Triglyceride/HDL ratio and its impact on the risk of diabetes mellitus development during ART

Squillace, Nicola; Lorenzini, Patrizia; Lapadula, Giuseppe; Bandera, Alessandra; Cozzi‐Lepri, Alessandro; Rusconi, Stefano; Puoti, Massimo; Castagna, Antonella; Antinori, Andrea; Gori, Andrea; Monforte, Antonella d’Arminio

doi:10.1093/jac/dkw185

Cited by 12 publications

(8 citation statements)

References 33 publications

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“…Squillace et al . 21 showed that high TG/HDL ratio increased the risk of NOD, independently of other traditional risk factors, supporting the results of the present study.…”

Section: Discussionsupporting

confidence: 92%

Lipid levels and new-onset diabetes in a hypertensive population: the China Stroke Primary Prevention Trial

Yang

et al. 2017

Sci Rep

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This study aimed to provide insights into the relationship between lipid levels and new-onset diabetes (NOD) in 14,864 Chinese hypertensive patients without diabetes (6056 men and 8808 women) aged 45–75 years from the China Stroke Primary Prevention Trial (CSPPT, led by Nanfang Hospital, Guangzhou, China). NOD (defined as fasting plasma glucose (FPG) ≥ 7.0 mmol/L at the end of study or self-reported physician diagnosis of diabetes or self-reported use of hypoglycemic agents during follow-up) was analyzed using multivariate analysis. Follow-up was censored on August 24, 2014. Among the 14,864 subjects, 1615 developed NOD (10.9%, men = 10.8% and women = 10.9%). Increased triglycerides (TG) [odds ratio (OR) = 1.18; 95% confidence interval (CI): 1.13–1.25, P < 0.001], TG/HDL (OR = 1.12; 95%CI: 1.08–1.17, P < 0.001), and decreased high density lipoprotein (HDL) (OR = 0.79; 95%CI: 0.67–0.93, P = 0.005) were associated with NOD, independently from age, gender, body mass index, clinical center, systolic blood pressure, diastolic blood pressure, FPG, smoking, and drinking. Compared to subjects with the methylenetetrahydrofolate reductase (MTHFR) 677 CC and TT genotypes, those with the CT genotype had a higher risk of NOD (OR = 1.54; 95%CI: 1.30–1.81, P for interaction = 0.044) in subjects with high TG. These results suggested that TG and TG/HDL were independent risk factors for NOD in this Chinese hypertensive population. HDL was a protective factor for NOD.

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“…Squillace et al . 21 showed that high TG/HDL ratio increased the risk of NOD, independently of other traditional risk factors, supporting the results of the present study.…”

Section: Discussionsupporting

confidence: 92%

Lipid levels and new-onset diabetes in a hypertensive population: the China Stroke Primary Prevention Trial

Yang

et al. 2017

Sci Rep

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“…Furthermore, using a retrospective study design, Squilace et al . 40 showed among PLH that an elevated TG/HDL-C ratio (>third quartile or 4.5) was an independent predictor of T2DM onset. The TG/HDL-C ratio could be used not only as indicator of a pro-atherogenic lipid profile, but also as a simple biomarker of insulin resistance.…”

Section: Discussionmentioning

confidence: 97%

Incidence and associated factors of type 2 diabetes mellitus onset in the Brazilian HIV/AIDS cohort study

Cassenote

Grangeiro

Escuder³

et al. 2021

The Brazilian Journal of Infectious Diseases

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“…We used TG:HDL‐C ratio and plasma ALT as surrogate markers of insulin resistance, as both predict type 2 diabetes in non‐HIV populations [29–32]. Also among PLWH, a high TG:HDL‐C ratio predicted new‐onset DM independently of traditional risk factors [14], and elevated ALT has been associated with a higher risk of diabetes [33]. In addition, the adjusted prevalence of IFG among PLWH (20.0%) was double that in the general population (9.8%) in our study, again implying a higher degree of insulin resistance.…”

Section: Discussionmentioning

confidence: 99%

“…We used fasting plasma triglycerides‐to‐HDL cholesterol ratio (TG:HDL‐C) and ALT as surrogate markers for insulin resistance. The conventional cut‐off values indicating insulin resistance with TG:HDL‐C ratio (mg/dL) are ≥ 3.75 for men and ≥ 3.0 for women [14,15]. As uncontrolled HIV infection increases TG and decreases HDL‐C concentrations, we performed a sensitivity analysis limited to subjects with viral load < 50 HIV RNA copies/mL.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of obesity and disturbances in glucose homeostasis in HIV‐infected subjects and general population – missed diagnoses of diabetes?

et al. 2020

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Objectives Comparative data on glucose disorders using fasting blood samples between people living with HIV (PLWH) and the general population are lacking. The objective of this study was to compare the prevalence and risk factors of obesity and disturbances in glucose homeostasis between PLWH treated with modern antiretroviral therapy and the general population. Methods Adjusted prevalence of obesity, features of insulin resistance (triglyceride:high‐density lipoprotein cholesterol ratio and alanine aminotransferase), impaired fasting glucose (IFG), diabetes mellitus (DM) and combined dysglycaemia (presence of IFG or DM) were determined using fasting blood samples among 1041 PLWH and 7047 subjects representing the general population. Results People living with HIV had a lower prevalence of obesity [18.2%, 95% confidence interval (CI): 15.1–21.2 vs. 23.9%, 95% CI: 22.4–25.4], but a higher prevalence of insulin resistance and IFG (20.0%, 95% CI: 16.6–23.4 vs. 9.8%, 95% CI: 8.7–10.8) than the general population. Fasting glucose concentration was higher, but glycated haemoglobin (HbA1c) was lower, among PLWH. Prevalence of dysglycaemia for a given body mass index (BMI) was higher in PLWH than in the general population. The prevalence of DM did not differ between PLWH (13.2%, 95% CI: 10.2–15.9) and the general population (14.5%, 95% CI: 13.6–15.4). Conclusions The prevalence of obesity was lower, but the risk of dysglycaemia for a given BMI was significantly higher, among PLWH, highlighting the importance of prevention and treatment of obesity among HIV‐infected subjects. Regardless of the increased prevalence of insulin resistance and IFG, DM was surprisingly not more common among PLWH, raising concern about the under‐diagnosis of DM, possibly due to low sensitivity of HbA1c in this patient population.

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Triglyceride/HDL ratio and its impact on the risk of diabetes mellitus development during ART

Abstract: High TRG/HDL ratio predicted risk of new-onset DM, independently of other traditional risk factors. Furthermore, our findings suggest that advanced hepatic fibrosis, estimated using the fibrosis-4 score, could provide an additional predictor for DM.

Cited by 12 publications

References 33 publications

Lipid levels and new-onset diabetes in a hypertensive population: the China Stroke Primary Prevention Trial

Lipid levels and new-onset diabetes in a hypertensive population: the China Stroke Primary Prevention Trial

Incidence and associated factors of type 2 diabetes mellitus onset in the Brazilian HIV/AIDS cohort study

Prevalence of obesity and disturbances in glucose homeostasis in HIV‐infected subjects and general population – missed diagnoses of diabetes?

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