Triglycerides to high density lipoprotein cholesterol ratio (TG/HDL), but not triglycerides and glucose product (TyG) index, is associated with arterial stiffness in prediabetes
Maurizio Di Marco, Sabrina Scilletta, Nicoletta Miano, Stefania Capuccio, Marco Musmeci, Stefania Di Mauro, Agnese Filippello, Alessandra Scamporrino, Giosiana Bosco, Francesco Barbagallo, Roberto Scicali, Salvatore Piro, Francesco Purrello, Robert Wagner, Antonino Di Pino
Abstract
AIMS: Prediabetes (preD) carries increased risk of cardiovascular (CV) events than normal-glucose-tolerance (NGT). Insulin resistance, a hallmark of preD, is closely linked to CV-risk, making its assessment crucial. Triglycerides-to-high-density-lipoprotein-cholesterol-ratio (TG/HDL) and triglycerides-and-glucose-product (TyG) have emerged as surrogate of insulin resistance. We aimed to evaluate the association of these indexes with CV-risk assessed through arterial stiffness in preD. METHODS: 377 individuals without diagnosis of diabetes underwent: (1) complete biochemistry and oral-glucose-tolerance-test; (2) CV-risk assessment through arterial stiffness (pulsed-wave-velocity - PWV - and augmentation-index - AugI) and intima-media-thickness (IMT). Participants were split according to current guidelines: NGT (n = 100), preD (n = 216), and newly-diagnosed-type-2-diabetes (ND-T2D) (n = 61). RESULTS: TG/HDL and TyG were higher in preD than NGT, with no difference between preD and ND-T2D regarding TG/HDL. PreD showed higher PWV, AugI, and IMT than NGT. In preD group, after adjusting for major confounders, PWV was correlated with TG/HDL (β = 0.16; P = 0.03), but not with TyG, and there was a trend of association with HOMA-IR (β = 0.19, P = 0.07). In logistic regression, being in the higher tertile of TG/HDL was associated with higher PWV (odds-ratio 2.51, 95 %CI 1.01-6.29, P = 0.048). CONCLUSIONS: In preD, TG/HDL was independently associated with PWV, suggesting its possible role as a simple, cost-effective tool for assessing CV risk.