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. 2025 Jul 30:16:1510470.
doi: 10.3389/fendo.2025.1510470. eCollection 2025.

Association between remnant cholesterol levels and reversion to normoglycemia from prediabetes: a 5-year longitudinal cohort study of Chinese non-obese adults

Wei Liu #  1 , Wenjing Jian #  2 , Suina Lin #  3 , Zhenhua Huang  4   5
Affiliations

Association between remnant cholesterol levels and reversion to normoglycemia from prediabetes: a 5-year longitudinal cohort study of Chinese non-obese adults

Wei Liu et al. Front Endocrinol (Lausanne). .

Abstract

Purpose: The primary objective of this study is to explore the relationship between remnant cholesterol (RC) levels and the reversion to normoglycemia in non-obese Chinese individuals with prediabetes.

Methods: To achieve this goal, we conducted a retrospective cohort study involving 8,109 non-obese prediabetic participants in China, using the Cox proportional hazards regression model to analyze the correlation between RC and the likelihood of returning to normoglycemia.

Results: The results indicate a significant negative correlation between RC levels and reversion to normoglycemia (HR=0.49, 95% CI: 0.47-0.52). Specifically, as RC quartiles increase, the probability of reverting to normoglycemia significantly decreases, with participants in the highest quartile having a 51% lower likelihood of recovery compared to those in the lowest quartile. Furthermore, we identified a nonlinear relationship between RC and the reversion to normoglycemia, with 1.10 mmol/L established as the inflection point. When RC levels are below this threshold, decreasing RC significantly increases the likelihood of recovery. To further validate the robustness of our findings, we conducted sensitivity and subgroup analyses, all of which support the reliability of the main results.

Conclusion: There exists a significant negative and nonlinear relationship between RC levels and the reversion to normoglycemia in non-obese Chinese prediabetic patients. This suggests that lowering RC levels may play an important role in reversion to normoglycemia from prediabetes.

Keywords: non-obese adults; normoglycemia; prediabetes; remnant cholesterol; reversion.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Overview of the process used for screening study participants.
Figure 2
Figure 2
The nonlinear relationship between RC and reversion to normoglycemia from Prediabetes in Chinese non-obese adults. The result showed that the relationship between RC and regression to normoglycemia from Prediabetes was nonlinear, with the inflection point of RC being 1.47 mmol/L. (Age, gender, SBP, DBP, BMI, ALT, BUN, Scr, TG, FPG at baseline, family history of diabetes, drinking status, and smoking status were all adjusted).
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