title: Lipoprotein particles and incident type 2 diabetes in the multi-ethnic study of atherosclerosis.
abstract: OBJECTIVE
  In the Multi-Ethnic Study of Atherosclerosis (MESA), we evaluated associations of baseline levels of a lipoprotein-based insulin resistance (IR) index (LP-IR), IR-related lipoprotein particles, mean particle sizes, and lipids, with incident type 2 diabetes, independent of confounders, glucose, insulin, and HOMA-IR.
  
  
  METHODS
  Among 5,314 adults aged 45-84 years without baseline diabetes or cardiovascular disease, 656 cases of diabetes were identified during a mean follow-up of 7.7 years. Lipoprotein particle concentrations, size, and LP-IR were determined by nuclear magnetic resonance spectroscopy of stored baseline plasma. Potential effect modification, by race/ethnicity, sex, baseline use of lipid-lowering medications or hormone therapy, or glucose strata (<90, 90-99, and ≥ 100 mg/dL), was also evaluated.
  
  
  RESULTS
  Higher levels of LP-IR, large VLDL particles (VLDL-P), small LDL particles, triglycerides (TG), and TG-to-HDL cholesterol (HDL-C) ratio and lower levels of large HDL particles, smaller HDL and LDL size, and larger VLDL size were significantly associated with incident diabetes adjusted for confounders and glucose or insulin. These also were similar by race/ethnicity, sex, and treatment group. Associations were similar for LP-IR, large VLDL-P, mean VLDL size, TG, and TG-to-HDL-C ratio; they persisted for LP-IR, large VLDL-P, or mean VLDL size adjusted for HOMA-IR or TG-to-HDL-C ratio and glucose but not for the TG-to-HDL-C ratio adjusted for LP-IR or for HOMA-IR or insulin if adjusted for LP-IR and glucose.
  
  
  CONCLUSIONS
  Among ethnically diverse men and women, LP-IR, large VLDL-P, large VLDL size, TG, and TG-to-HDL-C ratio were associated with incident diabetes independent of established risk factors, glucose, insulin, or HOMA-IR, as well as the use of lipid-lowering medications or hormone therapy.
authors.affiliation: University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA mackey@edc.pitt.edu.
authors.forename: Rachel H
authors.initials: RH
authors.lastname: Mackey
authors.affiliation: Brigham and Women's Hospital, Boston, MA.
authors.forename: Samia
authors.initials: S
authors.lastname: Mora
authors.affiliation: Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, NC.
authors.forename: Alain G
authors.initials: AG
authors.lastname: Bertoni
authors.affiliation: University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA.
authors.forename: Christina L
authors.initials: CL
authors.lastname: Wassel
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Mercedes R
authors.initials: MR
authors.lastname: Carnethon
authors.affiliation: Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Sibley
authors.affiliation: Colorado School of Public Health, Aurora, CO.
authors.forename: David C
authors.initials: DC
authors.lastname: Goff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood* / Q000453:epidemiology*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D008074:Lipoproteins / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008079:Lipoproteins, VLDL / Q000097:blood; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D014280:Triglycerides / Q000097:blood
chemical_list: D008074:Lipoproteins; D008075:Lipoproteins, HDL; D008079:Lipoproteins, VLDL; D014280:Triglycerides