Changes in triglyceride levels over time and risk of type 2 diabetes in young men.
OBJECTIVE
The association between changes in triglyceride concentrations over time and diabetes is unknown. We assessed whether two triglyceride determinations obtained 5 years apart can predict incident type 2 diabetes.


METHODS
Triglyceride levels at baseline (time 1) and 5 years later (time 2), followed by subsequent follow-up of 5.5 years, were measured in 13,953 apparently healthy men (age 26-45 years) with triglycerides <300 mg/dl (<3.39 mmol/l).


RESULTS
During 76,742 person-years, 322 cases of diabetes occurred. A multivariate model adjusted for age, BMI, total cholesterol-to-HDL cholesterol ratio, family history of diabetes, fasting glucose, blood pressure, physical activity, and smoking status revealed a continuous independent rise in incident diabetes with increasing time 1 triglyceride levels (P(trend) < 0.001). Men in the lowest tertile of time 1 triglyceride levels who progressed to the highest tertile over follow-up (low-high) exhibited a hazard ratio (HR) of 12.62 (95% CI 3.52-31.34) compared with those remaining in the lowest tertile at both time points (reference group: low-low). Whereas men who were at the top triglyceride level tertile throughout follow-up (high-high) had a HR for diabetes of 7.08 (2.52-14.45), those whose triglyceride level decreased to the lowest tertile (high-low) exhibited a HR of 1.97 (0.67-6.13). Alterations in triglyceride levels during follow-up were associated with changes in BMI, physical activity, and eating breakfast habit (P < 0.05), but remained an independent modifier of diabetes risk even after adjustment for such changes.


CONCLUSIONS
Two measurements of fasting triglyceride levels obtained 5 years apart can assist in identifying apparently healthy young men at increased risk for diabetes, independent of traditional risk factors and of associated changes in BMI and lifestyle parameters.
Tirosh
Amir
A
1Department of Internal Medicine A+C, Sheba Medical Center, Tel-Hashomer, Israel. amirt@bgu.ac.il
Shai
Iris
I
Bitzur
Rafael
R
Kochba
Ilan
I
Tekes-Manova
Dorit
D
Israeli
Eran
E
Shochat
Tzippora
T
Rudich
Assaf
A
D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D011236:Prediabetic State / Q000097:blood / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood*
D014280:Triglycerides