Association between the triglyceride to high-density lipoprotein cholesterol ratio and type 2 diabetes mellitus in non-alcoholic fatty liver disease

This study evaluated the ability of the triglyceride (TG) to high-density lipoprotein cholesterol (TG/HDL-C) ratio to identify individuals at risk of type 2 diabetes mellitus (T2DM) in the non-alcoholic fatty liver disease (NAFLD) population. We retrospectively studied 4,769 patients with NAFLD from the Affiliated Hospital of Hangzhou Normal University (2020-2023). Binary logistic regression models were used to evaluate the association between the TG/HDL-C ratio and lipid parameters with T2DM. TG/HDL-C ratio was positively associated with T2DM in patients with NAFLD, with an odds ratio (OR) of 2.72 (95% confidence interval, 2.23-3.31, p < 0.001) for T2DM in the highest TG/HDL-C ratio quartile compared with the lowest one after adjusting for known confounders. The OR for the TG/HDL-C ratio had a stronger predictive value than those of TG, total cholesterol, HDL-C, and low-density lipoprotein cholesterol, indicating that the TG/HDL-C ratio could be a better discriminator of T2DM. The TG/HDL-C ratio better identifies potential risks of T2DM in individuals with NAFLD than individual lipid parameters. Therefore, clinicians should pay attention to individuals with high TG and low HDL-C levels during T2DM risk assessment in NAFLD cohorts.