Abstract
BackgroundPrevious studies have reported that the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio could be a simple clinical indicator of insulin resistance (IR), but the results indicated that there were heterogeneities between different ethnicities. We aimed to investigate the association between TG/HDL-C and IR (as measured by homeostasis model assessment of IR [HOMA-IR]), and establish a clinical prediction rule for IR in middle-aged and elderly Taiwanese.MethodsA total of 398 subjects were recruited, and each subject completed a questionnaire that included personal and medical history data, and underwent anthropometric measurement and blood sampling. IR was defined as HOMA-IR index value ≥2.0. Chi-squared test, independent two-sample t-test, Pearson’s correlation coefficient, and multiple logistic regression were used to evaluate the association between IR and TG/HDL-C ratio. A receiver operating characteristic (ROC) analysis was conducted to evaluate the ability of the developed clinical prediction rule to correctly discriminate between subjects of IR positive and IR negative groups.ResultsA significant association between IR and TG/HDL-C ratio was identified with a Pearson’s correlation coefficient of 0.35 (p-value< 0.001). In multiple logistic regression, high BMI (OR = 1.23; 95% C.I. = 1.13–1.33), hypertension (OR = 1.90; 95% C.I. = 1.12–3.21), diabetes mellitus (OR = 5.44; 95% C.I. = 2.93–10.08) and high TG/HDL ratio (OR = 1.45; 95% C.I. = 1.23–1.72) were significantly associated with the risk of elevated HOMA-IR.The area under ROC curves for TG/HDL-C ratio was 0.729 and the optimal threshold value was 2.197 where the corresponding of sensitivity and specificity were 72.4 and 65.1%.ConclusionsOur findings showed that the elevated TG/HDL-C ratio was significantly associated with IR and could be used as an indicator of IR among the middle-aged and elderly population in Taiwan. It is clinically available, thus eliminating any additional costs. Future research is warranted to investigate the use of TG/HDL-C ratio combined with other risk factors for predicting IR under diverse ethnic backgrounds.
Highlights
Previous studies have reported that the triglyceride to high-density lipoprotein cholesterol (TG/HDLC) ratio could be a simple clinical indicator of insulin resistance (IR), but the results indicated that there were heterogeneities between different ethnicities
The lack of standardized insulin assay has limited the clinical utility of homeostasis model assessment of IR (HOMA-IR), it has been widely used in the study of metabolic syndrome [9]
In Model 4, Body mass index (BMI), HTN, diabetes mellitus (DM), and TG/High-density lipoprotein cholesterol (HDL-C) were all significantly associated with HOMA-IR index
Summary
Previous studies have reported that the triglyceride to high-density lipoprotein cholesterol (TG/HDLC) ratio could be a simple clinical indicator of insulin resistance (IR), but the results indicated that there were heterogeneities between different ethnicities. We aimed to investigate the association between TG/HDL-C and IR (as measured by homeostasis model assessment of IR [HOMA-IR]), and establish a clinical prediction rule for IR in middle-aged and elderly Taiwanese. The method is expensive, invasive, and time-consuming, making it not feasible for either epidemiological investigations or routine clinical applications [7]. The lack of standardized insulin assay has limited the clinical utility of HOMA-IR, it has been widely used in the study of metabolic syndrome [9]. The HOMA-IR is not routinely measured in clinical practice when used for quantifying IR. A simple and more accessible marker for predicting IR can be useful for early identification of subjects with IR for clinicians and eliminate any additional costs
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