TG/HDL-C ratio as a predictor of stroke in the population with healthy BMI: The Jichi Medical School Cohort Study

Background and aims The triglycerides-to-high-density lipoprotein cholesterol ratio (TG/HDL-C) is a predictor of metabolic syndrome and cardiovascular disease onset. However, the relationship between TG/HDL-C and stroke has not been established. This study examined whether TG/HDL-C helps in predicting stroke onset; this was compared between the whole population and healthy body mass index (BMI) population. Methods and results The Jichi Medical School Cohort Study is a prospective cohort study involving baseline data collected in 12 Japanese districts between April 1992 and July 1995. We used data from 11,699 participants; participants with a healthy BMI (20.0–24.9 kg/m2) were grouped into sex-specific TG/HDL-C quartiles. Using the first quartile groups as references, the hazard ratios (HRs) and 95% confidence intervals (CIs) of the Cox proportional hazards model were calculated. During the mean 10.8 years of follow-up, 419 new stroke events were recorded. The multivariable-adjusted HRs (95% CIs) in the fourth quartile of the whole population were 1.28 (0.94–1.75), 1.78 (0.91–3.48), 1.20 (0.82–1.77), and 1.13 (0.50–2.54), as compared to those in the fourth quartile of the healthy BMI population, which were 1.87 (1.24–2.83), 3.06 (1.21–7.74), 1.79 (1.05–3.05), and 1.29 (0.49–3.41) for all patients with all stroke, intracerebral hemorrhage, cerebral infarction, and subarachnoid hemorrhage, respectively. Conclusion Increased TG/HDL-C correlated with a significant increase in stroke risk only in the healthy BMI population and not the whole population. Furthermore, it was primarily associated with increased intracerebral hemorrhage and cerebral infarction risk.