title: Differential Association Between HDL Subclasses and the Development of Type 2 Diabetes in a Prospective Study of Japanese Americans.
abstract: OBJECTIVE
  Recent studies have suggested that HDL cholesterol is inversely associated with the development of type 2 diabetes. However, little is known about the association between different HDL subclasses and the risk for future type 2 diabetes.
  
  
  METHODS
  The study enrolled 406 Japanese Americans (51% male) without diabetes, aged 34-75 years. Oral glucose tolerance tests were performed to determine type 2 diabetes status at baseline, 2.5 years, 5 years, and 10 years after enrollment. HDL2, HDL3, total HDL cholesterol, and visceral adipose tissue (VAT) area by computed tomography were measured at baseline.
  
  
  RESULTS
  In univariate analysis, total HDL and HDL2 cholesterol were inversely associated with the incidence of type 2 diabetes, but HDL3 cholesterol was not. In multivariate analysis, total HDL cholesterol (odds ratio per 1-SD increment, 0.72 [95% CI 0.52-0.995], P = 0.047) and HDL2 cholesterol (odds ratio per 1-SD increment, 0.64 [95% CI 0.44-0.93], P = 0.018) were inversely associated with the risk for type 2 diabetes independent of age, sex, BMI, waist circumference, family history of diabetes, lifestyle factors, systolic blood pressure, lipid-lowering medication use, triglyceride level, HOMA-insulin resistance, and 2-h glucose; however, HDL3 cholesterol was not associated with diabetes risk. The association between diabetes risk and total HDL and HDL2 cholesterol became insignificant after adjustment for VAT area.
  
  
  CONCLUSIONS
  Subjects with higher HDL2 cholesterol were at lower risk for incident type 2 diabetes, but this association was confounded by and not independent of VAT. Higher HDL3 cholesterol was not associated with diabetes risk.
authors.affiliation: Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: You-Cheol
authors.initials: YC
authors.lastname: Hwang
authors.affiliation: Department of Preventive Medicine and Environmental Health, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: Tomoshige
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Seattle, WA.
authors.forename: Wilfred Y
authors.initials: WY
authors.lastname: Fujimoto
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Seattle, WA Hospital and Specialty Medicine Service, VA Puget Sound Health Care System, Seattle, WA.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Kahn
authors.affiliation: Department of Anthropology, University of Washington, Seattle, WA.
authors.forename: Donna L
authors.initials: DL
authors.lastname: Leonetti
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Seattle, WA.
authors.forename: Marguerite J
authors.initials: MJ
authors.lastname: McNeely
authors.affiliation: Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA Department of Medicine, University of Washington School of Medicine, Seattle, WA eboyko@uw.edu.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
mesh_terms: D000328:Adult; D000368:Aged; D001213:Asian; D008076:Cholesterol, HDL / Q000097:blood* / Q000145:classification; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL