scholarly journals Comparison of the Associations of Apolipoprotein B and Non-High-Density Lipoprotein Cholesterol With Other Cardiovascular Risk Factors in Patients With the Metabolic Syndrome in the Insulin Resistance Atherosclerosis Study

Circulation ◽  
2004 ◽  
Vol 110 (17) ◽  
pp. 2687-2693 ◽  
Author(s):  
Naveed Sattar ◽  
Ken Williams ◽  
Allan D. Sniderman ◽  
Ralph D’Agostino ◽  
Steven M. Haffner
2017 ◽  
Vol 49 (07) ◽  
pp. 542-549 ◽  
Author(s):  
Helene von Bibra ◽  
Sarama Saha ◽  
Alexander Hapfelmeier ◽  
Gabriele Müller ◽  
Peter Schwarz

AbstractInsulin resistance is the underlying mechanism for the metabolic syndrome and associated dyslipidaemia that theoretically implies a practical tool for identifying individuals at risk for cardiovascular disease and type-2-diabetes. Another screening tool is the hypertriglyceremic-waist phenotype (HTW). There is important impact of the ethnic background but a lack of studied European populations for the association of the triglyceride/high-density lipoprotein cholesterol (HDL-C) ratio and insulin resistance. This observational, retrospective study evaluated lipid ratios and the HTW for predicting the metabolic syndrome/insulin resistance in 1932 non-diabetic individuals from Germany in the fasting state and during a glucose tolerance test. The relations of triglyceride/HDL-C, total-cholesterol/HDL-C, and low-density lipoprotein cholesterol/HDL-C with 5 surrogate estimates of insulin resistance/sensitivity and metabolic syndrome were analysed by linear regression analysis and receiver operating characteristics (ROC) in participants with normal (n=1 333) or impaired fasting glucose (n=599), also for the impact of gender. Within the lipid ratios, triglyceride/HDL-C had the strongest associations with insulin resistance/sensitivity markers. In the prediction of metabolic syndrome, diagnostic accuracy was good for triglyceride/HDL-C (area under the ROC curve 0.817) with optimal cut-off points (in mg/dl units) of 2.8 for men (80% sensitivity, 71% specificity) and 1.9 for women (80% sensitivity, 75% specificity) and fair for HTW and HOMA-IR (area under the curve 0.773 and 0.761). These data suggest the triglyceride/HDL-C ratio as a physiologically relevant and practical index for predicting the concomitant presence of metabolic syndrome, insulin resistance and dyslipidaemia for therapeutic and preventive care in apparently healthy European populations.


Author(s):  
Monika Krawczyk ◽  
Małgorzata Rumińska ◽  
Ewelina Witkowska- Sędek ◽  
Anna Majcher ◽  
Beata Pyrżak

The triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C) is a useful surrogate marker of insulin resistance and cardiovascular risk factors. We aimed to assess the relationship between the TG/HDL-C ratio and insulin resistance (IR) and its usefulness in prediction of the metabolic syndrome (MS). This retrospective study involved 122 obese children with the mean age of 11.6±3 years and their 58 healthy lean peers. Anthropometric measurements, blood pressure, the plasma lipid profile and oral glucose tolerance test (OGTT) were analyzed. Based on the obtained results, the TG/HDL-C ratio and surrogate insulin resistance indices (HOMA-IR, FGIR, QUICKI, OGIS, Matsuda index) were calculated. The TG/HDL-C ratio positively correlated with weight, waist circumference, waist to hip ratio (WHR), lipid profile, HOMA-IR, fasting insulin and insulin measurements during OGTT, and negatively correlated with FGIR, QUICKI, OGIS, and the Matsuda index. Obese children with the TG/HDL-C ratio≥3 (47.5%) had higher values of WHR and HOMA-IR, and lower ones of FGIR, QUICKI, OGIS, and the Matsuda index when compared to their obese peers with the TG/HDL-C<3. The area under the curve (AUC) calculated for each insulin resistance index in prediction of the metabolic syndrome was the largest for the TG/HDL-C ratio (0.8936, 95% Cl:0.809–0.977, p=0.000). For 1 unit increase in the TG/HDL-C ratio, the odds for having MS increased by 2.09 times. The TG/HDL-C ratio is a good surrogate marker of insulin resistance in obese children. When comparing the usefulness of some IR markers in prediction of the metabolic syndrome, the TG/HDL-C ratio seems to be the best one and should be used in clinical practice to identify children at risk of metabolic syndrome development.


Author(s):  
Jonatan Fridolfsson ◽  
Christoph Buck ◽  
Monica Hunsberger ◽  
Joanna Baran ◽  
Fabio Lauria ◽  
...  

Abstract Background Physical activity (PA) during childhood is important for preventing future metabolic syndrome (MetS). To examine the relationship between PA and MetS in more detail, accurate measures of PA are needed. Previous studies have only utilized a small part of the information available from accelerometer measured PA. This study investigated the association between measured PA and MetS in children with a new method for data processing and analyses that enable more detailed interpretation of PA intensity level. Methods The association between PA pattern and risk factors related to MetS was investigated in a cross- sectional sample of children (n = 2592, mean age 10.9 years, 49.4% male) participating in the European multicenter I. Family study. The risk factors examined include body mass index, blood pressure, high-density lipoprotein cholesterol, insulin resistance and a combined risk factor score (MetS score). PA was measured by triaxial accelerometers and raw data was processed using the 10 Hz frequency extended method (FEM). The PA output was divided into an intensity spectrum and the association with MetS risk factors was analyzed by partial least squares regression. Results PA patterns differed between the European countries investigated, with Swedish children being most active and Italian children least active. Moderate intensity physical activity was associated with lower insulin resistance (R2 = 2.8%), while vigorous intensity physical activity was associated with lower body mass index (R2 = 3.6%), MetS score (R2 = 3.1%) and higher high-density lipoprotein cholesterol (R2 = 2.3%). PA of all intensities was associated with lower systolic- and diastolic blood pressure, although the associations were weaker than for the other risk factors (R2 = 1.5% and R2 = 1.4%). However, the multivariate analysis implies that the entire PA pattern must be considered. The main difference in PA was observed between normal weight and overweight children. Conclusions The present study suggests a greater importance of more PA corresponding to an intensity of at least brisk walking with inclusion of high-intense exercise, rather than a limited time spent sedentary, in the association to metabolic health in children. The methods of data processing and statistical analysis enabled accurate analysis and interpretation of the health benefits of high intensity PA that have not been shown previously.


1993 ◽  
Vol 39 (2) ◽  
pp. 209-212 ◽  
Author(s):  
J H Wu ◽  
J T Kao ◽  
M S Wen ◽  
D Wu

Abstract We measured lipid and lipoprotein concentrations in blood samples from control subjects and patients with coronary artery disease (CAD) in Taiwan. We found significant differences (P &lt; 0.01) in the concentrations of high-density lipoprotein cholesterol (HDLC), apolipoprotein AI (ApoAI), apolipoprotein B (ApoB), and lipoprotein(a) [Lp(a)]. Concentrations of HDLC &lt; 350 mg/L, ApoAI &lt; 900 mg/L, ApoB &gt; 800 mg/L, and Lp(a) &gt; 200 mg/L occurred, respectively, 2.8, 5.2, 1.7, and 2.3 times more frequently in the patients than in the control group. If one considers HDLC at &lt; 350 mg/L, ApoAI at &lt; 900 mg/L, ApoB at &gt; 800 mg/L, and Lp(a) at &gt; 200 mg/L as separate risk factors for CAD, the ratio of individual patients to control subjects having 4, 3, 2, 1, or 0 risk factors was [symbol: see text] 9.4, 2.1, 0.2, 0.2, respectively. Individuals displaying three or more risk factors were found 15 times more frequently in the CAD group than in the control group. These risk factors may be used clinically for the prediction and prevention of CAD in the general population.


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