OBJECTIVE

Although many studies have reported that elevated serum triglycerides to high-density lipoprotein cholesterol (TG-HDL) ratios constitute a risk for insulin resistance and increased arterial stiffness, no study has clarified as yet the association, in terms of the TG-HDL ratio, between diabetes and increased arterial stiffness evaluated by means of carotid intima-media thickness (CIMT) and cardio-ankle vascular index (CAVI). To investigate this association, we conducted a cross-sectional study of 1344 Japanese men aged 36-79 years undergoing a general health check.

METHODS

We investigated the associations between atherosclerosis/arterial stiffness, evaluated by means of CIMT and CAVI, and diabetes for all subjects, who were divided into tertiles according to TG-HDL levels. Diabetes was defined as HbA1c (NGSP) ≥6.5%, and/or initiation of glucose-lowering medication or insulin therapy.

RESULTS

Of the 130 diabetes patients identified in the cohort, 56 patients had high TG-HDL (high TG-HDL diabetes) and 43 had low TG-HDL (low TG-HDL diabetes). We found that only diabetic patients with high TG-HDL were at a significant risk for atherosclerosis (diagnosed as CIMT ≥ 1.1 mm) and increased arterial stiffness (diagnosed as CAVI ≥ 8.0). The multivariable-adjusted odds ratios and 95% confidence intervals of atherosclerosis and increased arterial stiffness for diabetes were 2.67 (95%CI: 1.35-5.28) and 2.36 (95%CI: 1.01-5.50), for total TG-HDL diabetes 2.57 (95%CI: 1.32-5.02) and 3.56 (95%CI: 1.50-8.46) for high TG-HDL diabetes, and 1.17 (95%CI: 0.52-2.63) and 0.80 (95%CI: 0.33-1.90) for low TG-HDL diabetes, respectively.

CONCLUSION

Diabetes, especially high TG-HDL diabetes, constitutes a significant risk for increased arterial stiffness and atherosclerosis.