Triglycerides\HDL Ratio as a Screening Tool for Metabolic Dysfunction in Newly Diagnosed DM Type 2

Abstract

Background: Diabetes mellitus is a growing global health issue associated with high morbidity, mortality, and health care costs. Diabetic dyslipidemia involving increased triglycerides (TG) and lower high-density lipoprotein cholesterol (HDL-C) are key predictors of insulin resistance and cardiovascular disease. Triglyceride-to-HDL cholesterol (TG/HDL-C) ratio is a crude surrogate index for metabolic derangement and insulin resistance.

Objective: To assess the TG/HDL-C ratio as a screening method to identify metabolic dysfunction in patients and evaluate its utility for predicting the glycemic control of newly diagnosed type 2 diabetes mellitus (DM2) patients.

Methods: A cross-sectional study with 80 recently diagnosed DM2 patients in both groups based on HbA1c is recommended to assess good glycemic control (HbA1c <7%, n=40) and poor glycemic control (HbA1c ≥7%, n=40). Measurement of anthropometric parameters was performed including blood pressure, fasting glucose, lipid profile, TG/HDL-C ratio, and TyG index. Traditionally, Spearman correlation analysis was applied to assess association of TG/HDL-C ratio and clinical variables. We ran multiple linear regressions on all HbA1c predictors within normal weight sub-groups and overweight/obese subgroups.

Results: DBP, fasting glucose, triglycerides and TG/HDL-C ratio were statistically significantly higher in patients with HbA1c ≥7% than in patients with HbA1c <7% (p<0.05). TG/HDL-C ratio positively and negatively significantly influenced the BMI (r=0.21), DBP (r=0.27), and TG (r=0.94) and HDL-C (r=−0.59) (p<0.05). In normal weight patients (BMI < 25 kg/m²), logTG/HDL-C predicted HbA1c independently (OR=0.21; p=0.017; R²=0.47). For overweight/obese patients (BMI > 25 kg/m²) TyG index was the only significant independent predictor of HbA1c (OR=0.063; p=0.027; R²=0.25).

Conclusion: The TG/HDL-C ratio is a remarkable predictor of glycemic control in newly diagnosed DM2 patients and can be considered a potential practical screening tool for metabolic dysfunction, especially in the normal weight population. In overweight/obese patients, the TyG index seems the more robust predictor of glycemic control. These low-cost and readily available markers may offer an adjunct to HbA1c in everyday clinical practice.