The Predictive Value of the Triglycerides/HDL-Cholesterol Ratio for Diabetes Incidence

Background: Type 2 diabetes mellitus (DM) is an important disease with an impact on public health globally. Early assessment is necessary with accessible markers, such as the TG/HDL ratio, in predicting DM. Methods: A total of 11,653 subjects from the ELSA-Brazil were included in this analysis and were reevaluated after 3.9 ± 0.6 years of follow-up. Participants were classified according to the quartiles of the TG/HDL index, stratified by sex. ANOVA with Bonferroni correction and p-for-trend analysis were used to compare groups. Cox analysis was performed with adjustments for covariables. Kaplan–Meier curves are presented with the log rank pool and linear analysis. Results: From 11,653 participants (56% female; aged 50.5 ± 8.7 years), 866 (7.8%) were diagnosed with DM (7.2% in women and 7.8% in men). For both sexes, a worsening of the cardiometabolic profile was observed across the increase in TG/HDL quartiles (p < 0.001). Incidence rates of DM increased across TG/HDL quartiles for both men (from Q1 3.3% to Q4 12.8%) and women (from Q1 3.3% to Q4 12.4%). For the entire period, the incidence was highest in participants in the fourth quartile of TG/HDL (log rank analysis < 0.001 for both sexes). In the Cox regression analyses, for men, the HR (95%CI) for risk of DM was 2.4 (1.49–3.26) across the fourth quartile of the TG/HDL ratio, and in women it was 1.57 (1.11–2.22) for the third quartile and 2.08 (1.48–2.93) for the fourth quartile, compared to the first quartile after adjustments. Conclusions: Higher levels of the TG/HDL ratio were independently predictors of DM in both men and women.