The Triglyceride/High-Density Lipoprotein Cholesterol Ratio Fails to Predict Insulin Resistance in African-American Women: An Analysis of Jackson Heart Study

Sumner, Anne E.; Harman, Jane; Buxbaum, Sarah G.; Miller, Bernard V.; Tambay, Anita V.; Wyatt, Sharon B.; Taylor, Herman A.; Rotimi, Charles N.; Sarpong, Daniel F.

doi:10.1089/met.2010.0028

Cited by 54 publications

(50 citation statements)

References 14 publications

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“…Lastly TAG:HDL-C also appeared to be associated with added sugar intake among non-Hispanic whites, but not among Mexican-Americans or non-Hispanic blacks. The differential association by race demonstrated in the present study has been seen in other studies examining TAG:HDL-C as an indicator of insulin resistance (27,(30)(31)(32) . In contrast, added sugar intake did not appear to be associated with elevated levels of ALT (surrogate for NAFLD) for the aggregate adolescent population.…”

Section: Discussionsupporting

confidence: 83%

Added sugar intake and metabolic syndrome in US adolescents: cross-sectional analysis of the National Health and Nutrition Examination Survey 2005–2012

Rodríguez¹,

Madsen²,

Cotterman³

et al. 2016

Public Health Nutr.

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Objective: To examine the association between added sugar intake and metabolic syndrome among adolescents. Design: Dietary, serum biomarker, anthropometric and physical activity data from the US National Health and Nutrition Examination Survey cycles between 2005 and 2012 were analysed using multivariate logistic regression models. Added sugar intake in grams per day was estimated from two 24 h standardized dietary recalls and then separated into quintiles from lowest to highest consumption. Multivariate logistic regression analyses were adjusted for physical activity, age, BMI Z-score and energy intake, and their interactions with race were included. Setting: Nationally representative sample, USA. Subjects: US adolescents aged 12-19 years (n 1623). Results: Added sugar was significantly associated with metabolic syndrome. The adjusted prevalence odds ratios for having metabolic syndrome comparing adolescents in the third, fourth and fifth quintiles v. those in the lowest quintile of added sugar were 5·3 (95 % CI 1·4, 20·6), 9·9 (95 % CI 1·9, 50·9) and 8·7 (95 % CI 1·4, 54·9), respectively. Conclusions: Our findings suggest that higher added sugar intake, independent of total energy intake, physical activity or BMI Z-score, is associated with increased prevalence of metabolic syndrome in US adolescents. Further studies are needed to determine if reducing intake of added sugar may help US adolescents prevent or reverse metabolic syndrome.

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Section: Discussionsupporting

confidence: 83%

Added sugar intake and metabolic syndrome in US adolescents: cross-sectional analysis of the National Health and Nutrition Examination Survey 2005–2012

Rodríguez¹,

Madsen²,

Cotterman³

et al. 2016

Public Health Nutr.

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show abstract

“…33,34 We have long postulated that failure of screening tests must be considered. 5,[13][14][15]35 Recently, Carnethon et al determined that diabetics of normal weight had higher overall mortality and higher cardiovascular mortality than their more overweight and obese counterparts. 36 To account for this unexpected finding, the investigators suggested that normal-weight diabetics were diagnosed late in the course of their disease because their health-care providers assumed they were low risk.…”

Section: Discussionmentioning

confidence: 99%

“…But, this remains to be determined. 13,35 Third, we are studying Africans living in the United States rather than Africa. However, when analyses were restricted to Africans who had lived in the United States for less than 5 years, the results did not change.…”

Section: Discussionmentioning

confidence: 99%

Triglyceride-Based Screening Tests Fail to Recognize Cardiometabolic Disease in African Immigrant and African-American Men

Ramsey²,

Castillo³

et al. 2013

Metabolic Syndrome and Related Disorders

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Background: The prevalence of cardiometabolic disease in Africa now rivals that of Western nations. Therefore, screening programs that lead to effective prevention of cardiometabolic disease in Africans is imperative. Most screening tests for cardiometabolic disease use triglyceride (TG) levels as a criterion. However, the failure rate of TG-based screening tests in African Americans is high. In Africans, the efficacy of TG-based screening tests is unknown. Our goal was to determine the association between hypertriglyceridemia (TG ‡ 150 mg/dL) and cardiometabolic disease in African and African-American men. Research Design and Methods: This was a cross-sectional study of 155 men (80 African immigrants, 75 African Americans) [age, 35 -9 years, mean -standard deviation (SD), body mass index (BMI) 28.5 -5.2 kg/m 2 ] who self-identified as healthy. Lipid profiles were performed. Glucose tolerance and insulin resistance was determined by oral glucose tolerance tests (OGTT) and the insulin sensitivity index (S I ), respectively. Cardiometabolic disease was defined by four possible subtypes-prediabetes, diabetes, insulin resistance, or metabolic triad [hyperinsulinemia, hyperapolipoprotein B, small low-density lipoprotein (LDL) particles]. Results: TG levels were higher in men with cardiometabolic disease than without (88 -43 versus 61 -26 mg/dL, P < 0.01). However, < 10% of men with cardiometabolic disease had TG ‡ 150 mg/dL. Even within each cardiometabolic disease subtype, the prevalence of TG ‡ 150 mg/dL was < 10%. Furthermore, TG levels in the 5% of men identified by OGTT as diabetic were £ 100 mg/dL (mean 71 -24, range 45-100 mg/dL). Conclusions: Hypertriglyceridemia is a poor marker of cardiometabolic disease in men of African descent. Therefore TG-based screening tests fail to identify both African immigrants and African-American men with cardiometabolic disease. As a consequence, the opportunity for early intervention and prevention is lost.

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“…This finding is similar to the finding of an age-dependent decline in the association between obesity and diabetes 19) . Because the AUC in the groups older than 40 years was not large enough (low accuracy) to calculate accurate cutoff values for LAP, we analyzed the data lesterol, another good lipid-related index 22) . Therefore, further studies are needed to elucidate whether the cutoff values for a high LAP proposed in this study are applicable to people of other races and ethnicities.…”

Section: 5%mentioning

confidence: 99%

A Strong Association between Lipid Accumulation Product and Diabetes Mellitus in Japanese Women and Men

Wakabayashi

Daimon

2014

JAT

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The Triglyceride/High-Density Lipoprotein Cholesterol Ratio Fails to Predict Insulin Resistance in African-American Women: An Analysis of Jackson Heart Study

Abstract: In African-American men, the recommended TG/HDL-C threshold of 2.0 should be adjusted upward to 2.5. In African-American women, TG/HDL-C cannot identify insulin resistance. The Jackson Heart Study can help determine the efficacy of screening programs in African-Americans.

Cited by 54 publications

References 14 publications

Added sugar intake and metabolic syndrome in US adolescents: cross-sectional analysis of the National Health and Nutrition Examination Survey 2005–2012

Added sugar intake and metabolic syndrome in US adolescents: cross-sectional analysis of the National Health and Nutrition Examination Survey 2005–2012

Triglyceride-Based Screening Tests Fail to Recognize Cardiometabolic Disease in African Immigrant and African-American Men

A Strong Association between Lipid Accumulation Product and Diabetes Mellitus in Japanese Women and Men

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