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 - Summary - MDSpire
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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
To evaluate the association between the TG/HDL-C ratio and cardiovascular disease (CVD) risk, with a specific focus on the modifying effect of diabetes status on this association.
Approach:
Literature Search: A systematic search of PubMed, Web of Science, Cochrane Library, and Embase was conducted from inception to June 29, 2025, using specific search terms related to the TG/HDL-C ratio and cardiovascular outcomes.
Study Selection: Twenty-seven cohort studies involving 949,043 participants were included, evaluated using the Newcastle-Ottawa Scale and random-effects models for hazard ratios with 95% confidence intervals.
Key Findings:
The TG/HDL-C ratio is associated with cardiovascular events (HR: 1.53 for diabetics vs. 1.47 for non-diabetics) and all-cause mortality (HR: 1.25 for diabetics vs. 1.23 for non-diabetics) regardless of diabetes status.
The association with stroke was stronger in individuals with diabetes (HR: 1.79) compared to non-diabetics (HR: 1.23).
The association with coronary heart disease was also stronger in diabetics (HR: 1.62) than in non-diabetics (HR: 0.88).
Interpretation:
The certainty of evidence ranged from very low to moderate.
Limitations:
The evidence quality varied, and the associations may not be generalizable to all populations, particularly those with different demographic or health characteristics.
Future studies are needed to validate findings and explore underlying mechanisms.
Conclusion:
The TG/HDL-C ratio is a significant indicator of cardiovascular risk, particularly in diabetic populations.
Plasma proteomic models of more than 40 cell types were associated with incident Alzheimer's disease, amyotrophic lateral sclerosis, cancer, and mortality across three large cohorts.
