Compared to serum triglyceride alone, the association between serum triglyceride to high-density lipoprotein cholesterol ratio and 10-year cardiovascular disease risk as determined by Framingham risk scores in a large Korean cohort

Abstract

Background: The incidence of cardiovascular disease (CVD) has gradually increased to the extent that it has become the most common cause of mortality worldwide, and triglyceride/high-density lipoprotein cholesterol (TG/HDL) ratio, a surrogate marker of insulin resistance, has emerged as an independent predictor of CVD. Additionally, several recent studies have reported an independent association between triglyceride-rich lipoproteins and CVD risk. The present study was conducted to investigate the association between the CVD risk determined by the Framingham risk score and the TG alone and TG/HDL ratio in a large Korean cohort.

Methods: This cross-sectional study included 6,995 participants aged 30 to 69 years that participated in a health examination program. TG/HDL ratio quartiles and TG quartiles were categorized as follows: Q1: ≤ 1.25, Q2: 1.26-2.07, Q3: 2.08-3.48, and Q4: ≥3.49; Q1: ≤ 71, Q2: 72-105, Q3: 106-159, and Q4: ≥160, respectively. Odds ratios (ORs) and 95% confidence intervals (CI) for high Framingham 10-year CVD risk (≥10%) were calculated across TG/HDL ratio quartiles and TG quartiles using multiple logistic regression analysis after adjusting for confounding variables.

Results: The mean values of most cardiometabolic variables including body mass index, blood pressure, fasting plasma glucose levels, leukocyte count, median CRP levels, and Framingham 10-year CVD risk scores increased gradually with TG/HDL ratio quartiles. The OR (95% CI) of the highest TG/HDL ratio quartile and TG quartile as compared with the lowest TG/HDL ratio quartile and TG quartile for high Framingham 10-year CVD risk was 9.27 (6.68-12.86) and 0.97 (0.69-1.36) after adjusting for confounding variables, respectively.

Conclusion: Compared to TG, the TG/HDL ratio was found to be positively and independently associated with Framingham 10-year CVD risk in a large Korean cohort.

Keywords: Cardiovascular disease; Insulin resistance; TG; TG/HDL ratio.