title: Use of the triglyceride/high-density lipoprotein cholesterol ratio to identify cardiometabolic risk: impact of obesity?
abstract: There is evidence that the plasma concentration ratio of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) identifies insulin resistance and increased cardiometabolic risk and outcome in apparently healthy individuals. Since use of the TG/HDL-C ratio to accomplish this task in persons over a wide range of adiposity has not been studied, the ability of previously defined sex-specific TG/HDL-C cut-points to identify increased cardiometabolic risk was evaluated in apparently healthy normal weight, overweight, and obese individuals. Data were analyzed from a population-based study of apparently healthy men (n=416) and women (n=893), subdivided into categories by body mass index (BMI, kg/m2): normal weight (BMI 20.0-24.9), overweight (BMI 25.0-29.9) and obese (BMI 30.0-34.9). The adiposity groups were further stratified on the basis of their TG/HDL-C ratio into groups defined as being either at 'high risk' versus 'low risk' of cardiometabolic disease. Multiple cardiometabolic risk factors were compared between these subgroups, as was their degree of insulin resistance assessed by fasting plasma insulin concentration and homeostasis model assessment of insulin resistance. The proportion of high-risk individuals varied with BMI category, ranging from 14% (normal weight) to 36% (obese). However, within each BMI category high-risk individuals had a significantly more adverse cardiometabolic risk profile. Finally, the adjusted OR of being insulin resistant was significantly greater in those with a high TG/HDL-C ratio in the normal (3.02), overweight (2.86), and obese (2.51) groups. Thus, irrespective of differences in BMI, the TG/HDL-C ratio identified apparently healthy persons with a more adverse cardiometabolic risk profile associated with an increased prevalence of insulin resistance.
authors.affiliation: Hospital Universitario General San Martín, La Plata, Argentina.|Facultad de Ciencias Médicas, UNLP, La Plata, Argentina.
authors.forename: M R
authors.identifier: 0000-0002-7103-5505
authors.initials: MR
authors.lastname: Salazar
authors.affiliation: Facultad de Ciencias Médicas, UNLP, La Plata, Argentina.
authors.forename: H A
authors.initials: HA
authors.lastname: Carbajal
authors.affiliation: Hospital Universitario General San Martín, La Plata, Argentina.|Facultad de Ciencias Médicas, UNLP, La Plata, Argentina.
authors.forename: W G
authors.initials: WG
authors.lastname: Espeche
authors.affiliation: Hospital Municipal de Rauch, Buenos Aires, Argentina.
authors.forename: M
authors.initials: M
authors.lastname: Aizpurúa
authors.affiliation: Hospital Municipal de San Andrés de Giles, Buenos Aires, Argentina.
authors.forename: A G
authors.initials: AG
authors.lastname: Marillet
authors.affiliation: Hospital Universitario General San Martín, La Plata, Argentina.|Facultad de Ciencias Médicas, UNLP, La Plata, Argentina.
authors.forename: C E
authors.initials: CE
authors.lastname: Leiva Sisnieguez
authors.affiliation: Hospital Universitario General San Martín, La Plata, Argentina.|Facultad de Ciencias Médicas, UNLP, La Plata, Argentina.
authors.forename: B C
authors.initials: BC
authors.lastname: Leiva Sisnieguez
authors.affiliation: Hospital Universitario General San Martín, La Plata, Argentina.|Facultad de Ciencias Médicas, UNLP, La Plata, Argentina.
authors.forename: R N
authors.initials: RN
authors.lastname: Stavile
authors.affiliation: Hospital Universitario General San Martín, La Plata, Argentina.|Facultad de Ciencias Médicas, UNLP, La Plata, Argentina.
authors.forename: C E
authors.initials: CE
authors.lastname: March
authors.affiliation: Stanford University School of Medicine, Stanford, California, USA.
authors.forename: G M
authors.initials: GM
authors.lastname: Reaven
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood*; D003710:Demography; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D008875:Middle Aged; D009765:Obesity / Q000097:blood; D016017:Odds Ratio; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; C034396:HDL-triglyceride; D008075:Lipoproteins, HDL; D014280:Triglycerides
keywords: Cardiovascular Diseases; Insulin; Obesity