Fasting triglycerides as a predictor of incident diabetes, insulin resistance and β-cell function in a Canadian First Nation

• Published in: International Journal of Circumpolar Health
• Main Authors: Natalie D. Riediger, Kirsten Clark, Virginia Lukianchuk, Joanne Roulette, Sharon Bruce
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis Group 2017
• Subjects: First Nation; diabetes; triglycerides; insulin resistance; cohort study; obesity; hypertriglyceridaemic waist; Arctic medicine. Tropical medicine; RC955-962; Arctic; Canada; Circumpolar Health; First Nations; International Journal of Circumpolar Health
• Online Access: https://doi.org/10.1080/22423982.2017.1310444; https://doaj.org/article/b42b20ac4591402a869bf236a678ac89

Background: Diabetes prevalence is substantially higher among Canadian First Nations populations than the non-First Nation population. Fasting serum triglycerides have been found to be an important predictor of incident diabetes among non-indigenous populations. However, there is a great need to understand diabetes progression within specific ethnic groups, particularly First Nations populations. Objective: The purpose of this study was to test for an association between fasting serum triglycerides and incident diabetes, changes in insulin resistance and changes in β-cell function in a Manitoba First Nation cohort. Methods: Study data were from two diabetes screening studies in Sandy Bay First Nation in Manitoba, Canada, collected in 2002/2003 and 2011/2012. The cohort was composed of respondents to both screening studies (n=171). Fasting blood samples and anthropometric, health and demographic data were collected. A generalised linear model with Poisson distribution was used to test for an association between fasting triglycerides and incident diabetes. Results: There were 35 incident cases of diabetes among 128 persons without diabetes at baseline. Participants who developed incident type 2 diabetes were significantly older and had significantly higher body mass index (BMI; p=0.012), total cholesterol (p=0.007), fasting triglycerides (p<0.001), and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (p<0.001). Fasting triglyceride level was found to be a statistically significant positive predictor of incident diabetes independent of age, sex and waist circumference at baseline. Participants with triglycerides in the highest tertile (≥2.11 mmol/l) had a 4.0-times higher risk of developing incident diabetes compared to those in the lowest tertile (p=0.03). Notably, neither waist circumference nor BMI were significant predictors of incident diabetes independent of age, sex and triglycerides. Conclusion: Fasting triglycerides may be useful as a clinical predictor of insulin resistance and diabetes ...