Triglycerides-to-HDL ratio as a new marker of endothelial dysfunction in obese prepubertal children
Triglycerides-to-HDL ratio as a new marker of endothelial dysfunction in obese prepubertal children
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DOI：
10.1530/eje-13-0452
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发表时间：
2014-02-01
影响因子：
5.8
通讯作者：
Mohn, Angelika
中科院分区：
文献类型：
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作者：
de Giorgis, Tommaso;Marcovecchio, M. Loredana;Mohn, Angelika
目的：探讨甘油三酯/高密度脂蛋白胆固醇(TG：HDLC)比值与肥胖青春期前儿童心血管危险因素及血管损伤早期体征之间的关系。对7.3+/-1.5岁青春期前儿童进行人体测量、氧化应激标志物(尿前列腺素F2α)、可溶性糖基化终产物受体(SRAGE)和胰岛素敏感性(胰岛素抵抗稳态模型评估(HOMA-IR)和全身胰岛素敏感指数(WBISI))的评估。测定血脂水平，计算甘油三酯/高密度脂蛋白胆固醇比值。结果：肥胖儿童甘油三酯/高密度脂蛋白胆固醇比值明显高于对照组(1.9+/-1.1vs1.2+/-0.6，P=0.002)。按三分位数划分人群后，甘油三酯/高密度脂蛋白胆固醇比值(1.67)、CIMT(P=0.0003)和HOMA-IR(P=0.0001)自下而上递增，而WBISI(P=0.0003)和SARAGE(P=0.05)则递减。在回归模型中，甘油三酯/高密度脂蛋白比值与颈动脉中膜厚度显著正相关(r=0.493；P=0.0005)。以甘油三酯/高密度脂蛋白胆固醇比值为临界值1.12时，CIMT值位于上四分位数(受试者工作特征曲线曲线下面积=0.633+/-0.065，P=0.045)的儿童的敏感性和特异性分别为81%和49%。结论：本研究证实了甘油三酯/高密度脂蛋白胆固醇比值作为心血管危险指标的可靠性。有趣的是，我们的结果强调，甘油三酯：高密度脂蛋白-C比率与青春期前儿童已经存在的血管损伤的早期迹象直接相关。
Objective: To investigate whether there is an association of the triglyceride-to-HDL cholesterol (TG:HDL-C) ratio with cardiovascular risk factors and early signs of vascular damage in obese prepubertal children.Design and methods: In 50 obese (27 boys, 7.8 +/- 1.4 years) and 37 normal-weight (20 boys; 7.3 +/- 1.5 years) prepubertal children, anthropometric measurements, oxidative stress markers (urinary isoprostanes (PGF2 alpha (prostaglandin F2 alpha)), soluble receptor for advanced glycation end-products (sRAGE)) and insulin sensitivity (homeostasis model assessment of insulin resistance (HOMA-IR) and whole-body insulin sensitivity index (WBISI)) were evaluated. Lipids profile was assessed and the TG: HDL-C ratio was calculated. In addition, high-resolution ultrasound was performed to assess carotid intima-media thickness (cIMT).Results: Obese children showed significantly higher values of the TG: HDL-C ratio (1.9 +/- 1.1 vs 1.2 +/- 0.6, P=0.002) compared with controls. After dividing the population in tertiles of the TG:HDL-C ratio (1.67), cIMT (P=0.0003), and HOMA-IR (P=0.0001) progressively increased from the lower to the upper tertile, whereas WBISI (P=0.0003) and sRAGE (P=0.05) progressively decreased. In a regression model, the TG:HDL ratio was significantly and positively associated with cIMT (r=0.493; P=0.0005). A cutoff point for TG:HDL-C ratio of 1.12 had 81% sensitivity and 49% specificity in the identification of children with cIMT values in the upper quartile (Area under the curve values from receiver operating characteristic curves=0.633 +/- 0.065, P=0.045).Conclusion: This study confirms the reliability of the TG:HDL-C ratio as a useful marker of cardiovascular risk. Interestingly, our results underline that the TG:HDL-C ratio is directly related with early signs of vascular damage already present in prepubertal children.