Association Between TG/HDL-C Ratio And Brachial-ankle Pulse Wave Velocity

Objective:The correlation between the ratio of triglyceride to high-density lipoprotein cholesterol(TG/HDL-C)and atherosclerosis is still a controversy.Brachial and ankle pulse wave conduction velocity(ba PWV)is an important indicator for the detection of atherosclerosis.The purpose of this study was to explore the relationship between TG/HDL-C and ba PWV,so as to provide a simple and effective method for the clinical evaluation of early atherosclerosis in healthy population.Methods:A total of 586 healthy subjects who underwent ba PWV test in the Physical Examination Center from July 2019 to July 2020 were randomly selected as the research subjects.At the same time,the basic information,physical examination,laboratory indicators and abdominal color ultrasound data of the subjects were collected.The subjects were divided into three groups according to the TG/HDL-C ratio tertiles.The baseline characteristics of people with different TG/HDL-C tertiles were studied and the heterogeneity between groups was compared.Univariate Logistic analysis was used to determine the related factors of ba PWV.The independent correlation between TG/HDL-C ratio and ba PWV was evaluated using multiple Logistic regression model.The generalized additive model was used to identify the nonlinear relationship,and the threshold saturation effect of the correlation between TG/HDL-C ratio and ba PWV was explored by smoothing curve fitting graph and piecewise linear regression analysis.The subjects were divided into different subgroups according to age,gender,SBP,DBP,BMI,smoking,alcohol consumption,diabetes,hypertension and fatty liver for interactive and stratified analysis.All data were analyzed using SPSS25.0 software and R software.Results:(1)According to the inclusion criteria and exclusion criteria,a total of 586 healthy subjects,ranging in age from 25 to 70 years old(59.03 ± 9.36),were included in the study,including 327 males(55.80%)and 259 females(44.20%).(2)The population were divided into tertiles of TG/HDL-C.Comparison of age,gender,BMI,DBP,FBG,ALT,AST,GGT,CR,UA,TC,LDL-C,alcohol consumption and fatty liver among the three groups showed statistically significant differences(P<0.05).(3)The univariate Logistic analysis results showed that age,SBP,DBP,FBG,GGT,TG/HDL-C,ABI,fatty liver,diabetes,hypertension and ba PWV were positively correlated.(4)When ba PWV was classified based on the 1400cm/s tangent point,TG/HDL-C was positively correlated with ba PWV in multiple Logistic regression models(OR>1,P<0.05),after adjusting for traditional risk factors and potential confounders,the risk of atherosclerosis increased by 63% for each 1 unit increase in TG/HDL-C(OR=1.63,95% CI: 1.24-2.15,P<0.05).(5)The results of the smoothing curve fitting diagram showed that the correlation between TG/HDL-C and ba PWV was not a single linear relationship after adjusting for confounding factors.There was a threshold saturation effect,and the critical value was about 3.26.Further piecewise linear regression model was shown in TG/HDL-C,when TG/HDL-C was less than 3.26,TG/HDL-C was significantly positively correlated with ba PWV,and each 1 unit increase in TG/HDL-C was associated with an increase in ba PWV of 43.34cm/s(β=43.34,95%CI: 16.15-70.53,P<0.05);when TG/HDL-C was more than 3.26,there was no significant correlation between increased TG/HDL-C and increased ba PWV(β=-3.70,95%CI:-32.81-25.41,P>0.05),and the log-likelihood ratio test showed that the slope of regression curves below 3.26 and above 3.26 was significantly different(P=0.036).(6)The results of interaction and stratification analysis showed that age,sex,SBP,DBP,BMI,smoking,alcohol consumption,hypertension,diabetes,and fatty liver had no interaction effect on the association between TG/HDL-C and ba PWV(interaction P>0.05).Conclusion:(1)There was a nonlinear correlation between TG/HDL-C and ba PWV in healthy subjects,and there was a threshold saturation effect.(2)When TG/HDL-C was less than 3.26,TG/HDL-C was positively correlated with ba PWV,and the increase of TG/HDL-C by 1 unit increased ba PWV by 43.34cm/s,which could be used as a simple and effective tool to evaluate the risk of atherosclerosis.(3)When TG/HDL-C was more than 3.26,there was no correlation between TG/HDL-C and ba PWV.