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Cholesterol  2012 

The Triglyceride to HDL Ratio and Its Relationship to Insulin Resistance in Pre- and Postpubertal Children: Observation from the Wausau SCHOOL Project

DOI: 10.1155/2012/794252

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Insulin resistance (IR) is a risk factor for ischemic heart disease and diabetes and raises the triglyceride/high-density lipoprotein (TG/HDL) ratio in adults, but is not well defined in children. Purpose. To investigate the TG/HDL ratios in children as an IR marker. Methods. Wausau SCHOOL Project assessed 99 prepubertal and 118 postpubertal children. The TG/HDL ratio was correlated with numerous risk factors. Results. TG/HDL ratio was significantly correlated with QUICKI, HOMA-IR, zBMI, waist-to hip ratio, systolic and diastolic BP, LDL size and LDL number. A group of 32 IR children (HOMA-IR > 1 SD from the mean, i.e., >2.45) had significantly higher TG/HDL (3.11 ± 1.77) compared to non-IR children (1.86 ± 0.75). A TG/HDL ratio of ≥2.0 identified 32 of the 40 children deemed IR by HOMA-IR (>2.45) with a sensitivity of 0.80 and a specificity of 0.66. Children with TG/HDL ratio ≥3 were heavier and had higher BP, glucose, HOMA-IR, LDL number, and lower HDL level, QUICKI, and LDL size, regardless of pubertal status. Conclusion. The TG/HDL ratio is strongly associated with IR in children, and with higher BMI, waist hip ratio, BP, and more athrogenic lipid profile. 1. Introduction Insulin resistance (IR) is a major risk factor for ischemic heart disease and diabetes [1–4]. IR significantly impacts lipoprotein metabolism and is associated with an increase in triglyceride (TG) levels, depressed high-density lipoprotein (HDL) levels, and an increase in the number of small dense LDL particles [4, 5]. The effect of IR on TG and HDL has made the TG/HDL ratio a useful marker of insulin resistance in adults [6, 7]. IR is increasingly identified in children [8]. Much less information is available regarding the impact of IR on lipid metabolism in children. The usefulness of the TG/HDL ratio in children as a marker of IR has not been adequately explored. The Wausau SCHOOL Project is the result of a community-based effort to investigate the prevalence and magnitude of cardiovascular risk factors in school age children in the Wausau School District [9, 10]. The Wausau SCHOOL Project database includes anthropometric measurements, fasting lipid profiles, and insulin and glucose levels from pre-and postpubertal children. The purpose of this investigation was to use this database to assess the impact of IR on lipid metabolism and determine the correlation of the TG/HDL ratio to IR and other markers of IR. 2. Methods Details of the data collection for the Wausau SCHOOL Project have been described previously [9, 10]. Briefly, the investigation was reviewed and approved by the


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