Usefulness of the Triglycerides to High-Density Lipoprotein Cholesterol ratio (TG/HDL-C) in prediction of metabolic syndrome in Polish obese children and adolescents

Abstract

The triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C) is a useful surrogate marker of insulin resistance and cardiovascular risk factors. We aimed to assess the relationship between the TG/HDL-C ratio and insulin resistance (IR) and its usefulness in prediction of the metabolic syndrome (MS). This retrospective study involved 122 obese children with the mean age of 11.6±3 years and their 58 healthy lean peers. Anthropometric measurements, blood pressure, the plasma lipid profile and oral glucose tolerance test (OGTT) were analyzed. Based on the obtained results, the TG/HDL-C ratio and surrogate insulin resistance indices (HOMA-IR, FGIR, QUICKI, OGIS, Matsuda index) were calculated. The TG/HDL-C ratio positively correlated with weight, waist circumference, waist to hip ratio (WHR), lipid profile, HOMA-IR, fasting insulin and insulin measurements during OGTT, and negatively correlated with FGIR, QUICKI, OGIS, and the Matsuda index. Obese children with the TG/HDL-C ratio≥3 (47.5%) had higher values of WHR and HOMA-IR, and lower ones of FGIR, QUICKI, OGIS, and the Matsuda index when compared to their obese peers with the TG/HDL-C<3. The area under the curve (AUC) calculated for each insulin resistance index in prediction of the metabolic syndrome was the largest for the TG/HDL-C ratio (0.8936, 95% Cl:0.809–0.977, p=0.000). For 1 unit increase in the TG/HDL-C ratio, the odds for having MS increased by 2.09 times. The TG/HDL-C ratio is a good surrogate marker of insulin resistance in obese children. When comparing the usefulness of some IR markers in prediction of the metabolic syndrome, the TG/HDL-C ratio seems to be the best one and should be used in clinical practice to identify children at risk of metabolic syndrome development.

TG : HDL-C Ratio Is a Good Marker to Identify Children Affected by Obesity with Increased Cardiometabolic Risk and Insulin Resistance

“…The utility of TG : HDL-C ratio in predicting IR among children with obesity has been reported in prior studies [11, 14, 28, 29]. Similarly, studies have also shown the use of TG : HDL-C ratio in identifying children at risk for MetS [14, 30, 31]. In this study, we found that TG : HDL-C ratio ≥1.11 (sensitivity = 42.7%, specificity = 74.8%) separated children with the highest tertile of TG : HDL-C ratio from the remaining two-thirds.…”

Obesity, metabolic syndrome, and primary hypertension

“…Other abnormalities typical of metabolic syndrome, i.e., low HDL cholesterol and high triglycerides, are surrogate markers of IR and relatively low muscle mass [41]. Overall, the prevalence of metabolic syndrome among adolescents with PH was within the range of 15-20%, in comparison with 0.2-2.8% depending on age, in the general paediatric populations of European countries (IDF definition) [42][43][44][45]. In the USA, using the definition formulated by Cook et al, metabolic syndrome was diagnosed in up to 8.6% of young people from the general population, more commonly among males [46].…”

“…The above-described main abnormalities found in children with PH and typical of metabolic syndrome, immune activation, and sympathetic drive, are closely associated with TOD. It has been documented that the prevalence of left ventricular hypertrophy (LVH) correlates with the exposure to metabolic syndrome criteria, and severe LVH was found only in hypertensive patients who suffered from metabolic syndrome [42]. Similarly, subclinical hypertensive arterial injury, expressed as increased carotid intima-media thickness (cIMT), correlates with lower adiponectin concentrations and higher inflammatory activity [42,65].…”

Lower Baseline Serum Triglyceride Levels Are Associated With Higher Decrease in Body Mass Index After Laparoscopy Sleeve Gastrectomy Among Obese Patients

“…Additionally, they found that HDL-C levels (<0.35 g/l), VLDL-TG levels (>0.656 g/l) can predict the presence of atherosclerotic plaque. In recent years, emerging studies have shown that the TG:HDL ratio can replace HOMA-IR and become a sensitive biomarker for early prediction of insulin resistance and cardiometabolic risk in obese people ( 37 – 39 ). Studies have highlighted that HDL can inhibit lipid oxidation and rebuild endothelial cells’ function, and has shown anti-inflammatory and anti-apoptotic activities in animal models ( 40 ).…”