Impact of the triglyceride-to-high-density lipoprotein ratio on 28-day mortality in non-diabetic patients with sepsis

Dong Xiaorong; Ma Li; Zhang Bei; Zheng Xiaojuan; Ma Xiaoxuan; Wang Xiaoxue

doi:10.3969/j.issn.1002-1949.2026.02.001

Abstract：Objective To explore the relationship between the triglyceride-to-high-density lipoprotein(TG/HDL)ratio and the 28-day mortality risk in non-diabetic sepsis patients,and to provide new indicators and evidence for the early clinical identification of patients at a high mortality risk.Methods A retrospective cohort study was conducted,enrolling a total of 578 non-diabetic sepsis cases admitted to the Department of Critical Care Medicine of the Second Hospital of Lanzhou University between January 2015 and November 2024,which were stratified into four groups based on the quartiles of TG/HDL levels(Q1,Q2,Q3,and Q4).Data were analyzed using appropriate statistical methods,including the t-test,non-parametric tests,x2 test,Logistic regression analysis,subgroup analysis,and Kaplan-Meier survival curve analysis.Results In the TG/HDL quartile grouping analysis,there were significant differences among the four groups in terms of age,BMI,heart rate,lymphocyte count,platelet count,multiple biochemical indicators(uric acid,urea nitrogen,creatinine),disease severity scores(APACHE Ⅱ,SOFA),select comorbidities(myocardial infarction,liver disease,kidney disease),treatment modality(CRRT),and 28-day mortality.Logistic regression analysis showed that compared with the Q1 group,in different adjusted models,the 28-day death risks of the Q2 and Q3 groups did not increase significantly;while the death risk of the Q4 group increased significantly(Model 1:OR=3.434,95％CI 2.115-5.575,P＜0.001;Model2:OR=4.655,95％CI 2.772-7.819,P＜0.001;Model3:OR=2.690,95％CI 1.360-5.320,P=0.004).The results of subgroup analysis showed that there was heterogeneity in the association between TG/HDL and 28-day mortality among subgroups of age,gender,hypertension status,and albumin level.The Kaplan-Meier survival curve further indicated that the cumulative survival rate of the Q4 group was significantly lower(P＜0.001).Conclusions The TG/HDL ratio is significantly associated with 28-day mortality in non-diabetic patients with sepsis.Elevated TG/HDL levels may represent a potential risk factor for mortality and could serve as a prognostic indicator in this patient population.However,further large-scale studies are required to validate these findings.