Department of Emergency Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
Department of Emergency Medicine, Pengpai Memorial Hospital, Shanwei, China.
Front Endocrinol (Lausanne). 2024 Nov 11;15:1442731. doi: 10.3389/fendo.2024.1442731. eCollection 2024.
Although several studies have explored the association between the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-c) and diabetes risk, most of these studies are cross-sectional and typically involve small sample sizes, limiting the ability to draw causal inferences. Additionally, there is currently a few studies specifically focusing on non-obese individuals. Consequently, we conducted a retrospective cohort study to investigate the impact of TG/HDL-c on the risk of developing diabetes among non-obese, normoglycemic individuals across East Asian countries.
This secondary retrospective cohort study recruited 85,029 non-obese individuals with normal glycemic levels from East Asian countries (China and Japan). We employed Cox proportional hazards regression models, incorporating cubic splines function for smooth curve fitting and using two-piecewise Cox regression for threshold effect analysis, to evaluate the nonlinear associations between baseline TG/HDL-c ratios and diabetes risk in non-obese individuals with normoglycemia. In addition, A range of subgroup and sensitivity analyses were performed to confirm the robustness of our results.
Among the individuals included, the average age was 42.14 ± 11.88 years, and 37,944 participants (44.62%) were male. After adjusting for covariates, the study revealed a significant correlation between the TG/HDL-c ratio and the risk of diabetes among non-obese individuals (HR=1.37, 95%CI: 1.22-1.54). Furthermore, a non-linear correlation was observed between the TG/HDL-c ratios and the incidence of non-obese diabetes, with an inflection point of 1.36. Under this threshold, the TG/HDL-c ratio notably boosts diabetes risk in non-obese populations, with an HR of 2.38 (95% CI: 1.57-3.59). Conversely, beyond the critical juncture, the upsurge in diabetes risk seems to level off, displaying no significant variation, with an HR of 1.18 (95% CI: 0.98-1.41).
This study reveals a non-linear association between the TG/HDL-c ratios and the likelihood of diabetes in non-obese individuals from East Asia. Maintaining a ratio of TG/HDL-C below 1.36 significantly reduces diabetes risk. However, once the ratio of TG/HDL-C exceeds 1.36, reducing it does not substantially lower diabetes onset risk.
尽管已有多项研究探讨了甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-c）与糖尿病风险之间的关联，但这些研究大多为横断面研究，且样本量通常较小，限制了得出因果关系推断的能力。此外，目前仅有少数研究专门针对非肥胖个体。因此，我们进行了一项回顾性队列研究，旨在调查东亚国家非肥胖、血糖正常人群中 TG/HDL-c 对糖尿病发病风险的影响。
本二次回顾性队列研究纳入了东亚国家（中国和日本）的 85029 名非肥胖、血糖正常的个体。我们采用 Cox 比例风险回归模型，结合三次样条函数进行平滑曲线拟合，并采用两段式 Cox 回归进行阈值效应分析，评估非肥胖、血糖正常个体基线 TG/HDL-c 比值与糖尿病风险之间的非线性关联。此外，还进行了一系列亚组和敏感性分析，以确认研究结果的稳健性。
在纳入的个体中，平均年龄为 42.14±11.88 岁，37944 名参与者（44.62%）为男性。调整协变量后，研究显示 TG/HDL-c 比值与非肥胖个体糖尿病风险之间存在显著相关性（HR=1.37，95%CI：1.22-1.54）。此外，还观察到 TG/HDL-c 比值与非肥胖型糖尿病的发病之间存在非线性关联，拐点为 1.36。在此阈值以下，TG/HDL-c 比值显著增加非肥胖人群的糖尿病风险，HR 为 2.38（95%CI：1.57-3.59）。相反，超过临界点后，糖尿病风险的上升似乎趋于平稳，无显著差异，HR 为 1.18（95%CI：0.98-1.41）。
本研究揭示了东亚非肥胖个体的 TG/HDL-c 比值与糖尿病发生风险之间的非线性关联。维持 TG/HDL-C 比值低于 1.36 可显著降低糖尿病风险。然而，一旦 TG/HDL-C 比值超过 1.36，降低该比值并不能显著降低糖尿病发病风险。
