Association between triglyceride-to-high-density lipoprotein cholesterol ratio and prediabetes: a cross-sectional study in Chinese non-obese people with a normal range of low-density lipoprotein cholesterol

Wu, Li‐Ling; Wu, Xiaodan; Hu, Haofei; Wan, Qijun

doi:10.1186/s12967-022-03684-1

Cited by 10 publications

(5 citation statements)

References 38 publications

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“…Recent studies have shown a nonlinear correlation between TG/HDL-C ratios and the risk of CKD in American adults, pinpointing the curve’s inflection point at a TG/HDL-C ratio of 6.68 ( 39 ). Furthermore, our literature review indicates that this ratio also exhibits a nonlinear relationship with the risk of other conditions, such as in-hospital mortality from acute type B aortic dissection, arterial stiffness, the incidence of type 2 diabetes, and the onset of pre-diabetes ( 40 – 43 ). These studies consistently reveal that as TG/HDL-C ratios increase, the risk of disease rises but then plateaus after exceeding a certain threshold, suggesting a saturation effect.…”

Section: Discussionmentioning

confidence: 96%

Defining the threshold: triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio’s non-linear impact on tubular atrophy in primary membranous nephropathy

Guan,

Wu,

Cheng

et al. 2024

Front. Endocrinol.

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BackgroundHyperlipidemia is common in primary membranous nephropathy (PMN) patients, and tubular atrophy (TA) is an unfavorable prognostic factor. However, the correlation between the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and TA is controversial. Therefore, our study aimed to investigate the association between the TG/HDL-C ratio and TA in PMN patients.MethodsWe conducted a cross-sectional study and collected data from 363 PMN patients at Shenzhen Second People’s Hospital from January 2008 to April 2023. The primary objective was to evaluate the independent correlation between the TG/HDL-C ratio and TA using binary logistic regression model. We used a generalized additive model along with smooth curve fitting and multiple sensitivity analyses to explore the relationship between these variables. Additionally, subgroup analyses were conducted to delve deeper into the results.ResultsOf the 363 PMN patients, 75 had TA (20.66%). The study population had a mean age of 46.598 ± 14.462 years, with 217 (59.78%) being male. After adjusting for sex, age, BMI, hypertension, history of diabetes, smoking, alcohol consumption, UPRO, eGFR, HB, FPG, and ALB, we found that the TG/HDL-C ratio was an independent risk factor for TA in PMN patients (OR=1.29, 95% CI: 1.04, 1.61, P=0.0213). A non-linear correlation was observed between the TG/HDL-C ratio and TA, with an inflection point at 4.25. The odds ratios (OR) on the left and right sides of this inflection point were 1.56 (95% CI: 1.17, 2.07) and 0.25 (95% CI: 0.04, 1.54), respectively. Sensitivity analysis confirmed these results. Subgroup analysis showed a consistent association between the TG/HDL-C ratio and TA, implying that factors such as gender, BMI, age, UPRO, ALB, hypertension and severe nephrotic syndrome had negligible effects on the link between the TG/HDL-C ratio and TA.ConclusionOur study demonstrates a non-linear positive correlation between the TG/HDL-C ratio and the risk of TA in PMN patients, independent of other factors. Specifically, the association is more pronounced when the ratio falls below 4.25. Based on our findings, it would be advisable to decrease the TG/HDL-C ratio below the inflection point in PMN patients as part of treatment strategies.

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Section: Discussionmentioning

confidence: 96%

Defining the threshold: triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio’s non-linear impact on tubular atrophy in primary membranous nephropathy

Guan,

Wu,

Cheng

et al. 2024

Front. Endocrinol.

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“…Furthermore, HDL-C levels in prediabetic subjects were negatively connected to the likelihood of developing diabetes 17 , 18 . Moreover, lower HDL-C levels have been linked to a substantial risk factor for Pre-DM 35 , 36 . Consequently, we postulate that a decline in HDL-C levels might be linked to an augmented probability of transitioning from prediabetes to normoglycemia.…”

Section: Discussionmentioning

confidence: 99%

Association between high-density lipoprotein cholesterol and reversion to normoglycemia from prediabetes: an analysis based on data from a retrospective cohort study

Mo,

Hu,

Han

et al. 2024

Sci Rep

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The available evidence on the connection between high-density lipoprotein cholesterol (HDL-C) levels and the reversion from prediabetes (Pre-DM) to normoglycemia is currently limited. The present research sought to examine the connection between HDL-C levels and the regression from Pre-DM to normoglycemia in a population of Chinese adults. This historical cohort study collected 15,420 Pre-DM patients in China who underwent health screening between 2010 and 2016. The present research used the Cox proportional hazards regression model to investigate the connection between HDL-C levels and reversion from Pre-DM to normoglycemia. The Cox proportional hazards regression model with cubic spline functions and smooth curve fitting was employed to ascertain the nonlinear association between HDL-C and reversion from Pre-DM to normoglycemia. Furthermore, a set of sensitivity analyses and subgroup analyses were employed. Following the adjustment of covariates, the findings revealed a positive connection between HDL-C levels and the likelihood of reversion from Pre-DM to normoglycemia (HR 1.898, 95% CI 1.758–2.048, P < 0.001). Furthermore, there was a non-linear relationship between HDL-C and the reversion from Pre-DM to normoglycemia in both genders, and the inflection point of HDL-C was 1.540 mmol/L in males and 1.620 mmol/L in females. We found a strong positive correlation between HDL-C and the reversion from Pre-DM to normoglycemia on the left of the inflection point (Male: HR 2.783, 95% CI 2.373–3.263; Female: HR 2.217, 95% CI 1.802–2.727). Our sensitivity analysis confirmed the robustness of these findings. Subgroup analyses indicated that patients with SBP < 140 mmHg and ever smoker exhibited a more pronounced correlation between HDL-C levels and the reversion from Pre-DM to normoglycemia. In contrast, a less robust correlation was observed among patients with SBP ≥ 140 mmHg, current and never smokers. This study provides evidence of a positive and nonlinear association between HDL-C levels and the reversion from Pre-DM to normoglycemia in Chinese patients. Implementing intensified intervention measures to control the HDL-C levels of patients with Pre-DM around the inflection point may substantially enhance the likelihood of regression to normoglycemia.

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“…Moreover, high blood glucose level is an early indicator of pre-diabetes to diabetes, when the patient is diagnosed with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) ( 32 ). Next, in PreDM patients, dyslipidemia has been caused by increased LDL-C level and decreased HDL-C levels ( 33 , 34 ). Aberrantly increased LDL-C as well as decreased HDL-C may lead to dysfunction of the islet β cells, and accelerated the procedure from PreDM to type 2 DM ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

Construction of a 3-year risk prediction model for developing diabetes in patients with pre-diabetes

Yang,

Liu,

et al. 2024

Front. Endocrinol.

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IntroductionTo analyze the influencing factors for progression from newly diagnosed prediabetes (PreDM) to diabetes within 3 years and establish a prediction model to assess the 3-year risk of developing diabetes in patients with PreDM.MethodsSubjects who were diagnosed with new-onset PreDM at the Physical Examination Center of the First Affiliated Hospital of Soochow University from October 1, 2015 to May 31, 2023 and completed the 3-year follow-up were selected as the study population. Data on gender, age, body mass index (BMI), waist circumference, etc. were collected. After 3 years of follow-up, subjects were divided into a diabetes group and a non-diabetes group. Baseline data between the two groups were compared. A prediction model based on logistic regression was established with nomogram drawn. The calibration was also depicted.ResultsComparison between diabetes group and non-diabetes group: Differences in 24 indicators including gender, age, history of hypertension, fatty liver, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, HbA1c, etc. were statistically significant between the two groups (P<0.05). Differences in smoking, creatinine and platelet count were not statistically significant between the two groups (P>0.05). Logistic regression analysis showed that ageing, elevated BMI, male gender, high fasting blood glucose, increased LDL-C, fatty liver, liver dysfunction were risk factors for progression from PreDM to diabetes within 3 years (P<0.05), while HDL-C was a protective factor (P<0.05). The derived formula was: In(p/1-p)=0.181×age (40-54 years old)/0.973×age (55-74 years old)/1.868×age (≥75 years old)-0.192×gender (male)+0.151×blood glucose-0.538×BMI (24-28)-0.538×BMI (≥28)-0.109×HDL-C+0.021×LDL-C+0.365×fatty liver (yes)+0.444×liver dysfunction (yes)-10.038. The AUC of the model for predicting progression from PreDM to diabetes within 3 years was 0.787, indicating good predictive ability of the model.ConclusionsThe risk prediction model for developing diabetes within 3 years in patients with PreDM constructed based on 8 influencing factors including age, BMI, gender, fasting blood glucose, LDL-C, HDL-C, fatty liver and liver dysfunction showed good discrimination and calibration.

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Association between triglyceride-to-high-density lipoprotein cholesterol ratio and prediabetes: a cross-sectional study in Chinese non-obese people with a normal range of low-density lipoprotein cholesterol

Cited by 10 publications

References 38 publications

Defining the threshold: triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio’s non-linear impact on tubular atrophy in primary membranous nephropathy

Defining the threshold: triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio’s non-linear impact on tubular atrophy in primary membranous nephropathy

Association between high-density lipoprotein cholesterol and reversion to normoglycemia from prediabetes: an analysis based on data from a retrospective cohort study

Construction of a 3-year risk prediction model for developing diabetes in patients with pre-diabetes

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