Correlation between triglycerides to high-density lipoprotein cholesterol ratio and visceral obesity in patients with type 2 diabetes mellitus

Objective To investigate the correlation between triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) and visceral fat area (VFA), and to evaluate the application value of TG/HDL-C in predicting type 2 diabetes mellitus (T2DM) complicated with visceral obesity (VO).

Methods A total of 1 676 T2DM patients in the Outpatient Department of Endocrinology of the Affiliated Hospital of Jiangsu University from June 2018 to September 2021 were included. Basic clinical data, laboratory indicators, and anthropometric parameters were retrospectively collected. According to the measured VFA values, they were divided into VAF-L group (VFA < 100 cm², n=1 051) and VO group (VFA≥100 cm², n=625). Based on the quartiles of TG/HDL-C, the subjects were divided into group A (TG/HDL-C < 1.075), group B (TG/HDL-C≥ 1.075- < 1.739), group C (TG/HDL-C≥1.739- < 2.839), and group D (TG/HDL-C≥2.839), with 419 cases in each group. General clinical data, biochemical indicators, anthropometric parameters, and the incidence of VO were compared among the groups. The correlation between VFA and multiple clinical variables was analyzed; the least absolute shrinkage and selection operator (LASSO) regression and a multivariate linear regression model were used to screen potential independent predictors affecting VFA. The differences in TG/HDL-C and related clinical parameters between theVAF-L group and the VO group were compared; the receiver operating characteristic (ROC) curve was used to evaluate the efficacy of TG/HDL-C in predicting T2DM complicated with VO.

Results The proportions of patients with VO in group A, group B, group C, and group D were 20.3%, 36.3%, 42.7%, and 49.9%, respectively, with significant between-group differences (P < 0.05). The incidence of VO in T2DM patients increased with the elevation of TG/HDL-C, and TG/HDL-C was significantly positively correlated with the risk of VO in T2DM patients (P < 0.05). The results of the multivariate linear regression model showed that TG/HDL-C was independently correlated with VFA, and for each unit increase in TG/HDL-C, VFA increased by 0.737 cm². ROC curve analysis showed that in the overall population, the area under the curve of TG/HDL-C for predicting T2DM complicated with VO was 0.641 (95% CI, 0.615 to 0.668, P < 0.01).

Conclusion In the T2DM population, a higher TG/HDL-C level indicates a higher risk of VO. This ratio has certain clinical value in predicting T2DM complicated with VO, and can be used as a simple auxiliary risk assessment indicator.