title: Association of serum triglyceride-to-HDL cholesterol ratio with carotid artery intima-media thickness, insulin resistance and nonalcoholic fatty liver disease in children and adolescents.
abstract: OBJECTIVE
  The triglyceride (TG)/high-density lipoprotein-cholesterol (HDL-C) ratio has been reported as a useful marker of atherogenic lipid abnormalities, insulin resistance, and cardiovascular disease. We evaluated in a large sample of children and adolescents the association of TG/HDL-C ratio with early signs of morphological vascular changes and cardiometabolic risk factors including nonalcoholic fatty liver disease (NAFLD).
  
  
  RESULTS
  The study population, including 548 children (aged 6-16 years), of whom 157 were normal-weight, 118 overweight, and 273 obese, had anthropometric, laboratory, liver and carotid ultrasonography (carotid artery intima-media thickness-cIMT) data collected. Subjects were stratified into tertiles of TG/HDL-C. There was a progressive increase in body mass index (BMI), BMI-SD score (SDS), waist circumference, blood pressure (BP), liver enzymes, glucose, insulin, homeostasis model assessment of insulin resistance, high-sensitivity C-reactive protein (hsCRP), and cIMT values across TG/HDL-C tertiles. The odds ratios for central obesity, insulin resistance, high hsCRP, NAFLD, metabolic syndrome, and elevated cIMT increased significantly with the increasing tertile of TG/HDL-C ratio, after adjustment for age, gender, pubertal status, and BMI-SDS. In a stepwise multivariate logistic regression analysis, increased cIMT was associated with high TG/HDL-C ratio [OR, 1.81 (95% CI, 1.08-3.04); P < 0.05], elevated BP [5.13 (95% CI, 1.03-15.08); P < 0.05], insulin resistance [2.16 (95% CI, 1.30-3.39); P < 0.01], and NAFLD [2.70 (95% CI, 1.62-4.56); P < 0.01].
  
  
  CONCLUSIONS
  TG/HDL-C ratio may help identify children and adolescents at high risk for structural vascular changes and metabolic derangement.
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Pacifico
authors.affiliation: Department of Experimental Medicine, Sapienza University of Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Bonci
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Andreoli
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Romaggioli
authors.affiliation: Department of Radiological Sciences, Sapienza University of Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Di Miscio
authors.affiliation: Department of Radiological Sciences, Sapienza University of Rome, Italy.
authors.forename: C V
authors.initials: CV
authors.lastname: Lombardo
authors.affiliation: Institute of Translational Pharmacology, National Research Council, Via del Fosso del Cavaliere 100, 00133 Rome, Italy. Electronic address: lucia.pacifico@uniroma1.it.
authors.forename: C
authors.initials: C
authors.lastname: Chiesa
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000517:prevention & control; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D008099:Liver / Q000000981:diagnostic imaging / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood*; D009765:Obesity / Q000097:blood; D050177:Overweight / Q000097:blood; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D055105:Waist Circumference
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides; D002097:C-Reactive Protein
keywords: Carotid artery intima-media thickness; Children; Insulin resistance; Nonalcoholic fatty liver disease; Triglyceride-to-HDL cholesterol ratio