Changes in triglyceride levels over time and risk of type 2 diabetes in young men

Abstract

Objective: The association between changes in triglycerides (TG) over time and diabetes is unknown. We determined whether two TG determinations obtained 5 years apart can predict incident type 2 diabetes.

Research Design and Methods: Baseline TG (Time1) and 5 years later (Time2), followed by subsequent follow-up of 5.5 years were measured among 13,953 apparently healthy men (age 26-45) with TG<300mg/dL(3.39mmol/L).

Results: During 76,742 person-years, 322 diabetes cases occurred. A multivariate model adjusted for age, body mass index (BMI), total cholesterol:HDL-cholesterol ratio, family history of diabetes, fasting glucose, blood pressure, physical activity, and smoking status, revealed a continuous independent rise in incident diabetes with increasing Time1 TG levels, (P trend<0.001). Men in the lowest tertile of Time1 TG who progressed to the highest tertile over follow-up (Low-High), exhibited hazard ratio (HR) of 12.62(95%CI;3.52–31.34) compared to those remaining in the lowest tertile at both time points (reference group: Low-Low). While men who were at the top TG tertile throughout follow-up (High-High) had a HR for diabetes of 7.08(95%CI;2.52–14.45), those whose TG decreased to the lowest tertile (High-Low) exhibited HR of 1.97(95%CI;0.67–6.13). Alterations in TG during follow-up were associated with changes in BMI, physical activity, and breakfast-eating habit (P<0.05), but remained an independent modifier of diabetes risk even after adjustment for such changes.

Conclusions: Two measurements of fasting TG obtained 5 years apart can assist in identifying apparently healthy young men at increased risk for diabetes, independent of traditional risk factors and of associated changes in BMI and life-style parameters.