High triglycerides-to-HDL-C ratio poses elevated stroke risk in people with healthy BMI

Increased triglycerides (TG)-to-high-density lipoprotein cholesterol ratio (TG/HDL-C) appears to be associated with a markedly raised risk of stroke only among individuals with healthy body mass index (BMI), according to a study.

The analysis included 11,699 individuals from 12 Japanese districts participating in the Jichi Medical School Cohort Study. Researchers identified individuals with a healthy BMI (20.0–24.9 kg/m²) and grouped them into sex-specific TG/HDL-C ratio quartiles.

A total of 419 incident stroke events were recorded over the mean 10.8 years of follow-up. Multivariable Cox proportional hazards analysis revealed that compared with the first quartile of TG/HDL-C ratio, the fourth quartile was linked to a significantly increased risk of stroke events in the group of individuals with healthy BMI.

The respective hazard ratios were 1.87 (95 percent confidence interval [CI], 1.24–2.83) for all stroke, 3.06 (95 percent CI, 1.21–7.74) for intracerebral haemorrhage, 1.79 (95 percent CI, 1.05–3.05) for cerebral infarction, and 1.29 (95 percent CI, 0.49–3.41) for subarachnoid haemorrhage.

There was no significant association between the fourth quartile of TG/HDL-C ratio and the risk of stroke events in the overall population.

The corresponding hazard ratios were 1.28 (95 percent CI, 0.94–1.75) for all stroke, 1.78 (95 percent CI, 0.91–3.48) for intracerebral haemorrhage, 1.20 (95 percent CI, 0.82–1.77) for cerebral infarction, and 1.13 (95 percent CI, 0.50–2.54) for subarachnoid haemorrhage.