TG/HDL-C Ratio: A Surrogate Marker of Insulin Resistance in Patients with Metabolic Syndrome

Abstract

Insulin resistance (IR) is hallmark of metabolic syndrome. It is important to identify IR as it is the early stage before development of diabetes mellitus. The standard method to measure insulin resistance is the euglycemic clamp technique, which is laborious. Hence, a number of surrogate measures like homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI) and triglyceride/high density lipoprotein cholesterol (TG/HDL-C) ratio have been developed. Both of the former involve calculations, while TG/HDL ratio may be readily available for clinicians. Therefore, this study was undertaken to assess whether TG/HDL-C ratio serves as a better predictive marker of IR. Objectives: The aim of the present study was to evaluate the triglyceride/HDL-C ratio as a surrogate marker of IR in metabolic syndrome patients. Materials and methods: Total 110 patients were recruited in the study after obtaining informed written consent. They were divided into two groups. Group I included healthy controls (n = 50) and subjects with metabolic syndrome (MS) (n = 60) as per NCEP ATP III criteria were included in group II. Anthropometric measurements and biochemical analysis was performed in all subjects. Results: There was statistically significant difference in anthropometric, glycemic and lipid parameters in control and study group (p < 0.0001). The regression model between HOMA-IR and TG/HDL-C ratio showed was positive correlation (r = 0.29, p = 0.01) while between QUICKI and TG/HDL-C ratio showed negative correlation (r =-0.37, p = 0.002). Conclusion: We report in our study that TG/HDL-C can be adopted in routine laboratory practice as a surrogate marker for prediction of insulin resistance. So that patients with metabolic syndrome may be beneficial at an early stage.

Higher Triglyceride and Normal HDL-C Concentrations, the Triglyceride/HDL-C Concentration Ratios ≥ 3.5, and Insulin Resistance as Potential Predictors of Developing Higher Paroxetine Concentrations and Suicide in the Early Months of Medication

“…Insulin resistance does not always involve the high concentration of blood glucose according to the results by Fujii et al [18], Samant et al [26], and Yin et al [42]. The results reported by Fujii et al [18] and Samant et al [26] suggested that patients with possible insulin resistance defined by HOMA-IR ≥ 2.5 [19] were not in the condition of high blood glucose, but the patients with diabetes were in the condition of high blood glucose [18]. The blood glucose levels 109.4 ± 1.5 mg/dL [18] and 113 ±1.19 mg/dL [26] were reported for the subjects (N = 71) classified as impaired glucose tolerant (IGT) with HOMA-IR 2.7 ± 0.3 [18] and the subjects (N = 60) classified as metabolic syndrome group with TG/HDL-C ratio 4.554 ± 0.152 and HOMA-IR 6.14 ± 0.09 [26].…”

“…Insulin resistance does not always involve the high concentration of blood glucose according to the results by Fujii et al [18], Samant et al [26], and Yin et al [42]. The results reported by Fujii et al [18] and Samant et al [26] suggested that patients with possible insulin resistance defined by HOMA-IR ≥ 2.5 [19] were not in the condition of high blood glucose, but the patients with diabetes were in the condition of high blood glucose [18].…”

“…Shin et al evaluated the data of Korean adults (N = 32,875,039), and reported that the cutoff value of the TG/HDL-C ratio for the fourth upper quartile was ≥3.52 [25]. Samant et al showed the positive correlation between HOMA-IR and TG/HDL-C ratio [26]. HOMA-IR was 2.23 ± 0.69, and TG/HDL-C ratio was 2.4653 ± 0.2094 in the control group (N = 50), while, HOMA-IR was 6.14 ± 0.09, and TG/HDL-C ratio was 4.554 ± 0.152 in the metabolic syndrome group (N = 60) [26].…”

“…Samant et al showed the positive correlation between HOMA-IR and TG/HDL-C ratio [26]. HOMA-IR was 2.23 ± 0.69, and TG/HDL-C ratio was 2.4653 ± 0.2094 in the control group (N = 50), while, HOMA-IR was 6.14 ± 0.09, and TG/HDL-C ratio was 4.554 ± 0.152 in the metabolic syndrome group (N = 60) [26]. Ray et al also reported that the TG/HDL-C ratio was significantly correlated with HOMA-IR in the study to assess whether serum lipoprotein ratios could predict insulin resistance in non-diabetic acute coronary syndrome patients (N = 90) [27].…”

“…Ray et al also reported that the TG/HDL-C ratio was significantly correlated with HOMA-IR in the study to assess whether serum lipoprotein ratios could predict insulin resistance in non-diabetic acute coronary syndrome patients (N = 90) [27]. HOMA-IR 2.5 corresponded to the TG/HDL-C ratio 3.2 in the scatter diagram showing positive correlation between them [26]. Based on these results, it seems likely that the TG/HDL-C concentration (mg/dL) ratios ≥ 3.5 are more certainly useful in identifying individuals who are insulin resistant.…”