Possible correlation between Triglyceride/HDL ratio and subclinical myocardial damage in patients with cardiovascular risk factors

The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio is considered a predictor of cardiovascular (CV) disease. The aim of the study was to evaluate the TG/HDL-C ratio as CV risk factor and its possible correlation with subclinical myocardial damage. We enrolled 545 patients, all of whom underwent oral glucose tolerance test (OGTT). The TG/HDL-C ratio was calculated as the arithmetic ratio between triglyceride and HDL cholesterol concentrations. Patients were stratified into four quartiles based on TG/HDL-C values. From the first to the fourth quartile, there was a progressive deterioration in glucose metabolism, as evidenced by significant increases in fasting plasma glucose (FPG), 2-hour glucose, fasting plasma insulin (FPI), 2-hour insulin (all p < 0.001), along with a reduction in insulin sensitivity. Left ventricular global systolic function, assessed via global longitudinal strain (GLS), showed progressive deterioration across quartiles (p < 0.001). Logistic regression analysis revealed that each one-unit increase in the TG/HDL-C ratio was associated with a 61 % higher likelihood of having a pathological GLS (crude odds ratio: 1.61). In conclusion, patients with elevated TG/HDL-C ratios exhibit subclinical myocardial dysfunction even in the absence of clinical symptoms. The TG/HDL-C ratio may represent a simple marker for early identification of CV risk.