Lowering TG/HDL-C ratio can prevent prediabetes and Type 2 diabetes

Dyslipidemia is associated with Insulin Resistance (IR). Previous studies have suggested that TG/HDL-C ratio is a diagnostic or screening tool for conditions like the risk of metabolic syndrome, Insulin Resistance, and Type 2 Diabetes Mellitus. Prediabetes and T2DM are tied to the high burden of non-communicable diseases, including cardiovascular and chronic kidney disease.

Considering the above background, researchers determined the association between TG/HDL-C and individuals at risk of incident prediabetes and T2DM.

Using Cox proportional hazard regression analyses, the team analysed the association of TG/HDL-C with incident prediabetes and T2DM among normoglycemic men and women, including 5064 subjects with 2247 men aged ≥ 20 years. They also assessed lipid ratio with incident T2DM among 1414 prediabetic subjects.

The results of the study could be summarised as follows:

• The median follow-up duration was 11.2 years.
• Two thousand one hundred forty new cases of prediabetes, including 1070 men and 360 incident T2DM, including 152 men, were identified.
• Among prediabetics, 574 new cases of T2DM (252 men ) were identified.
• The higher quartiles of TG/HDL-C had higher risks of incident prediabetes and T2DM (normoglycemic individuals) and incident T2DM (prediabetic population).
• The hazard ratios (HRs) for the fourth quartiles were 1.37, 1.92, and 1.57, respectively.
• Among prediabetic men,TG/HDL-C lost its association with incident T2DM
• The corresponding value for incident Type 2 DM in prediabetic individuals was 1.01.
• TG/HDL-C and incident prediabetes "association" and T2DM persisted even after replacing FPG with an IR index.

They said a 1 unit increase in TG/HDL-C among the normoglycemic population is significantly associated with incident prediabetes and T2DM.In the normoglycemic population, increasing TG/HDL-C value was unfavorably associated with incident prediabetes and T2DM.

TG/HDL-C was tied to incident T2DM in prediabetics.

They wrote that there is a correlation between TG/HDL-C and different states of dysglycemia independent of HOMA-IR.

Further reading:

Tohidi et al. Association of triglycerides to high-density lipoprotein cholesterol ratio to identify future prediabetes and type 2 diabetes mellitus: over one-decade follow-up in the Iranian population. Diabetol Metab Syndr 15, 13 (2023). https://doi.org/10.1186/s13098-023-00988-0