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Horm Metab Res 2017; 49(07): 542-549
DOI: 10.1055/s-0043-107782
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Impact of the Triglyceride/High-Density Lipoprotein Cholesterol Ratio and the Hypertriglyceremic-Waist Phenotype to Predict the Metabolic Syndrome and Insulin Resistance

Helene von Bibra
1   Clinic for Endocrinology, Diabetes and Vascular Medicine, Staedt. Klinikum Bogenhausen, Academic Hospital of the TUM, Munich, Germany
,
Sarama Saha
2   Department of Medicine III, University Hospital Carl Gustav Carus, TU Dresden, Germany
,
Alexander Hapfelmeier
3   Institute for Statistics and Epidemiology in Medicine of the Technische Universität, Munich, Germany
,
Gabriele Müller
4   Center for Evidence-based Healthcare, University Hospital Carl Gustav Carus, TU Dresden, Germany
,
Peter E. H. Schwarz
2   Department of Medicine III, University Hospital Carl Gustav Carus, TU Dresden, Germany
5   Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, TU Dresden, Dresden, Germany
6   German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
› Author Affiliations
Further Information

Publication History

received 30 June 2016

accepted 21 March 2017

Publication Date:
08 June 2017 (online)

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Abstract

Insulin resistance is the underlying mechanism for the metabolic syndrome and associated dyslipidaemia that theoretically implies a practical tool for identifying individuals at risk for cardiovascular disease and type-2-diabetes. Another screening tool is the hypertriglyceremic-waist phenotype (HTW). There is important impact of the ethnic background but a lack of studied European populations for the association of the triglyceride/high-density lipoprotein cholesterol (HDL-C) ratio and insulin resistance. This observational, retrospective study evaluated lipid ratios and the HTW for predicting the metabolic syndrome/insulin resistance in 1932 non-diabetic individuals from Germany in the fasting state and during a glucose tolerance test. The relations of triglyceride/HDL-C, total-cholesterol/HDL-C, and low-density lipoprotein cholesterol/HDL-C with 5 surrogate estimates of insulin resistance/sensitivity and metabolic syndrome were analysed by linear regression analysis and receiver operating characteristics (ROC) in participants with normal (n=1 333) or impaired fasting glucose (n=599), also for the impact of gender. Within the lipid ratios, triglyceride/HDL-C had the strongest associations with insulin resistance/sensitivity markers. In the prediction of metabolic syndrome, diagnostic accuracy was good for triglyceride/HDL-C (area under the ROC curve 0.817) with optimal cut-off points (in mg/dl units) of 2.8 for men (80% sensitivity, 71% specificity) and 1.9 for women (80% sensitivity, 75% specificity) and fair for HTW and HOMA-IR (area under the curve 0.773 and 0.761). These data suggest the triglyceride/HDL-C ratio as a physiologically relevant and practical index for predicting the concomitant presence of metabolic syndrome, insulin resistance and dyslipidaemia for therapeutic and preventive care in apparently healthy European populations.

Key words

metabolic syndrome - insulin resistance - triglycerides - HDL cholesterol - hypertriglyceremic-waist phenotype
 

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