Correlation between the triglyceride-to-high-density lipoprotein cholesterol ratio and other unconventional lipid parameters with the risk of prediabetes and Type 2 diabetes in patients with coronary heart disease: a RCSCD-TCM study in China

Abstract

Objective Type 2 diabetes mellitus (T2DM) is often accompanied by undiagnosed dyslipidemia. Research on the association of unconventional lipid markers with prediabetes (pre-DM) and T2DM simultaneously is limited in coronary heart disease (CHD) patients. Methods This study included 28,476 patients diagnosed with CHD. Their lipid levels, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured, and non-traditional lipid parameters were calculated. The patients were divided into three groups based on the diabetic status including normoglycemic (NG), pre-DM, and T2DM. Multiple logistic regression was used to compare the association of TG/HDL-C and other non-traditional lipid parameters with pre-DM and T2DM. The tertiles of TG/HDL-C included T1 (TG/HDL-C < 1.10), T2 (1.10 ≤ TG/HDL-C ≤ 1.89) and T3 (TG/HDL-C > 1.89). Low and high TG/HDL-C was defined with sex-specific cutoff points. Results Multiple logistic regression results showed that the non-traditional lipid parameters, including non-HDL-C, LDL-C/HDL-C, TC/HDL-C, non-HDL-C/HDL-C and TG/HDL-C, were all correlated with the risk of pre-DM and T2DM. Meanwhile TG/HDL-C showed the strongest correlation (odds ratio [OR]: 1.19; 95% confidence interval [CI] 1.16–1.23), (OR: 1.36; 95% CI 1.33–1.39). When dividing TG/HDL-C into tertiles, using T1 as a reference, T3 was observed to have the highest association with both pre-DM and T2DM (OR: 1.60; 95% CI 1.48–1.74), (OR: 2.79; 95% CI 2.60–3.00). High TG/HDL-C was significantly associated with pre-DM and T2DM (OR: 1.69; 95% CI 1.52–1.88), (OR: 2.85; 95% CI 2.60–3.12). The association of TG/HDL-C with T2DM and pre-DM existed across different sex, age, smoking, and drinking statuses. Conclusion Elevated non-traditional lipid parameters were significantly associated with pre-DM and T2DM in CHD patients, especially TG/HDL-C. High TG/HDL-C was the risk factor with a strong correlation with the risk of pre-DM and T2DM.

Association of four lipid-derived indicators with the risk of developing type 2 diabetes: a Chinese population-based cohort study

“…However, the efficacy of TG/HDL for predicting T2D risk was lower compared to TyG. These results are consistent with the study of Yang et al [ 14 ] on Chinese patients with coronary heart disease and the study of Liu et al [ 15 ] on the elderly Chinese population.…”

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

“…Compared the traditional lipid parameters including TG, TC, HDL-C, LDL-C, non-traditional lipid parameters like TG/HDL-C, LDL-C/HDL-C, non-HDL-C, TC/HDL-C and non-HDL-C/HDL-C are closely related to the occurrence of pre-DM. Especially TG/HDL-C, which has been recognized as a biomarker of insulin resistance that may accelerate the development of prediabetes, is more effective than single lipids measures [ 11 ]. Similar results were observed in individuals with normal BMI and LDL-c in this present study.…”

“…The following reasons may explain the relationship of TG/HDL-C ratio with pre-DM. A higher concentration of TGs leads to the development of pre-DM mainly via FFAs [ 11 ]. Elevated TG results in increased free fatty acids (FFAs), leading to the production of toxic lipids, which lead to change in pancreatic α-cell insulin signaling and glucagon hypersecretion [ 19 , 20 ].…”

“…In addition, traditional lipid parameters including TG, HDL-C, LDL-C and TC, previous study showed the high level of LDL-C influenced the onset of Pre-DM [ 8 ]. However, participants with elevated TG levels and lower HDL-C levels also promoted the onset of prediabetes [ 8 , 11 ]. A study of TG/HDL-C ratio and Pre-DM in non-obese Chinese with a normal range of low-density lipoprotein cholesterol is limited.…”

Cardioprotective and Hepatoprotective Effects of Ixora pavetta and Tecoma capensis Leaf Extracts

“…In addition HDL counteracts the LDL oxidation thereby inhibiting the atherogenic effect by reversing the cholesterol pathway. 36 Moreover, HDL impedes the LDL oxidation by transition metal ions, and also stops formation of 12-lipooxygenase-mediated lipid hydroperoxides. 37 The obtained results may confirm the antiatherogenic activity of the T. capensis and I. pavetta.…”