512-P: The Effect of Remnant Cholesterol on the Onset of Diabetes Mellitus

Remnant cholesterol (Rem-C) is the cholesterol content found in triglyceride-rich lipoproteins, which are produced in the metabolic process of VLDL and chylomicrons. REM-C is associated with an increased risk of cardiovascular disease and is a target of lipid-lowering therapies. Conversely, insulin resistance is linked to increased levels of Rem-C. However, the effect of Rem-C levels on the onset of diabetes mellitus (DM) has not been adequately clarified. Therefore, this study aims to examine the association between Rem-C levels and the onset of diabetes. We reviewed the records of 13,044 nondiabetic individuals (6,499 males, 6,545 females) who underwent health check-ups at least twice, with a median age of 44 (IQR 37-51) years. The observation period spanned 5.86 (0.60-16.92) years. DM onset was determined based on HbA1c≧6.5% or fasting plasma glucose≧126mg/dL. Four hundred sixty subjects developed DM. In univariate analysis, an increase in Rem-C significantly raised the risk of DM onset (HR: 1.017, 95% CI: 1.014-1.019). Similar results were obtained in multivariate analysis (adjusted HR: 1.009, 95% CI: 1.005-1.013), adjusting for gender, age, body mass index, systolic blood pressure, fasting blood glucose, alanine aminotransferase, creatinine, family history of diabetes, and smoking history.

In conclusion, a high level of Rem-C is a risk factor for the onset of DM. Therefore, Rem-C may serve as a useful surrogate marker for DM onset, and interventions, such as lifestyle guidance and drug therapy, focusing on Rem-C may help suppress the onset of DM.