Both low and high levels of low-density lipoprotein cholesterol are risk factors for diabetes diagnosis in Chinese adults

Guang Yang, Tingting Qian, Hui Sun, Qun Xu, Xujuan Hou, Wenqi Hu, Guang Zhang, Yan Fan, David Song, Zhonglin Chai, Dianna J. Magliano, Jonathan Golledge, Yutang Wang

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Aims: This study aimed to investigate whether both high and low levels of low-density lipoprotein cholesterol (LDL-C), i.e., hypercholesterolemia and hypocholesterolemia, were associated with diabetes in Chinese adults. Methods: This cross-sectional study included 22,557 Chinese adults. The LDL-C reference interval was determined from a healthy sub-cohort. Associations between hypocholesterolemia or hypercholesterolemia with diabetes were analyzed using binary logistic regression. Results: The LDL-C reference interval was 1.48–3.77 mmol/L (57.23–145.78 mg/dL). Therefore, hypocholesterolemia, normocholesterolemia, and hypercholesterolemia were defined as an LDL-C concentration of <1.48, 1.48–3.77, and >3.77 mmol/L, respectively. Prevalence of diabetes was higher in people with hypocholesterolemia or hypercholesterolemia than that in people with normocholesterolemia. Hypocholesterolemia was associated with an increased multivariable-adjusted risk for diabetes diagnosis (odds ratio, 1.57; 95% confidence interval, 1.18–2.08), and so was hypercholesterolemia (odds ratio, 1.29; 95% confidence interval, 1.10–1.51). The results remained significant after exclusion of those who took lipid-lowering drugs from the analysis. Conclusions: This study demonstrated that both low and high levels of LDL-C were associated with a higher risk of diabetes diagnosis. Patients with either high or low LDL-C may need to be closely monitored for the risk of diabetes.

Original languageEnglish
Article number100050
Number of pages5
JournalDiabetes Epidemiology and Management
Publication statusPublished - 1 Apr 2022


  • Diabetes mellitus
  • Dyslipidemia
  • Low-density lipoprotein
  • Reference interval
  • risk factor

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