Guan Mijie, Cui Shuang, Song Haiying, Hu Haofei, Hu Bo
Department of Nephrology, The First Affiliated Hospital of Jinan University, Jinan University, No.613 West Huangpu Avenue Tianhe District, Guangzhou, Guangdong Province, 510630, China.
Department of Nephrology, Shenzhen Second People's Hospital, No.3002 Sungang West Road, Futian District, Shenzhen, Guangdong Province, 518000, China.
BMC Nephrol. 2025 Aug 19;26(1):470. doi: 10.1186/s12882-025-04377-9.
Patients with chronic kidney disease (CKD) are at an increased risk of diabetes mellitus (DM) and dyslipidemia, yet the specific relationship between lipid profiles, particularly triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C ratio), and DM likelihood in this population has not been thoroughly elucidated.
We conducted a cross-sectional analysis of 20,310 unselected patients with CKD enrolled from 2006 to 2015. The relationship between the TG/HDL-C ratio and the likelihood of DM was evaluated using binary logistic regression. Sensitivity and subgroup analyses were performed, and a generalized additive model with smooth curve fitting assessed potential non-linear associations. We also performed the receiver operating characteristic (ROC) curve and decision curve analysis to assess the determination and clinical use, respectively.
Among the participants (mean age 60.907 ± 10.044 years; 79.580% male), 1,758 (8.656%) had DM. The median TG/HDL-C ratio was 0.655(interquartile range 0.465-0.920). After adjusting for covariates, a significant positive association was found between the TG/HDL-C ratio and DM likelihood (odds ratio [OR], 1.494; 95% confidence interval [CI], 1.354-1.648; P < 0.001). A non-linear relationship was observed with an inflection point at a TG/HDL-C ratio of 1.030. The ORs below and above this point were 1.866 (95% CI, 1.472-2.365) and 1.297 (95% CI, 1.094-1.538), respectively. The area under curve (AUC) of the nomogram was of 0.580 (95% CI, 0.566-0.594). Subgroup analyses indicated a stronger association in patients without hypertension, in female and patients with AF.
The TG/HDL-C ratio is independently associated with DM likelihood in patients with CKD, exhibiting a non-linear relationship particularly significant when the ratio is below 1.030. The TG/HDL-C ratio may serve as a useful marker for DM likelihood assessment in CKD patients, though prospective studies are needed to determine its role in prevention strategies.
Not applicable.
慢性肾脏病（CKD）患者患糖尿病（DM）和血脂异常的风险增加，但该人群中血脂谱，尤其是甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C比值）与患DM可能性之间的具体关系尚未完全阐明。
我们对2006年至2015年纳入的20310例未经选择的CKD患者进行了横断面分析。使用二元逻辑回归评估TG/HDL-C比值与DM可能性之间的关系。进行了敏感性和亚组分析，并采用具有平滑曲线拟合的广义相加模型评估潜在的非线性关联。我们还进行了受试者工作特征（ROC）曲线和决策曲线分析，分别评估其判别能力和临床应用价值。
在参与者中（平均年龄60.907±10.044岁；79.580%为男性），1758例（8.656%）患有DM。TG/HDL-C比值的中位数为0.655（四分位间距0.465 - 0.920）。在调整协变量后，发现TG/HDL-C比值与DM可能性之间存在显著正相关（比值比[OR]，1.494；95%置信区间[CI]，1.354 - 1.648；P < 0.001）。观察到一种非线性关系，拐点处的TG/HDL-C比值为1.030。该点以下和以上的OR分别为1.866（95%CI，1.472 - 2.365）和1.297（95%CI，1.094 - 1.538）。列线图的曲线下面积（AUC）为0.580（95%CI，0.566 - 0.594）。亚组分析表明，在无高血压患者、女性和房颤患者中关联更强。
TG/HDL-C比值与CKD患者患DM的可能性独立相关，呈现非线性关系，当比值低于1.030时尤为显著。TG/HDL-C比值可作为评估CKD患者患DM可能性的有用标志物，尽管需要前瞻性研究来确定其在预防策略中的作用。
不适用。
