Relationship TG/HDL-C and insulin resistance in adult women by nutritional status
DOI:
https://doi.org/10.14306/renhyd.18.1.41Keywords:
Dyslipidemias, Triglycerides, Lipoproteins, HDL, Insulin Resistance, Anthropometry, Body Mass Index, Waist Circumference, Nutritional Status, WomenAbstract
Introduction: The ratio assessment TG/HDL-C is an indicator of LDL size, facilitating the detection of individuals with increased atherogenic risk. Estimating the size of the LDL becomes important, especially in patients with TG values near the upper limit of normal values of reference and HDL-C. The objective of the study is to estimate the association between TG/HDL-C and insulin resistance (IR) by nutritional status in adult women attending the Foundation for Endocrine Metabolic Diseases Research and Applied Clinical Research (FIEEM).
Material and methods: Design Cross-sectional, non-pregnant adult women, apparently healthy, older than 30 years old, attending FIEEM in the Autonomous City of Buenos Aires. Dependent variable: TG/HDL-C ≥ 3.0 considered high value. Independent variables: IR by homeostatic model index HOMA-IR ≥ 2.5 categorizing the sample into two groups: with and without IR, and controlled by nutritional status using body mass index (BMI) and waist circumference (CC). SPSS Statistics 15.0, calculating X2 or Fisher exact test, OR with confidence intervals of 95% and establishing logistic regression p value < 0.05.
Results: We evaluated a purposive sample of 104 women (31.4% and 26% IR with TG/HDL-C high). 84.6% were overweight or obese and 88.5% increased CC. Women with BMI had significantly increased 0.15-fold increased risk (95% CI = 0.01 to 1.26) for TG/HDL-C high (p = 0.04) than the control women. There was no significance with increased CC. The ratio TG/HDL-C high IR was significantly correlated (r = 0.30 p = 0.002).
Conclusions: Body weight was significantly associated with IR and the ratio TG/HDL-C increased. This ratio correlated significantly with IR in apparently healthy women.
References
Reaven G. Insulin resistance, hyperinsulinemia, hypertriglyceridemia, and hypertension. Parallels between human disease and rodent models. Diabetes Care.1991; 14(3): 195-202.
Ruotolo G, Howard B. Dyslipidemia of the metabolic syndrome. Curr Cardiol Rep. 2002; 4(6): 494-500.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP). Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001; 285(19); 2486-97.
Brites FD, Bonavita CD, De Geitere C, Delfly B, Yael MJ, Fruchart JC, et al. Alterations in the main steps of reverse cholesterol transport in male patients with primary hypertriglyceridemia and low HDL-cholesterol levels. Atherosclerosis. 2000; 152(1): 181-92.
Brites FD, Bonavita CD, Cloës M, Yael MJ, Fruchart JC, Castro G, et al. VLDL compositional changes and plasma levels of triglycerides and high density lipoprotein. Clin Chim Acta. 1998; 269(2); 107-24.
Múscolo JM, D’Ambrosio ML, Núñez M, Trebisacce C, Lastretti G, Doallo C, et al. Síndrome metabólico en mujeres obesas. Evaluación de biomarcadores de resistencia insulínica y lipoproteicos. Acta Bioquím Clín Latinoam. 2004; 38(4): 481-8.
McLaughlin T, Reaven G, Abbasi F, Lamendola C, Sad M, Waters D, et al. Is there a simple way to identify insulin-resistant individuals at increased risk of cardiovascular disease? Am J Cardiol. 2005; 96(3): 399-404.
Reaven G. Metabolic Syndrome: pathophisiology and implications for management of cardiovascular disease. Circulation. 2002; 106(3): 286-8.
Gonzalez-Chavez A, Simental Mendía LE, Elizondo Argueta S. Relación triglicéridos/colesterol HDL elevada y resistencia a la insulina. Cir Cir. 2011; 79: 126-131.
Dobiasova M, Frollich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma. (FER(HDL)). Clin Biochem. 2001; 34(7): 583-8.
Torresani ME, Oliva ML, Echevarría C, Rossi ML, Maffei L. Perfil Antropométrico de Mujeres Perimenopáusicas. Spanish Journal of Community Nutrition. 2007; 13(1): 6-10.
Torresani ME, Oliva ML, Echevarría C, Rossi ML, Maffei L. Perfil Lipídico y Riesgo Cardiovascular en Mujeres Pre y Postmenopáusicas. DIAETA. 2009; 27(126): 6-11.
Raichlin ER, McConnell JP, Lerman A, Kremers WK, Edwards BS, Kushwaha SS, et al. Systemic inflammation and metabolic syndrome in cardiac allograft vasculopathy. J Heart Lung Transplant. 2007; 26(8): 826-33.
Clinical Guidelines on the identification, evaluation and treatment of Overweigth and Obesity in Adults. NIH Publication Nº 98: 1998.
World Health Organization. Report of a WHO Scientific Group: Research on the Menopause in the 1990’s. Geneva, Switzerland: World Health Organization; WHO Technical report Series 866. 1996.
Lann D, LeRoth D. Resistencia a la insulina como causa subyacente del síndrome metabólico. Med N Am. 2007; 91(6): 1063-71.
Ponte, CI. Redescubriendo los triglicéridos como factor de riesgo cardiovascular. Avances Cardiol. 2009; 29(4): 367-367.
De Fronzo RA, Tobin JD, Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol. 1979; 237(3): E214-23.
Boizel R, Benhamou PY, Lardy B, Laporte F, Foulon T, Halimi S. Ratio of triglycerides to HDL cholesterol is an indicator of LDL particle size in patients with type 2 diabetes and normal HDL cholesterol levels. Diabetes Care. 2000; 23(11): 1679–85.
Cordero A, Laclaustra M, Leon M, Grima A, Casasnovas J, Luengo E, et al. Prehypertension is associated with insulin resistance state and not with an initial renal function impairment. A Metabolic Syndrome in Active Subjects in Spain (MESYAS). Am J Hypertens. 2006; 19(2): 189–96.
Michelotto de Oliveira M, Martins Fagundes R, Machado Moreira E, Santos de Morae E, Tales de Carvalho T. Relación de Indicadores Antropométricos con Factores de Riesgo para Enfermedad Cardiovascular. Arq Bras Cardiol. 2010; 94(4): 462-9.
Torresani, ME, Oliva, ML, Echeverria C, Rossi ML. Peso relativo de factores de riesgo cardiometabólicos en mujeres pre y post menopáusicas. Diaeta. 2009; 27(126): 12-17.
Bonneau G, Fridrich A, Pedrozo, Castillo Rascón M, Albrekt A. Insulinoresistencia y su relación con las medidas antropométricas y tensión arterial en un grupo de empelados hospitalarios aparentemente sanos. Rev Argent Endocrino Metab. 2011; 48(1): 8-15.
Harris TB, Ballard-Barbasch R, Madans J, Makuc DM, Feldman JJ. Overweight, weight loss, and risk of coronary heart disease in older women. The NHANES I Epidemiologic Follow-Up Study. Am.J.Epidemiol. 1993; 137(12): 1318-27.
Horwich TB, Fonarow GC. Glucose, Obesity, Metabolic Syndrome, and Diabetes Relevance to Incidence of Heart Failure. J Am Coll Cardiol. 2010; 55(4): 283-93.
Coniglio RI, Etchepare C, Vásquez LA, Colombo O, Selles J, Salgueiro AM, et al. Frecuencia del síndrome metabólico en mujeres postmenopáusicas según el Índice de Masa Corporal y la relación cintura/cadera. Clin Invest Arteriosclerosis. 2001; 13(2): 54-62.
Cercato C, Mancini MC, Arguell AMC, Passos Q, Villares SMF, Halpern A. Systemic hypertension, diabetes mellitus, and dyslipemia in relation to body mass index: evaluation of a Brazilian population. Rev Hosp Clin. 2004; 59(3): 113-18.
Utzschneider KM, Carr DB, Hull R, Kodama K, Shofer JB, Retzlaff R, et al. Impact of Intra-Abdominal Fat and Age on Insulin Sensitivity and Cell Function. Diabetes. 2004; 53(11): 2867-72.
Lerman J, Siseles N. Terapia de reemplazo hormonal en prevención cardiovascular. Medicina (B Aires). 2008; 68(3): 251-7.
Mešalic L, Tupkovic E, Kendic S, Balic D. Correlation between hormonal and lipid status in women in menopause. Bosn J Basic Med Sci. 2008; 8(2): 188-92.
Torresani ME, Oliva ML, Echeverría C, Rossi ML, Maffei L. Perfil lipídico y riesgo cardiovascular en mujeres pre y postmenopáusicas. Diaeta. 2009; 27(126): 6-11.
Roa Barrios M, Arata-Bellabarba G, Valeri L, Velazquez-Maldonado E. Relación entre el cociente triglicéridos/HDL-C, índices de resistencia a la insulina y factores de riesgo cardiometabólico en mujeres con síndrome del ovario poliquístico. Endocrinol Nutr. 2006; 56(2): 59-65.
This journal 