The triglyceride-to-HDL cholesterol ratio: association with insulin resistance in obese youths of different ethnic backgrounds.
The triglyceride-to-HDL cholesterol ratio: association with insulin resistance in obese youths of different ethnic backgrounds.
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DOI：
10.2337/dc10-2234
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发表时间：
2011-08
期刊：
影响因子：
16.2
通讯作者：
Weiss R
中科院分区：
文献类型：
--
作者：
Giannini C;Santoro N;Caprio S;Kim G;Lartaud D;Shaw M;Pierpont B;Weiss R
我们评估了在一个大型多种族肥胖青少年队列中，甘油三酯与高密度脂蛋白胆固醇的比值（TG/HDL - C）是否与胰岛素抵抗（IR）相关。
1452名肥胖青少年进行了口服葡萄糖耐量试验和空腹血脂检查。使用全身胰岛素敏感性指数（WBISI）和稳态模型评估（HOMA - IR）来评估胰岛素敏感性，并在146名肥胖青少年的亚组中通过高胰岛素 - 正葡萄糖钳夹试验进行评估。该队列按种族划分（612名白人、357名西班牙裔和483名非裔美国人），然后按种族特异性的TG/HDL - C比值三分位数进行分层。评估了三分位数之间的差异，并通过多元逐步线性回归分析确定了TG/HDL - C比值与胰岛素敏感性（WBISI）之间的关联。确定了受试者工作特征（ROC）曲线下面积（AUC），以计算按种族区分胰岛素抵抗受试者的TG/HDL - C比值截断值。
在每个种族组中，随着TG/HDL - C比值三分位数的升高，胰岛素敏感性（WBISI）逐渐降低，而2小时血糖和血糖曲线下面积（AUC - 葡萄糖）逐渐升高。TG/HDL - C比值的截断值为2.27，在白人男孩和女孩中，TG/HDL - C比值高于截断值的青少年出现胰岛素抵抗的几率为6.023（95%置信区间2.798 - 12.964；P < 0.001），而对于西班牙裔和非裔美国人，ROC曲线下面积无显著差异，因此无法计算出最佳的TG/HDL - C截断值。
TG/HDL - C比值主要在白人肥胖男孩和女孩中与胰岛素抵抗相关，因此可与其他风险因素一起用于识别胰岛素抵抗相关疾病发病风险增加的个体。
We evaluated whether the triglyceride-to-HDL cholesterol (TG/HDL-C) ratio is associated with insulin resistance (IR) in a large multiethnic cohort of obese youths. Obese youths (1,452) had an oral glucose tolerance test and a fasting lipid profile. Insulin sensitivity was estimated using the whole body insulin sensitivity index (WBISI) and homeostasis model assessment (HOMA)-IR and evaluated, in a subgroup of 146 obese youths, by the hyperinsulinemic-euglycemic clamp. The cohort was divided by ethnicity (612 whites, 357 Hispanics, and 483 African Americans) and then stratified into ethnicity-specific tertiles of TG/HDL-C ratio. Differences across tertiles were evaluated, and the association between the TG/HDL-C ratio and insulin sensitivity (WBISI) was defined by a multiple stepwise linear regression analysis. The area under the receiver operating characteristic (ROC) curve (AUC) was determined to calculate the TG/HDL-C ratio cutoff to identify insulin-resistant subjects by ethnicity. In each ethnic group and across rising tertiles of TG/HDL-C ratio, insulin sensitivity (WBISI) progressively decreased, whereas 2-h glucose and the AUC-glucose progressively increased. The cutoff for TG/HDL-C ratio was 2.27, and the odds of presenting with IR, in youths with TG/HDL-C ratio higher than the cutoff, was 6.023 (95% CI 2.798–12.964; P < 0.001) in white girls and boys, whereas for both Hispanics and African Americans the AUC-ROCs were not significant, thus not allowing the calculation of an optimal cutoff TG/HDL-C value. The TG/HDL-C ratio is associated with IR mainly in white obese boys and girls and thus may be used with other risk factors to identify subjects at increased risk of IR-driven morbidity.