Does the association of the triglyceride to high-density lipoprotein cholesterol ratio with fasting serum insulin differ by race/ethnicity?
BACKGROUND
The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio has been reported to be as closely correlated with insulin resistance as is the fasting serum insulin concentration (FSI), and therefore it is seen as a clinically useful way to identify the concomitant presence of insulin resistance and dyslipidemia. However, conflicting findings exist for the association of the TG/HDL-C ratio with FSI by race/ethnicity.


METHODS
The associations of FSI concentration, serum triglyceride concentrations, and HDL-C were analyzed using log-binomial regression analyses and receiver operating characteristic (ROC) curve analysis among nondiabetic adults (n = 2652, aged > or = 20 years, 51.2% men) in the United States.


RESULTS
After adjustment for potential confounding effects, the prevalence ratio of hyperinsulinemia was 2.16 (95% confidence interval [CI], 1.74 to 2.08) when using a single cutoff point of 3.5, and 2.23 (95% CI, 1.83 to 2.72) when using race/ethnicity-specific cutoff points of 3.0 for non-Hispanic whites and Mexican Americans and 2.0 for non-Hispanic blacks for the TG/HDL-C ratio. The area under the ROC curve of the TG/HDL-C ratio for predicting hyperinsulinemia was 0.77 (95% CI, 0.74 to 0.79), 0.75 (95% CI, 0.69 to 0.77), and 0.74 (95% CI, 0.69 to 0.76) for non-Hispanic whites, non-Hispanic blacks, and Mexican Americans, respectively.


CONCLUSIONS
There was a significant association between the TG/HDL-C ratio and FSI among three major racial/ethnic groups in the United States. Our results add further support to the notion that the TG/HDL-C ratio may be a clinically simple and useful indicator for hyperinsulinemia among nondiabetic adults regardless of race/ethnicity.
Li
Chaoyang
C
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. cli@cdc.gov
Ford
Earl S
ES
Meng
Yuan-Xiang
YX
Mokdad
Ali H
AH
Reaven
Gerald M
GM
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D008076:Cholesterol, HDL / Q000097:blood*; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood / Q000208:ethnology* / Q000503:physiopathology; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data*; D015995:Prevalence; D012372:ROC Curve; D014280:Triglycerides / Q000097:blood*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides