Background: Studies have reported that lipid-derived indicators are associated with type 2 diabetes (T2D) in various populations; however, it is unclear which lipid-derived indicators could effectively predict T2D risk. Therefore, this study aimed to explore the association between four lipid-derived indicators and T2D risk.Methods: This was a post-hoc analysis from a large cohort that included data from 114,700 Chinese individuals aged 20 years and older from 11 cities and 32 sites. The association between four lipid-derived indicators and T2D risk was determined using Kaplan-Meier (KM) survival curves, Cox regression, and restricted cubic spline analyses. This study used receiver operating characteristic (ROC) curves for assessing the ability of four lipid-derived indicators to accurately predict the development of T2D during follow-up.Results: This study included a total of 114,700 participants, with a mean age of 44.15. These individuals were followed up for 3.1 years, of which 2668 participants developed T2D. ROC curve analysis showed that TyG was the most robust predictor of 3-year [aera under the ROC (AUC) = 0.77, 95% CI: 0.768, 0.772] and 5-year T2D risk (AUC = 0.763, 95% CI: 0.760, 0.765). In addition, sensitivity analysis showed an association between TyG and an increased incidence of T2D.Conclusions: The results suggest that TyG was a superior for predicting the risk of developing T2D in the general Chinese population.

Purpose: Previous observational studies about the link between dietary factors and diabetic microvascular complications (DMCs) is controversial. Thus, we systemically assessed the potential causal relationship between diet and DMCs risk using Mendelian randomization (MR) methods.Methods: We used genome-wide association studies (GWAS) statistics to estimate the causal effects of 17 dietary patterns on three common DMCs in European. Summary statistics on dietary intakes were obtained from the UK biobank, and data on DMCs [diabetic retinopathy (DR), diabetic nephropathy (DN), and diabetic neuropathy (DNP)] were obtained from the FinnGen Consortium. A two-sample MR (TSMR) was conducted to explore the causal relationships of dietary habits with DMCs. In addition, multivariable MR analysis (MVMR) was performed to adjust for traditional risk factors for eating habits, and evaluated the direct or indirect effects of diet on DMCs.Results: TSMR analysis revealed that salad/raw vegetable intake (odd ratio [OR]: 2.830; 95% confidence interval [CI]: 1.102–7.267; p = 0.0306) and fresh fruit intake (OR: 2.735; 95% CI: 1.622–4.611; p = 0.0002; false discovery rate [FDR] = 0.0082) increased the risk of DR, whereas cheese intake (OR: 0.742; 95% CI: 0.563–0.978; p = 0.0339) and cereal intake (OR: 0.658; 95% CI: 0.444–0.976; p = 0.0374) decreased the risk of DR. Salad/raw vegetable (OR: 6.540; 95% CI: 1.061–40.300; p = 0.0430) and fresh fruit consumption (OR: 3.573; 95% CI: 1.263–10.107; p = 0.0164) are risk factors for DN, while cereal consumption (OR: 0.380; 95% CI: 0.174–0.833; p = 0.0156) is the opposite. And genetically predicted higher pork intake increased the risk of DNP (OR: 160.971; 95% CI: 8.832–2933.974; p = 0.0006; FDR = 0.0153). The MVMR analysis revealed that cheese intake may act as an independent protective factor for DR development. Moreover, fresh fruit intake, salad/raw vegetable intake and pork intake may be independent risk factors for DR, DN and DNP, respectively. Other causal associations between dietary habits and DMCs risk may be mediated by intermediate factors.Conclusion: This causal relationship study supports that specific dietary interventions may reduce the risk of DMCs.