Objective To explore whether the HindIII polymorphism in the lipoprotein lipase (LPL) gene has a potential role in susceptibility to type 2 diabetes, and whether this relation is influenced by regulating LPL or other risk factors.

Research design and methods Overall, 654 Han Chinese adults were recruited from a community-based cross-sectional study. Genotyping was performed using the PCR-RFLP technique. Pre-heparin LPL (PrLPL) and other metabolic variables were measured using standard methods.

Results Individuals with the HindIII H–/H– genotype tended to have higher PrLPL and lower triglyceride (TG) levels but an unexpected higher prevalence of type 2 diabetes compared with carriers with the H+H+ genotype. The association between the H–/H– genotype and diabetes risk remained unchanged across all subgroups of diabetes-related risk factors and PrLPL. In an additive model, the H–/H– genotype conferred 178% increased risk [OR:2.78; 95% CI 1.04 to 7.47] for diabetes after controlling for age and sex. The strength of this association increased further after adjusting for other traditional risk factors, and for PrLPL (OR=4.06; 95% CI= 1.35 to 12.23). Furthermore, the H–/H– genotype was also associated with an increased risk of dysglycemia defined as insulin resistance plus diabetes.

Conclusions This study revealed that Chinese adults with the LPL gene HindIII H–/H– genotype had a significantly increased risk of type 2 diabetes compared with individuals with other genotypes, even if they had favourable lipid profiles.