The triglyceride/HDL-cholesterol ratio as a marker of cardiovascular risk in obese children; association with traditional and emergent risk factors

Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de Los Andes, Mérida, Venezuela.
Pediatric Diabetes (Impact Factor: 2.57). 06/2008; 9(5):464-71. DOI: 10.1111/j.1399-5448.2008.00406.x
Source: PubMed


To determine the presence of traditional and emergent cardiovascular risk factors and to evaluate the triglyceride/high-density lipoprotein cholesterol (Tg/HDL-C) ratio as a marker for cardiovascular disease and metabolic syndrome (MS) in obese children.
Sixty-seven prepubertal children of both sexes, between the ages of 6 and 12 yr, 20 normal-weight children, 18 overweight, and 29 obese subjects, were studied. Anthropometric measures, blood pressure, body mass index (BMI), and fat mass (FM), were measured. Plasma glucose, serum insulin, lipid profile, C-reactive protein (CRP), and leptin concentrations were quantified. Glucose and insulin concentrations 2 h post-glucose load were determined. The Tg/HDL-C ratio, homeostasis model assessment index (HOMA), and quantitative insulin sensitivity check index (QUICKI) were calculated.
Systolic, diastolic, and mean blood pressures (MBP), low-density lipoprotein cholesterol (LDL-C), Tg/HDL-C, total cholesterol/HDL-C, LDL-C/HDL-C ratios, basal and 2 h postload insulin, CRP, and leptin were significantly higher and the QUICKI index were lower in the obese group. MBP, Tg/HDL-C ratio, HOMA, CRP, and leptin levels showed a positive and significant correlation and QUICKI a negative correlation with abdominal circumference, BMI, and FM. The Tg/HDL-C ratio correlated positively with MBP. The frequency of MS in the obese group was 69%. While Tg/HDL-C ratio, CRP, and leptin were higher and the values of QUICKI were lower in subjects with MS, it was the Tg/HDL-C ratio and the BMI that significantly explained the MS.
Obesity increases the cardiovascular risk in childhood. The Tg/HDL-C ratio could be a useful index in identifying children at risk for dyslipidemia, hypertension, and MS.


Available from: Mariela Paoli, Jan 27, 2014
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    • "As previously reported, the predicting factors that are most tightly linked to metabolic syndrome (MetS) are obesity and insulin resistance (IR). A study reported that 90% of obese adolescents present with at least one MetS component, whereas 30% meet all MetS criteria [3], including abdominal obesity, dyslipidemia (increase in triglycerides [TG] and low high-density lipoprotein cholesterol [HDL-C] levels), high blood pressure and glucose intolerance [4,5]. The importance and interest in MetS lies in its association with type 2 diabetes mellitus (T2DM), coronary heart disease, and increased mortality, even in subjects without T2DM [6]. "
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    • "LDL-C was estimated using the Friedewald formula (LDL-C = TC – Tg/5 + HDL-C) [27]. The triglyceride/HDL-C ratio was calculated [28]. All assays were performed in the clinical biochemistry laboratory of the Hospital. "
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    • "In adults, the simple TGs/HDL-c index was shown to identify patients with dyslipidemia and insulin resistance [36] [37]; in overweight adults, Barter et al. [38] recently showed that only those subjects with an increase in TGs and a decrease in HDLc presented hypertension, elevated levels of CRP, and insulin resistance. Furthermore, these studies reinforce the idea that classic risk factors explain only about 50–60% of CVD [39]; thus, there has been an increasing interest in identifying novel biomarkers that might improve the global risk prediction of CVD [40] [41]. "
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