IR. A mediation analysis was used to examine mediating effect.

ResultsAfter adjusting for covariates, the cross-lagged path coefficients from baseline TG and HDL-C to follow-up Gutt index were significantly greater than those from baseline Gutt index to follow-up TG and HDL-C β1 = −0.131 vs β2 = −0.047, P < 0.001 for TG; β1 = 0.134 vs β2 = 0.023, P < 0.001 for HDL-C. The path coefficients from baseline TG and HDL-C to follow-up 2-h insulin were significantly greater than those from baseline 2-h insulin to follow-up TG and HDL-C β1 = 0.125 vs β2 = 0.040, P < 0.001 for TG; β1 = −0.112 vs β2 = −0.026, P < 0.001 for HDL-C. 2-h insulin partially mediated the effect of TG-HDL-C on Gutt index with a 59.3% mediating effect for TG and 61.0% for HDL-C.

ConclusionsThese findings provide strong evidence that dyslipidemia probably precede peripheral IR and that 2-h insulin partially mediates this unidirectional temporal relationship.

KeywordsBlood lipids 2-h insulin Insulin resistance Temporal relationship Mediating effect AbbreviationsBMIbody mass index

CFIcomparative fitness index

FFAsfree fatty acids

HDL-Chigh-density lipoprotein cholesterol

HPHSHarbin People’s Health Study

IRinsulin resistance

LDL-Clow-density lipoprotein cholesterol

RMRroot mean square residual

T-CHOtotal cholesterol

TGtriglycerides

VLDLvery low density lipoprotein

Electronic supplementary materialThe online version of this article doi:10.1186-s12933-016-0469-3 contains supplementary material, which is available to authorized users.

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Autor: Tianshu Han - Yu Cheng - Shuang Tian - Li Wang - Xi Liang - Wei Duan - Lixin Na - Changhao Sun

Fuente: https://link.springer.com/article/10.1186/s12933-016-0469-3







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