Preventive cardiologyUsefulness 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)
Section snippets
Methods
The Framingham Offspring Study was initiated in 1971, and the design and selection criteria were described previously.1 Subjects who attended the examination cycle 5 (1991 to 1995) were eligible for the present study (n = 3,799). At each quadrennial examination, offspring cohort subjects underwent a routine medical history, physical examination that included blood pressure measurement and anthropometry, and blood sampling (after an overnight fast). We excluded 785 subjects because of age <20
Results
Baseline characteristics of our study sample (overall and according to presence vs absence of IR) are listed in Table 1. Subjects with IR were older and more likely to be men and weigh more and had higher blood pressure and greater prevalence of hypertension. TG was higher and HDL cholesterol was lower in those with IR, resulting in higher TG/HDL cholesterol ratios. Total/HDL cholesterol ratio was also higher in subjects with IR.
Age- and gender-adjusted correlations among lipid variables are
Discussion
Our principal findings are threefold. First, cross-sectional analyses suggested that of the several candidate lipid markers evaluated, TG/HDL cholesterol ratio was the best correlate of IR. However, performance of this ratio for predicting IR was only fair, reflected by the area under the curve of 0.745. Second, longitudinal analyses showed that even after adjustment for lipid variables (including TG/HDL cholesterol ratio), IR was significantly and strongly associated with CHD risk. These
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- 1
Dr. Vasan was supported by Contracts N01-HC-25195 and 2K24 HL04334 from the National Institutes of Health/National Heart, Lung, and Blood Institute, Bethesda, Maryland.
- 2
Dr. Kannel was supported by the Visiting Scientist Program, which is supported by Astra Zeneca, Waltham, Massachusetts.