The modifying effect of diabetes on the association between triglyceride to high-density lipoprotein cholesterol ratio and cardiovascular risk: a systematic review and meta-analysis
Bai H, Xia L, Song L, Long Z, Wu Y, Ru J, Li Y, Ni X, Wang Z, Liao L
Frontiers in cardiovascular medicine · 1 cita
Cómo se estudió
- Diseño
- Revisión sistemática (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
Según la declaración de financiación del texto completo.
Publicación
- Publicado
- 2026-06-24 · Front Cardiovasc Med · vol. 13 · pág. 1829984
- Editorial
- Frontiers Media
- Citado
- 1 cita · más que el 86% de estudios similares · 1.9× el promedio de su campo
- Referencias
- 59 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY
- Áreas de investigación
- Diabetes, Cardiovascular Risks, and Lipoproteins · Lipoproteins and Cardiovascular Health · Lipid metabolism and disorders
- Palabras clave
- triglyceride to HDL cholesterol ratio, diabetes mellitus, cardiovascular risk, cardiovascular events, all-cause mortality, stroke, coronary artery disease, lipid biomarkers, dyslipidemia, cardiovascular risk stratification, cardiovascular risk prediction models, cardiovascular risk reclassification
10 autores
- Hao Bai🇨🇳University of South China
- Lihua Xia🇨🇳Hengyang Normal University; Hunan Normal University
- Lingqiao Song🇨🇳University of South China
- Zeyuan Long🇨🇳University of South China
- Youxing Wu🇨🇳Hengyang Normal University; Hunan Normal University
- Jiangyun Ru🇨🇳 · autor de correspondenciaHengyang Normal University; Hunan Normal University
- Yuanzhi Li🇨🇳 · autor de correspondenciaHengyang Normal University; Hunan Normal University
- Xing Ni🇨🇳 · autor de correspondenciaHengyang Normal University; Hunan Normal University
- Zhangyi Wang🇨🇳 · autor de correspondenciaHengyang Normal University; Hunan Normal University
- Li Liao🇨🇳 · autor de correspondenciaUniversity of South China
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Previous studies have demonstrated an association between the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and cardiovascular events. However, whether diabetes modifies this relationship remains unclear. This meta-analysis aimed to evaluate the association between the TG/HDL-C ratio and CVD risk, stratified by diabetes status, and to assess the potential modifying effect of diabetes on this association.
Methods
A systematic search of PubMed, Web of Science, Cochrane Library, and Embase was conducted from inception to June 29, 2025, to identify studies on the TG/HDL-C ratio and its association with cardiovascular events or mortality in diabetic and non-diabetic populations. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale. Random-effects models were used to pool hazard ratios with 95% confidence intervals.
Results
Twenty-seven cohort studies (949,043 participants) were included. The participants had a mean age of 56.58 years [diabetes mellitus (DM): 62.21; non-DM: 55.76], and 51.32% of participants were female (DM: 44.01%; non-DM: 54.34%). The associations between the TG/HDL-C ratio and cardiovascular events (HR: 1.53 vs. 1.47, P = 0.76) and all-cause mortality (HR: 1.25 vs. 1.23, P = 0.89) were similar in DM and non-DM groups. However, the associations with stroke (HR: 1.79 vs. 1.23, P = 0.04) and coronary heart disease (HR: 1.62 vs. 0.88, P = 0.003) were significantly stronger among individuals with DM than among those without DM.
Conclusions
The TG/HDL-C ratio is associated with cardiovascular events and all-cause mortality regardless of diabetes status. The certainty of evidence ranged from very low to moderate. The associations with stroke and coronary heart disease were stronger among individuals with diabetes than among those without diabetes. Future large-scale prospective studies are needed to validate these findings, establish standardized cut-off values, and further investigate the mechanisms underlying the modifying effect of diabetes.
Systematic review registration
https://www.crd.york.ac.uk/PROSPERO/view/CRD420251089171, CRD420251089171.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY).
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