Both triglyceride to high-density lipoprotein cholesterol (HDL-C) and total cholesterol to HDL-C ratios are useful markers for metabolic syndrome (MetS) in adolescents, according to study results published in Annals of Pediatric Endocrinology & Metabolism.
The study included adolescents age 10 to 18 years from the Korean National Health and Nutrition Examination Surveys from 2008 to 2010 (n = 2721). The researchers used International Diabetes Federation criteria to define MetS.
In total, 1436 participants were boys and 1285 were girls. The researchers did not find any significant gender-related differences in triglyceride/HDL-C or total cholesterol/HDL-C ratios.
Triglyceride/HDL-C and total cholesterol/HDL-C ratios were significantly associated with homeostatic model assessment for insulin resistance (HOMA-IR) and waist circumference.
To understand clinical utility and optimal cutoff values for the lipid ratios in predicting MetS, area under the receiver operating characteristic curve analyses were performed. The triglyceride/HDL-C and total cholesterol/HDL-C ratios both had a greater area under the curve value for MetS compared with individual lipid profiles, including HOMA-IR (0.932 and 0.923 vs 0.812, respectively).
The researchers determined that the optimal ratio cutoff value for validating adolescents with MetS was 3.3 for the triglyceride/HDL-C ratio (sensitivity, 85.7%; specificity, 89.9%) and 3.8 (sensitivity, 92.9%; specificity, 82.8%) for the total cholesterol/HDL-C ratio.
In participants with a total cholesterol/HDL-C ratio above the cutoff value, the odds ratio (OR) for MetS was 14.8 (95% CI, 2.8-77.4). In patients with a triglyceride/HDL-C ratio above the cutoff value, the OR of MetS was 30.6 (95% CI, 6.0-157.6). In participants with both ratios above the cutoff values, the OR for MetS was 36.2 (95% CI, 7.2-186.2).
“[B]oth of these lipid ratios could help health providers to identify adolescents who require therapeutic management and follow-up,” the researchers wrote.
Chu S, Jung J, Park M, Kim S. Risk assessment of metabolic syndrome in adolescents using the triglyceride/high-density lipoprotein cholesterol ratio and the total cholesterol/high-density lipoprotein cholesterol ratio. Ann Pediatr Endocrinol Metab. 2019;24:41-48.