Utility of the Triglyceride and HDL Cholesterol Index in Older Persons in Colombia.

BACKGROUND

Alterations in lipid metabolism are key contributors to the development of atherogenesis and the increasing prevalence of atherosclerotic cardiovascular diseases, including coronary artery disease, peripheral arterial disease, and cerebrovascular disease. The triglyceride-to-HDL cholesterol (TG/HDL-c) index is commonly used to assess cardiovascular disease risk; however, its effectiveness in older adults remains unclear.

METHODS

This study evaluated the association and predictive capacity of the TG/HDL-c index for cardiometabolic risk factors in older adults from the SABE Colombian study. A cross-sectional analysis was performed among adults aged ≥ 60 years from the national SABE survey. Univariable and multivariable logistic regression models were constructed to examine associations between the TG/HDL-c index and diabetes or metabolic syndrome, adjusting for age, sex, BMI, smoking, diet, and physical activity. Discriminatory capacity was assessed using receiver operating characteristic curves, and optimal cut-off points were determined using the Youden index.

RESULTS

A total of 23,694 participants with a median age of 69 years were included; 57.3% were women. The TG/HDL-c index was independently associated with both diabetes (adjusted OR per 1 SD: 1.25; 95% CI: 1.13-1.37; p < 0.001) and metabolic syndrome (adjusted OR per 1 SD: 2.82; 95% CI: 2.46-3.22; p < 0.001). The index demonstrated a good discriminatory performance for diabetes (AUC = 0.89; 95% CI: 0.86-0.93; cut-off = 9.17; sensitivity = 0.81; specificity = 0.90) and metabolic syndrome (AUC = 0.86; 95% CI: 0.85-0.88; cut-off = 8.81; sensitivity = 0.71; specificity = 0.92). In contrast, discriminatory performance was limited for hypertension, prediabetes, cardiovascular disease, and cerebrovascular disease (AUC range 0.52-0.67).

CONCLUSIONS

The TG/HDL-c index was independently associated with diabetes and metabolic syndrome and demonstrated good discriminatory performance in this nationally representative sample of older adults. Although these results highlight its potential utility for identifying individuals at higher cardiometabolic risk, further longitudinal studies are needed to validate these findings and determine the prognostic value of TG/HDL-c for clinical decision-making in elderly populations.