Triglyceride-to-HDL ratio accurate marker of the metabolic syndrome

12 August 2008

MedWire News: The ratio of triglycerides to high-density lipoprotein (HDL) cholesterol is an accurate and practical surrogate measure of the metabolic syndrome, report investigators in the American Journal of Cardiology.

The ratio of triglyceride to HDL has been proposed as a surrogate marker of insulin resistance in overweight subjects," say Alberto Cordero (Hospital Universitario de San Juan, Alicante, Spain) and colleagues.

They believe it is a good surrogate marker for insulin resistance, which they say can be difficult to measure.

To test this, they recruited 18,778 active workers (77.6% men) from Spain aged 42.2 years on average. Participants were assessed for presence of the metabolic syndrome and its components, including body mass index, blood pressure, HDL cholesterol, triglycerides, and insulin resistance, using criteria from the National Cholesterol Education Program Adult Treatment Panel III guidelines.

The researchers found that 18.8% of men and 6.1% of women tested had the metabolic syndrome and the average triglyceride-to-HDL ratio was 2.50.

Participants with the metabolic syndrome had a ratio that was two-fold higher than those without, at 5.10 versus 2.03. Of note, they observed that the ratio increased proportionally to the number of components of the metabolic syndrome present.

Cordero and team used receiver operating curve analysis to determine the accuracy of using the triglyceride-to-HDL ratio for identifying the metabolic syndrome. They found that values above 2.75 in men and above 1.65 in women had an 80% sensitivity and a 78% specificity, and propose these values as reasonable cutoff points indicating presence of the metabolic syndrome.

Am J Cardiol 2008; 102: 424-428