title: Triglycerides-to-HDL ratio as a new marker of endothelial dysfunction in obese prepubertal children.
abstract: OBJECTIVE
  To investigate whether there is an association of the triglyceride-to-HDL cholesterol (TG:HDL-C) ratio with cardiovascular risk factors and early signs of vascular damage in obese prepubertal children.
  
  
  METHODS
  In 50 obese (27 boys, 7.8±1.4 years) and 37 normal-weight (20 boys; 7.3±1.5 years) prepubertal children, anthropometric measurements, oxidative stress markers (urinary isoprostanes (PGF2α (prostaglandin F2α)), soluble receptor for advanced glycation end-products (sRAGE)) and insulin sensitivity (homeostasis model assessment of insulin resistance (HOMA-IR) and whole-body insulin sensitivity index (WBISI)) were evaluated. Lipids profile was assessed and the TG:HDL-C ratio was calculated. In addition, high-resolution ultrasound was performed to assess carotid intima-media thickness (cIMT).
  
  
  RESULTS
  Obese children showed significantly higher values of the TG:HDL-C ratio (1.9±1.1 vs 1.2±0.6, P=0.002) compared with controls. After dividing the population in tertiles of the TG:HDL-C ratio (<1.04, 1.04-1.67, >1.67), cIMT (P=0.0003), and HOMA-IR (P=0.0001) progressively increased from the lower to the upper tertile, whereas WBISI (P=0.0003) and sRAGE (P=0.05) progressively decreased. In a regression model, the TG:HDL ratio was significantly and positively associated with cIMT (r=0.493; P=0.0005). A cutoff point for TG:HDL-C ratio of 1.12 had 81% sensitivity and 49% specificity in the identification of children with cIMT values in the upper quartile (Area under the curve values from receiver operating characteristic curves=0.633±0.065, P=0.045).
  
  
  CONCLUSIONS
  This study confirms the reliability of the TG:HDL-C ratio as a useful marker of cardiovascular risk. Interestingly, our results underline that the TG:HDL-C ratio is directly related with early signs of vascular damage already present in prepubertal children.
authors.affiliation: Department of Pediatrics, University of Chieti, Ospedale Policlinico, Via dei Vestini 5, 66100 Chieti, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: de Giorgis
authors.forename: M Loredana
authors.initials: ML
authors.lastname: Marcovecchio
authors.forename: Ilaria
authors.initials: I
authors.lastname: Di Giovanni
authors.forename: Cosimo
authors.initials: C
authors.lastname: Giannini
authors.forename: Valentina
authors.initials: V
authors.lastname: Chiavaroli
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarelli
authors.forename: Angelika
authors.initials: A
authors.lastname: Mohn
mesh_terms: D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000097:blood / Q000453:epidemiology*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D014280:Triglycerides