title: Relevance of the triglyceride-to-high-density lipoprotein cholesterol ratio as an important lipid fraction in apparently healthy, young, and middle-aged Indian men.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is the largest cause of mortality in Indians. Insulin resistance and related dyslipidemia of increased triglyceride (TG), small dense low-density lipoprotein (sd-LDL) particles, and decreased high-density lipoprotein-cholesterol (HDL-C) are associated with increased risk of CVD. TG/HDL-C ratio could be a potential surrogate marker for this South Asian phenotype. Data are scarce on the relevance of TG/HDL-C ratio as a useful lipid marker among Indians.
  
  
  OBJECTIVE
  To study the prevalence of TG/HDL-C ratio among healthy, young, and middle-aged Indian men (25-44 years) and its relationship with other lipid and nonlipid factors.
  
  
  METHODS
  In this cross-sectional analysis, fasting blood samples from 236 healthy participants recruited from an urban community setting were tested for TG/HDL-C ratio, HDL-C, TG, total cholesterol (TC), non-HDL-C, TC/HDL-C, high-sensitivity C-reactive protein, body mass index (BMI), and body fat.
  
  
  RESULTS
  Mean (standard deviation) age of participants was 34.7 (7.7) years; median (interquartile range) TG/HDL-C ratio was 4 (2.85-5.2). More than half (51.3%) the participants (n= 121) recorded abnormal TG/HDL-C ratio (≥4.0). Across tertiles of TG/HDL-C ratio, there was a significant trend of higher conventional lipid parameters such as non-HDL-C*, TC/HDL-C ratio*, TG*, HDL-C*, TC**; and non-lipid parameters body-fat* and BMI*** (*P< 0.001, **P= 0.015, ***P= 0.002). LDL-C showed moderate and nonsignificant (P= 0.646) increase across tertiles.
  
  
  CONCLUSIONS
  In a sample of apparently healthy, young, and middle-aged Indian men abnormal TG/HDL-C ratio levels were observed among more than half the participants. The TG/HDL-C ratio was closely associated with other lipid parameters and measures of adiposity, such as BMI and body fat, apart from its previously documented unique association with sd-LDL particles. TG/HDL-C ratio should be evaluated in future for risk prediction of incident CVD among Indians.
authors.affiliation: Public Health Foundation of India, Delhi-NCR, New Delhi, India; Department of Food and Nutrition, Lady Irwin College, University of Delhi, New Delhi, India.
authors.forename: Aparna
authors.initials: A
authors.lastname: Kohli
authors.affiliation: Department of Food and Nutrition, Lady Irwin College, University of Delhi, New Delhi, India.
authors.forename: Anupa
authors.initials: A
authors.lastname: Siddhu
authors.affiliation: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ravindra M
authors.initials: RM
authors.lastname: Pandey
authors.affiliation: Public Health Foundation of India, Delhi-NCR, New Delhi, India.
authors.forename: K Srinath
authors.initials: KS
authors.lastname: Reddy
keywords: Indian men; lipid fraction; lipid marker; triglyceride/high-density lipoprotein-cholesterol ratio