Advertisement

Comparison of Serum Lipid Values in Subjects With and Without the Metabolic Syndrome

      Insulin resistance is supposed to be the basis of metabolic syndrome (MS), although it is difficult to measure. The ratio of triglyceride (TG) to high-density lipoprotein (HDL) has been proposed as a surrogate marker of insulin resistance in overweight subjects. The aim of the present study was to assess the accuracy of the TG/HDL ratio for the diagnosis of MS. Data of 18,778 active workers (77.6% men) enrolled in 3 insurance companies in Spain were collected from their annual health examinations. Mean age was 42.2 ± 10.7 years. MS was assessed according to modified Adult Treatment Panel III criteria. Prevalences of MS were 18.8% in men and 6.1% in women. Mean value of the TG/HDL ratio was 2.50 ± 2.2 and increased in parallel to the number of MS components present. Subjects with MS had a ratio that was 2 times higher compared with those without (5.10 vs 2.03, p <0.001). Receiver operating characteristic curves were performed to assess the capability of the TG/HDL ratio to contribute to a diagnosis of MS and 80% sensitivity and 78% specificity were obtained for values >2.75 in men and >1.65 in women. In conclusion, the TG/HDL ratio is a feasible and accurate measurement for assessment of MS in healthy subjects. We propose cut-off values of 2.75 for men and 1.65 for women for a diagnosis of MS.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Sattar N.
        • Gaw A.
        • Scherbakova O.
        • Ford I.
        • O'Reilly D.S.
        • Haffner S.M.
        • Isles C.
        • Macfarlane P.W.
        • Packard C.J.
        • Cobbe S.M.
        • Shepherd J.
        Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study.
        Circulation. 2003; 108: 414-419
        • Ridker P.M.
        • Buring J.E.
        • Cook N.R.
        • Rifai N.
        C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14 719 initially healthy American women.
        Circulation. 2003; 107: 391-397
        • Levantesi G.
        • Macchia A.
        • Marfisi R.
        • Franzosi M.G.
        • Maggioni A.P.
        • Nicolosi G.L.
        • Schweiger C.
        • Tavazzi L.
        • Tognoni G.
        • Valagussa F.
        • Marchioli R.
        Metabolic syndrome and risk of cardiovascular events after myocardial infarction.
        J Am Coll Cardiol. 2005; 46: 277-283
        • Gami A.S.
        • Witt B.J.
        • Howard D.E.
        • Erwin P.J.
        • Gami L.A.
        • Somers V.K.
        • Montori V.M.
        Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies.
        J Am Coll Cardiol. 2007; 49: 403-414
        • Golden S.H.
        • Folsom A.R.
        • Coresh J.
        • Sharrett A.R.
        • Szklo M.
        • Brancati F.
        Risk factor groupings related to insulin resistance and their synergistic effects on subclinical atherosclerosis: the atherosclerosis risk in communities study.
        Diabetes. 2002; 51: 3069-3076
        • Deedwania P.
        • Barter P.
        • Carmena R.
        • Fruchart J.C.
        • Grundy S.M.
        • Haffner S.
        • Kastelein J.J.
        • LaRosa J.C.
        • Schachner H.
        • Shepherd J.
        • Waters D.D.
        Reduction of low-density lipoprotein cholesterol in patients with coronary heart disease and metabolic syndrome: analysis of the Treating to New Targets study.
        Lancet. 2006; 368: 919-928
        • Cordero A.
        • Laclaustra M.
        • Leon M.
        • Grima A.
        • Casasnovas J.A.
        • Luengo E.
        • Del Rio A.
        • Ferreira I.
        • Alegria E.
        Prehypertension is associated with insulin resistance state and not with an initial renal function impairment.
        Am J Hypertens. 2006; 19: 189-196
        • Cordero A.
        • Laclaustra M.
        • Leon M.
        • Casasnovas J.A.
        • Grima A.
        • Najar M.
        • Luengo E.
        • Del Rio A.
        • Ferreira I.
        • Alegria E.
        Cardiovascular risk factors and metabolic syndrome associated with subclinical renal failure.
        Med Clin (Barc). 2005; 125: 653-658
        • Alegria E.
        • Cordero A.
        • Laclaustra M.
        • Grima A.
        • Leon M.
        • Casasnovas J.A.
        • Luengo E.
        • Del Rio A.
        • Ferreira I.
        Prevalence of metabolic syndrome in the Spanish working population: MESYAS registry.
        Rev Esp Cardiol. 2005; 58: 797-806
      1. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III).
        JAMA. 2001; 285: 2486-2497
        • Grundy S.M.
        • Howard B.
        • Smith S.
        • Eckel R.
        • Redberg R.
        • Bonow R.O.
        Prevention conference VI: diabetes and cardiovascular disease: executive summary: conference proceeding for healthcare professionals from a special writing group of the American Heart Association.
        Circulation. 2002; 105: 2231-2239
        • Cook N.R.
        Use and misuse of the receiver operating characteristic curve in risk prediction.
        Circulation. 2007; 115: 928-935
        • Reaven G.M.
        Banting lecture 1988.
        Diabetes. 1988; 37: 1595-1607
        • Eckel R.H.
        • Grundy S.M.
        • Zimmet P.Z.
        The metabolic syndrome.
        Lancet. 2005; 365: 1415-1428
        • Criqui M.H.
        • Heiss G.
        • Cohn R.
        • Cowan L.D.
        • Suchindran C.M.
        • Bangdiwala S.
        • Kritchevsky S.
        • Jacobs D.R.
        • O'Grady H.K.
        • Davis C.E.
        Plasma triglyceride level and mortality from coronary heart disease.
        N Engl J Med. 1993; 328: 1220-1225
        • Gaziano J.M.
        • Hennekens C.H.
        • O'Donnell C.J.
        • Breslow J.L.
        • Buring J.E.
        Fasting triglycerides, high-density lipoprotein, and risk of myocardial infarction.
        Circulation. 1997; 96: 2520-2525
        • Jeppesen J.
        • Hein H.O.
        • Suadicani P.
        • Gyntelberg F.
        Low triglycerides-high high-density lipoprotein cholesterol and risk of ischemic heart disease.
        Arch Intern Med. 2001; 161: 361-366
        • Barter P.
        • Gotto A.M.
        • LaRosa J.C.
        • Maroni J.
        • Szarek M.
        • Grundy S.M.
        • Kastelein J.J.
        • Bittner V.
        • Fruchart J.C.
        HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events.
        N Engl J Med. 2007; 357: 1301-1310
        • deGoma E.M.
        • Leeper N.J.
        • Heidenreich P.A.
        Clinical significance of high-density lipoprotein cholesterol in patients with low low-density lipoprotein cholesterol.
        J Am Coll Cardiol. 2008; 51: 49-55
        • Laclaustra M.
        • Corella D.
        • Ordovas J.M.
        Metabolic syndrome pathophysiology: the role of adipose tissue.
        Nutr Metab Cardiovasc Dis. 2007; 17: 125-139
        • Lamarche B.
        • Tchernof A.
        • Moorjani S.
        • Cantin B.
        • Dagenais G.R.
        • Lupien P.J.
        • Despres J.P.
        Small, dense low-density lipoprotein particles as a predictor of the risk of ischemic heart disease in men.
        Circulation. 1997; 95: 69-75
        • Hayashi Y.
        • Okumura K.
        • Matsui H.
        • Imamura A.
        • Miura M.
        • Takahashi R.
        • Murakami R.
        • Ogawa Y.
        • Numaguchi Y.
        • Murohara T.
        Impact of low-density lipoprotein particle size on carotid intima-media thickness in patients with type 2 diabetes mellitus.
        Metabolism. 2007; 56: 608-613
        • Hulthe J.
        • Bokemark L.
        • Wikstrand J.
        • Fagerberg B.
        The metabolic syndrome, LDL particle size, and atherosclerosis: the Atherosclerosis and Insulin Resistance (AIR) study.
        Arterioscler Thromb Vasc Biol. 2000; 20: 2140-2147
        • Reilly M.P.
        • Wolfe M.L.
        • Rhodes T.
        • Girman C.
        • Mehta N.
        • Rader D.J.
        Measures of insulin resistance add incremental value to the clinical diagnosis of metabolic syndrome in association with coronary atherosclerosis.
        Circulation. 2004; 110: 803-809
        • Sumner A.E.
        • Finley K.B.
        • Genovese D.J.
        • Criqui M.H.
        • Boston R.C.
        Fasting triglyceride and the triglyceride–HDL cholesterol ratio are not markers of insulin resistance in African Americans.
        Arch Intern Med. 2005; 165: 1395-1400