Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan.
Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, 5-55 Sotojima-Cho, Moriguchi, 570-8540, Japan.
Cardiovasc Diabetol. 2023 Nov 8;22(1):308. doi: 10.1186/s12933-023-02046-5.
Previous studies have investigated the association between the ratio of triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) and the incidence of diabetes in adults and discovered that a high TG/HDL-C ratio was linked to an elevated risk of new-onset diabetes. However, the comparison of predicting diabetes development among lipid profiles including the TG/HDL-C ratio, and the ratio of TG/HDL-C cut-off value has received limited attention. We examined the relationship between diabetes onset and the TG/HDL-C ratio in addition to the applicable cut-off value for predicting diabetes onset.
This study included 120,613 participants from the health examination database at Panasonic Corporation from 2008 to 2017. Cox regression analysis employing multivariable models was used to investigate the association between lipid profiles, particularly the ratio of TG/HDL-C and the development of type 2 diabetes (T2D). The multivariable model was adjusted for age, sex, BMI, systolic blood pressure, plasma glucose levels after fasting, smoking status, and exercise habits. Areas under time-dependent receiver operating characteristic (ROC) curves (AUCs) were employed to assess the prediction performance and cut-off values of each indicator. A fasting plasma glucose level of 126 mg/dL, a self-reported history of diabetes, or usage of antidiabetic medicines were used to identify T2D.
During the course of the study, 6,080 people developed T2D. The median follow-up duration was 6.0 (3-10) years. Multivariable analysis revealed that the ratio of TG/HDL-C (per unit, HR; 1.03 [95% CI 1.02-1.03]) was substantially linked to the risk of incident T2D. AUC and cut-off points for the ratio of TG/HDL-C for T2D development after 10 years were 0.679 and 2.1, respectively. Furthermore, the AUC of the ratio of TG/HDL-C was considerably larger compared to that of LDL-C, HDL-C, and TG alone (all P < 0.001). We discovered an interaction effect between sex, BMI, and lipid profiles in subgroup analysis. Females and participants having a BMI of < 25 kg/m showed a higher correlation between lipid profile levels and T2D onset.
The ratio of TG/HDL-C was found to be a stronger predictor of T2D development within 10 years than LDL-C, HDL-C, or TG, indicating that it may be useful in future medical treatment support.
先前的研究已经探讨了甘油三酯（TG）与高密度脂蛋白胆固醇（HDL-C）比值与成年人糖尿病发病之间的关联，并发现高 TG/HDL-C 比值与新发糖尿病的风险增加有关。然而，对于包括 TG/HDL-C 比值在内的血脂谱预测糖尿病发展的能力比较，以及 TG/HDL-C 比值的适用切点预测糖尿病发病的研究还很有限。我们检测了 TG/HDL-C 比值与适用切点预测糖尿病发病之外，糖尿病发病与 TG/HDL-C 比值之间的关系。
本研究纳入了 2008 年至 2017 年期间松下公司健康检查数据库中的 120613 名参与者。采用多变量模型的 Cox 回归分析，研究了血脂谱，尤其是 TG/HDL-C 比值与 2 型糖尿病（T2D）发病之间的关系。多变量模型调整了年龄、性别、BMI、收缩压、空腹后血糖水平、吸烟状况和运动习惯。时间依赖性受试者工作特征（ROC）曲线下面积（AUCs）用于评估每个指标的预测性能和切点值。空腹血糖水平为 126mg/dL、自我报告的糖尿病史或使用降糖药物被用于识别 T2D。
在研究过程中，有 6080 人发生了 T2D。中位随访时间为 6.0（3-10）年。多变量分析显示，TG/HDL-C 比值（每单位，HR；1.03[95%CI 1.02-1.03]）与新发 T2D 风险显著相关。10 年后，TG/HDL-C 比值预测 T2D 发病的 AUC 和切点值分别为 0.679 和 2.1。此外，TG/HDL-C 比值的 AUC 明显大于 LDL-C、HDL-C 和 TG 单独的 AUC（均 P<0.001）。我们在亚组分析中发现了性别、BMI 和血脂谱之间的交互作用效应。女性和 BMI<25kg/m2 的参与者中，血脂谱水平与 T2D 发病之间的相关性更高。
与 LDL-C、HDL-C 或 TG 相比，TG/HDL-C 比值在 10 年内预测 T2D 发病的能力更强，这表明它可能在未来的医疗支持中有用。
