Triglyceride to High-Density Lipoprotein Ratio can predict coronary artery calcification

  • Beilei Wang
  • Jinsheng Hua
  • Likun Ma The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China
Keywords: Coronary artery disease, Coronary artery calcification, Triglycerides, High density lipoprotein cholesterol, Risk factor, Prediction model


Objectives: We assessed the TG/HDL-C ratio as a predictor for the presence of coronary artery calcifications (CACs).

Methods: We collected demographic characteristics (age and gender), physical examination (height, weight, BMI, SBP, DBP), comorbidities, medication use, and laboratory variables Triglyceride to High-Density Lipoprotein (TG, HDL-C, TG/HDL-C, UA, TBG, 25-OH-VitD3); and we used coronary angiography to determine the presence of CACs. We performed univariate and multivariate analyses to evaluate the correlation between the TG/HDL-C ratio and CACs and established a predictive model.

Results: CAC was present in 121 patients (25.80%). The levels of TG and TG/HDL-C ratio in the CAC group were higher than those in the non-CAC group, while the level of HDL-C in the CAC group was lower than that in the non-CAC group. The univariate analysis showed that the TG/HDL-C ratio was associated with CAC (OR, 0.021; 95% CI, 0.008 to 0.052; P<0.001), and the multivariate analysis indicated that the ratio was an independent risk factor for CAC (OR, 4.088; 95% CI, 2.787-5.996; P<0.001). Using the ratio to establish a prediction model, the area under the ROC curve was 0.814 (95% CI, 0.775-0.853; P<0.001), suggesting that the TG/HDL-C ratio has a high diagnostic efficiency. The diagnostic threshold was 1.037, and the corresponding sensitivity and specificity were 89.3% and 60.5%, respectively.

Conclusion: The Triglyceride to High-Density Lipoprotein TG/HDL-C ratio is an independent risk factor for CAC with good diagnostic efficacy.

Abbreviations: TG: Triglycerides, HDL-C: High-Density Lipoprotein, CAC: Coronary Artery Calcifications, BMI: Body Mass Index, SBP: Systolic Blood Pressure, DBP: Diastolic Blood Pressure, UA: Uric Acid, FBG: Fasting Blood Glucose, 25-OH-VitD3: 25-Hydroxyvitamin D3, ACEI: Angiotensin-Converting Enzyme Inhibitors, ARB: Angiotensin Receptor Blockers, CCB: Calcium Channel Blockers, ARNI: Angiotensin Receptor-Neprilysin Inhibitor, CAG: Coronary Angiography, AUCROC: Area Under the Receiver Operating Curve.


How to cite this:
Wang B, Hua J, Ma L. Triglyceride to High-Density Lipoprotein Ratio can predict coronary artery calcification. Pak J Med Sci. 2022;38(3):624-631. doi:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to Cite
Wang, B., Hua, J., & Ma, L. (2022). Triglyceride to High-Density Lipoprotein Ratio can predict coronary artery calcification. Pakistan Journal of Medical Sciences, 38(3).