HDL cholesterol subfractions and risk of developing type 2 diabetes among Pima Indians

OBJECTIVE - To examine the relationships between HDL cholesterol subfractio ns and the incidence of type 2 diabetes and to evaluate potential sex diffe rences in these relationships. RESEARCH DESIGN IND METHODS - Proportional hazards analyses were performed to examine the relationships between HDL subfractions and the development o f type 2 diabetes in Pima Indian women and men. Results were controlled for age, BMI, systolic blood pressure, and 2-h glucose. RESULTS - Some 54 of 123 women and 25 of 50 men developed type 2 diabetes d uring a mean follow-up of 10 (2-19) years. For women, in separate models, h igh levels of total HDL, HDL2a, and HDL3 were negatively associated with in cidence of type 2 diabetes; results were unchanged in models further contro lled for fasting insulin level or alcohol consumption For men, the results were inconsistent and associated with wide confidence intervals; high total HDL and HDL3 were positively associated with incidence of type 2 diabetes in models further controlled for fasting insulin level, but the risk estima tes were attenuated in models further controlled for alcohol consumption. CONCLUSIONS - High levels of total HDL, HDL2a, and HDL3 were potential prot ective factors against type 2 diabetes in women after accounting for alcoho l consumption and insulin resistance. High levels of total HDL and HDL3 wer e predictive of type 2 diabetes in men; the relationship in men appeared to be due to an association with alcohol consumption. The sex differences in the effects of HDL cholesterol may be related to the effects of sex hormone s or lipoproteins.