title: Association between the ratio of triglyceride to high-density lipoprotein cholesterol and incident type 2 diabetes in Singapore Chinese men and women.
abstract: BACKGROUND
  Increased triglycerides (TG) and decreased high-density lipoprotein cholesterol (HDL-C) are risk factors for type 2 diabetes (T2D). The relationship between TG:HDL-C ratio and T2D risk is not clear, and it is not known whether the association is modified by gender, body mass index, or fasting status. This study examined the relationship between TG:HDL-C ratio and risk of incident T2D, and the predictive ability of the ratio on top of other diabetes risk factors.
  
  
  METHODS
  Blood biomarkers were determined in 571 T2D cases and 571 controls nested within a prospective, population-based cohort study, the Singapore Chinese Health Study. Participants were free of diagnosed diabetes, cardiovascular disease, and cancer at the time of blood collection (1999-2004). Incident self-reported T2D cases were identified at follow-up interview (2006-10). Controls were matched 1:  1 for age, sex, dialect group, and date of blood collection. Multivariable logistic regression was used to compute the odds ratio (OR) and 95 % confidence interval (CI).
  
  
  RESULTS
  The ORs (95 % CI) of T2D per 1-SD increment in TG and TG:  HDL-C ratio were 1.70 (1.39-2.09) and 1.72 (1.37-2.17), respectively. The relationships were stronger among females than males (Pinteraction= 0.028 and 0.017, respectively), and stronger among lean (<23 kg/m2) than overweight/obese participants (Pinteraction= 0.051 and 0.046, respectively). Both TG and TG:  HDL-C improved T2D prediction to a similar degree.
  
  
  CONCLUSIONS
  Both TG and TG:HDL-C ratio are independent risk factors for incident T2D, and confer greater risk in women and lean participants. The TG:  HDL-C ratio is not a better predictor of diabetes than TG alone.
authors: Saw Swee Hock School of Public Health, National University of Singapore (NUS) and National University Health System, Singapore.
authors: Ye-Li
authors: YL
authors: Wang
authors: Saw Swee Hock School of Public Health, National University of Singapore (NUS) and National University Health System, Singapore.|Duke-NUS Medical School, Singapore.
authors: Woon-Puay
authors: WP
authors: Koh
authors: Saw Swee Hock School of Public Health, National University of Singapore (NUS) and National University Health System, Singapore.
authors: Mohammad
authors: M
authors: Talaei
authors: Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, USA.|Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors: Jian-Min
authors: JM
authors: Yuan
authors: Department of Epidemiology and Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors: An
authors: http://orcid.org/0000-0002-1089-7945
authors: A
authors: Pan
mesh_terms: D044466:Asian People; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012846:Singapore / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood*
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D014280:Triglycerides
keywords: 2型糖尿病; high-density lipoprotein cholesterol; nested case-control study; triglycerides; type 2 diabetes mellitus; 三酰甘油; 巢式病例对照研究; 高密度脂蛋白胆固醇