Associations of Insulin Resistance and Beta Cell Function with Abnormal Lipid Profile in Newly Diagnosed Diabetes: A Cross-sectional Study
Background: Abnormal lipids are strong predictive factors of cardiovascular disease (CVD) in both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). However, the potential associations of insulin resistance (IR) and beta cell function (BCF) in diabetes and abnormal lipids, i.e. high triglyceride (TG), low high-density lipoprotein cholesterol (HDL-C) and high low-density lipoprotein cholesterol (LDL-C) are not fully understood. In this study, we aim to explore whether decreased
... e whether decreased BCF and increased IR in newly diagnosed T1DM or T2DM are associated with abnormal lipids.Methods: Clinical and laboratory data were collected from 16334 adults with newly diagnosed diabetes in this cross-sectional study. Types of diabetes were diagnosed based on clinical characteristics and diabetes-related biochemical measurement results. Homeostasis model assessment were used to estimate IR and BCF. Restricted cubic spline and binary logistic regression were used to examine the associations of IR or BCF and abnormal lipids in T1DM and T2DM, respectively. Results: High TG, low HDL-C and high LDL-C accounted for 49.7%, 47.7% and 59.2%, respectively. In multivariable analysis, high IR was associated with increased risk of high TG (Odds ratios (ORs) of homeostasis model assessment of insulin resistance (HOMA2-IR) ≥2, ≥1-<2 vs <1: 4.77, 95% CI 2.69-8.57; 2.31, 95% CI 1.54-3.47, p for trend < 0.001) in T1DM and was associated with elevated risk of high TG, low HDL-C and high LDL-C (all p for trend <0.01) in T2DM. Low BCF, i.e., homeostasis model assessment of beta-cell function (HOMA2-B) <30 versus ≥30, was associated with marginally increased risk of high TG (OR 1.42, 95% CI 0.98-2.10, p = 0.07) in T1DM and associated with increased risk of high TG (OR 1.21, 95% CI 1.09-1.34, p <0.001) and high LDL-C (OR 1.23, 95% CI 1.12-1.36, p <0.001) in T2DM.Conclusions: In patients with newly diagnosed diabetes, high IR and low BCF had different associations with risk of dyslipidemia in T1DM and T2DM, suggesting that early treatment that improve IR or BCF may have a benefit for abnormal lipid metabolism.