title: Comparison of the abilities of the plasma triglyceride/high-density lipoprotein cholesterol ratio and the metabolic syndrome to identify insulin resistance.
abstract: This study compares the ability of an elevated triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio, using sex-specific cut-points, to identify insulin-resistant individuals within a population without known cardiac disease or diabetes with that obtained using the diagnostic criteria of the metabolic syndrome (MetS). Measurements were made of waist circumference (WC), systolic and diastolic blood pressure, fasting plasma glucose, fasting plasma insulin (FPI), plasma TG and plasma HDL-C concentrations in 1102 women and 464 men. These data were used to classify subjects as being insulin resistant (FPI concentration in the upper quartile) and having the MetS or an elevated TG/HDL-C ratio (>2.5 and >3.5 for women and men, respectively). The sensitivity and specificity with which the two indices identified insulin-resistant subjects were similar (43% and 81% for TG/HDL-C ratio and 45% and 82% for MetS), as the number of individuals was found with either an elevated TG/HDL-C ratio (n = 386) or the MetS (n = 384). Eighty-one per cent of the individuals were identified concordantly. Cardio-metabolic risk profiles in 'low-risk' individuals identified by a low TG/HDL-C ratio were comparable to those who did not have the MetS, and this was also the case when comparing 'high-risk' groups identified by having the MetS or an elevated TG/HDL-C ratio. These findings suggest that TG/HDL-C concentration ratio is as adequate as MetS diagnosis to identify insulin-resistant subjects.
authors.affiliation: Hospital Universitario General San Martín, La Plata, Argentina. salazarlandea@gmail.com
authors.forename: Martin R
authors.initials: MR
authors.lastname: Salazar
authors.forename: Horacio A
authors.initials: HA
authors.lastname: Carbajal
authors.forename: Walter G
authors.initials: WG
authors.lastname: Espeche
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Leiva Sisnieguez
authors.forename: Carlos E
authors.initials: CE
authors.lastname: March
authors.forename: Eduardo
authors.initials: E
authors.lastname: Balbín
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Dulbecco
authors.forename: Marcelo
authors.initials: M
authors.lastname: Aizpurúa
authors.forename: Alberto G
authors.initials: AG
authors.lastname: Marillet
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Reaven
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000175:diagnosis; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood*; D055105:Waist Circumference / Q000502:physiology
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides
keywords: cardio-metabolic risk; insulin resistance; metabolic syndrome; triglyceride/high-density lipoprotein cholesterol ratio