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Lipids in Health and Disease

, 13:159

First Online: 10 October 2014Received: 24 April 2014Accepted: 28 September 2014

Abstract

BackgroundWaist circumference, a metabolic syndrome MetSy criterion, is not routinely measured in clinical practice making early identification of individuals with MetSy challenging. It has been argued that ratios of commonly measured parameters such as lipids and lipoproteins may be an acceptable alternative for identifying individuals with MetSy. The objective of our study was to explore clinical utility of lipid ratios to identify men and women with MetSy; and to explore the association between lipid ratios and the number of MetSy components.

MethodsMen and women N = 797 of Aboriginal, Chinese, European, and South Asian origin 35–60 years, recruited across ranges of body mass index BMI, with no diagnosed cardiovascular disease CVD or on medications to treat CVD risk factors were assessed for anthropometrics, family history of CVD, MetSy components waist circumference, blood pressure, glucose, triglycerides TG, high-density-lipoprotein-cholesterol HDL-C, low-density-lipoprotein-cholesterol LDL-C, nonHDL-C, and health-related behaviours.

ResultsMean levels of lipid ratios significantly increased with increasing number of MetSy components in men and women p < 0.05. After adjustment for age, ethnicity, smoking, alcohol consumption, physical activity, family history of CVD and BMI, and menopausal status in women, all lipid ratios were associated with the number of MetSy components in men and women Poisson regression, p < 0.001. Compared to the rest of the lipid ratios ROC curve analysis, TG-HDL-C was best able to discriminate between individuals with and without MetSy AUC = 0.869 95% CI: 0.830, 0.908 men; AUC = 0.872 95% CI: 0.832, 0.912 women. The discriminatory power of TC-HDL-C and nonHDL-C-HDL-C to identify individuals with MetSY was the same for both ratios, AUC = 0.793 95% CI: 0.744, 0.842 men; 0.818 95% CI: 0.772, 0.864 women. Additionally, LDL-C-HDL-C was a good marker for women AUC = 0.759 95% CI: 0.706, 0.812, but not for men AUC = 0.689 95% CI: 0.631, 0.748. Based on a multiethnic sample, we identified TG-HDL-C cut-off values of 1.62 in men and 1.18 in women that were best able to discriminate between men and women with and without MetSY.

ConclusionsOur results indicate that TG-HDL-C is a superior marker to identify men and women with MetSy compared to TC-HDL-C, LDL-C-HDL-C, and nonHDL-C-HDL-C.

KeywordsMetabolic syndrome Lipid ratios Triglyceride-to-high-density-lipoprotein-cholesterol Low-density-lipoprotein-cholesterol-to-high-density-lipoprotein-cholesterol Non-high-density-lipoprotein-cholesterol-to-high-density-lipoprotein-cholesterol and total cholesterol-to-high-density-lipoprotein-cholesterol AbbreviationsAUCArea under the curve

BMIBody mass index

CVDCardiovascular disease

LDL-C-HDL-CLow-density-lipoprotein-cholesterol-to-high-density-lipoprotein-cholesterol

M-CHATMulti-Cultural Health Assessment Trial

nonHDL-C-HDL-Cnon-high-density-lipoprotein-cholesterol-to-high-density-lipoprotein-cholesterol

ROCReceiver-operating characteristic curve

SDStandard deviation

SPSSStatistical Package for Social Sciences

TC-HDL-CTotal cholesterol-to-high-density-lipoprotein-cholesterol

TG-HDL-CTriglyceride-to-high-density-lipoprotein-cholesterol.

Electronic supplementary materialThe online version of this article doi:10.1186-1476-511X-13-159 contains supplementary material, which is available to authorized users.

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Author: Danijela Gasevic - Jiri Frohlich - GB John Mancini - Scott A Lear

Source: https://link.springer.com/







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