Korean J Fam Pract. 2018; 8(3): 462-467  https://doi.org/10.21215/kjfp.2018.8.3.462
Relationship between the Ratio of Triglyceride to High Density Lipoprotein and Glycated Hemoglobin A in 4-5 Years Follow-up in Non-Diabetic Adults
Hyun-Ha Kim, Woo-Joo Park, Soo-Eun Jang, Seung-Ryong Yoo, Hyeona-A Lee, Mi-Kyeong Oh*
Department of Family Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
Mi-Kyeong Oh
Tel: +82-33-610-3325, Fax: +82-33-641-8130
E-mail: omk@gnah.co.kr
ORCID: http://orcid.org/0000-0003-3602-9588
Received: June 13, 2017; Revised: August 18, 2017; Accepted: August 28, 2017; Published online: June 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: There is growing interest in factors that can predict the occurrence of diabetes. Several studies have reported that the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C ratio) reflects insulin resistance. The present study investigated whether the TG/HDL-C ratio can be a predictor of diabetes mellitus, considering that insulin resistance is an important mechanism for the risk of diabetes mellitus.
Methods: Among 1,177 patients who underwent two or more tests at 4- or 5-year intervals from 2006 to 2016 at a hospital health examination center in Gangwon-do Province, except for patients with chronic illnesses affecting the quality of data and lipid levels, 817 patients were included in the study. High TG/HDL-C ratios were based on previous studies: 3.5 for men and 2.0 for women. We investigated the relationship between the TG/HDL-C ratio and glycated hemoglobin A (HbA1c) levels, and we examined whether the first TG/HDL-C ratio was related to changes in HbA1c levels and the presence or absence of diabetes after 4–5 years.
Results: Simultaneously, the high TG/HDL-C ratio group had significantly higher mean HbA1c levels. In men, the high TG/HDL-C ratio group showed a tendency of increased HbA1c levels 4–5 years later (P=0.060). In logistic regression analysis, the TG/HDL-C ratio did not show a significant relationship with the incidence of diabetes after 4–5 years.
Conclusion: Although the TG/HDL-C ratio is closely related to HbA1c levels, this study did not predict the increase in HbA1c levels and the occurrence of diabetes after 4–5 years.
Keywords: Triglycerides; Lipoprotein HDL; Glycated Hemoglobin A ; Diabetes Mellitus; Insulin Resistance
  1. Korean Diabetes Association. Korean diabetes fact sheet 2015 [Internet]. Seoul: National Health Insurance Service; c2015 [cited 2016 Apr 12].
  2. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595-607.
  3. DeFronzo RA. Pathogenesis of type 2 diabetes mellitus. Med Clin North Am 2004; 88: 787-835, ix.
    Pubmed CrossRef
  4. Buchanan TA, Xiang AH, Peters RK, Kjos SL, Marroquin A, Goico J, et al. Preservation of pancreatic beta-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in high-risk hispanic women. Diabetes 2002; 51: 2796-803.
    Pubmed CrossRef
  5. DeFronzo RA, Tobin JD, Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol 1979; 237: E214-23.
  6. Shen SW, Reaven GM, Farquhar JW. Comparison of impedance to insulinmediated glucose uptake in normal subjects and in subjects with latent diabetes. J Clin Invest 1970; 49: 2151-60.
    Pubmed KoreaMed CrossRef
  7. Harano Y, Hidaka H, Takatsuki K, Ohgaku S, Haneda M, Motoi S, et al. Glucose, insulin, and somatostatin infusion for the determination of insulin sensitivity in vivo. Metabolism 1978; 27(9 Suppl 1): 1449-52.
  8. Bergman RN, Ider YZ, Bowden CR, Cobelli C. Quantitative estimation of insulin sensitivity. Am J Physiol 1979; 236: E667-77.
  9. Dalla Man C, Campioni M, Polonsky KS, Basu R, Rizza RA, Toffolo G, et al. Two-hour seven-sample oral glucose tolerance test and meal protocol: minimal model assessment of beta-cell responsivity and insulin sensitivity in nondiabetic individuals. Diabetes 2005; 54: 3265-73.
    Pubmed CrossRef
  10. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-9.
    Pubmed CrossRef
  11. Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab 2000; 85: 2402-10.
    Pubmed CrossRef
  12. McLaughlin T, Abbasi F, Cheal K, Chu J, Lamendola C, Reaven G. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med 2003; 139: 802-9.
    Pubmed CrossRef
  13. Li C, Ford ES, Meng YX, Mokdad AH, Reaven GM. Does the association of the triglyceride to high-density lipoprotein cholesterol ratio with fasting serum insulin differ by race/ethnicity? Cardiovasc Diabetol 2008; 7: 4.
    Pubmed KoreaMed CrossRef
  14. Giannini C, Santoro N, Caprio S, Kim G, Lartaud D, Shaw M, et al. The triglycerideto-HDL cholesterol ratio: association with insulin resistance in obese youths of different ethnic backgrounds. Diabetes Care 2011; 34:1869-74.
    Pubmed KoreaMed CrossRef
  15. Bittner V, Johnson BD, Zineh I, Rogers WJ, Vido D, Marroquin OC, et al. The triglyceride/high-density lipoprotein cholesterol ratio predicts all-cause mortality in women with suspected myocardial ischemia: a report from the Women’s Ischemia Syndrome Evaluation (WISE). Am Heart J 2009; 157:548-55.
    Pubmed KoreaMed CrossRef
  16. Park JM, Kang SM, Lee JW, Lee JW, Kim SW, Lee JH, et al. Correlation between the ratio of triglyceride to high-density lipoprotein cholesterol and fasting glucose & hemoglobin A1C. Korean J Fam Pract 2015; 5(Suppl 3):S462-7.
  17. Salazar MR, Carbajal HA, Espeche WG, Leiva Sisnieguez CE, Balbín E, Dulbecco CA, et al. Relation among the plasma triglyceride/high-density lipoprotein cholesterol concentration ratio, insulin resistance, and associated cardio-metabolic risk factors in med and women. AM J Cardiol 2012; 109:1749-53.
    Pubmed CrossRef
  18. Salazar MR, Carbajal HA, Espeche WG, Aizpurúa M, Leiva Sisnieguez CE, March CE, et al. Identifying cardiovascular disease risk and outcome: use of the plasma triglyceride/high-density lipoprotein cholesterol concentration ratio versus metabolic syndrome criteria. J Intern Med 2013; 273: 595-601.
    Pubmed CrossRef
  19. Salazar MR, Carbajal HA, Espeche WG, Leiva Sisnieguez CE, March CE, Balbín E, et al. Comparison of the abilities of the plasma triglyceride/highdensity lipoprotein cholesterol ratio and the metabolic syndrome to identify insulin resistance. Diab Vasc Dis Res 2013; 10: 346-52.
    Pubmed KoreaMed CrossRef
  20. Sung KC, Reaven G, Kim S. Ability of the plasma concentration ratio of triglyceride/high-density lipoprotein cholesterol to identify increased cardiometabolic risk in an east Asian population. Diabetes Res Clin Pract 2014;105: 96-101.
    Pubmed CrossRef
  21. Lillioja S, Mott DM, Spraul M, Ferraro R, Foley JE, Ravussin E, et al. Insulin resistance and insulin secretory dysfunction as precursors of non-insulindependent diabetes mellitus. Prospective studies of Pima Indians. N Engl J Med 1993; 329: 1988-92.
    Pubmed CrossRef
  22. Kim JH, Kwon HS, Park YM, Lim SY, Lee JH, Lee SH, et al. Best surrogate marker for insulin resistance in middle aged non-diabetic Korean: Chungju metabolic syndrome study. Korean J Med 2007; 73: 611-7.

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