Background: It is reported that the prevalence of young-onset type 2 diabetes (YOD) is increasing in recent. YOD usually defined that it diagnosis at age <40 year. However, the underlying pathophysiology of YOD is still unknown. Previous studies suggested that lipid level and its variability associated with various health outcome.

Aim: We aimed to examine the effect of lipid profile and variability of low-density lipoprotein cholesterol (LDL-C) on the risk of young-onset type 2 diabetes in Participants with 20 to 40 Years

Methods: We examined the General Health Check-up sub-dataset of the Korean National Health Insurance Service (NHIS) of 1,376,416 participants with 20 to 40 year who had at least three health check-ups between 2012 and 2017, and were not reported to have diabetes during that time. The visit to visit variability of LDL-C was measured using variability independent of the mean (VIM), standard deviation (SD), average successive variability (ASV), and coefficient of variation (CV),.

Results: During a median of 5 years of follow up, 19,706 subjects (1.5%) developed YOD. Risk of incident YOD increased with quartiles 2, 3 and 4 versus quartile 1 in Total cholesterol (TC), LDL-C, triglyceride (TC) whereas, inversely associated with high density lipoprotein cholesterol (HDL-C) in multivariate analysis. Compare with the lowest quartile, the highest quartile of VIM, SD, ASV and CV of LDL-C was associated with 1.22-1.43 fold risk of YOD (VIM HR, 1.292; SD HR 1.428; ASV HR 1.364; CV HR 1.218, P for trend <0.0001) in the multivariable adjusted model. When calculating variability of TC, LDL and HDL-C index, we did not observe that consistent results were obtained.

Conclusion: Risk of incident YOD is increased with increasing lipid profile. High visit to visit LDL-C variability and level of LDL-C per se, were independent predictors of YOD. Both lowering and stabilizing LDL-C can be beneficial for reducing diabetes risk in young population.


M.Seo: None. S.Park: None. E.Rhee: None. W.Lee: None.

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