title: Triglyceride-to-high-density-lipoprotein-cholesterol ratio is an index of heart disease mortality and of incidence of type 2 diabetes mellitus in men.
abstract: BACKGROUND
  High triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) impart risk for heart disease. This study examines the relationships of TG/HDL-C ratio to mortality from all causes, coronary heart disease (CHD), or cardiovascular disease (CVD).
  
  
  METHODS
  Survival analysis was done in 39,447 men grouped by TG/HDL-C ratio cut point of 3.5 and for metabolic syndrome. National Death Index International Classification of Diseases (ICD-9 and ICD-10) codes were used for CVD and CHD deaths occurring from 1970 to 2008. Incidence of type 2 diabetes mellitus (DM) according to ratio was estimated in 22,215 men. Triglyceride/HDL-C ratio and cross-product of TG and fasting blood glucose (TyG index) were used in analysis.
  
  
  RESULTS
  Men were followed up for 581,194 person-years. Triglyceride/HDL-C ratio predicted CHD, CVD, and all-cause mortality after adjustment for established risk factors and non-HDL-C. Mortality rates were higher in individuals with a high ratio than in those with a low ratio. Fifty-five percent of men had metabolic syndrome that was also predictive of CHD, CVD, and all-cause mortality. Annual incidence of DM was 2 times higher in men with high TG/HDL-C ratio than in those with a low ratio. Individuals with high TG/HDL-C ratio had a higher incidence of DM than those with a low ratio. The TyG index was not equally predictive of causes of mortality to TG/HDL-C, but both were equally predictive of diabetes incidence.
  
  
  CONCLUSIONS
  Triglyceride/HDL-C ratio predicts CHD and CVD mortality as well as or better than do metabolic syndrome in men. Also, a high ratio predisposes to DM. The TyG index does not predict CHD, CVD, or all-cause mortality equally well, but like TG/HDL-C ratio, it predicts DM incidence.
authors.affiliation: From the *Center for Human Nutrition, University of Texas Southwestern Medical Center, the Veterans Affairs Medical Center at Dallas; and †The Cooper Institute, Dallas, TX.
authors.forename: Gloria Lena
authors.initials: GL
authors.lastname: Vega
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Barlow
authors.forename: Scott M
authors.initials: SM
authors.lastname: Grundy
authors.forename: David
authors.initials: D
authors.lastname: Leonard
authors.forename: Laura F
authors.initials: LF
authors.lastname: DeFina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D008076:Cholesterol, HDL / Q000097:blood*; D003327:Coronary Disease / Q000097:blood* / Q000401:mortality*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000401:mortality; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood*; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides