The Role of Triglyceride to HDL Cholesterol Ratio in Sera as a Clinical Surrogate Marker for Cardiovascular Risk and Insulin Resistance in Patients with Metabolic Syndrome

Silviya S. Ganeva; Ginka H. Rayanova; Katya N. Todorova; Tzvetan H. Lukanov; Svetla O. Blazheva

doi:10.2478/jbcr-2021-0012

Journal of Biomedical and Clinical Research 14(2): 162-168, doi: 10.2478/jbcr-2021-0012

The Role of Triglyceride to HDL Cholesterol Ratio in Sera as a Clinical Surrogate Marker for Cardiovascular Risk and Insulin Resistance in Patients with Metabolic Syndrome

Silviya S. Ganeva, Ginka H. Rayanova, Katya N. Todorova, Tzvetan H. Lukanov, Svetla O. Blazheva

This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC-ND 4.0), which permits to copy and distribute the article for non-commercial purposes, provided that the article is not altered or modified and the original author and source are credited.

Citation: Ganeva SS, Rayanova GH, Todorova KN, Lukanov TH, Blazheva SO (2021) The Role of Triglyceride to HDL Cholesterol Ratio in Sera as a Clinical Surrogate Marker for Cardiovascular Risk and Insulin Resistance in Patients with Metabolic Syndrome. Journal of Biomedical and Clinical Research 14(2): 162-168. https://doi.org/10.2478/jbcr-2021-0012

Abstract

The study aimed to investigate the triglycerides to HDL-cholesterol ratio (Tg/HDL) and the interaction of this ratio with insulin resistance (IR) and insulin secretion indices, with the levels of interleukin - 1(IL-1), interleukin-6 (Il-6), and tumour necrotic factor-α (TNF-α) in sera among patients with metabolic syndrome (MS). A prospective, cross-sectional, comparative study was conducted on 45 patients with MS without data for hyperglycemia and 21 metabolically healthy non-obese controls. The levels of fasting and postprandial glucose, immunoreactive insulin (IRI), total cholesterol, triglycerides (Tg), IL-1, IL-6, and TNF-α were measured in all the participants. We calculated the LDL cholesterol levels, Tg/HDL ratio, homeostatic model of insulin resistance (HOMA-IR), and the homeostatic model of β-cell function (HOMA-b). Patients with MS had higher BMI (38.73±1.84 vs. 24.32±2.71 kg/m2; р<0.05) and waist circumference (115.56 ±4.7 vs. 81.1±8.4cm; р<0.05) than non-obese controls. The same patients had higher LDL cholesterol levels (3.42±0.3 vs. 2.63±0.66 mmol/l; р<0.05) and Tg (1.59±0.22 vs. 1.08±0.31mmol/l; р<0.05), as well as lower levels of HDL-cholesterol (1.03±0.09 vs. 1.27 ± 0.24mmol/l; р<0.05) compared to the controls. The Tg/HDL ratio was 2.03±0.87 among the patients with MS and 0.88±0.27 in controls; р<0.05. The plasma levels of basal IRI (19.32±3.22 mIU/l vs. 9.13±0.73mIU/l; р<0.05), HOMA-IR (4.02 vs. 1.97; р<0.05) and HOMA-b (258.77±57.76 vs. 183.31±17.52; р<0.05) were significantly higher in the MS group. The same patients with MS had higher concentrations of IL-1 (18.37±4.28pg/ml vs. 7.12±1.74pg/ml; p<0.05), IL-6 (1.01±0.3pg/ml vs. 0.1±0.3pg/ml; р<0.05) and TNF-α (2.13±1.43 pg/ml vs. 1.82±0.94pg/ml; р=0.24) too. Positive correlations between the levels of IL-1 and Tg/HDL ratio (r= 0.46; p=0.008), IL-1 and HOMA-%В (r=0.47; p=0.005) were found. The Tg/HDL ratio is a potential, cheap and available surrogate marker for screening for cardiovascular risk and insulin resistance in patients with MS in clinical practice.

Keywords

metabolic syndrome, insulin resistance, atherogenic index, cytokines