Sex-specific associations of lipid profiles with type 2 diabetes: Insights from the Shiraz University employees cohort.

Abstract

Type 2 diabetes (T2D) is a growing global health concern, with its prevalence rising rapidly in Iran. Dysregulation of lipid metabolism has been implicated in the development of T2D, yet potential differences between men and women remain underexplored. Lipid markers, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and the TG/HDL-C ratio, may serve as early predictors of metabolic dysfunction. This study investigates the sex-specific associations between lipid profiles and T2D within the Shiraz University Employees Cohort. Data from 7100 participants of the Shiraz University Employees Cohort, with type 2 diabetes at baseline, were analyzed. Demographic, anthropometric, and biochemical data, including lipid profiles (TG, HDL-C, TC, LDL-C) and derived ratios (TG/HDL-C, TC/HDL-C), were collected. Sex-specific logistic regression and ROC analyses were used to evaluate the association between lipid indices and type 2 diabetes and to determine optimal cut-off points RESULTS: The study included 3035 men and 4047 women. Higher TG and TG/HDL-C ratios were observed in person with diabetes, with 1-SD increases in TG/HDL-C raising diabetes odds (men: OR=1.28, 95 % CI 1.12-1.45; women: OR=1.35, 95 % CI 1.19-1.52), while HDL-C was protective (men: OR=0.80, 95 % CI 0.66-0.98; women: OR=0.81, 95 % CI 0.67-0.97). TG/HDL-C cut-offs of 3.72 (men) and 2.73 (women) showed the best predictive performance. TG and TG/HDL-C ratios are simple, accessible, and independent predictors of type 2 diabetes, especially in women, and can help identify high-risk individuals for targeted preventive interventions in clinical settings.