Abstract
ObjectivesTo explore the association between the triglyceride to HDL-C ratio (TG/HDL-C) and insulin resistance in Chinese patients with newly diagnosed type 2 diabetes mellitus.MethodsPatients with newly diagnosed type 2 diabetes mellitus (272 men and 288 women) were enrolled and divided into three groups according to TG/HDL-C tertiles. Insulin resistance was defined by homeostatic model assessment of insulin resistance (HOMA-IR). Demographic information and clinical characteristics were obtained. Spearman’s correlation was used to estimate the association between TG/HDL-C and other variables. Multiple logistic regression analyses were adopted to obtain probabilities of insulin resistance. A receiver operating characteristic analysis was conducted to evaluate the ability of TG/HDL-C to discriminate insulin resistance.ResultsTG/HDL-C was associated with insulin resistance in Chinese patients with newly diagnosed T2DM (Spearman’s correlation coefficient = 0.21, P < 0.01). Patients in the higher tertiles of TG/HDL-C had significantly higher HOMA-IR values than patients in the lower tertiles [T1: 2.68(1.74–3.70); T2: 2.96(2.29–4.56); T3: 3.09(2.30–4.99)]. Multiple logistic regression analysis showed that TG/HDL-C was significantly associated with HOMA-IR, and patients in the higher TG/HDL-C tertile had a higher OR than those in the lower TG/HDL-C tertile, after adjusting for multiple covariates including indices for central obesity [T1: 1; T2: 4.02(1.86–8.71); T3: 4.30(1.99–9.29)]. Following stratification of waist circumference into quartiles, the effect of TG/HDL-C on insulin resistance remained significant irrespective of waist circumference.ConclusionsTG/HDL-C was associated with insulin resistance independent of waist circumference. Whether it could be a surrogate marker for insulin resistance in Chinese patients with newly diagnosed type 2 diabetes mellitus still needs to be confirmed by more researches.
Highlights
Type 2 diabetes mellitus (T2DM) is a progressive disease, characterized by insulin resistance and ongoing loss of endogenous insulin secretion [1]
TG/high-density lipoprotein cholesterol (HDL-C) was associated with insulin resistance in Chinese patients with newly diagnosed T2DM (Spearman’s correlation coefficient = 0.21, P < 0.01)
Multiple logistic regression analysis showed that TG/HDL-C was significantly associated with homeostatic model assessment of insulin resistance (HOMA-IR), and patients in the higher TG/HDL-C tertile had a higher odds ratios (ORs) than those in the lower TG/HDL-C tertile, after adjusting for multiple covariates including indices for central obesity [T1: 1; P < 0.05 (T2): 4.02 (1.86–8.71); T3: 4.30(1.99–9.29)]
Summary
Type 2 diabetes mellitus (T2DM) is a progressive disease, characterized by insulin resistance and ongoing loss of endogenous insulin secretion [1]. The gold standard method for insulin resistance is glucose clamp technique firstly requested by DeFronzo [4]. It is complex, time-consuming and invasive, making it not feasible for routine clinical applications. Previous studies have demonstrated that insulin resistance identified by homeostasis model assessment (HOMA-IR) is strongly associated with glucose clamp-assessed insulin resistance [5,6,7]. This model utilizes a set of empirically derived equations based on the homeostatic concentration of fasting serum insulin (FINS) and fasting plasma glucose (FPG), which reflect the varying degrees of pancreatic β-cell function and insulin resistance [8]
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