Association of Triglyceride to high-density lipoprotein cholesterol ratio and incident of diabetes mellitus: a secondary retrospective analysis based on a Chinese cohort study

Abstract

Background: Previous studies have revealed that triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) is one of major risk factors of insulin resistance and diabetes. However, study on the association between TG/ HDL-C and diabetes mellitus (DM) risk is limited, especially in Chinese people. This study was undertaken to investigate the relationship between TG/HDL-C and incident of diabetes in a large cohort in Chinese population. Methods: The present study was a retrospective cohort study. A total of 114,787 adults from Rich Healthcare Group in China, which includes all medical records for participants who received a health check from 2010 to 2016. The target independent variable and the dependent variable were triglyceride to high-density lipoprotein cholesterol ratio measured at baseline and incident of diabetes mellitus appeared during follow-up respectively. Covariates involved in this study included age, gender, body mass index, diastolic blood pressure, systolic blood pressure, fasting plasma glucose, total cholesterol, low density lipoprotein cholesterol, serum creatinine, smoking and drinking status and family history of diabetes. Cox proportional-hazards regression was used to investigate the association of TG/HDL-C and diabetes. Generalized additive models was used to identify non-linear relationships. Additionally, we also performed a subgroup analysis. It was stated that the data had been uploaded to the DATADRYAD website.(Continued on next page) Result: After adjusting age, gender, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol, serum creatinine, smoking and drinking status and family history of diabetes, result showed TG/HDL-C was positively associated with incident of diabetes mellitus (HR = 1.159, 95%CI (1.104, 1.215)). A non-linear relationship was detected between TG/HDL-C and incident of diabetes, which had an inflection point of TG/HDL-C was 1.186. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 1.718(1.433,2.060) and 1.049(0.981,1.120), respectively. Subgroup analysis showed, the stronger association can be found in the population with fasting plasma glucose (FPG) < 6.1 mmol/L (P for interaction< 0.0001; HR = 1.296 with FPG < 6.1 mmol/L vs HR = 1.051 with FPG ≥ 6.1 mmol/L).The same trend was also seen in the population with body mass index (BMI)(≥18.5, < 24 kg/m 2 ) (P for interaction = 0.010,HR = 1.324) and family history without diabetes(P for interaction = 0.025, HR = 1.170).Conclusion: TG/HDL-C is positively associated with diabetes risk. The relationship between TG/HDL-C and incident of diabetes is also non-linear. TG/HDL-C was strong positively related to incident of diabetes when TG/HDL-C is less than 1.186.

Association ofTG/HDLCratio trajectory and risk of type 2 diabetes: A retrospective cohort study inChina

“…Previous cross‐sectional studies and cohort studies found a significant association between TG/HDL‐C ratio and T2DM in Chinese people, 18,38‐41 based on a single measurement but not dynamic change of TG/HDL‐C ratio. We first estimated significant associations between the trajectories of TG/HDL‐C ratio and T2DM and found that the increasing, U‐shape, bell‐shape, and other shape trajectories were associated with increased probability of T2DM as compared with the decreasing group after adjusting for baseline age, sex, smoking, drinking, medication use, BMI, RHR, SBP, DBP, and levels of FPG, TC, BUN, CR, and UA and follow‐up time.…”

Systemic immune-inflammation index independently predicts poor survival of older adults with hip fracture: a prospective cohort study

“…All data received a double check before the analysis, and missing data were identified, including serum albumin ( n = 7, 2.4%), time to surgery ( n = 5, 1.7%). While the missing data were continuous variables, and the percentages were low, they were supplemented with simple imputations using the median nonmissing value, as described elsewhere [ 31 ]. Continous data were expressed as means (standard deviation, SD) or median (interquartile range, IQR) according to the distribution, and examined by independent Student’s t -test for normally distributed variables, and Wilcoxon rank-sum test for non-normally distributed variables.…”

Serum 25-hydroxyvitamin D levels in relation to lipids and clinical outcomes in pregnant women with gestational diabetes mellitus: an observational cohort study

“… 21 The TG/HDL-c ratio may be a good marker to identify insulin-resistant Chinese individuals 4 and is positively associated with diabetes risk. 22 23 Our finding about TG/HDL-c ratios implied that it may be possible to decrease the TG/HDL-c ratio by increasing the concentration of 25(OH)D, which would be helpful for improving insulin resistance. In healthy normal pregnancies, we have previously observed that inadequate 25(OH)D concentrations during early pregnancy are associated with more pronounced changes of TC, LDL-c concentrations and TC/HDL-c ratios throughout pregnancy.…”