Higher TG/HDL-C ratio linked with lower skeletal muscle mass in type 2 diabetes patients

The study showed that skeletal muscle index score correlated with TG/HDL ratio, and a higher TG/HDL ratio was linked with lower skeletal muscle mass in type 2 diabetes patients.

Sarcopenia is a disease characterized by progressive skeletal muscle mass and strength loss. Sarcopenia increases the risk of mortality, falls and fractures, metabolic disorders, infection, and disabilities risk. Traditional factors such as malnutrition, physical inactivity, and ageing are correlated with sarcopenia development. Type 2 diabetes is reported to significantly raise the risk of sarcopenia development compared with control subjects. T2DM patients are shown to have a higher prevalence of sarcopenia than healthy controls.

Dyslipidemia, represented by increased blood LDL-C (low-density lipoprotein cholesterol), decreased HDL, and elevated TG levels, is a well-known marker for metabolic syndrome, cardiovascular disease, and type 2 diabetes. The TG/HDL ratio has emerged as a good predictive index for diabetes, insulin resistance, and cardiovascular diseases (CVDs).

Against the above background, Qingsong Fu, Shandong University, Qingdao, China, and colleagues aimed to evaluate the correlation of TG/HDL-C ratio with muscle mass in T2DM patients.

The study involved 1048 type 2 diabetes inpatients recruited from the endocrinology department. Skeletal muscle index (SMI) was detected using a dual-energy X-ray absorptiometry method. SMI less than 7.0 kg/m2 (in male subjects) or 5.4 kg/m2 (in female subjects) was identified as low muscle mass.

The study revealed the following findings:

·In the female and male groups, the prevalence of low muscle mass was 14.5% and 20.9%, respectively.

· SMI was correlated with TG/HDL ratio after adjustment for age, duration of diabetes, diastolic blood pressure (DBP), and HbA1c in the male subgroup.

· In the female subgroup, skeletal muscle index was associated with TG/HDL ratio after adjustment for age and DBP.

"Our findings indicated that high-density lipoprotein was significantly higher in the low muscle mass group of patients with type 2 diabetes than in the normal muscle mass group," the researchers wrote. "HDL was negatively correlated with skeletal muscle index in T2DM patients."

The findings imply that TG/HDL-C ratio may be a biomarker to diagnose or predict low muscle mass in type 2 diabetes patients.

The study's limitations include the relatively small sample size and the cross-sectional design, which limited its causal conclusions. There is a need to assess the causality in further longitudinal research.

Reference:

Fu, Q., Zhang, Z., Hu, W. et al. The correlation of triglyceride/high-density lipoprotein cholesterol ratio with muscle mass in type 2 diabetes patients. BMC Endocr Disord 23, 93 (2023). https://doi.org/10.1186/s12902-023-01349-8