{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:13:49Z","timestamp":1783660429922,"version":"3.55.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the associations and diagnostic ability of non-traditional lipid parameters and lipid-inflammation parameters with abnormal glucose metabolism, and to investigate the mediating role of high-sensitivity C-reactive protein (hs-CRP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Based on cross-sectional survey data from 9,790 adults in Fujian Province, China (2020-2021), 2,301 participants were included in the analysis. Eight non-traditional lipid parameters and lipid-inflammation parameters incorporating hs-CRP were calculated. Associations with impaired glucose metabolism were examined using ordinal logistic regression, restricted cubic spline analysis, and subgroup analyses. Incremental diagnostic ability was evaluated using receiver operating characteristic curve analysis, C-statistics, net reclassification improvement, and integrated discrimination improvement. Mediation analysis was performed to examine the role of hs-CRP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All parameters were significantly positively associated with impaired glucose metabolism, with several showing nonlinear dose-response relationships. Subgroup analyses demonstrated generally consistent associations with those in the overall population. In the prediabetes comparison, atherogenic coefficient, Castelli\u2019s index-I, remnant cholesterol-C-reactive protein index, and remnant cholesterol to high-density lipoprotein cholesterol-C-reactive protein index (RC\/HDL-C-CRP) had superior diagnostic ability, whereas atherogenic index of plasma and RC\/HDL-C-CRP performed better in the diabetic comparison. Mediation analysis indicated that hs-CRP partially mediated the association between non-traditional lipid parameters and prediabetes, with bidirectional mediation effects observed. No mediation effect was observed for diabetes risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Non-traditional lipid parameters and lipid-inflammation parameters were significantly associated with impaired glucose metabolism. Incorporating inflammatory information may enhance the identification of high-risk individuals, providing early warning particularly in prediabetic populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1873940","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:24:28Z","timestamp":1783657468000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nontraditional lipid and lipid-inflammatory parameters for risk stratification of abnormal glucose metabolism: a cross-sectional study in Chinese adults"],"prefix":"10.3389","volume":"17","author":[{"given":"Dan-jing","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University","place":["Fuzhou, China"]},{"name":"Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, School of Basic Medical Sciences, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University","place":["Fuzhou, China"]},{"name":"Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, School of Basic Medical Sciences, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-gen","family":"Wu","sequence":"additional","affiliation":[{"name":"Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Si","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University","place":["Fuzhou, China"]},{"name":"Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, School of Basic Medical Sciences, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-yuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University","place":["Fuzhou, China"]},{"name":"Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, School of Basic Medical Sciences, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-zhi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University","place":["Fuzhou, China"]},{"name":"Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, School of Basic Medical Sciences, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University","place":["Fuzhou, China"]},{"name":"Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University","place":["Fuzhou, China"]},{"name":"Branch of National Clinical Research Center for Aging and Medicine, The First Affiliated Hospital of Fujian Medical University","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xian-E","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University","place":["Fuzhou, China"]},{"name":"Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, School of Basic Medical Sciences, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21176275","article-title":"Pathophysiology of type 2 diabetes mellitus","volume":"21","author":"Galicia-Garcia","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2019.107843","article-title":"Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9(th) edition","volume":"157","author":"Saeedi","year":"2019","journal-title":"Diabetes Res Clin Pract"},{"key":"B3","doi-asserted-by":"publisher","first-page":"491","DOI":"10.2217\/fca-2018-0045","article-title":"Type-2 diabetes mellitus and cardiovascular disease","volume":"14","author":"Henning","year":"2018","journal-title":"Future Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1007\/978-94-011-4962-4_2","article-title":"The stages in diabetic renal disease. With emphasis on the stage of incipient diabetic nephropathy","volume":"32","author":"Mogensen","year":"1983","journal-title":"Diabetes"},{"key":"B5","doi-asserted-by":"publisher","first-page":"17376","DOI":"10.1038\/s41598-020-73668-y","article-title":"A national observation study of cancer incidence and mortality risks in type 2 diabetes compared to the background population over time","volume":"10","author":"Bjornsdottir","year":"2020","journal-title":"Sci Rep"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2991\/jegh.k.191028.001","article-title":"Epidemiology of type 2 diabetes - global burden of disease and forecasted trends","volume":"10","author":"Khan","year":"2020","journal-title":"J Epidemiol Glob Health"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.838027","article-title":"Prevalence, deaths and disability-adjusted-life-years (DALYs) due to type 2 diabetes and its attributable risk factors in 204 countries and territories, 1990-2019: Results from the Global Burden of Disease Study 2019","volume":"13","author":"Safiri","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109119","article-title":"IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045","volume":"183","author":"Sun","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-8587(19)30093-2","article-title":"Morbidity and mortality after lifestyle intervention for people with impaired glucose tolerance: 30-year results of the Da Qing Diabetes Prevention Outcome Study","volume":"7","author":"Gong","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1016\/s2213-8587(23)00235-8","article-title":"Mechanisms of weight loss-induced remission in people with prediabetes: a post-hoc analysis of the randomised, controlled, multicentre Prediabetes Lifestyle Intervention Study (PLIS)","volume":"11","author":"Sandforth","year":"2023","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1007\/s00125-021-05645-7","article-title":"Using genetics to assess the association of commonly used antihypertensive drugs with diabetes, glycaemic traits and lipids: a trans-ancestry Mendelian randomisation study","volume":"65","author":"Zhao","year":"2022","journal-title":"Diabetologia"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1186\/s12944-021-01612-8","article-title":"Triglyceride\/low-density-lipoprotein cholesterol ratio is the most valuable predictor for increased small, dense LDL in type 2 diabetes patients","volume":"21","author":"Ouchi","year":"2022","journal-title":"Lipids Health Dis"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-042821","article-title":"Association between dyslipidemia and risk of type 2 diabetes mellitus in middle-aged and older Chinese adults: a secondary analysis of a nationwide cohort","volume":"11","author":"Peng","year":"2021","journal-title":"BMJ Open"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn112338-20200401-00490","article-title":"A nested case-control study on relationship of traditional and combined lipid metabolism indexes with incidence of diabetes","volume":"42","author":"Bai","year":"2021","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.5603\/kp.a2015.0086","article-title":"Lipoprotein ratios are better than conventional lipid parameters in predicting coronary heart disease in Chinese Han people","volume":"73","author":"Zhu","year":"2015","journal-title":"Kardiol Pol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s12933-024-02144-y","article-title":"Association between atherogenic index of plasma control level and incident cardiovascular disease in middle-aged and elderly Chinese individuals with abnormal glucose metabolism","volume":"23","author":"Min","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jare.2025.11.029","article-title":"Non-traditional lipid-inflammatory parameters estimate the risk of stroke in middle-aged and older Chinese adults: a nationwide prospective cohort study","author":"Huang","year":"2025","journal-title":"J Adv Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1186\/s12967-023-04047-0","article-title":"Lipid metabolism, BMI and the risk of nonalcoholic fatty liver disease in the general population: evidence from a mediation analysis","volume":"21","author":"Lu","year":"2023","journal-title":"J Transl Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-023-02103-z","article-title":"Nonlinear relationship between untraditional lipid parameters and the risk of prediabetes: a large retrospective study based on Chinese adults","volume":"23","author":"Li","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1186\/s12929-016-0303-y","article-title":"Mechanisms of inflammatory responses and development of insulin resistance: how are they interlinked","volume":"23","author":"Rehman","year":"2016","journal-title":"J BioMed Sci"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/3706508","article-title":"Role of C-reactive protein in diabetic inflammation","volume":"2022","author":"Stanimirovic","year":"2022","journal-title":"Mediators Inflammation"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.2147\/dddt.s468147","article-title":"Impact of lipids on insulin resistance: insights from human and animal studies","volume":"18","author":"Elkanawati","year":"2024","journal-title":"Drug Des Devel Ther"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1692742","article-title":"Metabolic crossroads in insulin resistance: exploring lipid dysregulation and inflammation","volume":"16","author":"Saadati","year":"2025","journal-title":"Front Immunol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.03.117","article-title":"Survey on prevalence of hypertension in China: background, aim, method and design","volume":"174","author":"Wang","year":"2014","journal-title":"Int J Cardiol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-s002","article-title":"Diagnosis and classification of diabetes: Standards of care in diabetes-2024","volume":"47","year":"2024","journal-title":"Diabetes Care"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.coph.2021.08.013","article-title":"Dyslipidemia and diabetes mellitus: Role of lipoprotein species and interrelated pathways of lipid metabolism in diabetes mellitus","volume":"61","author":"Kane","year":"2021","journal-title":"Curr Opin Pharmacol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1186\/s12944-025-02747-8","article-title":"Lipid droplet dynamics in type 2 diabetes and its complications: pathophysiological insights and therapeutic options","volume":"24","author":"Long","year":"2025","journal-title":"Lipids Health Dis"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.5551\/jat.rv17023","article-title":"Pathophysiology of diabetic dyslipidemia","volume":"25","author":"Hirano","year":"2018","journal-title":"J Atheroscler Thromb"},{"key":"B29","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1186\/s12967-022-03470-z","article-title":"Evaluation of the value of conventional and unconventional lipid parameters for predicting the risk of diabetes in a non-diabetic population","volume":"20","author":"Sheng","year":"2022","journal-title":"J Transl Med"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1576602","article-title":"Non-traditional lipid biomarkers in atherosclerotic cardiovascular disease: pathophysiological mechanisms and strategies to address residual risk","volume":"16","author":"Wang","year":"2025","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad337","article-title":"Triglyceride-rich lipoprotein remnants, low-density lipoproteins, and risk of coronary heart disease: a UK Biobank study","volume":"44","author":"Bjornson","year":"2023","journal-title":"Eur Heart J"},{"key":"B32","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1007\/s10238-025-01819-4","article-title":"Association of non-traditional lipid indices with diabetes and insulin resistance in US adults: mediating effects of HOMA-IR and evidence from a national cohort","volume":"25","author":"Wang","year":"2025","journal-title":"Clin Exp Med"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1007\/s10787-025-01996-4","article-title":"Inflammation and immune biomarkers: new frontiers in understanding and managing diabetes complications","volume":"33","author":"Rao","year":"2025","journal-title":"Inflammopharmacology"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-021-00454-y","article-title":"Pro-resolving lipid mediators: regulators of inflammation, metabolism and kidney function","volume":"17","author":"Brennan","year":"2021","journal-title":"Nat Rev Nephrol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.774272","article-title":"The variation and correlation of serum adiponectin, nesfatin-1, IL-6, and TNF-alpha levels in prediabetes","volume":"13","author":"Huang","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B36","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1038\/s41392-025-02401-w","article-title":"Diabetes and its complications: molecular mechanisms, prevention and treatment","volume":"11","author":"Zhao","year":"2026","journal-title":"Signal Transduct Target Ther"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad422","article-title":"Associations of clinical risk factors and novel biomarkers with age at onset of type 2 diabetes","volume":"109","author":"Chen","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.690484","article-title":"Molecular insulin actions are sexually dimorphic in lipid metabolism","volume":"12","author":"Ortiz-Huidobro","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1530\/joe-23-0245","article-title":"Sex-based differences in insulin resistance","volume":"261","author":"Gado","year":"2024","journal-title":"J Endocrinol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60283-9","article-title":"Prediabetes: a high-risk state for diabetes development","volume":"379","author":"Tabak","year":"2012","journal-title":"Lancet"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1177\/2150132719847374","article-title":"Evaluation of a community-based diabetes prevention program in Thailand: a cluster randomized controlled trial","volume":"10","author":"Aekplakorn","year":"2019","journal-title":"J Prim Care Community Health"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.5938","article-title":"Lifestyle intervention with or without lay volunteers to prevent type 2 diabetes in people with impaired fasting glucose and\/or nondiabetic hyperglycemia: a randomized clinical trial","volume":"181","author":"Sampson","year":"2021","journal-title":"JAMA Intern Med"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2024.111637","article-title":"Long-term lifestyle intervention can reduce the development of type 2 diabetes mellitus in subjects with prediabetes: a systematic review and meta-analysis","volume":"210","author":"Portal Teixeira","year":"2024","journal-title":"Diabetes Res Clin Pract"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1873940\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:24:29Z","timestamp":1783657469000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1873940\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":43,"alternative-id":["10.3389\/fendo.2026.1873940"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1873940","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,10]]},"article-number":"1873940"}}