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Guotai Sheng,1,* Dingyang Liu,1,* Maobin Kuang,1,* Yanjia Zhong,2 Shuhua Zhang,3 Yang Zou3 1Cardiology Department, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Provincial, 330006, People’s Republic of China; 2Endocrinology Department, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, 330006, People’s Republic of China; 3Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Provincial, People’s Republic of China*These authors have contributed equally to this workCorrespondence: Yang Zou, Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Provincial, People’s Republic of China, Email jxyxyzy@163.comPurpose: Diabetes is one of the most prevalent chronic diseases in the world, and its prevalence is expected to rise further. To help understand the utility of the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) in diabetes prevention, this large-scale longitudinal cohort study aims to explore the association of NHHR with diabetes risk and compare it as a risk predictor with conventional lipid parameters.Patients and Methods: This observational study extracted data from the NAGALA longitudinal cohort study conducted in Japan between 2004 and 2015. Multivariate Cox regression analysis was used to evaluate the association between NHHR and the risk of diabetes. The dose–response relationship was analyzed by restricted cubic spline (RCS) regression and the potential risk threshold was estimated. The receiver operator characteristic curve (ROC) was used to analyze and calculate the predictive value and optimal threshold of NHHR and other conventional lipids for new-onset diabetes.Results: Of the 15,464 people aged 18– 79, 373 (2.41%) were diagnosed with new-onset diabetes during the study period, with a median age of 46 years. The sensitivity analysis based on m

Guobo Xie,1 Yanjia Zhong,2 Shuo Yang,3 Yang Zou4 1Cardiology Department, Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 2Endocrinology Department, Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 3Cardiology Department, Dean County People’s Hospital, Jiujiang, Jiangxi, People’s Republic of China; 4From the Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, People’s Republic of ChinaCorrespondence: Yang Zou Email jxyxyzy@163.comPurpose: Remnant cholesterol (RC) is the cholesterol of triglyceride-rich lipoproteins, which has a high degree of atherogenic effect. To date, epidemiological evidence supports that higher RC levels lead to a greater risk of adverse cardiovascular events in patients with diabetes, but the nature of the association between RC levels and diabetes risk remains unclear. This study was designed to assess the association of RC with the risk of new-onset diabetes and to investigate whether there is a causal relationship between the two.Patients and Methods: The subjects included 15,464 individuals of the general population who participated in a health examination. Subjects were quartered according to the RC quartile, and the Cox proportional hazard model was used to assess the independent association between RC and new-onset diabetes.Results: During an average observation period of 6.13 years, 2.41% of the subjects were diagnosed with new-onset diabetes. Kaplan–Meier analysis showed that the 13-year cumulative diabetes rates corresponding to the RC quartile were 8.62%, 2.49%, 12.78%, and 17.91%. Multivariate Cox regression analysis indicated that higher RC levels were independently associated with an increased risk of new-onset diabetes (HR: 2.44, 95% CI: 1.50– 3.89). Additionally, according to the results of