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. 2021 Oct 11;21(1):198.
doi: 10.1186/s12902-021-00863-x.

The relationship between high-density lipoprotein cholesterol (HDL-C) and glycosylated hemoglobin in diabetic patients aged 20 or above: a cross-sectional study

Rui Huang #  1 , Li Yan #  2 , Yuhua Lei  3
Affiliations

The relationship between high-density lipoprotein cholesterol (HDL-C) and glycosylated hemoglobin in diabetic patients aged 20 or above: a cross-sectional study

Rui Huang et al. BMC Endocr Disord. .

Abstract

Aim: The incidence rate of diabetes is increasing year by year, seriously threatening human health. As a predictor of glycemic control, glycated hemoglobin is reported to be related to various complications and prognoses of diabetes. Besides, HDL-C dyslipidemia is a component of metabolic syndrome and may be related to various cardiovascular and cerebrovascular diseases. The principal objective of this project was to investigate the relationship between HDL-C and glycosylated hemoglobin in adult diabetic patients.

Methods: A total of 3171 adult diabetic patients aged 20 years and above were included in the present study from the National Health and Nutrition Examination Survey (NHANES). HDL-C and glycosylated hemoglobin were regarded as independent and dependent variables, respectively. EmpowerStats software and R (version 3.4.3) were used to examine the association between HDL-C and glycosylated hemoglobin.

Results: HDL-C was inversely associated with glycohemoglobin after adjusting for other covariates (β = - 0.004, 95% CI:- 0.008 to - 0.000, p = 0.044). Race/ethnicity and age were considered the most prominent interactive factors that affect the relationship between HDL and glycosylated hemoglobin by the interaction analysis. A U-shaped association was detected between HDL-C and glycosylated hemoglobin for people of other race/ethnicity or aged 60 and above, which had an inflection point of HDL-C at 60 mg/dL. In contrast, we observed an inverted U-shaped distribution between HDL-C and glycosylated hemoglobin in people under 40 with point of inflection located at 60 mg/dL as well.

Conclusions: HDL-C in diabetic patients is inversely associated with glycosylated hemoglobin and may be relevant to glycemic control. However, a U-shaped relationship was also observed in a certain kind of people, which implied that, though HDL-C is considered as metabolism and anti-atherogenic property, for diabetics, it is not the higher, the better.

Keywords: Diabetes; Glycosylated hemoglobin; HDL-C; High-density lipoprotein cholesterol.

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Conflict of interest statement

The author declares no competing interests.

Figures

Fig. 1
Fig. 1
Scatter plot of the distribution of HDL-C and glycohemoglobin. Each black point represents a sample(a). The red line represents the smooth curve fit between variables. In comparison, blue bands represent the 95% CI(b). Sex, age, race/ethnicity, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, ALT, Cr, TG, TC, LDL, FDG, γGT, uric acid,insulin, lipid-lowering medications and anti-diabetic medications were adjusted
Fig. 2
Fig. 2
The association between HDL-C and glycohemoglobin stratified by race. Each line represents the smooth curve fit between variables. Sex, age, race/ethnicity, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, ALT, Cr, TG, TC, LDL, FDG, γGT, uric acid, insulin, lipid-lowering medications and anti-diabetic medications were adjusted
Fig. 3
Fig. 3
The association between HDL-C and glycohemoglobin stratified by age. Each line represents the smooth curve fit between variables. Sex, age, race/ethnicity, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, ALT, Cr, TG, TC, LDL, FDG, γGT, uric acid, insulin, lipid-lowering medications and anti-diabetic medications were adjusted
See this image and copyright information in PMC

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