Remnant cholesterol, iron status and diabetes mellitus: a dose–response relationship and mediation analysis

Autor: Xiangming Hu, Yan Lin, Allison A. Appleton, Weimian Wang, Bingyan Yu, Langping Zhou, Guang Li, Yingling Zhou, Yanqiu Ou, Haojian Dong
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Diabetology & Metabolic Syndrome, Vol 16, Iss 1, Pp 1-11 (2024)
Druh dokumentu: article
ISSN: 1758-5996
DOI: 10.1186/s13098-024-01304-0
Popis: Abstract Background Remnant cholesterol (RC) is recognized as a risk factor for diabetes mellitus (DM). Although iron status has been shown to be associated with cholesterol metabolism and DM, the association between RC, iron status, and DM remains unclear. We examined the relationship between RC and iron status and investigated the role of iron status in the association between RC and DM. Methods A total of 7308 patients were enrolled from the China Health and Nutrition Survey. RC was calculated as total cholesterol minus low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. Iron status was assessed as serum ferritin (SF) and total body iron (TBI). DM was ascertained by self-reported physician diagnosis and/or antidiabetic drug use and/or fasting plasma glucose ≥ 126 mg/dL and/or glycated haemoglobin ≥ 6.5%. General linear models were used to evaluate the relationships between RC and iron status. Restricted cubic splines were used to assess the association between RC and DM. Mediation analysis was used to clarified the mediating role of iron status in the association between the RC and DM. Results The average age of the participants was 50.6 (standard deviation = 15.1) years. Higher RC was significantly associated with increased SF (β = 73.14, SE = 3.75, 95% confidence interval [CI] 65.79–80.49) and TBI (β = 1.61, SE = 0.08, 95% CI 1.44–1.78). J-shape relationships were found in the association between RC levels with DM, as well as iron status with DM. Significant indirect effects of SF and TBI in the association between RC and DM were found, with the index mediated at 9.58% and 6.37%, respectively. Conclusions RC has a dose–response relationship with iron status. The association between RC and DM was mediated in part by iron status. Future studies are needed to confirm these findings and further clarify the underlying mechanism.
Databáze: Directory of Open Access Journals
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