title: Association between hemoglobin and diabetes in relation to the triglycerides-to-high-density lipoprotein cholesterol (TG-HDL) ratio in Japanese individuals: the Nagasaki Islands Study.
abstract: OBJECTIVE
  Our previous study reported that categorizing diabetes patients according to the serum triglycerides-to-high-density lipoprotein cholesterol (TG-HDL) ratio is useful for estimating the risk of atherosclerosis, as a high TG-HDL ratio in patients with diabetes constitutes risk factors for atherosclerosis. Another study showed that a high hemoglobin level is associated with the risk of atherosclerosis. However, no previous studies have examined the association between the hemoglobin level and diabetes categorized by the TG-HDL ratio. In order to investigate these associations, we conducted a cross-sectional study of 3,733 (1,299 men and 2,434 women) Japanese participants 30-89 years of age undergoing a general health checkup.
  
  
  METHODS
  We investigated the association between the hemoglobin levels and the incidence of diabetes in all subjects, who were divided into tertiles according to the TG-HDL ratio. Diabetes was defined as an HbA1c (NGSP) level of ≥ 6.5% and/or the initiation of glucose-lowering or insulin therapy.
  
  
  RESULTS
  Of the 265 diabetes patients identified in this study, 116 had a high TG-HDL ratio (high TG-HDL diabetes) and 71 had a low TG-HDL ratio (low TG-HDL diabetes). Independent from classical cardiovascular risk factors, the multivariate odds ratio of a 1 SD (standard deviation) increment in hemoglobin (1.30 g/dL for men, 1.16 g/dL for women) was 1.04 (95% confidence intervals (CI): 0.88-1.22) for all patients with diabetes, 1.44 (95%CI: 1.17-1.77) for the patients with high TG-HDL diabetes and 0.67 (95%CI: 0.54-0.83) for the patients with low TG-HDL diabetes.
  
  
  CONCLUSIONS
  The hemoglobin level is positively associated with high TG-HDL diabetes and inversely associated with low TG-HDL diabetes. These findings suggest that measuring the hemoglobin level is clinically relevant for estimating the risk of atherosclerosis in patients with diabetes categorized according to the TG-HDL ratio.
authors.affiliation: Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Mio
authors.initials: M
authors.lastname: Nakazato
authors.forename: Takaharu
authors.initials: T
authors.lastname: Sekita
authors.forename: Jun
authors.initials: J
authors.lastname: Koyamatsu
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kadota
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamasaki
authors.forename: Hisashi
authors.initials: H
authors.lastname: Goto
authors.forename: Noboru
authors.initials: N
authors.lastname: Takamura
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Aoyagi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Maeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D050197:Atherosclerosis / Q000097:blood / Q000453:epidemiology*; D015992:Body Mass Index; D002784:Cholesterol; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006454:Hemoglobins; D014280:Triglycerides; D002784:Cholesterol