PDF(Pubmed)
Abstract：
The current body of evidence on the association between the ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDL-c) and the reversal of prediabetes to normoglycemia remains limited. The aim of this study is to investigate the association between TG/HDL-c and the reversion to normoglycemia in patients with prediabetes.
This retrospective cohort study included 15,107 individuals with prediabetes from 32 Chinese districts and 11 cities who completed health checks from 2010 to 2016. The Cox proportional-hazards regression model examined baseline TG/HDL-c and reversion to normoglycemia from prediabetes. Cox proportional hazards regression with cubic spline functions and smooth curve fitting determined the non-linear connection between TG/HDL-c and reversion to normoglycemia. We also ran sensitivity and subgroup analysis. By characterizing progression to diabetes as a competing risk for the reversal of prediabetes to normoglycemic event, a multivariate Cox proportional hazards regression model with competing risks was created.
Upon adjusting for covariates, the findings indicate a negative association between TG/HDL-c and the likelihood of returning to normoglycemia (HR = 0.869, 95%CI:0.842-0.897). Additionally, a non-linear relationship between TG/HDL-c and the probability of reversion to normoglycemia was observed, with an inflection point of 1.675. The HR on the left side of the inflection point was 0.748 (95%CI:0.699, 0.801). The robustness of our results was confirmed through competing risks multivariate Cox\'s regression and a series of sensitivity analyses.
The present study reveals a negative and non-linear correlation between TG/HDL-c and the reversion to normoglycemia among Chinese individuals with prediabetes. The findings of this study are anticipated to serve as a valuable resource for clinicians in managing dyslipidemia in prediabetic patients. Interventions aimed at reducing the TG/HDL-c ratio through the reduction of TG or elevation of HDL-c levels may substantially enhance the likelihood of achieving normoglycemia in individuals with prediabetes.
This retrospective cohort study included 15,107 individuals with prediabetes from 32 Chinese districts and 11 cities who completed health checks from 2010 to 2016. The Cox proportional-hazards regression model examined baseline TG/HDL-c and reversion to normoglycemia from prediabetes. Cox proportional hazards regression with cubic spline functions and smooth curve fitting determined the non-linear connection between TG/HDL-c and reversion to normoglycemia. We also ran sensitivity and subgroup analysis. By characterizing progression to diabetes as a competing risk for the reversal of prediabetes to normoglycemic event, a multivariate Cox proportional hazards regression model with competing risks was created.
Upon adjusting for covariates, the findings indicate a negative association between TG/HDL-c and the likelihood of returning to normoglycemia (HR = 0.869, 95%CI:0.842-0.897). Additionally, a non-linear relationship between TG/HDL-c and the probability of reversion to normoglycemia was observed, with an inflection point of 1.675. The HR on the left side of the inflection point was 0.748 (95%CI:0.699, 0.801). The robustness of our results was confirmed through competing risks multivariate Cox\'s regression and a series of sensitivity analyses.
The present study reveals a negative and non-linear correlation between TG/HDL-c and the reversion to normoglycemia among Chinese individuals with prediabetes. The findings of this study are anticipated to serve as a valuable resource for clinicians in managing dyslipidemia in prediabetic patients. Interventions aimed at reducing the TG/HDL-c ratio through the reduction of TG or elevation of HDL-c levels may substantially enhance the likelihood of achieving normoglycemia in individuals with prediabetes.
摘要：
目的：目前关于甘油三酯与高密度脂蛋白胆固醇（TG/HDL-c）的比值与糖尿病前期逆转为血糖正常相关的证据仍然有限。这项研究的目的是调查TG/HDL-c与糖尿病前期患者血糖恢复正常之间的关系。
方法：这项回顾性队列研究包括2010年至2016年中国32个地区和11个城市的15,107名糖尿病前期患者。Cox比例风险回归模型检查了基线TG/HDL-c和糖尿病前期血糖恢复正常。使用三次样条函数和平滑曲线拟合的Cox比例风险回归确定了TG/HDL-c与血糖恢复正常之间的非线性联系。我们还进行了敏感性和亚组分析。通过将糖尿病进展描述为糖尿病前期逆转为血糖正常事件的竞争风险，建立了具有竞争风险的多变量Cox比例风险回归模型.
结果：调整协变量后，研究结果表明,TG/HDL-c与血糖恢复正常的可能性呈负相关(HR=0.869,95CI:0.842~0.897).此外,观察到TG/HDL-c与血糖恢复正常概率之间的非线性关系,拐点为1.675。拐点左侧HR为0.748(95CI:0.699,0.801)。通过竞争风险多变量Cox回归和一系列敏感性分析证实了我们结果的稳健性。
结论：本研究显示，在中国糖尿病前期患者中，TG/HDL-c与血糖恢复正常之间存在负相关性和非线性相关性。这项研究的结果有望为临床医生管理糖尿病前期患者的血脂异常提供宝贵的资源。旨在通过降低TG或升高HDL-c水平来降低TG/HDL-c比率的干预措施可能会大大提高糖尿病前期患者实现正常血糖的可能性。
方法：这项回顾性队列研究包括2010年至2016年中国32个地区和11个城市的15,107名糖尿病前期患者。Cox比例风险回归模型检查了基线TG/HDL-c和糖尿病前期血糖恢复正常。使用三次样条函数和平滑曲线拟合的Cox比例风险回归确定了TG/HDL-c与血糖恢复正常之间的非线性联系。我们还进行了敏感性和亚组分析。通过将糖尿病进展描述为糖尿病前期逆转为血糖正常事件的竞争风险，建立了具有竞争风险的多变量Cox比例风险回归模型.
结果：调整协变量后，研究结果表明,TG/HDL-c与血糖恢复正常的可能性呈负相关(HR=0.869,95CI:0.842~0.897).此外,观察到TG/HDL-c与血糖恢复正常概率之间的非线性关系,拐点为1.675。拐点左侧HR为0.748(95CI:0.699,0.801)。通过竞争风险多变量Cox回归和一系列敏感性分析证实了我们结果的稳健性。
结论：本研究显示，在中国糖尿病前期患者中，TG/HDL-c与血糖恢复正常之间存在负相关性和非线性相关性。这项研究的结果有望为临床医生管理糖尿病前期患者的血脂异常提供宝贵的资源。旨在通过降低TG或升高HDL-c水平来降低TG/HDL-c比率的干预措施可能会大大提高糖尿病前期患者实现正常血糖的可能性。
