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

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.

Glycated hemoglobin (HbA1c) is independently associated with the bioelectrical impedance phase angle in junior sumo wrestlers: A pilot study

“…Moreover, HDL‐C amplifies insulin receptors in muscle cells by activating GLUT‐4, which facilitates glucose uptake by these cells (van Linthout et al., 2010 ). Furthermore, HDL‐C and HbA1c levels demonstrate an inverse correlation, as reduced HDL‐C levels are associated with reduced glucose homeostasis (Huang et al., 2021 ; Maharjan et al., 2017 ). HbA1c originates from an irreversible Schiff base reaction in which glucose molecules bind to the N‐terminal end of the β ‐globin chain of hemoglobin.…”

Serum Uric Acid to High‑density Lipoprotein Cholesterol Ratio is Associated with Visceral Fat in Patients with Type 2 Diabetes

“…26 A previous cross-sectional study found that HDL-C is inversely associated with HbA1c and may be relevant to glycemic control in patients with diabetes. 27 The carotid IMT, as a noninvasive marker of atherosclerosis, can predict the risk of cardiovascular disease, and increased IMT is linked to an increased risk of subsequent cardiovascular events. 28,29 UHR as a biomarker for evaluating inflammatory status was found to be positively associated with incident heart ischemia incidence in Koreans without diabetes.…”

“… 26 A previous cross-sectional study found that HDL-C is inversely associated with HbA1c and may be relevant to glycemic control in patients with diabetes. 27 …”

Prevalence of dyslipidemia, treatment rate and its control among patients with type 2 diabetes mellitus in Northwest China: a cross-sectional study

“…Dyslipidemia has been suggested to have a linear relationship with HbA1c in recent studies, and HbA1c could reflect cholesterol and LDL levels among T2DM patients. A marked increase for TC and TG levels and a decrease for HDL-C levels compared to patients with good glycemic control [ 21 – 23 ]. For most patients with DM, the better the glycemic control, the more likely they are to exhibit a more active and healthy lifestyle that leads to better management of lipid levels [ 17 ].…”