High TG/HDL-C variability tied to diabetes risk

High variability in the ratio between triglycerides and high-density lipoprotein-cholesterol (TG/HDL-C) seems to increase the risk of incident diabetes, a China study has shown.

The researchers enrolled 45,911 patients (mean age 52.37±12.03 years, 75.73 percent men) who had three TG and HDL-C measurements taken between 2006 and 2011. Average real variability (ARV) was calculated, and patients were grouped into tertiles of TG/HDL-C-ARV.

Over a mean observation period of 6.24±12 years, 3,724 incident cases of diabetes mellitus were reported. The 7-year cumulative incidence rate was lowest in the bottom tertile of TG/HDL-C-ARC and climbed with each succeeding category (6.13 percent to 8.09 percent to 11.77 percent; p<0.001).

Cox proportional hazards model further showed a link between TG/HDL-C-ARV and diabetes risk. Compared to the lowest category, the risk of incident diabetes was higher by 16 percent and 38 percent in the second (hazard ratio [HR], 1.16, 95 percent confidence interval [CI], 1.06–1.26) and third (HR, 1.38, 95 percent CI, 1.25–1.50) tertiles of TG/HDL-C-ARV, respectively.

When taken as a continuous variable, each standard deviation increment in TG/HDL-C-ARC correlated with a 4-percent increase in incident diabetes risk.

The above analyses were adjusted for potential confounders, including age, sex, body mass index, blood lipid profile, lifestyle factors, family history, medications, and glucose history.

“To the best of our knowledge, this was the first study to determine a positive correlation between TG/HDL-C ratio variability and new-onset diabetes in a large cohort. These findings were confirmed in sensitivity and subgroup analyses, suggesting that this relationship was fairly universal,” the researchers said.

“Further epidemiological experimental research should be performed to confirm this finding and to gain a fuller understanding of the mechanisms linking visit-to-visit TG/HDL-C ratio variability and diabetes,” they added.