Plasma Apolipoprotein Concentrations and New-Onset Diabetes in Subjects with Prediabetes

Background and Aims : To investigate the association of plasma apolipoprotein concentrations with the incidence of new-onset diabetes (NOD) in subjects with prediabetes.Methods: NOD was assessed in 307 participants with impaired fasting glucose levels (fasting plasma glucose [FPG]: 110–125 mg/dL). NOD was defined as a first FPG value ≥ 126 mg/dL during follow-up. Apolipoprotein plasma concentrations were determined by mass spectrometry. Kaplan–Meier curves were drawn using a ternary approach based on terciles and incident NOD. The association between plasma apolipoproteins and the incidence of NOD was determined using Cox proportional-hazard models.Results: During a median follow-up of 5-year, 115 participants (37.5%) developed NOD. After adjustment for age, sex, BMI, FPG, HbA1c, and statin use, the plasma levels of apoC-I, apoC-II, apoC-III, apoE, apoF, apoH, apoJ, and apoL1 were positively associated with the risk of NOD. After further adjustment for plasma triglycerides, apoE (1 SD natural-log-transformed hazard ratio: 1.28 [95% CI: 1.06; 1.54]; p = 0.010), apoF (1.22 [1.01; 1.48]; p = 0.037), apoJ (1.24 [1.03; 1.49]; p = 0.024), and apoL1 (1.26 [1.05; 1.52]; p = 0.014) remained significant. Besides, Kaplan–Meier survival curves showed that patients with lowest plasma apoE levels (<5.97 mg/dL) had significantly less risk of NOD (log-rank test, p = 0.002).Conclusions: The plasma apoE concentrations were positively associated with the risk of NOD in individuals with prediabetes, independently of traditional risk factors. The positive but non-causal association of apoF, apoJ, and apoL1 levels with the risk of NOD also pave the way for further investigations. Background and Aims : To investigate the association of plasma apolipoprotein concentrations with the incidence of new-onset diabetes (NOD) in subjects with prediabetes. Methods: NOD was assessed in 307 participants with impaired fasting glucose levels (fasting plasma glucose [FPG]: 110–125 mg/dL). NOD was defined as a first FPG value ≥ 126 mg/dL during follow-up. Apolipoprotein plasma concentrations were determined by mass spectrometry. Kaplan–Meier curves were drawn using a ternary approach based on terciles and incident NOD. The association between plasma apolipoproteins and the incidence of NOD was determined using Cox proportional-hazard models. Results: During a median follow-up of 5-year, 115 participants (37.5%) developed NOD. After adjustment for age, sex, BMI, FPG, HbA1c, and statin use, the plasma levels of apoC-I, apoC-II, apoC-III, apoE, apoF, apoH, apoJ, and apoL1 were positively associated with the risk of NOD. After further adjustment for plasma triglycerides, apoE (1 SD natural-log-transformed hazard ratio: 1.28 [95% CI: 1.06; 1.54]; p = 0.010), apoF (1.22 [1.01; 1.48]; p = 0.037), apoJ (1.24 [1.03; 1.49]; p = 0.024), and apoL1 (1.26 [1.05; 1.52]; p = 0.014) remained significant. Besides, Kaplan–Meier survival curves showed that patients with lowest plasma apoE levels (<5.97 mg/dL) had significantly less risk of NOD (log-rank test, p = 0.002). Conclusions: The plasma apoE concentrations were positively associated with the risk of NOD in individuals with prediabetes, independently of traditional risk factors. The positive but non-causal association of apoF, apoJ, and apoL1 levels with the risk of NOD also pave the way for further investigations.