Zhang Liying, Chen Shanying, Deng Aiwen, Liu Xinyu, Liang Yan, Shao Xiaofei, Sun Mingxia, Zou Hequn
Department of Nephrology, Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China; Department of Nephrology, First Affiliated Hospital of Inner Mongolia Medical University, Huhehaote, China.
Department of Nephrology, Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China; Department of Nephrology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China.
PLoS One. 2015 Jan 30;10(1):e0116110. doi: 10.1371/journal.pone.0116110. eCollection 2015.
To explore the association of lipid ratios and triglyceride (TG) with insulin resistance (IR) in a Chinese population. We also provide the clinical utility of lipid ratios to identify men and women with IR.
This cross-sectional study included 614 men and 1055 women without diabetes. Insulin resistance was defined by homeostatic model assessment of IR > 2.69. Lipid ratios included the TG/ high density lipoprotein cholesterol (HDL-C), the total cholesterol (TC)/HDL-C and the low density lipoprotein cholesterol (LDL-C)/HDL -C. Logistic regression models and accurate estimates of the area under the receiver operating characteristic (AUROC) curves were obtained.
In normal-weight men, none of lipid ratios nor TG was associated with IR. In overweight/obese men, normal-weight women and overweight/obese women, the TG/HDL-C, the TC/HDL-C and TG were significantly associated with IR, and the associations were independent of waist circumference. All of the AUROCs for the TG/HDL-C and TG were > 0.7. The AUROCs for TC/HDL-C ratio were 0.69-0.77. The optimal cut-offs for TG/HDL-C were 1.51 in men and 0.84 in women. The optimal cut-offs for TG were 1.78 mmol/L in men and 1.49 mmol/L in women, respectively. In men, the optimal cut-off for LDL-C/HDL-C is 3.80. In women, the optimal cut-off for LDL-C/HDL-C is 3.82.
The TG/HDL-C, the TC/HDL-C and TG are associated with IR in overweight/obese men, normal-weight and overweight/obese women. The LDL-C/HDL-C is only associated with IR in normal-weight women. The TG/HDL-C and TG might be used as surrogate markers for assessing IR.
探讨中国人群中血脂比值及甘油三酯（TG）与胰岛素抵抗（IR）的关联。我们还提供了血脂比值在识别患有IR的男性和女性方面的临床效用。
这项横断面研究纳入了614名男性和1055名无糖尿病女性。胰岛素抵抗通过稳态模型评估（HOMA-IR）>2.69来定义。血脂比值包括TG/高密度脂蛋白胆固醇（HDL-C）、总胆固醇（TC）/HDL-C和低密度脂蛋白胆固醇（LDL-C）/HDL-C。获得了逻辑回归模型和受试者工作特征曲线下面积（AUROC）的准确估计值。
在体重正常的男性中，血脂比值和TG均与IR无关。在超重/肥胖男性、体重正常女性和超重/肥胖女性中，TG/HDL-C、TC/HDL-C和TG与IR显著相关，且这些关联独立于腰围。TG/HDL-C和TG的所有AUROC均>0.7。TC/HDL-C比值的AUROC为0.69 - 0.77。TG/HDL-C的最佳截断值男性为1.51，女性为0.84。TG的最佳截断值男性为1.78 mmol/L，女性为1.49 mmol/L。在男性中，LDL-C/HDL-C的最佳截断值为3.80。在女性中，LDL-C/HDL-C的最佳截断值为3.82。
TG/HDL-C、TC/HDL-C和TG与超重/肥胖男性、体重正常和超重/肥胖女性的IR相关。LDL-C/HDL-C仅与体重正常女性的IR相关。TG/HDL-C和TG可能用作评估IR的替代标志物。
