Correlation between the triglyceride-to-high-density lipoprotein cholesterol ratio and other unconventional lipid parameters with the risk of prediabetes and Type 2 diabetes in patients with coronary heart disease: a RCSCD-TCM study in China

Objective: Type 2 diabetes (T2DM) is often accompanied by undiagnosed dyslipidemia. Research on the association and predictive value of unconventional lipid markers for prediabetes (pre-DM) and T2DM simultaneously is limited in CHD patients. Methods: : We collected patients who were diagnosed with CHD. Their lipid levels including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) were measured and non-traditional lipid parameters were calculated. The diabetic status was defined as: normoglycemic (NG), Pre-DM, T2DM, multiple logistic regression was used to evaluate the relationship between the various lipid parameters with diabetic status. Pearson correlation analysis and linear regression analysis were used to test the correlation between TG/HDL-C and clinical factors of glucose metabolism, and ROC curve was used to test the predictive value of non-traditional lipid parameters for pre-DM and T2DM. Results: : Multiple logistic regression results showed that in addition to traditional lipid parameters, the non-traditional lipid parameters including non-HDL-C, LDL-C/HDL-C, TC/HDL-C, TG/HDL-C were all correlated with the risk of pre-DM and T2DM, meanwhile TG/HDL-C showed the strongest correlation (OR: 1.21; 95% CI 1.6-1.25), (OR: 1.35; 95% CI 1.30-1.39). When dividing TG/HDL-C into tertiles, using T1( 1.89) was observed to have the highest association with both pre-DM and T2DM (OR: 1.60; 95% CI 1.48-1.74), (OR: 2.79; 95% CI 2.60-3.00). The association of TG/HDL-C with T2DM and pre-DM is independent of gender, age and lifestyle. TG/HDL-C was significantly correlated with FBG and HbA1c (P < 0.001). It was the strongest predictor of pre-DM and T2DM in unconventional lipid parameters. The cut-off points were 1.46 and 1.50. Conclusion: Elevated non-traditional lipid parameters were significantly associated with pre-DM and T2DM in CHD patients, elevated TG/HDL-C was the risk factor with the strongest correlation with the risk of pre-DM and T2DM. It is also a valid predictor of T2DM occurrence.