BACKGROUND AND AIMS: High-density lipoproteins (HDL) may be protective against type 2 diabetes (T2D) development, but HDL particles vary in size and function which could lead to differential associations with incident T2D. A newly developed nuclear magnetic resonance (NMR)-derived algorithm provides concentrations for seven HDL subspecies. We aimed to investigate the association of HDL particle subspecies with incident T2D in the general population.
MATERIALS AND METHODS: Among 4828 subjects of the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study without T2D at baseline. HDL subspecies with increasing size from H1P to H7P were measured by NMR (LP4 algorithm of the Vantera NMR platform).
RESULTS: 265 individuals developed T2D (median follow-up of 7.3 years). In Cox regression models, HDL size and H4P [HR per 1 SD increase 0.83 (95% CI, 0.69-0.99) and 0.85 (95% CI, 0.75-0.95), respectively] were inversely associated with incident T2D, after adjustment for relevant covariates. Oppositely, levels of H2P were positively associated with incident T2D (HR 1.15 (95% CI, 1.01-1.32)). In secondary analyses, associations with large HDL particles and H6P were modified by BMI in such a way that they were particularly associated with a lower risk of incident T2D, in subjects with BMI < 30 kg/m 2.
CONCLUSION: Greater HDL size and lower levels of H4P were associated with a lower risk, whereas higher levels of H2P were associated with a higher risk of developing T2D. In addition, large HDL particles and H6P were inversely associated with T2D in non-obese subjects.