Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea.
Diabetes Res Clin Pract. 2020 May;163:108150. doi: 10.1016/j.diabres.2020.108150. Epub 2020 Apr 17.
Serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio is known to be associated with cardiometabolic diseases. This study is aimed to evaluate the association between the TG/HDL-C ratio and incident type 2 diabetes with a large-sample, community-based Korean cohort over 12 years.
Among 10,038 participants, a total of 8655 participants aged 40 to 69 years without diabetes were selected from the Korean Genome and Epidemiology Study (KoGES). The baseline TG/HDL-C ratio was divided into quartiles. Newly developed type 2 diabetes was defined by any of the following: a fasting plasma glucose level ≥ 126 mg/dL; a glucose level ≥ 200 mg/dL 2-hours after a 75 g oral glucose tolerance test; an HbA1c ≥ 6.5%; or treatment with anti-diabetic therapy. The hazard ratios (HRs) with 95% confidence intervals (CIs) for incident type 2 diabetes were calculated using multivariate Cox proportional hazards regression models after adjusting for potentially confounding variables.
During the 12-year follow-up period, type 2 diabetes developed in 1437 subjects (16.6%, 1437/8655), with incidence rate of 2.8-5.0 (over 2 years). Compared to the reference first quartile, the HRs (95% CIs) of incident type 2 diabetes in the second, third, and fourth quartiles increased in a dose-response manner after adjusting for potentially confounding variables.
High TG/HDL-C ratio at baseline may be a useful surrogate indicator of future incident type 2 diabetes.
血清甘油三酯与高密度脂蛋白胆固醇（TG/HDL-C）比值与心血管代谢疾病有关。本研究旨在评估在一个大规模、以社区为基础的韩国队列中，该比值与 12 年以上新发 2 型糖尿病之间的关联。
在 10038 名参与者中，从韩国基因组与流行病学研究（KoGES）中选择了年龄在 40 至 69 岁、无糖尿病的 8655 名参与者。将基线 TG/HDL-C 比值分为四组。新诊断的 2 型糖尿病定义为以下任何一种情况：空腹血糖水平≥126mg/dL；口服 75g 葡萄糖耐量试验后 2 小时血糖水平≥200mg/dL；HbA1c≥6.5%；或接受抗糖尿病治疗。在校正潜在混杂变量后，使用多变量 Cox 比例风险回归模型计算发生 2 型糖尿病的风险比（HR）及其 95%置信区间（CI）。
在 12 年的随访期间，1437 名（16.6%，1437/8655）受试者发生 2 型糖尿病，发病率为 2.8-5.0（每 2 年）。与参考第一四分位数相比，在校正潜在混杂变量后，第二、三、四分位数发生 2 型糖尿病的 HR（95%CI）呈剂量反应关系。
基线高 TG/HDL-C 比值可能是未来发生 2 型糖尿病的有用替代指标。
