The Predictive Value of the Triglycerides/HDL-Cholesterol Ratio for Diabetes Incidence

Author:

de Almeida-Pititto Bianca12ORCID,Branda Julia Ines3,de Oliveira Julia M.2ORCID,Dualib Patrícia M.24,de Aquino Fernandes Dias Luisa Bittencourt2ORCID,Bensenor Isabela M.35ORCID,Lotufo Paulo A.35,Ferreira Sandra Roberta G.6

Affiliation:

1. Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Botucatu 740, São Paulo 04023900, Brazil

2. Programa de Pós Graduação em Endocrinologia e Metabologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Estado de Israel 639, São Paulo 040023900, Brazil

3. Centro de Pesquisa do Hospital Universitário, Universidade de São Paulo, Av. Lineu Prestes 2565, 3rd Floor, São Paulo 05508000, Brazil

4. Disciplina de Endocrinologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Estado de Israel 639, São Paulo 040023900, Brazil

5. Departamento de Clínica Médica, Faculdade de Medicina, Universidade de São Paulo, Av. Lineu Prestes 2565-4° Floor, São Paulo 05508000, Brazil

6. Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr Arnaldo, 715, São Paulo 01246904, Brazil

Abstract

Background: Type 2 diabetes mellitus (DM) is an important disease with an impact on public health globally. Early assessment is necessary with accessible markers, such as the TG/HDL ratio, in predicting DM. Methods: A total of 11,653 subjects from the ELSA-Brazil were included in this analysis and were reevaluated after 3.9 ± 0.6 years of follow-up. Participants were classified according to the quartiles of the TG/HDL index, stratified by sex. ANOVA with Bonferroni correction and p-for-trend analysis were used to compare groups. Cox analysis was performed with adjustments for covariables. Kaplan–Meier curves are presented with the log rank pool and linear analysis. Results: From 11,653 participants (56% female; aged 50.5 ± 8.7 years), 866 (7.8%) were diagnosed with DM (7.2% in women and 7.8% in men). For both sexes, a worsening of the cardiometabolic profile was observed across the increase in TG/HDL quartiles (p < 0.001). Incidence rates of DM increased across TG/HDL quartiles for both men (from Q1 3.3% to Q4 12.8%) and women (from Q1 3.3% to Q4 12.4%). For the entire period, the incidence was highest in participants in the fourth quartile of TG/HDL (log rank analysis < 0.001 for both sexes). In the Cox regression analyses, for men, the HR (95%CI) for risk of DM was 2.4 (1.49–3.26) across the fourth quartile of the TG/HDL ratio, and in women it was 1.57 (1.11–2.22) for the third quartile and 2.08 (1.48–2.93) for the fourth quartile, compared to the first quartile after adjustments. Conclusions: Higher levels of the TG/HDL ratio were independently predictors of DM in both men and women.

Funder

Brazilian Ministry of Health

Publisher

MDPI AG

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