Effect of remnant cholesterol on the onset of diabetes mellitus - Original Article - study findings

Q: What was the study’s main aim regarding remnant cholesterol and diabetes onset?

To assess the association between remnant cholesterol (Rem-C) levels and diabetes mellitus (DM) onset, stratified by sex and age.

Q: How was the study conducted and analyzed?

A retrospective cohort used data from 13,952 participants who had two or more medical checkups over 2003–2021; Cox proportional hazard models evaluated the relationship between Rem-C and DM onset.

Q: In which age group did higher Rem-C relate to diabetes onset?

Higher Rem-C was associated with DM onset in people aged under 50 years, but this association was not observed in those aged 50 or older.

Sep 28, 2026

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Aims examine how remnant cholesterol (Rem-C) levels relate to diabetes mellitus (DM) onset, focusing on differences by sex and age. Methods use a retrospective cohort from 13,952 health checkup participants followed for a mean 4.66 years, applying Cox proportional hazard models to evaluate Rem-C and DM onset. Results show Rem-C predicts DM onset in individuals aged <50 years, with no clear association in those aged ≥50. Conclusions suggest Rem-C and triglycerides (TG) as age-specific predictors for earlier DM prevention.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Introduction

Remnant lipoproteins and Rem-C as risk factors

Need to clarify predictive utility for DM onset

Methods

Results

Conclusions

ORIGINAL ARTICLE Effect of remnant cholesterol on the onset of diabetes mellitus Teruki Miyake1* , Shinya Furukawa2, Ayumi Kanamoto1, Osamu Yoshida1, Yoshimasa Murakami1, Masumi Miyazaki1, Akihito Shiomi1, Sho Ishikawa1, Yuki Numata1, Hironobu Nakaguchi3, Yoshiko Nakamura1, Mitsuhito Koizumi1, Takao Watanabe1, Yasunori Yamamoto1, Hirohito Mori1, Eiji Takeshita1, Teru Kumagi4, Yoshio Ikeda1, Masanori Abe1, Bunzo Matsuura3, Takeru Iwata5, Yoichi Hiasa1 1Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan, 2Health Services Center, Ehime University, Matsuyama, Ehime, Japan, 3Department of Lifestyle-Related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan, 4Post Graduate Medical Education Center, Ehime University Hospital, Toon, Ehime, Japan, and 5Ehime General Health Care Association, Matsuyama, Japan Keywords Glycated hemoglobin, Remnant cholesterol, Younger subjects *Correspondence Teruki Miyake Tel.: +81 89 960 5308 Fax: +81 89 960 5310 E-mail address: [teruki-ygc@umin.ac.jp](teruki-ygc@umin.ac.jp) J Diabetes Investig 2026; 17: 120–128 doi: 10.1111/jdi.70163 ABSTRACT Aims: Higher levels of remnant cholesterol (Rem-C) are associated with diabetic conditions, serving as a treatment target and surrogate marker for identifying high-risk groups for diabetes mellitus (DM) onset. However, the effect of Rem-C on DM onset based on sex and age remains unclear. We aimed to examine the association between Rem-C levels and DM onset, stratified by sex and age. Methods: In this health checkup-based retrospective cohort study, we analyzed data from 13,952 participants who underwent medical checkups two or more times at the Ehime General Health Care Association between April 2003 and March 2021, a non-hospital facility where health care services are provided to company employees and local residents. The mean follow-up period was 4.66 years. Cox proportional hazard models were used to assess the association between Rem-C and DM onset. Results: In the multivariate analysis, higher Rem-C levels were associated with DM onset in individuals aged <50 years (men: adjusted hazard ratio [aHR] = 1.81, 95% CI: 1.46–2.20; women: aHR = 2. 13, 95% CI: 1.18–3.37). However, this association was not observed in those aged ≥50 years. Triglycerides (TG) were also significantly associated with DM onset in younger adults, with slightly higher predictive ability (AUC) than Rem-C, particularly among younger women. Sensitivity analyses using continuous age as a variable showed similar trends. Conclusions: Rem-C and TG may be useful predictors of DM onset in younger adults, with TG showing slightly better performance. Age-specific strategies may improve early DM prevention. INTRODUCTION Recent advances in dietary therapy, exercise therapy, and pharmacotherapy have improved glycemic control and the prevention of complications in diabetes mellitus (DM)1–4. However, by the time diabetes is diagnosed, the risk of cardiovascular disease has already increased, and complications such as metabolic dysfunction-associated steatotic liver disease (MASLD) may progress even with good glycemic control5,6. Therefore, preventing the onset of diabetes is crucial. To achieve this, identifying Received 13 February 2025; revised 11 September 2025; accepted 16 September 2025 high-risk individuals appropriately and providing early guidance on lifestyle modiﬁcations are necessary to prevent its development. Remnant lipoproteins, which include chylomicron remnants, very-low-density lipoprotein, and intermediate-density lipoprotein, are rich in triglycerides (TG)7. Elevated levels of these lipoproteins are linked to increased production and impaired clearance of TG-rich lipoproteins. Furthermore, remnant cholesterol (Rem-C), the cholesterol component of these lipoproteins, is recognized as a risk factor for various metabolic diseases, such as car

FAQs

What was the study’s main aim regarding remnant cholesterol and diabetes onset?

To assess the association between remnant cholesterol (Rem-C) levels and diabetes mellitus (DM) onset, stratified by sex and age.

How was the study conducted and analyzed?

A retrospective cohort used data from 13,952 participants who had two or more medical checkups over 2003–2021; Cox proportional hazard models evaluated the relationship between Rem-C and DM onset.

In which age group did higher Rem-C relate to diabetes onset?

Higher Rem-C was associated with DM onset in people aged under 50 years, but this association was not observed in those aged 50 or older.

Sep 28, 2026

Uploaded by Cart