# Association between remnant cholesterol levels and reversion to normoglycemia from prediabetes: a 5-year longitudinal cohort study of Chinese non-obese adults

**Authors:** Wei Liu, Wenjing Jian, Suina Lin, Zhenhua Huang

PMC · DOI: 10.3389/fendo.2025.1510470 · Frontiers in Endocrinology · 2025-07-30

## TL;DR

This study finds that higher remnant cholesterol levels are linked to a lower chance of reversing prediabetes to normal blood sugar levels in non-obese Chinese adults over five years.

## Contribution

The study identifies a nonlinear relationship between remnant cholesterol and prediabetes reversion in non-obese individuals.

## Key findings

- Higher remnant cholesterol levels are associated with a 51% lower likelihood of reversion to normoglycemia.
- A nonlinear relationship exists with an inflection point at 1.10 mmol/L remnant cholesterol.
- Sensitivity and subgroup analyses confirm the robustness of the findings.

## Abstract

The primary objective of this study is to explore the relationship between remnant cholesterol (RC) levels and the reversion to normoglycemia in non-obese Chinese individuals with prediabetes.

To achieve this goal, we conducted a retrospective cohort study involving 8,109 non-obese prediabetic participants in China, using the Cox proportional hazards regression model to analyze the correlation between RC and the likelihood of returning to normoglycemia.

The results indicate a significant negative correlation between RC levels and reversion to normoglycemia (HR=0.49, 95% CI: 0.47-0.52). Specifically, as RC quartiles increase, the probability of reverting to normoglycemia significantly decreases, with participants in the highest quartile having a 51% lower likelihood of recovery compared to those in the lowest quartile. Furthermore, we identified a nonlinear relationship between RC and the reversion to normoglycemia, with 1.10 mmol/L established as the inflection point. When RC levels are below this threshold, decreasing RC significantly increases the likelihood of recovery. To further validate the robustness of our findings, we conducted sensitivity and subgroup analyses, all of which support the reliability of the main results.

There exists a significant negative and nonlinear relationship between RC levels and the reversion to normoglycemia in non-obese Chinese prediabetic patients. This suggests that lowering RC levels may play an important role in reversion to normoglycemia from prediabetes.

## Linked entities

- **Diseases:** prediabetes (MONDO:0006920)

## Full-text entities

- **Genes:** INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}, GPT (glutamic--pyruvic transaminase) [NCBI Gene 2875] {aka AAT1, ALT, ALT1, GPT1, SGPT}
- **Diseases:** Prediabetes (MESH:D011236), underweight (MESH:D013851), IGT (MESH:D018149), RC (MESH:C535937), stroke (MESH:D020521), endothelial dysfunction (MESH:D014652), hypertension (MESH:D006973), type 2 diabetes (MESH:D003924), inflammation (MESH:D007249), metabolic disorders (MESH:D008659), DM (MESH:D003920), IFG (MESH:D007003), dyslipidemia (MESH:D050171), overweight (MESH:D050177), heart disease (MESH:D006331), obese (MESH:D009765), IR (MESH:D007333)
- **Chemicals:** lipid (MESH:D008055), blood glucose (MESH:D001786), cholesterol (MESH:D002784), creatinine (MESH:D003404), glucose (MESH:D005947), TG (MESH:D014280), FPG (-), alcohol (MESH:D000438)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12343219/full.md

## References

36 references — full list in the complete paper: https://tomesphere.com/paper/PMC12343219/full.md

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Source: https://tomesphere.com/paper/PMC12343219