Risk assessment of metabolic syndrome in adolescents using the triglyceride/high-density lipoprotein cholesterol ratio and the total cholesterol/high-density lipoprotein cholesterol ratio

Abstract

Purpose This study was conducted to investigate the distributions of the triglyceride (TG) to high-density lipoprotein-cholesterol (HDL-C) ratio and total cholesterol (TC) to HDL-C ratio, and to explore their usefulness as markers of metabolic syndrome (MetS) in Korean adolescents. Methods We obtained data for 2,721 adolescents (1,436 boys and 1,285 girls) aged 10–18 years who participated in the Korean National Health and Nutrition Examination Surveys from 2008 to 2010. International Diabetes Federation criteria were used to define MetS. Results There were no significant gender-related differences in TG/HDL-C or TC/HDL-C ratios. These lipid ratios showed significant associations with homeostatic model assessment for insulin resistance (HOMA-IR) and waist circumference. Areas under the receiver operating characteristic curve to identify MetS were 0.947 for TG/HDL-C and 0.924 for TC/HDL-C, which were higher than that of HOMA-IR (0.822). Optimal cutoff values (sensitivity, specificity) of TG/HDL-C and TC/HDL-C ratios for MetS prediction were 3.3 (85.7%, 89.9%), and 3.8 (92.9%, 82.8%), respectively. Odds ratio (OR; 95% confidence intervals [CIs]) for MetS in adolescents with TC/HDL-C ratio above the cutoff value was 14.8 (2.8–77.4), while that for TG/HDL-C ratio about the cutoff value was 30.6 (6.0–157.6). In adolescents who had both lipid ratios above the cutoff values, the OR (95% CI) for MetS was 36.2 (7.2–186.2). Conclusion TG/HDL-C and TC/HDL-C ratios are useful markers of metabolic syndrome with high predictive value in Korean adolescents.

High TG/HDL ratio suggests a higher risk of metabolic syndrome among an elderly Chinese population: a cross-sectional study

“…For example, the TG/HDL-C ratio has been found to have a high predictive value for MetS among Korean adolescents. 21 Prior to our study, research on the link between TG/HDL-C and MetS in the Chinese elderly was rare. Additionally, many clinical trials to date have shown that lipid metabolism disorder has toxic effects on cells, which can affect the function of islet β cells and cause or aggravate insulin resistance.…”

“… 22 Insulin resistance and deficiency of insulin secretion can further aggravate lipid metabolism disorders. 21 23 24 In the future, studies can carefully investigate the effectiveness of the TG/HDL-C ratio in the diagnosis of insulin resistance since these measurements are usually easier to obtain than performing the insulin resistance test.…”

Lipid Biomarkers as Predictors of Diastolic Dysfunction in Diabetes with Poor Glycemic Control

“…Their levels of total cholesterol (TC) were 172.0 mg/dL, low-density lipoprotein cholesterol (LDL) was 106.54 mg/dL and they had a high-density lipoprotein cholesterol (HDL) of 50.0 mg/dL (171.0, 101.0 and 49.0 mg/dL, as averages of the last three years, respectively). Concerning to triglycerides (TG), girls showed a concentration of 90.0 mg/dL in the latest year (86.0 mg/dL as median for three years), and thus the risk scores for atherosclerosis (TC/HDL ratio) and that for insulin resistance (TG/HDL ratio) were 3.46 and 1.67, respectively (3.57 and 1.84 for the last three years), which fell within the normal ranges [23][24][25]. Body mass index (BMI) was 21.25 kg/m 2 , with BMI-SDS of 0.59 and height-SDS of −0.77, and their waist circumference (WC) was 71.77 cm (Table 1).…”

“…They exhibited TC levels of 163.5 mg/dL and had an LDL of 98.32 mg/dL and HDL of 43.5 mg/dL (169.5, 96.0 and 49.0 mg/dL as averages of the last three years, respectively). In boys, the median of TG levels was 83.5 mg/dL (80.0 mg/dL in the last three years) and thus the ratios for TC/HDL and TG/HDL were 3.44 and 1.71, respectively (3.39 and 1.72 in the last 3 years), falling also within the safety ranges [23][24][25]. The BMI was 20.61 kg/m 2 , with BMI-SDS of 0.51 and height-SDS of −0.80, and the WC was 71.06 cm (Table 1).…”

“…Thus, in the Diabetes Control and Complications Trial (DCTT), patients with poorly controlled insulin-treated T1DM were found to have low HDL levels [51]. Consequently, a TC/HDL higher than 3.8 has been suggested to predict cardiovascular injuries (i.e., ischemic heart disease) in adolescents [23]. Similarly, a TG/HDL ratio greater than 3 has been considered a marker of insulin resistance in adults, and that a ratio over 2.05 may be a good indicator of insulin resistance in youth [24,52].…”