Triglyceride to high-density lipoprotein ratio as a predictor for 10-year cardiovascular disease in individuals with diabetes in Thailand

Abstract Background Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. The triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio has emerged as a potential marker for CVD risk. However, its predictive value for high 10-year predicted Cardiovasc...

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Main Authors: Methavee Poochanasri, Sethapong Lertsakulbunlue, Chutawat Kookanok, Ram Rangsin, Wisit Kaewput, Mathirut Mungthin, Parinya Samakkarnthai
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Journal of Health, Population and Nutrition
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Online Access:https://doi.org/10.1186/s41043-025-00835-0
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author Methavee Poochanasri
Sethapong Lertsakulbunlue
Chutawat Kookanok
Ram Rangsin
Wisit Kaewput
Mathirut Mungthin
Parinya Samakkarnthai
author_facet Methavee Poochanasri
Sethapong Lertsakulbunlue
Chutawat Kookanok
Ram Rangsin
Wisit Kaewput
Mathirut Mungthin
Parinya Samakkarnthai
author_sort Methavee Poochanasri
collection DOAJ
description Abstract Background Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. The triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio has emerged as a potential marker for CVD risk. However, its predictive value for high 10-year predicted Cardiovascular (CV) risk remains unclear; This study evaluates the predictive value of the TG/HDL-C ratio for 10-year cardiovascular risk using the Framingham Heart Study (FHS) risk prediction model in individuals with Type 2 Diabetes Mellitus (T2DM). Methods A cross-sectional study was conducted on 61,004 adults from 2014,2015, and 2018 aged 30–74 years with T2DM, without a history of CVD. The FHS model was used to estimate 10-year predicted CV risk, and high CVD risk was defined as ≥ 20%. ROC curve analysis was used to determine the optimal TG/HDL cutoff for high 10-year predicted CV risk in the overall population and age-specific subgroups. Logistic regression was performed to find the association between TG/HDL and high 10-year predicted CV risk, adjusting for potential confounders. Results The optimal TG/HDL-C cutoff was 2.52 (AUC = 0.618, 95% CI: 0.612–0.624), with 67% sensitivity and 50% specificity. Higher TG/HDL were associated with increased odds of high predicted CVD risk in a dose-dependent manner, with an adjusted odds ratio (AOR) of 5.16 (95% CI: 4.86–5.49) in the highest TG/HDL quartile (> 4.91). Age-stratified analysis identified lower cutoffs for older adults (≥ 60 years: 2.42, AUC = 0.694) than younger individuals (< 60 years: 2.98, AUC = 0.636), indicating stronger predictive performance in older adults. Conclusions The TG/HDL ratio is significantly associated with 10-year predicted CVD risk in T2DM with age-specific differences in predictive value. The lower cutoff for older adults (2.42) suggests even modest elevations indicate increased risk. These findings support TG/HDL integration into routine CVD risk assessments and highlight the importance of age-specific cutoffs for improved risk stratification.
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spelling doaj-art-d13653a6665d46e0a824f64811fa6aa22025-08-20T02:15:11ZengBMCJournal of Health, Population and Nutrition2072-13152025-05-0144111110.1186/s41043-025-00835-0Triglyceride to high-density lipoprotein ratio as a predictor for 10-year cardiovascular disease in individuals with diabetes in ThailandMethavee Poochanasri0Sethapong Lertsakulbunlue1Chutawat Kookanok2Ram Rangsin3Wisit Kaewput4Mathirut Mungthin5Parinya Samakkarnthai6Phramongkutklao College of MedicineDepartment of Pharmacology, Phramongkutklao College of MedicinePhramongkutklao College of MedicineDepartment of Military and Community Medicine, Phramongkutklao College of MedicineDepartment of Military and Community Medicine, Phramongkutklao College of MedicineDepartment of Parasitology, Phramongkutklao College of MedicineDivision of Endocrinology, Department of Medicine, Phramongkutklao Hospital and College of MedicineAbstract Background Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. The triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio has emerged as a potential marker for CVD risk. However, its predictive value for high 10-year predicted Cardiovascular (CV) risk remains unclear; This study evaluates the predictive value of the TG/HDL-C ratio for 10-year cardiovascular risk using the Framingham Heart Study (FHS) risk prediction model in individuals with Type 2 Diabetes Mellitus (T2DM). Methods A cross-sectional study was conducted on 61,004 adults from 2014,2015, and 2018 aged 30–74 years with T2DM, without a history of CVD. The FHS model was used to estimate 10-year predicted CV risk, and high CVD risk was defined as ≥ 20%. ROC curve analysis was used to determine the optimal TG/HDL cutoff for high 10-year predicted CV risk in the overall population and age-specific subgroups. Logistic regression was performed to find the association between TG/HDL and high 10-year predicted CV risk, adjusting for potential confounders. Results The optimal TG/HDL-C cutoff was 2.52 (AUC = 0.618, 95% CI: 0.612–0.624), with 67% sensitivity and 50% specificity. Higher TG/HDL were associated with increased odds of high predicted CVD risk in a dose-dependent manner, with an adjusted odds ratio (AOR) of 5.16 (95% CI: 4.86–5.49) in the highest TG/HDL quartile (> 4.91). Age-stratified analysis identified lower cutoffs for older adults (≥ 60 years: 2.42, AUC = 0.694) than younger individuals (< 60 years: 2.98, AUC = 0.636), indicating stronger predictive performance in older adults. Conclusions The TG/HDL ratio is significantly associated with 10-year predicted CVD risk in T2DM with age-specific differences in predictive value. The lower cutoff for older adults (2.42) suggests even modest elevations indicate increased risk. These findings support TG/HDL integration into routine CVD risk assessments and highlight the importance of age-specific cutoffs for improved risk stratification.https://doi.org/10.1186/s41043-025-00835-0Triglyceride to HDL ratioTG/HDLAssociationCardiovascular riskDiabetes mellitusThailand
spellingShingle Methavee Poochanasri
Sethapong Lertsakulbunlue
Chutawat Kookanok
Ram Rangsin
Wisit Kaewput
Mathirut Mungthin
Parinya Samakkarnthai
Triglyceride to high-density lipoprotein ratio as a predictor for 10-year cardiovascular disease in individuals with diabetes in Thailand
Journal of Health, Population and Nutrition
Triglyceride to HDL ratio
TG/HDL
Association
Cardiovascular risk
Diabetes mellitus
Thailand
title Triglyceride to high-density lipoprotein ratio as a predictor for 10-year cardiovascular disease in individuals with diabetes in Thailand
title_full Triglyceride to high-density lipoprotein ratio as a predictor for 10-year cardiovascular disease in individuals with diabetes in Thailand
title_fullStr Triglyceride to high-density lipoprotein ratio as a predictor for 10-year cardiovascular disease in individuals with diabetes in Thailand
title_full_unstemmed Triglyceride to high-density lipoprotein ratio as a predictor for 10-year cardiovascular disease in individuals with diabetes in Thailand
title_short Triglyceride to high-density lipoprotein ratio as a predictor for 10-year cardiovascular disease in individuals with diabetes in Thailand
title_sort triglyceride to high density lipoprotein ratio as a predictor for 10 year cardiovascular disease in individuals with diabetes in thailand
topic Triglyceride to HDL ratio
TG/HDL
Association
Cardiovascular risk
Diabetes mellitus
Thailand
url https://doi.org/10.1186/s41043-025-00835-0
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