title: Relationship between TG/HDL-C ratio and metabolic syndrome risk factors with chronic kidney disease in healthy adult population.
abstract: OBJECTIVE
  The triglycerides-to-high-density lipoprotein-cholesterol (TG/HDL-C) ratio has been identified as a biomarker of insulin resistance and a predictor for atherosclerosis. The objectives of this study were to investigate which the TG/HDL-C ratio is useful to detect metabolic syndrome (MS) risk factors and subclinical chronic kidney disease (CKD) in general population without known CKD or renal impairment and to compare predictive accuracy of MS risk factors.
  
  
  METHODS
  This was a cross-sectional study. A total 46,255 subjects aged ≥18 years undergoing health examination during 2010-2011 in Taiwan. The independent associations between TG/HDL-C ratio quartiles, waist circumstance (WC) waist-to-height ratio (WHtR), mean atrial pressure (MAP), and CKD prevalence was analyzed by using logistic regression models. Analyses of the areas under receiver operating characteristic (ROC) were performed to determine the accuracy of MS risk factors in predicting CKD.
  
  
  RESULTS
  A dose-response manner was observed for the prevalence of CKD and measurements of MS risk factors, showing increases from the lowest to the highest quartile of the TG/HDL-C ratio. Males and females in the highest TG/HDL-C ratio quartile (>2.76) had a 1.4-fold and 1.74-fold greater risk of CKD than those in the lowest quartile (≤1.04), independent of confounding factors. Mean arterial pressure (MAP) had the highest AUC for predicting CKD among MS risk factors. The TG/HDL-C ratio was an independent risk factor for CKD, but it showed no superiority over MAP in predicting CKD. A TG/HDL-C ratio ≥2.76 may be useful in clinical practice to detect subjects with worsened cardiometabolic profile who need monitoring to prevent CKD.
  
  
  CONCLUSIONS
  TG/HDL-C ratio is an independent risk factor for CKD in adults aged 18-50 years. MAP was the most powerful predictor over other MS risk factors in predicting CKD. However, longitudinal and comparative studies are required to demonstrate the predictive value of TG/HDL-C on the onset and progression of CKD over time.
authors.affiliation: Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Chih-I
authors.initials: CI
authors.lastname: Ho
authors.affiliation: Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Jau-Yuan
authors.initials: JY
authors.lastname: Chen
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Shou-Yen
authors.initials: SY
authors.lastname: Chen
authors.affiliation: Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Yi-Wen
authors.initials: YW
authors.lastname: Tsai
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Weng
authors.affiliation: Department of Occupation Medicine, Chang-Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Yu-Chung
authors.initials: YC
authors.lastname: Tsao
authors.affiliation: Department of Occupation Medicine, Chang-Gung Memorial Hospital, Taipei, Taiwan. Electronic address: 620313@adm.cgmh.org.tw.
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology*; D012307:Risk Factors; D013624:Taiwan; D014280:Triglycerides / Q000097:blood*; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D014280:Triglycerides
keywords: Chronic kidney disease; Mean arterial pressure; Metabolic syndrome risk factor; TG/HDL-C ratio; eGFR