Behiry Eman G, El Nady Nazih Mohamed, AbdEl Haie Omima M, Mattar May Kamel, Magdy Amira
Department of Clinical and Chemical Pathology, Faculty of Medicine, Benha University, Benha, Egypt.
Department of Pediatrics, Faculty of Medicine, Benha University, Benha, Egypt.
Endocr Metab Immune Disord Drug Targets. 2019;19(5):676-682. doi: 10.2174/1871530319666190121123535.
Homeostasis model assessment for insulin resistance (HOMA-IR) is widely used as a marker of insulin resistance in adults and has also been validated in children and adolescents. Triglyceride (TG) and HDL-C on the other hand is a routine test and inexpensive compared to insulin. Previous studies reported conflicting findings on the usefulness of the triglyceride to HDL-C ratio (TG:HDL-C ratio) as predictor or marker of IR. The aim of this work was to investigate the usefulness of Triglyceride to HDL-C ratio (TG/HDL-C) as an Insulin Resistance (IR) marker in overweight and children with obesity.
This study was a comparative cross sectional study which was conducted on ninety overweight and children with obesity attending National Nutrition Institute "Pediatric obesity clinic. They were classified into 2 groups as follows: group (1) included overweight and children with obesity with insulin resistance, group (2) included overweight and children with obesity with non-insulin resistance. All the subjects were subjected to history, clinical examination and laboratory investigations including total lipid profile, fasting glucose, insulin and TG:HDL-C ratio instead of HOMA ratio.
Prevalence of IR among the studied sample was 42 (46.7%). Mean value of TG/ HDL-C ratio was greater among the insulin resistance group than non insulin resistance group (p value= < 0.001)value). TG/HDL ratio ≥1.36 had 85.7% sensitivity, 66.7% specificity. There was statistically significant positive correlation between TG/HDL ratio and HOMA-IR.
TG:HDL ratio ≥1.36 is a significant early and sensitive predictor of insulin resistance in children instead of HOMA-IR.
胰岛素抵抗的稳态模型评估（HOMA-IR）被广泛用作成人胰岛素抵抗的标志物，并且已在儿童和青少年中得到验证。另一方面，甘油三酯（TG）和高密度脂蛋白胆固醇（HDL-C）是常规检测项目，与胰岛素相比成本较低。先前的研究报告了关于甘油三酯与HDL-C比值（TG:HDL-C比值）作为胰岛素抵抗（IR）预测指标或标志物的有用性存在相互矛盾的结果。这项研究的目的是调查甘油三酯与HDL-C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。
本研究是一项比较性横断面研究，对90名前往国家营养研究所“儿科肥胖诊所”就诊的超重和肥胖儿童进行。他们被分为以下两组：第（1）组包括有胰岛素抵抗的超重和肥胖儿童，第（2）组包括无胰岛素抵抗的超重和肥胖儿童。所有受试者均接受病史、临床检查和实验室检查，包括总血脂谱、空腹血糖、胰岛素以及TG:HDL-C比值而非HOMA比值。
研究样本中IR的患病率为42例（46.7%）。胰岛素抵抗组的TG/HDL-C比值平均值高于非胰岛素抵抗组（p值 = < 0.001）。TG/HDL比值≥1.36的敏感度为85.7%，特异度为66.7%。TG/HDL比值与HOMA-IR之间存在统计学显著正相关。
对于儿童，TG:HDL比值≥1.36是胰岛素抵抗的一个重要早期敏感预测指标，而非HOMA-IR。
