Non‐high‐density lipoprotein cholesterol:  High‐density lipoprotein cholesterol ratio is an independent risk factor for diabetes mellitus: Results from a population‐based cohort study

Zhang, Nan; Hu, Xiang; Zhang, Qiao; Bai, Peng; Cai, Miao; Zeng, Tian; Zhang, Jiaoyue; Tian, Shenghua; Min, Jie; Huang, Hantao; Zheng, Juan; Peng, Miaomiao; Li, Meng‐Jia; Chen, Lulu

doi:10.1111/1753-0407.12650

Cited by 64 publications

(57 citation statements)

References 12 publications

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“…For further research, we were excluded missing values of baseline TG (n = 5747) and HDL-C (n = 89,231) from the analysis cohort. And then TG/HDL-C was calculated as TG divided by HDL-C, we excluded outliers of TG/ HDL-C(<means minus three standard deviation (SD) or > means plus three SD) (n = 2068) [13]. The final analysis included 114,787 subjects (61,097 male and 53,690 female) for data analysis in our study.…”

Section: Data Source and Participantsmentioning

confidence: 99%

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

Chen

et al. 2020

Lipids Health Dis

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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.

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Section: Data Source and Participantsmentioning

confidence: 99%

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

Chen

et al. 2020

Lipids Health Dis

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“…besides being a substitute of IR, is associated with susceptibility of β-cells to glucotoxicity and lipotoxicity. Evidence suggested that elevated glucose levels can induced reactive oxygen species generation on islet β-cells, which in turn cause oxidative stress and β-cells dysfunction, and then lead to IR and T2DM [33][34][35]. Other studies revealed that long-term high free fatty acid content was related to prolonged exposure of TG in pancreatic islets, which may impair pancreatic β-cell function [36][37][38].…”

Section: Discussionmentioning

confidence: 99%

Association Between Triglyceride-Glucose Index and Risk of Incident Diabetes: A Secondary Analysis Based on A Chinese Cohort Study

Tien

et al. 2020

Preprint

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Background: Recent studies have suggested the triglyceride-glucose index (TyG index) may serve as a suitable substitute for insulin resistance. However, evidence for the relationship between TyG index and risk of diabetes remains limited. This study sought to explore the association of baseline TyG index with risk of developing diabetes in Chinese adults.Methods: This retrospective cohort study was conducted using data from the health screening program in China. A total of 201,298 non-diabetic individuals were included. TyG index was calculated as Ln [fasting plasma glucose (mg/dl) × fasting triglyceride level (mg/dl)/2]. Diabetes was defined as fasting plasma glucose ≥7.0 mmol/L and/or self-reported diabetes. Cox proportion-hazard model was employed to evaluate the independent impact of baseline TyG index on future diabetes risk. Sensitivity and subgroup analyses were implemented to verify the reliability of results. Notably, data were downloaded from the DATADRYAD website, and used only for secondary analyses.Results: During an average follow-up of 3.12 years, among 201,298 individuals aged ≥20 years, 3,389 subjects developed diabetes. After adjusting for potential confounders, elevated TyG index were independently correlated with greater risk of incident diabetes (hazard ratio (HR), 3.34; 95% confidence interval (CI), 3.11–3.60). Compared with the lowest quartile (Q1), increasing TyG index (Q2, Q3, and Q4) was related to increased HR estimates of incident diabetes [HR (95% CI), 1.83 (1.49–2.26); 3.29 ( 2.70–4.01), and 6.26 (5.15–7.6), respectively]. Moreover, a nonlinear relationship was observed between TyG index and risk of diabetes and the slope of the curve increased accompanying the rise of TyG index. Subgroup analysis revealed the positive association was stronger among subjects with age< 40 years, body mass index ≥18.5 kg/m2 and < 24 kg/m2, or systolic blood pressure <140 mmHg, or in females.Conclusions: Elevated TyG index is independently correlated with increased risk of incident diabetes in Chinese adults, indicating it may represent a reliable predictor of diabetes in high-risk populations.

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“…The exploration of subgroup analysis and interaction was crucial for clinical research, which could better understand the true relationship between independent variables and dependent variables [20].…”

Section: Discussionmentioning

confidence: 99%

“…According to the recommendation of the STROBE statement[20], besides the unadjusted model, the results for mildly adjusted model (model 1) and fully adjusted model (model 2) were presented: model 1, adjusting for gender, age and BMI; model 2, additionally adjusted for SBP, DBP,…”

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confidence: 99%

Association of Triglyceride-glucose Index and the Risk of Incident Diabetes: a Secondary Analysis Based on a Chinese Cohort Study

Tien

et al. 2020

Preprint

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BackgroundTriglyceride-glucose index (TyG index) has been regarded as a reliable alternative marker of insulin resistance. However, study on the relationship between TyG index and incident diabetes remains limited. This study aimed to investigate the association between TyG index and incident diabetes in a large cohort of Chinese population.MethodsThe present study was a retrospective cohort study using healthy screening programme data in China. A total of 201,298 subjects free of baseline diabetes were included who received a health check with all medical records from 2010 to 2016. TyG index was calculated as Ln[fasting triglyceride level (mg/dl) x fasting plasma glucose (mg/dl)/2]. Diagnosis of diabetes was based on fasting plasma glucose ≥ 7.00 mmol/L and/or self-reported diabetes. Cox proportion-hazard model was used to assess the relationship between TyG index at baseline and the risk of incident diabetes. It should be noted that the data was uploaded to the DATADRYAD website, and we only used this data for secondary analysis.ResultsDuring a mean follow-up of 3.12 years of 201,298 individuals aged ≥ 20 years old, 3389 subjects developed diabetes. After adjusting for age, sex, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, low density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, serum creatinine, smoking, drinking and family history of diabetes, multivariate cox hazards regression analysis indicated that TyG index was positive correlation with the risk of developing diabetes in Chinese population (HR, 3.34; 95% CI, 3.11 to 3.60). The risk of incident diabetes increased with increasing TyG index. Subjects with TyG index in the fourth quartile were 6.26 times more likely to develop diabetes than the lowest quartile (P trend < 0.001). Subgroup analysis showed the stronger association was observed in the population with age < 40, BMI (≥ 18.5, < 24 kg/m2), SBP < 140 mmHg or females (all P for interaction < 0.0001).Conclusions TyG index was independently correlated with the increased risk of diabetes in Chinese adults, suggesting that TyG index may be a useful marker for identifying individuals at high risk of developing diabetes.

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Non‐high‐density lipoprotein cholesterol: High‐density lipoprotein cholesterol ratio is an independent risk factor for diabetes mellitus: Results from a population‐based cohort study

Abstract: The non-HDL-C: HDL-C ratio was found to be an independent risk factor for diabetes.

Cited by 64 publications

References 12 publications

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

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

Association Between Triglyceride-Glucose Index and Risk of Incident Diabetes: A Secondary Analysis Based on A Chinese Cohort Study

Association of Triglyceride-glucose Index and the Risk of Incident Diabetes: a Secondary Analysis Based on a Chinese Cohort Study

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