title: The triglycerides-to-HDL-cholesterol ratio and cardiovascular disease risk in obese patients with type 2 diabetes: an observational study from the Swedish National Diabetes Register (NDR).
abstract: OBJECTIVE
  Assessing the association between BMI and risk of coronary heart disease (CHD), cardiovascular disease (CVD) and mortality in patients with type 2 diabetes, also with regard to higher or lower levels of the ratio triglycerides-to-HDL-cholesterol (TG:HDL).
  
  
  METHODS
  54,061 patients with BMI≥18.5kg/m(2), mean age and duration 61.5±8 and 6.9±6 years, 59% males, 14% with CVD history, from the Swedish National Diabetes Register, followed for mean 4.8 years.
  
  
  RESULTS
  Adjusting at Cox regression for non-BMI-linked (age, sex, smoking, CVD history) and BMI-linked (blood lipids, blood pressure, HbA1c, albuminuria) covariates, hazard ratios (HR) for fatal/nonfatal CHD and CVD were mainly increased with prominent obesity (BMI≥35kg/m(2)), 1.19 (p=0.01) and 1.17 (p=0.009), compared to normal weight (BMI 18.5-24.9kg/m(2)), although increased also with obesity (BMI 30-34.9kg/m(2)), 1.34 and 1.30 (p<0.001), when adjusting only for non-BMI-linked covariates. Stratifying by 75th percentile of TG:HDL, with normal weight and TG:HDL<1.9 as reference, obese and prominently obese with TG:HDL≥1.9 had considerably increased HR around 1.7 for fatal/nonfatal CHD and 1.6 for CVD (p<0.001), while obese and prominently obese with TG:HDL<1.9 only had HR 1.2-1.3 for CHD and CVD (p0.003-<0.01).
  
  
  CONCLUSIONS
  Obese T2D patients with high TG:HDL, associated with increased insulin resistance, had considerably increased risk of CHD and CVD.
authors.affiliation: Department of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden. Electronic address: katarina.eeg-olofsson@vgregion.se.
authors.forename: Katarina
authors.initials: K
authors.lastname: Eeg-Olofsson
authors.affiliation: Department of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Soffia
authors.initials: S
authors.lastname: Gudbjörnsdottir
authors.affiliation: Department of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Eliasson
authors.affiliation: Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, and Medical Products Agency, Uppsala, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Zethelius
authors.affiliation: Department of Public Health and Caring Sciences/Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Cederholm
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D001794:Blood Pressure / Q000502:physiology; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology*; D011379:Prognosis; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D015415:Biomarkers; C034396:HDL-triglyceride; D008075:Lipoproteins, HDL; D014280:Triglycerides
keywords: BMI; Cardiovascular diseases; Diabetes; Insulin resistance; Obesity