Usefulness of the triglyceride-high-density lipoprotein versus the cholesterol-high-density lipoprotein ratio for predicting insulin resistance and cardiometabolic risk (from the Framingham Offspring Cohort).

Description

In order to measure the usefulness of the triglyceride to HDL cholesterol ratio (TG/HDL), Kannel et al. from the Framingham Offspring Study performed cross-sectional analyses in 3,014 participants and followed them for an average of 6.4 years. During the follow-up, 112 participants experienced a first coronary heart disease (CHD) event. The TG/HDL ratio was positively associated with insulin resistance (as defined by the top quartile of the homeostasis model assessment) upon adjustment for sex and age (r=0.46), which was slightly better than the cholesterol/HDL cholesterol ratio (r=0.38). The authors reported that out of all the available lipid ratios, the TG/HDL ratio was the best correlate of insulin resistance (apolipoprotein B/apolipoprotein AI ratio was not measured). Moreover, insulin resistance increased CHD risk with a hazard ratio of 2.71 (95% CI, 1.79-4.11) per each increase in standard deviation value. This relationship was found to be independent of all studied lipid ratios. These observations suggest that the TG/HDL ratio is a crude correlate of insulin resistance and associated CHD risk.