Zhang Zhiqiang, Chen Hejun, Chen Lei, Liang Wenyan, Hu Tenglong, Sun Na, Zhao Yangyu, Wei Xiqing
Department of Cardiology, Affiliated Hospital of Jining Medical University, Clinical Medical College, Jining Medical University, Jining, 272000, China.
Shandong Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Jining, 272000, Shandong, China.
Sci Rep. 2025 May 9;15(1):16261. doi: 10.1038/s41598-025-87277-0.
A common complication of type 2 diabetes is hypercholesterolemia in many patients. It is still unclear, nevertheless, how high-density lipoprotein cholesterol ratio (TC/HDL-C), total cholesterol, and diabetes are related. The purpose of this study is to look at the prediction ability and causal relationship between TC/HDL-C and diabetes. This study included 117,268 subjects who were undergoing physical examinations. The subjects were grouped into four equal groups according to the TC/HDL-C quartiles; the main outcome was the occurrence of diabetes events. TC/HDL-C is calculated as total cholesterol divided by high-density lipoprotein cholesterol. In 3.1 years (± 0.95) of follow-up, 795 women (0.68%) and 1,894 men (1.62%) received new diabetes diagnoses. TC/HDL-C is an independent predictor of new-onset diabetes, according to multivariable Cox regression analysis (HR 1.27 per SD increase, 95% CI: 1.09-1.48, P for trend < 0.001). It turned out that a cutoff value of 3.55 (area under the curve 0.64, sensitivity 0.66, specificity 0.56), was ideal for TC/HDL-C in predicting new-onset diabetes. A subgroup analysis demonstrated that the younger population had a significantly higher risk of TC/HDL-C-related diabetes than the middle-aged group (interaction P < 0.05). After controlling for confounding variables, this Chinese cohort study reveals a direct correlation between TC/HDL-C and diabetes, with a stronger independent association observed in younger and middle-aged individuals.
2型糖尿病的一个常见并发症是许多患者出现高胆固醇血症。然而，目前仍不清楚高密度脂蛋白胆固醇比值（TC/HDL-C）、总胆固醇与糖尿病之间的关系。本研究的目的是探讨TC/HDL-C与糖尿病之间的预测能力和因果关系。本研究纳入了117268名接受体检的受试者。根据TC/HDL-C四分位数将受试者分为四组，主要结局是糖尿病事件的发生。TC/HDL-C的计算方法是总胆固醇除以高密度脂蛋白胆固醇。在3.1年（±0.95）的随访中，795名女性（0.68%）和1894名男性（1.62%）被新诊断为糖尿病。多变量Cox回归分析显示，TC/HDL-C是新发糖尿病的独立预测因素（每标准差增加HR 1.27，95%CI：1.09-1.48，趋势P<0.001）。结果表明，截断值为3.55（曲线下面积0.64，敏感性0.66，特异性0.56）时，TC/HDL-C对新发糖尿病的预测效果最佳。亚组分析表明，年轻人群中与TC/HDL-C相关的糖尿病风险显著高于中年人群（交互作用P<0.05）。在控制混杂变量后，这项中国队列研究揭示了TC/HDL-C与糖尿病之间的直接关联，在年轻和中年个体中观察到更强的独立关联。
