Gender differences in the relationship between plasma lipids and fasting plasma glucose in non-diabetic urban Chinese population: a cross-section study

Abstract

The association between dyslipidemia and elevated fasting glucose in type 2 diabetes is well known. In non-diabetes, whether this association still exists, and whether dyslipidemia is an independent risk factor for high fasting plasma glucose (FPG) levels are not clear. This cross-sectional study recruited 3460 non-diabetic Chinese subjects (1027 men, and 2433 women, aged 35-75 years old) who participated in a health survey. Men and women were classified into tertiles by levels of plasma lipids respectively. In women, the prevalence of impaired fasting glucose (IFG) was decreased with increased HDL-C. A stepwise increase in HDL-C was associated with decreasing FPG levels (lowest tertiles, FPG: 5.376 ± 0.018; middle tertiles, 5.324 ± 0.018; highest tertiles, 5.276 ± 0.018 mmol/L; P = 0.001). Reversely, FPG levels increased from lowest tertiles to highest tertiles of LDL-C, TC, and TG. we found that women in the first tertile with lower HDL-C level had a 1.75-fold increase in risk of IFG compared with non-diabetic women in the third tertile with higher HDL-C level (OR: 1.75; 95% CI: 1.20-2.56). In men, no significant association was found. We took age, BMI, waist/hip ratio, education, smoking, alcohol drinking, and physical exercise as adjusted variables. In Chinese non-diabetic women, dyslipidemia is independently associated with high levels of FPG; TG, HDL-C, and LDL-C are predictors of IFG independent of BMI and waist/hip ratio.

Factors associated with pre-diabetes in Tehranian men and women: A structural equations modeling

“…In the current study, although elevated TG levels were more prevalent in men, it was a stronger direct predictor of pre-diabetes in women, a finding that contrasts with previous reports which show that in the pre-diabetic state, high TG and low HDL-C are more prevalent among women compared to men [ 29 , 30 ]; suggesting the presence of a sex-specific underlying mechanism for increasing both TG levels and its different detrimental effects on the progression of pre-diabetes among men and women; these mechanisms may include the effect of female hormones, especially estrogen, on insulin resistance pathways [ 31 ].…”

Cardiometabolic risk factors in Thai individuals with prediabetes treated in a high‐risk, prevention clinic: Unexpected relationship between high‐density lipoprotein cholesterol and glycemia in men

“…In the present group of high cardiovascular risk Thai participants, HDL cholesterol levels in women and men showed opposite directions of association with glycemia, such that, with increasing glycemia, they converged and the well-established advantage of high HDL cholesterol levels in women 30 was eliminated. In the Thai women we studied, HDL cholesterol levels fell with increasing HbA1c, which accords with previously reported observations of the relationship between glycemia and HDL cholesterol across the full range of glycemia; and with the adverse effect of increasing glycemia on the CVD risk profiles being greater in women than in men 31,32 . In men, however, there was a rise in HDL cholesterol levels with increasing FPG, which is contrary to the expected relationship.…”

Increasing glycaemia is associated with a significant decline in HDL cholesterol in women with prediabetes in two national populations

“…Our observations are also consistent with our previous research in a Thai clinical sample at high cardiometabolic risk and with prediabetes defined by FPG and/or HbA1c, which found HDL cholesterol tended to fall with glycemia in women but not in men after taking all relevant factors into account 24 . It also accords with previous clinical studies that have found the adverse effect of increasing glycemia on the CVD risk profiles to be greater in women than in men 25 , 26 .…”