Lipid metabolism-related inflammatory indices (LMIIs) and incident peripheral artery diseases (peripheral artery disease (PAD)) in patients with type 2 diabetes mellitus (T2DM): a multicohort study from China and the UK biobank
Authors' conclusion
Elevated levels of LMIIs, such as NHR, MHR, PHR and LHR, were associated with an increased risk of incident PAD among elderly diabetic patients. These associations exhibited notable population heterogeneity, with stronger effects observed in females and individuals with higher HbA1c level. eGFR may serve as a mediating factor in the associations between LMIIs and the occurrence of PAD. These findings provide novel evidence for immune inflammation-based risk assessment and personalized preventive strategies for PAD.
Study context
- Population
- Elderly (aged ≥ 60 years) patients with T2DM, Jinshan Cohort (China) and UK Biobank (UK)
- Comparison
- Per one-unit increase in LMIIs
- Outcome
- Incident PAD
Methodological detailsgeneralized propensity score weighting, E-value, negative control exposure analyses
- Generalized propensity score weighting
- E-value
- Negative control exposure analyses
Main finding
As reported in the abstract
Incident PAD per one-unit increase in LMII
- Jinshan Cohort (n=2837), NHR, OR
- 1.24 (1.11-1.39) (95% CI)
- Jinshan Cohort, MHR, OR
- 1.22 (1.08-1.37) (95% CI)
- Jinshan Cohort, PHR, OR
- 1.69 (1.32-2.15) (95% CI)
- Jinshan Cohort, LHR, OR
- 1.57 (1.22-2.01) (95% CI)
- UK Biobank (n=13,542), NHR, HR
- 1.14 (1.10-1.18) (95% CI)
- UK Biobank, MHR, HR
- 1.03 (1.01-1.04) (95% CI)
- UK Biobank, PHR, HR
- 1.19 (1.09-1.29) (95% CI)
- UK Biobank, LHR, HR
- 1.11 (1.07-1.14) (95% CI)
Further findings
Subgroups
- UK Biobank: aspirin use and HbA1c may modify effects
- P for interaction < 0.05
- Jinshan: associations varied by sex, residential area, smoking and HbA1c; pronounced in females, urban residents, smokers, HbA1c ≥ 7%
Mediation by estimated glomerular filtration rate (eGFR)
- Proportion mediated, Jinshan Cohort
- 10.03% to 19.95%
- Proportion mediated, UK Biobank
- 10.20 to 20.80%
Original publication
Lipid metabolism-related inflammatory indices (LMIIs) and incident peripheral artery diseases (PAD) in patients with type 2 diabetes mellitus (T2DM): a multicohort study from China and the UK biobank. Cardiovasc Diabetol. Published 22 August 2025. doi:10.
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