Hypertriglyceridemia in adults with diabetes mellitus in Korea: Sex, age, and lifestyle determinants

초록

BACKGROUND Hypertriglyceridemia remains prevalent among individuals with diabetes mellitus despite lipid-lowering treatments; however, evidence in Asian populations, particularly Koreans, is limited. OBJECTIVE To evaluate the prevalence and determinants of hypertriglyceridemia according to low-density lipoprotein cholesterol (LDL-C) levels and lipid-lowering therapy among Korean adults with diabetes mellitus, and to compare findings with U.S. data. METHODS Data from 7713 Korean adults with diabetes mellitus in the 2011-2021 Korea National Health and Nutrition Examination Survey (NHANES) were analyzed. Hypertriglyceridemia prevalence (≥150 mg/dL and ≥200 mg/dL) was assessed by LDL-C levels and lipid-lowering medication use. Multivariable logistic regression identified risk factors, and results were compared with U.S. NHANES data. RESULTS Among individuals with diabetes mellitus, the prevalence of hypertriglyceridemia was 43.3% (≥150 mg/dL) and 24.6% (≥200 mg/dL). Even in those achieving LDL-C <70 mg/dL with lipid-lowering medications, 37.8% had triglyceride levels ≥150 mg/dL and 19.3% had levels ≥200 mg/dL. Male sex (adjusted odds ratio [OR] 1.39, 95% CI 1.03-1.88) and higher LDL-C were positively associated with hypertriglyceridemia, whereas older age (OR 0.97 per year, 95% CI 0.96-0.99) and higher high-density lipoprotein cholesterol were inversely associated. Smoking was a significant risk factor for hypertriglyceridemia among women, and heavy alcohol consumption was a risk factor in both sexes. Compared with NHANES data, prevalence was similar, but associations with younger age, male sex, and elevated LDL-C were stronger among Koreans. CONCLUSION Hypertriglyceridemia is highly prevalent among Korean adults with diabetes mellitus, including those achieving LDL-C targets. Younger age, male, elevated LDL-C levels, and adverse lifestyle factors were key determinants, highlighting the need for comprehensive lipid management strategies beyond LDL-C control.

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