Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Diabetes and Endocrine Unit, Institute For Medical Research, Kuala Lumpur, Malaysia.
Sci Rep. 2017 Jan 6;7:40055. doi: 10.1038/srep40055.
The purpose of this study was to investigate the usefulness of triglyceride to hdl-c ratio (TG:HDL-C) as an insulin resistance (IR) marker for overweight and obese children. A total of 271 blood samples of obese and overweight children aged 9-16 years were analysed for fasting glucose, lipids and insulin. Children were divided into IR and non-insulin resistance, using homeostasis model assessment (HOMA). The children were then stratified by tertiles of TG: HDL-C ratio. The strength between TG:HDL-C ratio and other parameters of IR were quantified using Pearson correlation coefficient (r). Odds ratio was estimated using multiple logistic regression adjusted for age, gender, pubertal stages and IR potential risk factors. Children with IR had significantly higher TG:HDL-C ratio (2.48) (p = 0.01). TG:HDL-C ratio was significantly correlated with HOMA-IR (r = 0.104, p < 0.005) and waist circumference (r = 0.134, p < 0.001). Increasing tertiles of TG:HDL-C ratio showed significant increase in mean insulin level (p = 0.03), HOMA-IR (p = 0.04) and significantly higher number of children with acanthosis nigricans and metabolic syndrome. The odds of having IR was about 2.5 times higher (OR = 2.47; 95% CI 1.23, 4.95; p = 0.01) for those in the highest tertiles of TG:HDL-C ratio. Hence, TG:HDL-C may be a useful tool to identify high risk individuals.
本研究旨在探讨三酰甘油与高密度脂蛋白胆固醇比值（TG：HDL-C）作为超重和肥胖儿童胰岛素抵抗（IR）标志物的有用性。共分析了 271 例 9-16 岁肥胖和超重儿童的空腹血糖、血脂和胰岛素。采用稳态模型评估（HOMA）将儿童分为 IR 和非胰岛素抵抗。然后根据 TG：HDL-C 比值的三分位数将儿童分层。使用 Pearson 相关系数（r）量化 TG：HDL-C 比值与其他 IR 参数之间的强度。使用多元逻辑回归调整年龄、性别、青春期阶段和 IR 潜在危险因素来估计比值比。IR 儿童的 TG：HDL-C 比值明显更高（2.48）（p=0.01）。TG：HDL-C 比值与 HOMA-IR（r=0.104，p<0.005）和腰围（r=0.134，p<0.001）呈显著相关。TG：HDL-C 比值三分位数的增加显示出平均胰岛素水平（p=0.03）、HOMA-IR（p=0.04）和患有黑棘皮病和代谢综合征的儿童数量显著增加。TG：HDL-C 比值最高三分位数的儿童发生 IR 的几率约为 2.5 倍（OR=2.47；95%CI 1.23，4.95；p=0.01）。因此，TG：HDL-C 可能是识别高危个体的有用工具。
