| 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). | |
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MedLine Citation:
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PMID: 18312765 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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William B Kannel; Ramachandran S Vasan; Michelle J Keyes; Lisa M Sullivan; Sander J Robins |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 101 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2008 Feb |
Date Detail:
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Created Date: 2008-03-03 Completed Date: 2008-03-28 Revised Date: 2011-04-01 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 497-501 Citation Subset: AIM; IM |
Affiliation:
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The National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA. billkannel@yahoo.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cholesterol, HDL
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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:
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2K24HL04334/HL/NHLBI NIH HHS; N01 HC025195/HC/NHLBI NIH HHS; N01-HC-251595/HC/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Cholesterol, HDL; 0/Lipoproteins, HDL; 0/Triglycerides |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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