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ORIGINAL RESEARCH article

Front. Endocrinol.

Sec. Clinical Diabetes

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1650989

This article is part of the Research TopicCardiovascular Risks in Cardiovascular-Kidney-Metabolic Syndrome: Mechanisms and TherapiesView all articles

Associations between high cholesterol and insulin sensitivity in diabetic versus non-diabetic among young adults in Lephalale, Limpopo Province, South Africa

Provisionally accepted
Themba  Titus SiguduThemba Titus Sigudu1*Thandiwe  Ntombifuthi MkhatshwaThandiwe Ntombifuthi Mkhatshwa2Kotsedi  Daniel MonyekiKotsedi Daniel Monyeki2Moloko  MatshipiMoloko Matshipi2
  • 1University of the Witwatersrand, Johannesburg, South Africa
  • 2University of Limpopo, Mankweng, South Africa

The final, formatted version of the article will be published soon.

Background: The rising global burden of diabetes mellitus and associated metabolic disorders disproportionately affects low and middle-income countries, with dyslipidemia being a key contributor to cardiovascular risk in insulin-resistant individuals. Limited data exist on population-specific associations between cholesterol levels and insulin sensitivity among young adults in transitioning African communities. Methods: This cross-sectional study analyzed 781 young adults (18–29 years) from the Ellisras Longitudinal Study in Lephalale, South Africa. Participants were stratified by diabetic status using ADA criteria. Fasting blood samples assessed glucose, insulin (HOMA-IR), and lipid profiles. Multivariable linear regression evaluated cholesterol-HOMA-IR associations, adjusted for confounders. Results: Diabetics (n=169) showed significantly higher total cholesterol (5.1 vs. 4.3 mmol/L), LDL-C (3.2 vs. 2.6 mmol/L), triglycerides (1.8 vs. 1.1 mmol/L), and lower HDL-C (1.0 vs. 1.2 mmol/L) than non-diabetics (all p<0.001). Dyslipidemia prevalence was 2–3 times higher in diabetics (e.g., 52.7% vs. 23.2% for high total cholesterol). HOMA-IR correlated positively with total cholesterol (β=0.42, p<0.001), LDL-C (β=0.38, p<0.001), and triglycerides (β=0.47, p<0.001), and inversely with HDL-C (β=−0.51, p<0.001). Conclusion: Young diabetic adults in Lephalale exhibit pronounced dyslipidemia and insulin resistance, with strong lipid-HOMA-IR associations. Findings highlight the need for early metabolic screening and targeted interventions in transitioning African communities to mitigate future cardio metabolic risk.

Keywords: Dyslipidemia, Insulin Resistance, young adults, type 2 diabetes, South Africa

Received: 25 Jun 2025; Accepted: 03 Sep 2025.

Copyright: © 2025 Sigudu, Mkhatshwa, Monyeki and Matshipi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Themba Titus Sigudu, University of the Witwatersrand, Johannesburg, South Africa

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