title: Changes in triglyceride levels over time and risk of type 2 diabetes in young men.
abstract: 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.
authors.affiliation: 1Department of Internal Medicine A+C, Sheba Medical Center, Tel-Hashomer, Israel. amirt@bgu.ac.il
authors.forename: Amir
authors.initials: A
authors.lastname: Tirosh
authors.forename: Iris
authors.initials: I
authors.lastname: Shai
authors.forename: Rafael
authors.initials: R
authors.lastname: Bitzur
authors.forename: Ilan
authors.initials: I
authors.lastname: Kochba
authors.forename: Dorit
authors.initials: D
authors.lastname: Tekes-Manova
authors.forename: Eran
authors.initials: E
authors.lastname: Israeli
authors.forename: Tzippora
authors.initials: T
authors.lastname: Shochat
authors.forename: Assaf
authors.initials: A
authors.lastname: Rudich
mesh_terms: 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*
chemical_list: D014280:Triglycerides