Association between the triglyceride to high-density lipoprotein cholesterol ratio and the risk of type 2 diabetes mellitus among Chinese elderly: the Beijing Longitudinal Study of Aging

Zheng, Deqiang; Li, Haibin; Ai, Feiling; Sun, Fei; Singh, Manjot; Cao, Xue; Jiang, Jiajia; He, Yan; Tang, Zhe; Guo, Xiuhua

doi:10.1136/bmjdrc-2019-000811

Cited by 34 publications

(23 citation statements)

References 37 publications

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“…Some studies showed that baseline TG levels and changes of TG levels over time independently predicted arterial stiffness progression after adjusting for other cardiovascular risk factors [22][23][24][25], while others have not [26][27][28][29]. TG/HDL-C has been considered as an independent predictor of insulin resistance [30,31], diabetes mellitus [32], and CVD [33]. High-level TG/HDL-C ratio was also proved to be associated with higher arterial stiffness in cross-sectional studies [34][35][36], and the relationship might be non-linear [34].…”

Section: Discussionmentioning

confidence: 99%

Use of lipid parameters to identify apparently healthy men at high risk of arterial stiffness progression

Sang

Cao

et al. 2021

BMC Cardiovasc Disord

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Background Dyslipidemia contributes to the development and progression of arterial stiffness. We aimed to identify the most informative measures of serum lipids and their calculated ratios in terms of arterial stiffness progression risk. Methods Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and brachial-ankle pulse wave velocity (baPWV) of 659 healthy males (47.4 ± 10.7 years) were measured at baseline. Values for non-HDL-C, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, and non-HDL-C/HDL-C were calculated. BaPWV was re-performed after 4.1 years follow-up. Elevated baPWV was defined as baPWV ≥ 1400 cm/s. Results Over the follow-up period, the mean baPWV value increased from 1340 cm/s to 1410 cm/s, and 331 individuals increased/persisted with high baPWV (outcome 1). Among the 448 subjects who had normal baseline baPWV, 100 incident elevated baPWV occurred (outcome 2). Only baseline logTG (OR 1.64 [95% CI: 1.14–2.37] for outcome 1; 1.89 [1.14–3.17] for outcome 2) and logTG/HDL-C (1.54 [1.15–2.10] for outcome 1; 1.60 [1.05–2.45] for outcome 2) were significantly associated with arterial stiffness progression after adjusting for confounding factors. Adding logTG or logTG/HDL-C to age and blood pressure improved the accuracy of risk predictions for arterial stiffness progression. These associations remained significant when lipids were analyzed as categorical variables. Conclusions Baseline serum TG and TG/HDL-C were independently associated with increases in/persistently high baPWV and incident elevated baPWV, and they performed more effectively than other lipid variables in identifying healthy men at high risk of arterial stiffness progression.

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Section: Discussionmentioning

confidence: 99%

Use of lipid parameters to identify apparently healthy men at high risk of arterial stiffness progression

Sang

Cao

et al. 2021

BMC Cardiovasc Disord

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“…Moreover, recent ndings suggested that the combination of TG and HDL-C in the form of a ratio has better predictive value for mortality than individual cholesterol risk factors [54]. It is well established that TG/HDL-C ratio is positively associated with the risk of T2DM risk [44][45][46][47][48]. Elevated TG/HDL-C ratios is also associated with increased risk of CAD in patients with T2DM independent of the baseline LDL-C levels [49].…”

Section: Discussionmentioning

confidence: 99%

Triglyceride to high-density lipoprotein cholesterol ratio predicts all-cause and cardiovascular mortality in diabetic patients with coronary artery disease on statin treatment

Wang

Cong

Zhang

et al. 2021

Preprint

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Background The triglyceride (TG)to high-density lipoprotein cholesterol (HDL-C) ratio has been regarded as an independent predictor of cardiovascular events. However, the association of TG/HDL-C ratio with survival in patients with diabetes and coronary artery disease (CAD) on statin therapy remains uncertain. The aim of the present study was to explore whether TG/HDL-C ratio predicts mortality in diabetic patients with CAD on statin treatment.Methods A total of 2080 consecutive patients with type 2 diabetes and angiographic-proven CAD who were treated with statin were enrolled in the presents study. Patients were divided into tertiles according to baseline TG/HDL-C ratio. The primary endpoints were all-cause and cardiovascular mortality.Results During 4-year follow-up, 209(10.0%) patients died, 136(65.1%) caused by cardiovascular disease (CVD). The Kaplan-Meier analyses showed that all-cause and cardiovascular mortality increased gradually with rising TG/HDL-C ratio tertiles (log-rank test, P < 0.001, respectively). Multivariate cox hazard regression analysis revealed that patients in tertile 3 but not teretile 2 had significantly higher rate of all-cause and cardiovascular mortality (P < 0.001, P < 0.05, respectively). Moreover, TG/HDL-C ratio was independently associated with all-cause mortality (HR: 1.21, 95% CI:1.11–1.31; P < 0.001) and cardiovascular mortality (HR:1.28, 95% CI: 1.19–1.37; P < 0.001). For all-cause mortality, TG/HDL-C ratio significantly improved the C-statistic (0.799[0.766–0.833] to 0.813[0.780–0.845]; P = 0.018), net reclassification index (NRI) (0.315; P < 0.001), and integrated discrimination index (IDI) (0.012; P = 0.003). For cardiovascular mortality, TG/HDL-C ratio significantly improved the C-statistic (0.769[0.727–0.812] to 0.810[0.771–0.849]; P = 0.001), NRI (0.442; P < 0.001), and IDI (0.039; P < 0.001).Conclusions TG/HDL-C ratio may predict mortality risk among diabetic CAD patients receiving statin treatment. These findings suggest that assessing TG/HDL-C ratio may be useful for risk stratification for mortality risk in patients with diabetes and CAD.

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“…Some studies showed that baseline TG levels and changes of TG levels over time independently predicted arterial stiffness progression after adjusting for other cardiovascular risk factors [18][19][20][21], while others have not [22][23][24][25]. TG/HDL-C has been considered as an independent predictor of insulin resistance [26,27], diabetes mellitus [28], and CVD [29]. High-level TG/HDL-C ratio was also proved to be associated with higher arterial stiffness in cross-sectional studies [30][31][32], and the relationship might be non-linear [30].…”

Section: Discussionmentioning

confidence: 99%

Use of Lipid Parameters to Identify Healthy Men at a Higher Risk of Arterial Stiffness Progression

Sang¹,

Cao²,

Wu³

et al. 2020

Preprint

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Background: Dyslipidemia contributes to the development and progression of arterial stiffness. We aimed to confirm the superiority of the serum lipids and their calculated ratios in predicting arterial stiffness progression.Methods: Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and brachial-ankle pulse wave velocity (baPWV) of 612 healthy males (47.0 ± 10.5 years) were measured at baseline. Values for non-HDL-C, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, and non-HDL-C/HDL-C were calculated. BaPWV was re-performed after 4.1 years follow-up. A baPWV cutoff of 1400 cm/s was used to diagnose arterial stiffness.Results: Over the follow-up period, the mean baPWV value increased from 1330 cm/s to 1400 cm/s, and 309 individuals increased/persisted with high baPWV (outcome 1). Among the 430 subjects who were free of arterial stiffness at baseline, 90 arterial stiffness events occurred (outcome 2). Only logTG (OR 1.65 [95% CI: 1.14-2.40] for outcome 1; 2.08 [1.24-3.52] for outcome 2) and logTG/HDL-C (1.56 [1.15-2.13] for outcome 1; 1.69 [1.10-2.62] for outcome 2) were significantly associated with arterial stiffness progression after adjusting for confounding factors. Adding logTG or logTG/HDL-C to age and blood pressure improved the accuracy of risk predictions for arterial stiffness progression. These associations remained significant when lipids were analyzed as categorical variables.Conclusions: Baseline serum TG and TG/HDL-C were independently associated with increases in/persistently high baPWV and incident arterial stiffness, and they performed more effectively than other lipid variables in identifying healthy men at a higher risk of arterial stiffness progression.

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Association between the triglyceride to high-density lipoprotein cholesterol ratio and the risk of type 2 diabetes mellitus among Chinese elderly: the Beijing Longitudinal Study of Aging

Cited by 34 publications

References 37 publications

Use of lipid parameters to identify apparently healthy men at high risk of arterial stiffness progression

Use of lipid parameters to identify apparently healthy men at high risk of arterial stiffness progression

Triglyceride to high-density lipoprotein cholesterol ratio predicts all-cause and cardiovascular mortality in diabetic patients with coronary artery disease on statin treatment

Use of Lipid Parameters to Identify Healthy Men at a Higher Risk of Arterial Stiffness Progression

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