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甘油三酯/高密度脂蛋白胆固醇比值作为委内瑞拉梅里达市儿童和青少年心脏代谢风险标志物的研究

Triglycerides/High density lipoprotein cholesterol ratio as a cardiometabolic risk marker in children and adolescents from Mérida city, Venezuela.

作者信息

Aguirre Miguel, Briceño Yajaira, Gómez-Pérez Roald, Zerpa Yajaira, Camacho Nolis, Paoli Mariela

机构信息

Centro de Investigaciones Endocrino-Metabólicas Dr. Félix Gómez, Facultad de Medicina, Universidad del Zulia, Servicio de Endocrinología, Hospital Universitario de Maracaibo, Maracaibo, Estado Zulia, Venezuela.

Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de Los Andes, Universidad de Los Andes, Mérida, Venezuela.

出版信息

Endocrinol Diabetes Nutr (Engl Ed). 2018 Feb;65(2):74-83. doi: 10.1016/j.endinu.2017.10.010. Epub 2017 Dec 29.

Abstract

OBJECTIVE

To determine the behavior of the triglycerides/HDL-cholesterol ratio (TG/HDL) as a cardiometabolic risk marker in children and adolescents from Mérida, Venezuela.

METHODS

A total of 1292 children and adolescents aged 7-18 years who attended educational institutions in the Libertador Municipality were enrolled into this study. Anthropometric measurements and blood pressure values were recorded. Fasting blood glucose, insulin and lipid levels were measured. The TG/HDL ratio, HOMA-IR, and QUICKI indexes were calculated. Subjects were categorized as with and without cardiometabolic risk based on the presence or absence of 2or more risk factors. Cut-off points for the TG/HDL ratio were determined by constructing ROC curves.

RESULTS

Significantly higher mean TG/HDL ratios were found in pubertal (2.2 ± 1.7) as compared to prepubertal subjects (1.8 ± 1.5; P=.001), with no sex differences. Two or more risk factors were found in 14.7% (n=192) of the participants, in whom TG/HDL ratios were significantly higher as compared to those with no risk (3.5±2.9 versus 1.6±0.8 in prepubertal and 4.1 ± 3.5 versus 1.8 ± 0.9 in pubertal subjects; P=.0001). According to cardiometabolic risk, cut-off points for the TG/HDL ratio of 1.8 and 2.5 were found for prepubertal and pubertal children respectively. These cut-off points showed risks (odds ratio) higher than 2.5 for conditions such as metabolic syndrome, elevated non-HDL-C, abdominal obesity, and elevated HOMA-IR.

CONCLUSION

In this sample of children and adolescents, an elevated TG/HDLc ratio was found to be a good marker for predicting cardiometabolic risk.

摘要

目的

确定甘油三酯/高密度脂蛋白胆固醇比值(TG/HDL)作为委内瑞拉梅里达儿童和青少年心脏代谢风险标志物的表现。

方法

共有1292名年龄在7至18岁、就读于解放者市教育机构的儿童和青少年纳入本研究。记录人体测量数据和血压值。测量空腹血糖、胰岛素和血脂水平。计算TG/HDL比值、HOMA-IR和QUICKI指数。根据是否存在2个或更多风险因素,将受试者分为有和没有心脏代谢风险两类。通过构建ROC曲线确定TG/HDL比值的切点。

结果

与青春期前受试者(1.8±1.5;P=0.001)相比,青春期受试者(2.2±1.7)的平均TG/HDL比值显著更高,且无性别差异。14.7%(n=192)的参与者存在2个或更多风险因素,与无风险者相比,他们的TG/HDL比值显著更高(青春期前分别为3.5±2.9和1.6±0.8,青春期受试者分别为4.1±3.5和1.8±0.9;P=0.0001)。根据心脏代谢风险,发现青春期前和青春期儿童的TG/HDL比值切点分别为1.8和2.5。这些切点显示代谢综合征、非HDL-C升高、腹型肥胖和HOMA-IR升高等情况的风险(比值比)高于2.5。

结论

在这个儿童和青少年样本中,TG/HDLc比值升高被发现是预测心脏代谢风险的良好标志物。

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