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Usefulness of the triglyceride to high-density lipoprotein cholesterol ratio for predicting mortality risk in type 2 diabetes: role of kidney dysfunction.
Atherosclerosis. 2010 Sep; 212(1):287-91.A

Abstract

OBJECTIVE

An increased level of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio has been identified as an independent predictor for cardiovascular events in the general population and in some groups of high-risk patients, such as type 2 diabetes. The aim of this study was to evaluate whether a high TG/HDL-C ratio is associated with an increased risk of all-cause and cardiovascular mortality in type 2 diabetic subjects, and whether this risk is modified by the presence of kidney dysfunction.

METHODS

We followed 3084 type 2 diabetic outpatients for a mean period of 4.9 years for the occurrence of mortality. The independent association between the TG/HDL-C ratio and all-cause and cardiovascular mortality was analyzed by Cox proportional hazard models and adjusted for several potential confounders, including kidney function measures.

RESULTS

During follow-up, 356 (12%) participants died, 46% of whom from cardiovascular causes. Higher TG/HDL-C ratio (third vs. first tertile) was associated with an increased hazard ratio of all-cause (hazard ratio 1.51, CI 95% 1.13-2.00, p=0.005) and cardiovascular (hazard ratio 1.70, 1.12-2.59, p=0.015) mortality after adjustment for traditional risk factors, body mass index, hemoglobin A1c and medication use. After additional adjustment for renal function measures (estimated glomerular filtration rate or albuminuria), the association between the TG/HDL-C ratio and the risk of mortality was abolished.

CONCLUSION

Our findings suggest that the predictive role of a high TG/HDL-C ratio in type 2 diabetes on cardiovascular and all-cause mortality might be largely mediated by the presence of kidney dysfunction.

Authors+Show Affiliations

Section of Endocrinology and Metabolism, Department of Medicine, University of Verona, Verona, Italy. giacomo.zoppini@univr.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20510417

Citation

Zoppini, Giacomo, et al. "Usefulness of the Triglyceride to High-density Lipoprotein Cholesterol Ratio for Predicting Mortality Risk in Type 2 Diabetes: Role of Kidney Dysfunction." Atherosclerosis, vol. 212, no. 1, 2010, pp. 287-91.
Zoppini G, Targher G, Negri C, et al. Usefulness of the triglyceride to high-density lipoprotein cholesterol ratio for predicting mortality risk in type 2 diabetes: role of kidney dysfunction. Atherosclerosis. 2010;212(1):287-91.
Zoppini, G., Targher, G., Negri, C., Stoico, V., Gemma, M. L., & Bonora, E. (2010). Usefulness of the triglyceride to high-density lipoprotein cholesterol ratio for predicting mortality risk in type 2 diabetes: role of kidney dysfunction. Atherosclerosis, 212(1), 287-91. https://doi.org/10.1016/j.atherosclerosis.2010.04.035
Zoppini G, et al. Usefulness of the Triglyceride to High-density Lipoprotein Cholesterol Ratio for Predicting Mortality Risk in Type 2 Diabetes: Role of Kidney Dysfunction. Atherosclerosis. 2010;212(1):287-91. PubMed PMID: 20510417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Usefulness of the triglyceride to high-density lipoprotein cholesterol ratio for predicting mortality risk in type 2 diabetes: role of kidney dysfunction. AU - Zoppini,Giacomo, AU - Targher,Giovanni, AU - Negri,Carlo, AU - Stoico,Vincenzo, AU - Gemma,Maria Luisa, AU - Bonora,Enzo, Y1 - 2010/05/06/ PY - 2010/02/05/received PY - 2010/03/19/revised PY - 2010/04/27/accepted PY - 2010/6/1/entrez PY - 2010/6/1/pubmed PY - 2010/12/29/medline SP - 287 EP - 91 JF - Atherosclerosis JO - Atherosclerosis VL - 212 IS - 1 N2 - OBJECTIVE: An increased level of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio has been identified as an independent predictor for cardiovascular events in the general population and in some groups of high-risk patients, such as type 2 diabetes. The aim of this study was to evaluate whether a high TG/HDL-C ratio is associated with an increased risk of all-cause and cardiovascular mortality in type 2 diabetic subjects, and whether this risk is modified by the presence of kidney dysfunction. METHODS: We followed 3084 type 2 diabetic outpatients for a mean period of 4.9 years for the occurrence of mortality. The independent association between the TG/HDL-C ratio and all-cause and cardiovascular mortality was analyzed by Cox proportional hazard models and adjusted for several potential confounders, including kidney function measures. RESULTS: During follow-up, 356 (12%) participants died, 46% of whom from cardiovascular causes. Higher TG/HDL-C ratio (third vs. first tertile) was associated with an increased hazard ratio of all-cause (hazard ratio 1.51, CI 95% 1.13-2.00, p=0.005) and cardiovascular (hazard ratio 1.70, 1.12-2.59, p=0.015) mortality after adjustment for traditional risk factors, body mass index, hemoglobin A1c and medication use. After additional adjustment for renal function measures (estimated glomerular filtration rate or albuminuria), the association between the TG/HDL-C ratio and the risk of mortality was abolished. CONCLUSION: Our findings suggest that the predictive role of a high TG/HDL-C ratio in type 2 diabetes on cardiovascular and all-cause mortality might be largely mediated by the presence of kidney dysfunction. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/20510417/Usefulness_of_the_triglyceride_to_high_density_lipoprotein_cholesterol_ratio_for_predicting_mortality_risk_in_type_2_diabetes:_role_of_kidney_dysfunction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(10)00326-6 DB - PRIME DP - Unbound Medicine ER -