Association between Hemoglobin and Diabetes in Relation to the Triglycerides-to-High-Density Lipoprotein Cholesterol (TG-HDL) Ratio in Japanese Individuals: The Nagasaki Islands Study

Abstract

Objective Our previous study reported that categorizing diabetes patients according to the serum triglycerides-to-high-density lipoprotein cholesterol (TG-HDL) ratio is useful for estimating the risk of atherosclerosis, as a high TG-HDL ratio in patients with diabetes constitutes risk factors for atherosclerosis. Another study showed that a high hemoglobin level is associated with the risk of atherosclerosis. However, no previous studies have examined the association between the hemoglobin level and diabetes categorized by the TG-HDL ratio. In order to investigate these associations, we conducted a cross-sectional study of 3,733 (1,299 men and 2,434 women) Japanese participants 30-89 years of age undergoing a general health checkup.
Methods We investigated the association between the hemoglobin levels and the incidence of diabetes in all subjects, who were divided into tertiles according to the TG-HDL ratio. Diabetes was defined as an HbA1c (NGSP) level of ≥6.5% and/or the initiation of glucose-lowering or insulin therapy.
Results Of the 265 diabetes patients identified in this study, 116 had a high TG-HDL ratio (high TG-HDL diabetes) and 71 had a low TG-HDL ratio (low TG-HDL diabetes). Independent from classical cardiovascular risk factors, the multivariate odds ratio of a 1 SD (standard deviation) increment in hemoglobin (1.30 g/dL for men, 1.16 g/dL for women) was 1.04 (95% confidence intervals (CI): 0.88-1.22) for all patients with diabetes, 1.44 (95%CI: 1.17-1.77) for the patients with high TG-HDL diabetes and 0.67 (95%CI: 0.54-0.83) for the patients with low TG-HDL diabetes.
Conclusion The hemoglobin level is positively associated with high TG-HDL diabetes and inversely associated with low TG-HDL diabetes. These findings suggest that measuring the hemoglobin level is clinically relevant for estimating the risk of atherosclerosis in patients with diabetes categorized according to the TG-HDL ratio.