Krawczyk Monika, Rumińska Małgorzata, Witkowska-Sędek Ewelina, Majcher Anna, Pyrżak Beata
Department of Paediatric and Endocrinology, Medical Univesity of Warsaw, Warszawa, Poland.
Acta Biochim Pol. 2018 Nov 19;65(4):605-611. doi: 10.18388/abp.2018_2649.
The triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C) is a useful surrogate marker of insulin resistance and cardiovascular risk factors. We aimed to assess the relationship between the TG/HDL-C ratio and insulin resistance (IR) and its usefulness in prediction of the metabolic syndrome (MS). This retrospective study involved 122 obese children with the mean age of 11.6±3 years and their 58 healthy lean peers. Anthropometric measurements, blood pressure, the plasma lipid profile and oral glucose tolerance test (OGTT) were analyzed. Based on the obtained results, the TG/HDL-C ratio and surrogate insulin resistance indices (HOMA-IR, FGIR, QUICKI, OGIS, Matsuda index) were calculated. The TG/HDL-C ratio positively correlated with weight, waist circumference, waist to hip ratio (WHR), lipid profile, HOMA-IR, fasting insulin and insulin measurements during OGTT, and negatively correlated with FGIR, QUICKI, OGIS, and the Matsuda index. Obese children with the TG/HDL-C ratio≥3 (47.5%) had higher values of WHR and HOMA-IR, and lower ones of FGIR, QUICKI, OGIS, and the Matsuda index when compared to their obese peers with the TG/HDL-C<3. The area under the curve (AUC) calculated for each insulin resistance index in prediction of the metabolic syndrome was the largest for the TG/HDL-C ratio (0.8936, 95% Cl:0.809-0.977, p=0.000). For 1 unit increase in the TG/HDL-C ratio, the odds for having MS increased by 2.09 times. The TG/HDL-C ratio is a good surrogate marker of insulin resistance in obese children. When comparing the usefulness of some IR markers in prediction of the metabolic syndrome, the TG/HDL-C ratio seems to be the best one and should be used in clinical practice to identify children at risk of metabolic syndrome development.
甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）是胰岛素抵抗和心血管危险因素的一个有用替代指标。我们旨在评估TG/HDL-C比值与胰岛素抵抗（IR）之间的关系及其在代谢综合征（MS）预测中的效用。这项回顾性研究纳入了122名平均年龄为11.6±3岁的肥胖儿童及其58名健康的瘦体重同龄人。分析了人体测量指标、血压、血脂谱和口服葡萄糖耐量试验（OGTT）。根据所得结果，计算了TG/HDL-C比值和替代胰岛素抵抗指数（HOMA-IR、FGIR、QUICKI、OGIS、松田指数）。TG/HDL-C比值与体重、腰围、腰臀比（WHR）、血脂谱、HOMA-IR、空腹胰岛素以及OGTT期间的胰岛素测量值呈正相关，与FGIR、QUICKI、OGIS和松田指数呈负相关。与TG/HDL-C<3的肥胖同龄人相比，TG/HDL-C比值≥3的肥胖儿童（47.5%）的WHR和HOMA-IR值更高，而FGIR、QUICKI、OGIS和松田指数的值更低。在预测代谢综合征时，为每个胰岛素抵抗指数计算的曲线下面积（AUC）中，TG/HDL-C比值最大（0.8936，95%CI：0.809 - 0.977，p = 0.000）。TG/HDL-C比值每增加1个单位，患MS的几率增加2.09倍。TG/HDL-C比值是肥胖儿童胰岛素抵抗的一个良好替代指标。在比较一些IR标志物在预测代谢综合征中的效用时，TG/HDL-C比值似乎是最佳指标，应在临床实践中用于识别有代谢综合征发生风险的儿童。
