Dose-response Association between Triglycerides to High-density Lipoprotein Cholesterol Ratio and Type 2 Diabetes Mellitus Risk: The Rural Chinese Cohort Study and Meta-analysis.

BACKGROUND: Evidence shows that high triglycerides (TG) level and low high-density lipoprotein cholesterol (HDL-C) level are traditional risk factors for type 2 diabetes mellitus (T2DM). The present study evaluated the dose-response relation between TG/HDL ratio and risk of T2DM.

METHODS: We included 11946 adults without baseline diabetes from the Rural Chinese Cohort Study. Cox proportional-hazards regression was used to investigate the association of TG/HDL ratio and T2DM. The dose-response relation was evaluated by restricted cubic spline analysis. Additionally, we calculated the pooled odds ratio (OR) with a random-effects model in meta-analysis including the current study and 3 eligible articles.

RESULTS: During the period 2007-2014, we identified 618 T2DM (9.68/1000 person-years). People with the highest quartile of TG/HDL ratio had higher risk of T2DM incidence than lowest quartile group overall (adjusting hazard ratio [aHR]: 2.11, 95% confidence interval [CI]: 1.55-2.86); however, the association between TG/HDL ratio and T2DM was stronger in females (aHR: 1.27, 95% CI: 1.16-1.39) than in males (aHR: 1.19, 95% CI: 1.04-1.37). In BMI-specific analysis, people with normal weight showed the strongest association than overweight/obesity. In addition, the dose-response meta-analysis showed that 1-unit increment in TG/HDL ratio increased 28% (95% CI: 1.20-1.36) risk of T2DM, with a positive linear relation (P linear =0.326).

CONCLUSIONS: TG/HDL ratio was the independently risk factor of T2DM, especially in females. TG/HDL ratio linearly increase the risk of T2DM incidence, which may be a useful indicator to identify future T2DM. This article is protected by copyright. All rights reserved.