Document Detail


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).
MedLine Citation:
PMID:  18312765     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Increased triglycerides (TG) and decreased high-density lipoprotein (HDL) cholesterol are key metabolic abnormalities in patients with insulin resistance (IR) states, including diabetes mellitus. The TG/HDL cholesterol ratio was advocated as a simple clinical indicator of IR, but studies yielded inconsistent results. The total cholesterol/HDL cholesterol ratio was widely used to assess lipid atherogenesis, but its utility for assessing IR or its associated coronary heart disease (CHD) risk was unknown. TG/HDL cholesterol and total cholesterol/HDL cholesterol ratios were related to IR (top quartile of the homeostasis model assessment-IR) in 3,014 patients (mean age 54 years; 55% women). Logistic regression was used to construct receiver-operator characteristic curves for predicting IR, with lipid ratios as predictors. Multivariable Cox regression was used to evaluate whether adjusting for lipid ratios attenuated the association of IR with CHD. Cross sectionally, age- and gender-adjusted correlations of IR were 0.46 with TG/HDL cholesterol ratio and 0.38 with total/HDL cholesterol ratio. IR prevalence increased across tertiles of lipid ratios (p <0.0001). The area under the receiver-operator characteristic curves for predicting IR with TG/HDL cholesterol ratio was 0.745, slightly higher than that for total/HDL cholesterol ratio (0.707; p <0.001 for comparison). On follow-up (mean 6.4 years), 112 patients experienced initial CHD events. IR was associated with CHD risk (multivariable-adjusted hazards ratio 2.71, 95% confidence interval 1.79 to 4.11), which remained significant even after adjustment for lipid ratios. In conclusion, our observations suggested that the TG/HDL cholesterol ratio was an imperfect surrogate for IR and its associated CHD risk, and it was only slightly better than the total/HDL cholesterol ratio for this purpose.
Authors:
William B Kannel; Ramachandran S Vasan; Michelle J Keyes; Lisa M Sullivan; Sander J Robins
Related Documents :
1361175 - Differentiation of beta-blocker effects on serum lipids and apolipoproteins in hyperten...
10052025 - Influence of baseline values. i: effects on plasma total cholesterol and triglyceride l...
15648805 - Combined hyperlipidemia in a single subject with tetraplegia: ineffective risk reductio...
11078235 - High carbohydrate diets, triglyceride-rich lipoproteins, and coronary heart disease risk.
205385 - Lecithin--cholesterol acyltransferase and the lipoprotein abnormalities of obstructive ...
3764095 - Accumulation of copper on albumin in bovine plasma in vivo after intravenous trithiomol...
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  101     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-03-03     Completed Date:  2008-03-28     Revised Date:  2011-04-01    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  497-501     Citation Subset:  AIM; IM    
Affiliation:
The National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA. billkannel@yahoo.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Cholesterol, HDL / blood*
Cohort Studies
Coronary Disease / blood
Female
Humans
Insulin Resistance*
Lipoproteins, HDL / blood*
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Risk Assessment / methods
Triglycerides / blood*
Grant Support
ID/Acronym/Agency:
2K24HL04334/HL/NHLBI NIH HHS; N01 HC025195/HC/NHLBI NIH HHS; N01-HC-251595/HC/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Cholesterol, HDL; 0/Lipoproteins, HDL; 0/Triglycerides

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Efficacy and tolerability of fluvastatin XL 80 mg alone, ezetimibe alone, and the combination of flu...
Next Document:  Comparison of findings on stress myocardial perfusion imaging in men with versus without erectile dy...