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Triglyceride measurements predict diabetes risk in young men

Diabetes Care 2008; 31: 2032-2037

Changes in triglyceride levels over time can predict risk for Type 2 diabetes in young men, report investigators in the journal Diabetes Care.

“Some evidence suggests that fasting triglyceride levels can aid in predicting future Type 2 diabetes,” say Amir Tirosh (Ben-Gurion University of the Negev, Beer-Sheva, Israel) and colleagues.

“However, this was shown mainly when triglyceride levels were combined with additional clinical parameters, such as body mass index (BMI), blood pressure, and other classic risk factors for cardiovascular disease,” they add.

Tirosh and team investigated whether measuring triglycerides alone could predict risk for Type 2 diabetes in a group of 13,953 apparently healthy men, aged 32.4 years on average, taking part in the Metabolic, Lifestyle, and Nutritional Assessment in Young Adults (MELANY) study.

The researchers measured triglyceride levels at baseline and 5 years later, and followed-up the men for an additional 5.5 years.

During the study period (76,742 person-years), 322 men developed Type 2 diabetes.

Multivariate analysis adjusting for factors such as BMI, lipid levels, physical activity, and blood pressure, showed a significant increase in incident Type 2 diabetes with increasing levels of baseline triglycerides.

When both measurements were taken into account, men in the lowest tertile of baseline triglycerides (30–66 mg/dl or 0.34–0.75 mmol/l) who progressed to being in the highest tertile of triglycerides at 5 years (164–299 mg/dl or 1.85–3.38 mmol/l) had the highest risk. Men in this category had a hazard ratio of 12.62 for Type 2 diabetes compared with those who remained in the lowest tertile of triglyceride levels at 5 years.

In comparison, participants who had triglyceride levels in the top tertile throughout the study, and those who had initially high but subsequently low triglycerides, had hazard ratios of 7.08 and 1.97, respectively, for Type 2 diabetes, compared with men with low levels throughout.

Of note, lifestyle factors such as changes in BMI, eating breakfast habit, and physical activity were all found to influence triglyceride levels. However, the link between Type 2 diabetes risk and triglycerides was still valid even after adjustment for these factors.

Tirosh and co-authors conclude that “although our observational study falls short in unraveling cause–effect relationships, it is tempting to speculate that lowering triglyceride levels, either pharmacologically or through lifestyle modification, may constitute a viable means to attenuate diabetes risk in apparently healthy young men.”

Read the abstract