The Triglyceride to High-density Lipoprotein Cholesterol (TG/HDL-C) Ratio As a Predictor of Insulin Resistance, β-cell Function, and Diabetes in Hispanics and African Americans

Overview

Journal J Diabetes Complications

Specialty Endocrinology

Date 2018 Dec 8

PMID 30522790

Citations 53

Authors

Kendra A Young

Amita Maturu

Carlos Lorenzo

Carl D Langefeld

Lynne E Wagenknecht

Yii-Der I Chen

Kent D Taylor

Jerome I Rotter

Jill M Norris

Neda Rasouli

Affiliations

Soon will be listed here.

Abstract

Objective: The TG/HDL-C ratio is used as a marker of insulin resistance (IR) in Caucasians; however, there is limited data in other ethnic groups. We hypothesized that the TG/HDL-C ratio is associated with IR in Hispanics and African Americans (AA).

Research Design And Methods: Data from the Insulin Resistance Atherosclerosis Family Study was examined for associations between TG/HDL-C ratio and IR, β-cell function and incident diabetes in non-diabetic Hispanics (n = 872, 63% female) and AA (n = 371, 61% female). Insulin sensitivity index (S) and disposition index (DI) from frequently-sampled intravenous glucose tolerance tests were used as markers of IR and β-cell function respectively. Incident type 2 diabetes was determined by fasting glucose ≥ 126 mg/dl or initiation of anti-hyperglycemia agents over 5 year follow-up.

Results: Higher TG/HDL-C ratio was associated with IR in Hispanic and AA men and women (P < 0.0002), as well as β-cell function in Hispanic women and AA men and women (P < 0.02). TG/HDL-C predicted incident type 2 diabetes in women (area under the curves 0.703 and 0.795 for Hispanics and AA respectively).

Conclusions: Similar to Caucasians, the TG/HDL-C ratio can be used to identify IR in Hispanics and AA, and may predict type 2 diabetes in women.

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References

Henkin L, Bergman R, Bowden D, Ellsworth D, Haffner S, Langefeld C . Genetic epidemiology of insulin resistance and visceral adiposity. The IRAS Family Study design and methods. Ann Epidemiol. 2003; 13(4):211-7. DOI: 10.1016/s1047-2797(02)00412-x. View

Wagenknecht L, Langefeld C, Scherzinger A, Norris J, Haffner S, Saad M . Insulin sensitivity, insulin secretion, and abdominal fat: the Insulin Resistance Atherosclerosis Study (IRAS) Family Study. Diabetes. 2003; 52(10):2490-6. DOI: 10.2337/diabetes.52.10.2490. View

Almasy L, Blangero J . Multipoint quantitative-trait linkage analysis in general pedigrees. Am J Hum Genet. 1998; 62(5):1198-211. PMC: 1377101. DOI: 10.1086/301844. View

Wagenknecht L, Mayer E, Rewers M, Haffner S, SELBY J, Borok G . The insulin resistance atherosclerosis study (IRAS) objectives, design, and recruitment results. Ann Epidemiol. 1995; 5(6):464-72. DOI: 10.1016/1047-2797(95)00062-3. View

Lorenzo C, Wagenknecht L, Rewers M, Karter A, Bergman R, Hanley A . Disposition index, glucose effectiveness, and conversion to type 2 diabetes: the Insulin Resistance Atherosclerosis Study (IRAS). Diabetes Care. 2010; 33(9):2098-103. PMC: 2928371. DOI: 10.2337/dc10-0165. View

Maturu A, DeWitt P, Kern P, Rasouli N . The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio as a predictor of β-cell function in African American women. Metabolism. 2015; 64(5):561-5. DOI: 10.1016/j.metabol.2015.01.004. View

Power M, Schulkin J . Sex differences in fat storage, fat metabolism, and the health risks from obesity: possible evolutionary origins. Br J Nutr. 2007; 99(5):931-40. DOI: 10.1017/S0007114507853347. View

Sumner A . Ethnic differences in triglyceride levels and high-density lipoprotein lead to underdiagnosis of the metabolic syndrome in black children and adults. J Pediatr. 2009; 155(3):S7.e7-11. PMC: 3275909. DOI: 10.1016/j.jpeds.2009.04.049. View

McLaughlin T, Reaven G, Abbasi F, Lamendola C, Saad M, Waters D . Is there a simple way to identify insulin-resistant individuals at increased risk of cardiovascular disease?. Am J Cardiol. 2005; 96(3):399-404. DOI: 10.1016/j.amjcard.2005.03.085. View

10.

Sumner A, Cowie C . Ethnic differences in the ability of triglyceride levels to identify insulin resistance. Atherosclerosis. 2007; 196(2):696-703. DOI: 10.1016/j.atherosclerosis.2006.12.018. View

11.

Shimabukuro M, Zhou Y, Levi M, Unger R . Fatty acid-induced beta cell apoptosis: a link between obesity and diabetes. Proc Natl Acad Sci U S A. 1998; 95(5):2498-502. PMC: 19389. DOI: 10.1073/pnas.95.5.2498. View

12.

DeFronzo R . Pathogenesis of type 2 diabetes mellitus. Med Clin North Am. 2004; 88(4):787-835, ix. DOI: 10.1016/j.mcna.2004.04.013. View

13.

Lorenzo C, Wagenknecht L, DAgostino Jr R, Rewers M, Karter A, Haffner S . Insulin resistance, beta-cell dysfunction, and conversion to type 2 diabetes in a multiethnic population: the Insulin Resistance Atherosclerosis Study. Diabetes Care. 2009; 33(1):67-72. PMC: 2797988. DOI: 10.2337/dc09-1115. View

14.

Hao M, Head W, Gunawardana S, Hasty A, Piston D . Direct effect of cholesterol on insulin secretion: a novel mechanism for pancreatic beta-cell dysfunction. Diabetes. 2007; 56(9):2328-38. DOI: 10.2337/db07-0056. View

15.

Kim-Dorner S, Deuster P, Zeno S, Remaley A, Poth M . Should triglycerides and the triglycerides to high-density lipoprotein cholesterol ratio be used as surrogates for insulin resistance?. Metabolism. 2009; 59(2):299-304. DOI: 10.1016/j.metabol.2009.07.027. View

16.

Sidney S, Jacobs Jr D, Haskell W, Armstrong M, Dimicco A, Oberman A . Comparison of two methods of assessing physical activity in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Epidemiol. 1991; 133(12):1231-45. DOI: 10.1093/oxfordjournals.aje.a115835. View

17.

Li C, Ford E, Meng Y, Mokdad A, Reaven G . Does the association of the triglyceride to high-density lipoprotein cholesterol ratio with fasting serum insulin differ by race/ethnicity?. Cardiovasc Diabetol. 2008; 7:4. PMC: 2292689. DOI: 10.1186/1475-2840-7-4. View

18.

Kanaya A, Herrington D, Vittinghoff E, Ewing S, Liu K, Blaha M . Understanding the high prevalence of diabetes in U.S. south Asians compared with four racial/ethnic groups: the MASALA and MESA studies. Diabetes Care. 2014; 37(6):1621-8. PMC: 4030091. DOI: 10.2337/dc13-2656. View

19.

Owei I, Umekwe N, Wan J, Dagogo-Jack S . Plasma lipid levels predict dysglycemia in a biracial cohort of nondiabetic subjects: Potential mechanisms. Exp Biol Med (Maywood). 2016; 241(17):1961-1967. PMC: 5068467. DOI: 10.1177/1535370216659946. View

20.

Sumner A, Finley K, Genovese D, Criqui M, Boston R . Fasting triglyceride and the triglyceride-HDL cholesterol ratio are not markers of insulin resistance in African Americans. Arch Intern Med. 2005; 165(12):1395-400. DOI: 10.1001/archinte.165.12.1395. View