title: Utility of the triglyceride level for predicting incident diabetes mellitus according to the fasting status and body mass index category: the Ibaraki Prefectural Health Study.
abstract: OBJECTIVE
  The levels of lipids, especially triglycerides (TG), and obesity are associated with diabetes mellitus (DM). Although typically measured in fasting individuals, non-fasting lipid measurements play an important role in predicting future DM. This study compared the predictive efficacy of lipid variables according to the fasting status and body mass index (BMI) category.
  
  
  METHODS
  Data were collected for 39,196 nondiabetic men and 87,980 nondiabetic women 40-79years of age who underwent health checkups in Ibaraki-Prefecture, Japan in 1993 and were followed through 2007. The hazard ratios (HRs) for DM in relation to sex, the fasting status and BMI were estimated using a Cox proportional hazards model.
  
  
  RESULTS
  A total of 8,867 participants, 4,012 men and 4,855 women, developed DM during a mean follow-up of 5.5 years. TG was found to be an independent predictor of incident DM in both fasting and non-fasting men and non-fasting women. The multivariable-adjusted HR for DM according to the TG quartile (Q) 4 vs. Q1 was 1.18 (95% confidence interval (CI): 1.05, 1.34) in the non-fasting men with a normal BMI (18.5-24.9). This trend was also observed in the non-fasting women with a normal BMI. That is, the multivariable-adjusted HRs for DM for TG Q2, Q3 and Q4 compared with Q1 were 1.07 (95% CI: 0.94, 1.23), 1.17 (95%CI: 1.03, 1.34) and 1.48 (95%CI: 1.30, 1.69), respectively.
  
  
  CONCLUSIONS
  The fasting and non-fasting TG levels in men and non-fasting TG levels in women are predictive of future DM among those with a normal BMI. Clinicians must pay attention to those individuals at high risk for DM.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Fujihara
authors.forename: Ayumi
authors.initials: A
authors.lastname: Sugawara
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Heianza
authors.forename: Toshimi
authors.initials: T
authors.lastname: Sairenchi
authors.forename: Fujiko
authors.initials: F
authors.lastname: Irie
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
authors.forename: Mikio
authors.initials: M
authors.lastname: Doi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shimano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Hirohito
authors.initials: H
authors.lastname: Sone
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ota
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D005215:Fasting / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D001786:Blood Glucose; D014280:Triglycerides