Usefulness of the High Triglyceride-to-HDL Cholesterol Ratio to Identify Cardiometabolic Risk Factors and Preclinical Signs of Organ Damage in Outpatient Children

Abstract

OBJECTIVETo evaluate whether the high triglyceride-to-HDL cholesterol (TG-to-HDL-C) ratio is associated with cardiometabolic risk (CMR) factors and preclinical signs of organ damage in an outpatient population of white children and adolescents.RESEARCH DESIGN AND METHODSThe study population included 884 subjects (aged 6–16 years), of whom 206 (23%) were normal weight, 135 (15%) were overweight, and 543 (61%) were obese. Biochemical variables were analyzed in the whole sample, whereas homocysteine and left ventricular (LV) geometry and function were evaluated in 536 and 258 children, respectively.RESULTSThe percentage of pubertal children (P < 0.001), as well as measurements of BMI, waist circumference, homeostasis model assessment of insulin resistance, white blood cell count, alanine aminotransferase (ALT), systolic blood pressure (P < 0.0001, for all), creatinine (P < 0.001), and diastolic blood pressure (P < 0.02), increased from the lowest to the highest tertile of the TG-to-HDL-C ratio. Age, sex, homocysteine, and glomerular filtration rate did not change. Moreover, interventricular septum thickness, relative wall thickness, and LV mass index (P = 0.01 to P < 0.0001) increased across tertiles of the TG-to-HDL-C ratio. Children with a TG-to-HDL-C ratio ≥2.0 showed a two- to threefold higher risk of elevated ALT levels and concentric LV hypertrophy than those with a TG-to-HDL-C ratio <2.0, independent of confounding factors.CONCLUSIONSThe high TG-to-HDL-C ratio is associated with several CMR factors and preclinical signs of liver and cardiac abnormalities in the outpatient, white pediatric population. Thus, a TG-to-HDL-C ratio ≥2.0 may be useful in clinical practice to detect children with a worsened CMR profile who need monitoring to prevent cardiovascular disease in adulthood.

Association of Serum Triglyceride-to-High-density Lipoprotein Cholesterol Ratio with Insulin Resistance and Non-alcoholic Fatty Liver Disease in Children and Adolescents

“…One study in which this relationship was investigated in a pediatric population showed that the association between TG-to-HDL-C and ALT in obese children with NAFLD was independent of visceral adiposity and IR (6). In our study, consistent with these results, we also observed an association between TG-to-HDL-C ratio and elevated ALT.…”

“…In one study based on ALT elevation for the determination of NAFLD, Di Bonito et al (6) determined a high TG/HDL-C ratio as >2 and reported that this value was useful for predicting NAFLD in clinical practice. To the best of our knowledge, no other value has been recommended for NAFLD in the pediatric age group.…”

“…Lipoprotein ratios are considered to be of greater use than isolated lipid values in the assessment of cardiovascular risk in adult patients, since these constitute a more accurate reflection of the interactions between lipid fractions (5). Although NAFLD is known to be a major risk factor for cardiovascular disease, there has been little investigation of the clinical value of lipid ratios in this condition, particularly in the pediatric age group (6)(7)(8)(9). Studies concerning IR and triglyceride-(TG)-to-high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C) have revealed a clear association between them, and TG/HDL ratio was found to be significantly correlated with IR (10).…”

Circunferencia Hipertrigliceridemica Y Perfil De Riesgo Cardiometabolico en Adolescentes Normopeso Y Con Exceso De Peso

“…La relación TGL/HDLc se clasificó como adecuada cuando fue <2.0 (22). Se estableció CHT cuando existió simultáneamente elevación de la CC y trigliceridemia ≥110 mg/dL (10).…”

Relación entre el déficit de sueño nocturno, el exceso de peso y las alteraciones metabólicas en adolescentes

“…21 Se consideró elevado cuando el índice TGL/HDLc fue ≥ 2,0. 22 De acuerdo con el sexo y estadio de maduración puberal, la insulinemia e índice HOMA-IR se definieron como elevados cuando fueron ≥ al percentil 90 informado por Barja y cols. 23 Se calcularon estadísticos descriptivos de tendencia central y frecuencias absolutas y relativas.…”