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Purpose. To determine whether hypertriglyceridemic waist (HTGW) and high lipid accumulation product (LAP) preceded the incidence of type 2 diabetes mellitus (T2DM), and to investigate the interactions of HTGW and LAP with other components of metabolic syndrome on the risk of T2DM. Methods. A total of 15,717 eligible participants without baseline T2DM and aged 35 and over were included from a Chinese rural cohort. Cox proportional hazards regression models were used to estimate the association of HTGW and LAP with the incidence of T2DM, and the restricted cubic spline model was used to evaluate the dose-response association. Results. Overall, 867 new T2DM cases were diagnosed after 7.77 years of follow-up. Participants with HTGW had a higher hazard ratio for T2DM (hazard ratio (HR): 6.249, 95% confidence interval (CI): 5.199-7.511) after adjustment for potential confounders. The risk of incident T2DM was increased with quartiles 3 and 4 versus quartile 1 of LAP, and the adjusted HRs (95% CIs) were 2.903 (2.226-3.784) and 6.298 (4.911-8.077), respectively. There were additive interactions of HTGW (synergy index (SI): 1.678, 95% CI: 1.358-2.072) and high LAP (SI: 1.701, 95% CI: 1.406-2.059) with increased fasting plasma glucose (FPG) on the risk of T2DM. Additionally, a nonlinear ( P nonlinear < 0.001) dose-response association was found between LAP and T2DM. Conclusion. The subjects with HTGW and high LAP were at high risk of developing T2DM, and the association between LAP and the risk of T2DM may be nonlinear. Our study further demonstrates additive interactions of HTGW and high LAP with increased FPG on the risk of T2DM.

Objectives We conducted a meta-analysis of relevant randomised trials to assess whether folic acid supplementation reduces the progression of atherosclerosis as measured by carotid intima-media thickness (CIMT) Methods This analysis included 2052 subjects from 10 folic acid randomised trials with the change in CIMT reported as one of the end points. Summary estimates of weighted mean differences (WMDs) and 95% CIs were obtained by using random-effect models. Meta-regression and subgroup analyses were performed to identify the source of heterogeneity Results Our analysis showed that folic acid supplementation significantly reduces the progression of CIMT (WMD: −0.04 mm, 95% CI −0.07 to −0.02, p<0.001), particularly in subjects with chronic kidney disease risk (WMD: −0.05 mm, 95% CI −0.01, p=0.06) but not in subjects who were generally healthy with only elevated homocysteine concentrations (WMD: 0.00 mm, 95% CI −0.01 to 0.01, p=0.35). Furthermore, meta-regression analysis of the data showed that the baseline CIMT levels ( p=0.011) and the percent reduction of homocysteine ( p<0.001) were positively related to the effect size. Consistently, a greater beneficial effect was seen in thoese trials with baseline CIMT levels >0.8 mm (WMD: −0.14 mm, 95% CI −0.19 to −0.08, p<0.0001) and a reduction in the homocysteine concentration>30% (WMD: −0.22 mm, 95% CI −0.38 to −0.06, p=0.009). In the corresponding comparison groups the effect siezes were attenuated and insignificant. Conclusions Our findings indicated that folic acid supplementation is effective in reducing the progression of CIMT, particularly in subjects with CKD or high CVD risk and among trials with higher baseline CIMT levels or a larger homocysteine reduction.Heart 2012;98(Suppl 2): E1-E319 E277 ABSTRACTS on 12 May 2018 by guest. Protected by copyright.