Higher 'Residual Cholesterol' Increases Diabetes Risk... More Dangerous for Younger People

A study has found that high levels of remnant cholesterol increase the incidence of diabetes. In particular, remnant cholesterol was found to have a greater impact on the development of diabetes in younger individuals.

Professors Kang Jung-gu, Heo Ji-hye, and Noh Eun from the Department of Endocrinology at Hallym University Sacred Heart Hospital, and Professor Han Kyung-do from the Department of Information Statistics and Actuarial Science at Soongsil University (from left).

A research team led by Professors Kang Jung-koo, Heo Ji-hye, and Noh Eun from the Department of Endocrinology at Hallym University Sacred Heart Hospital, along with Professor Han Kyung-do from the Department of Information Statistics and Actuarial Science at Soongsil University, announced on the 20th the results of a study on the risk of diabetes occurrence according to remnant cholesterol levels in Koreans using the National Health Insurance Service database.

Remnant cholesterol refers to the cholesterol contained in very low-density lipoproteins (VLDL) or intermediate-density lipoproteins (IDL). Although previous studies have revealed that remnant cholesterol is a risk factor for cardiovascular disease, the correlation between remnant cholesterol and glucose metabolism remained unclear.

The research team conducted a follow-up study until 2019 on approximately 8.5 million Korean adults without diabetes who underwent health checkups in 2009, investigating whether there was a difference in subsequent diabetes incidence based on remnant cholesterol levels measured at the time of the 2009 checkup.

As a result, the incidence of diabetes 9 years later was 13.3 cases per 1,000 person-years for those with high remnant cholesterol levels (30 mg/dL or higher) and 3.1 cases per 1,000 person-years for those with low levels (14 mg/dL or lower), showing about a 3.3-fold difference. After adjusting for age, sex, body mass index, smoking, alcohol consumption, hypertension, chronic kidney disease, treatment history for dyslipidemia, and fasting blood glucose, the group with remnant cholesterol levels of 30 mg/dL or higher still showed about twice the risk compared to the group with 14 mg/dL or lower.

Higher levels of residual cholesterol were significantly associated with an increased risk of developing diabetes. [Data provided by Hallym University Sacred Heart Hospital]

In particular, the increase in diabetes risk due to high remnant cholesterol levels was more pronounced in younger age groups. After adjusting for various risk factors, the relative risk of diabetes incidence by age group for the high remnant cholesterol group compared to the low group was 1.20 times for those aged 70 and above, 1.51 times for 60?69 years, 1.90 times for 50?59 years, 2.47 times for 40?49 years, 3.07 times for 30?39 years, and 3.06 times for 20?29 years, confirming that remnant cholesterol has a greater impact on diabetes development in younger individuals.

Moreover, the increase in diabetes risk due to high remnant cholesterol levels was more evident in groups traditionally considered at lower risk for diabetes, such as women, individuals without metabolic abnormalities like impaired fasting glucose, those without hypertension, and those without atherosclerotic dyslipidemia such as hypertriglyceridemia or low HDL cholesterol. Professor Kang Jung-koo explained, "This study once again confirms that lipid toxicity plays an important pathogenic role in the development of diabetes," adding, "We confirmed that remnant cholesterol can adversely affect not only vascular cells but also pancreatic beta cells, which play a crucial role in insulin secretion."

This study was published in the recent issue of the SCI-level international journal Diabetes Care (IF 17.152).

This content was produced with the assistance of AI translation services.