1279-P: Cumulative Exposure to High Triglyceride–to–HDL Cholesterol Ratio and Risk of Type 2 Diabetes in Young Adults

Introduction & Objective: As the prevalence of type 2 diabetes in young adults is increasing, predicting and preventing it has become a significant challenge. We aimed to evaluate whether the persistence of high triglyceride-to-HDL cholesterol (TG/HDL-C) ratio, which is a marker for insulin resistance, is associated with type 2 diabetes in young adults, considering the variability in TG/HDL-C levels over time.

Methods: This study used data from South Korea National Health Insurance Service between 2009 and 2012. A total of 1,840,251 young adults without type 2 diabetes aged 20-39 years who had undergone four consecutive annual health checkups were included. Participants were classified into five groups based on the exposure score of high TG/HDL-C ratio over a four-year period: 0, 1, 2, 3, and 4. A TG/HDL-C ratio of ≥2.8 in male and ≥1.7 in female was defined as high TG/HDL-C ratio. The risk for developing type 2 diabetes according to different exposure scores was evaluated using multivariable Cox proportional hazards regression model.

Results: During a follow-up period of 6.53 years, 40,286 (2.2%) participants developed type 2 diabetes. The cumulative incidence of type 2 diabetes significantly increased with higher TG/HDL-C ratio exposure scores (log-rank test, P < 0.001). The multivariable-adjusted hazard ratios for type 2 diabetes were 1.557 (95% CI, 1.463, 1.657), 2.046 (95% CI, 1.929, 2.171), 2.857 (95% CI, 2.707, 3.016), and 4.8 (95% CI, 4.563, 5.048) for groups with scores 1-4, respectively, compared with those with a score of 0.

Conclusion: In this large-scale prospective cohort study of young adults, cumulative exposure to high TG/HDL-C ratio was an independent risk factor for type 2 diabetes in young adults.