Association between the triglyceride to high-density lipoprotein cholesterol ratio and diabetes mellitus likelihood in patients with chronic kidney disease
Abstract Background Patients with chronic kidney disease (CKD) are at an increased risk of diabetes mellitus (DM) and dyslipidemia, yet the specific relationship between lipid profiles, particularly triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C ratio), and DM likelihood in thi...
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BMC
2025-08-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-025-04377-9 |
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| author | Mijie Guan Shuang Cui Haiying Song Haofei Hu Bo Hu |
| author_facet | Mijie Guan Shuang Cui Haiying Song Haofei Hu Bo Hu |
| author_sort | Mijie Guan |
| collection | DOAJ |
| description | Abstract Background Patients with chronic kidney disease (CKD) are at an increased risk of diabetes mellitus (DM) and dyslipidemia, yet the specific relationship between lipid profiles, particularly triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C ratio), and DM likelihood in this population has not been thoroughly elucidated. Methods We conducted a cross-sectional analysis of 20,310 unselected patients with CKD enrolled from 2006 to 2015. The relationship between the TG/HDL-C ratio and the likelihood of DM was evaluated using binary logistic regression. Sensitivity and subgroup analyses were performed, and a generalized additive model with smooth curve fitting assessed potential non-linear associations. We also performed the receiver operating characteristic (ROC) curve and decision curve analysis to assess the determination and clinical use, respectively. Results Among the participants (mean age 60.907 ± 10.044 years; 79.580% male), 1,758 (8.656%) had DM. The median TG/HDL-C ratio was 0.655(interquartile range 0.465–0.920). After adjusting for covariates, a significant positive association was found between the TG/HDL-C ratio and DM likelihood (odds ratio [OR], 1.494; 95% confidence interval [CI], 1.354–1.648; P < 0.001). A non-linear relationship was observed with an inflection point at a TG/HDL-C ratio of 1.030. The ORs below and above this point were 1.866 (95% CI, 1.472–2.365) and 1.297 (95% CI, 1.094–1.538), respectively. The area under curve (AUC) of the nomogram was of 0.580 (95% CI, 0.566–0.594). Subgroup analyses indicated a stronger association in patients without hypertension, in female and patients with AF. Conclusion The TG/HDL-C ratio is independently associated with DM likelihood in patients with CKD, exhibiting a non-linear relationship particularly significant when the ratio is below 1.030. The TG/HDL-C ratio may serve as a useful marker for DM likelihood assessment in CKD patients, though prospective studies are needed to determine its role in prevention strategies. Clinical trial number Not applicable. |
| format | Article |
| id | doaj-art-8900ee142111442c8c6a1e549d300b5b |
| institution | Kabale University |
| issn | 1471-2369 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj-art-8900ee142111442c8c6a1e549d300b5b2025-08-24T11:12:47ZengBMCBMC Nephrology1471-23692025-08-0126111910.1186/s12882-025-04377-9Association between the triglyceride to high-density lipoprotein cholesterol ratio and diabetes mellitus likelihood in patients with chronic kidney diseaseMijie Guan0Shuang Cui1Haiying Song2Haofei Hu3Bo Hu4Department of Nephrology, The First Affiliated Hospital of Jinan University, Jinan UniversityDepartment of Nephrology, The First Affiliated Hospital of Jinan University, Jinan UniversityDepartment of Nephrology, Shenzhen Second People’s HospitalDepartment of Nephrology, Shenzhen Second People’s HospitalDepartment of Nephrology, The First Affiliated Hospital of Jinan University, Jinan UniversityAbstract Background Patients with chronic kidney disease (CKD) are at an increased risk of diabetes mellitus (DM) and dyslipidemia, yet the specific relationship between lipid profiles, particularly triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C ratio), and DM likelihood in this population has not been thoroughly elucidated. Methods We conducted a cross-sectional analysis of 20,310 unselected patients with CKD enrolled from 2006 to 2015. The relationship between the TG/HDL-C ratio and the likelihood of DM was evaluated using binary logistic regression. Sensitivity and subgroup analyses were performed, and a generalized additive model with smooth curve fitting assessed potential non-linear associations. We also performed the receiver operating characteristic (ROC) curve and decision curve analysis to assess the determination and clinical use, respectively. Results Among the participants (mean age 60.907 ± 10.044 years; 79.580% male), 1,758 (8.656%) had DM. The median TG/HDL-C ratio was 0.655(interquartile range 0.465–0.920). After adjusting for covariates, a significant positive association was found between the TG/HDL-C ratio and DM likelihood (odds ratio [OR], 1.494; 95% confidence interval [CI], 1.354–1.648; P < 0.001). A non-linear relationship was observed with an inflection point at a TG/HDL-C ratio of 1.030. The ORs below and above this point were 1.866 (95% CI, 1.472–2.365) and 1.297 (95% CI, 1.094–1.538), respectively. The area under curve (AUC) of the nomogram was of 0.580 (95% CI, 0.566–0.594). Subgroup analyses indicated a stronger association in patients without hypertension, in female and patients with AF. Conclusion The TG/HDL-C ratio is independently associated with DM likelihood in patients with CKD, exhibiting a non-linear relationship particularly significant when the ratio is below 1.030. The TG/HDL-C ratio may serve as a useful marker for DM likelihood assessment in CKD patients, though prospective studies are needed to determine its role in prevention strategies. Clinical trial number Not applicable.https://doi.org/10.1186/s12882-025-04377-9Triglyceride to high-density lipoprotein cholesterol ratioDiabetesChronic kidney diseaseNon-linearCross-sectional study |
| spellingShingle | Mijie Guan Shuang Cui Haiying Song Haofei Hu Bo Hu Association between the triglyceride to high-density lipoprotein cholesterol ratio and diabetes mellitus likelihood in patients with chronic kidney disease BMC Nephrology Triglyceride to high-density lipoprotein cholesterol ratio Diabetes Chronic kidney disease Non-linear Cross-sectional study |
| title | Association between the triglyceride to high-density lipoprotein cholesterol ratio and diabetes mellitus likelihood in patients with chronic kidney disease |
| title_full | Association between the triglyceride to high-density lipoprotein cholesterol ratio and diabetes mellitus likelihood in patients with chronic kidney disease |
| title_fullStr | Association between the triglyceride to high-density lipoprotein cholesterol ratio and diabetes mellitus likelihood in patients with chronic kidney disease |
| title_full_unstemmed | Association between the triglyceride to high-density lipoprotein cholesterol ratio and diabetes mellitus likelihood in patients with chronic kidney disease |
| title_short | Association between the triglyceride to high-density lipoprotein cholesterol ratio and diabetes mellitus likelihood in patients with chronic kidney disease |
| title_sort | association between the triglyceride to high density lipoprotein cholesterol ratio and diabetes mellitus likelihood in patients with chronic kidney disease |
| topic | Triglyceride to high-density lipoprotein cholesterol ratio Diabetes Chronic kidney disease Non-linear Cross-sectional study |
| url | https://doi.org/10.1186/s12882-025-04377-9 |
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