title: The triglyceride-to-HDL cholesterol ratio: association with insulin resistance in obese youths of different ethnic backgrounds.
abstract: OBJECTIVE
  We evaluated whether the triglyceride-to-HDL cholesterol (TG/HDL-C) ratio is associated with insulin resistance (IR) in a large multiethnic cohort of obese youths.
  
  
  METHODS
  Obese youths (1,452) had an oral glucose tolerance test and a fasting lipid profile. Insulin sensitivity was estimated using the whole body insulin sensitivity index (WBISI) and homeostasis model assessment (HOMA)-IR and evaluated, in a subgroup of 146 obese youths, by the hyperinsulinemic-euglycemic clamp. The cohort was divided by ethnicity (612 whites, 357 Hispanics, and 483 African Americans) and then stratified into ethnicity-specific tertiles of TG/HDL-C ratio. Differences across tertiles were evaluated, and the association between the TG/HDL-C ratio and insulin sensitivity (WBISI) was defined by a multiple stepwise linear regression analysis. The area under the receiver operating characteristic (ROC) curve (AUC) was determined to calculate the TG/HDL-C ratio cutoff to identify insulin-resistant subjects by ethnicity.
  
  
  RESULTS
  In each ethnic group and across rising tertiles of TG/HDL-C ratio, insulin sensitivity (WBISI) progressively decreased, whereas 2-h glucose and the AUC-glucose progressively increased. The cutoff for TG/HDL-C ratio was 2.27, and the odds of presenting with IR, in youths with TG/HDL-C ratio higher than the cutoff, was 6.023 (95% CI 2.798-12.964; P < 0.001) in white girls and boys, whereas for both Hispanics and African Americans the AUC-ROCs were not significant, thus not allowing the calculation of an optimal cutoff TG/HDL-C value.
  
  
  CONCLUSIONS
  The TG/HDL-C ratio is associated with IR mainly in white obese boys and girls and thus may be used with other risk factors to identify subjects at increased risk of IR-driven morbidity.
authors: Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
authors: Cosimo
authors: C
authors: Giannini
authors: Nicola
authors: N
authors: Santoro
authors: Sonia
authors: S
authors: Caprio
authors: Grace
authors: G
authors: Kim
authors: Derek
authors: D
authors: Lartaud
authors: Melissa
authors: M
authors: Shaw
authors: Bridget
authors: B
authors: Pierpont
authors: Ram
authors: R
authors: Weiss
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D005951:Glucose Tolerance Test; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007333:Insulin Resistance / Q000208:ethnology* / Q000502:physiology*; D008297:Male; D009765:Obesity / Q000097:blood* / Q000453:epidemiology / Q000208:ethnology*; D014280:Triglycerides / Q000097:blood*; D044465:White People / Q000706:statistics & numerical data
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides