Is triglyceride/HDL ratio a reliable screening test for assessment of atherosclerotic risk in patients with chronic inflammatory disease? (original) (raw)
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High ratio of triglycerides to hdl-cholesterol predicts extensive coronary disease
Clinics, 2008
da Luz PL, Favarato D, Faria-Neto Jr JR, Lemos P; Chagas ACP. High ratio of triglycerides to HDL-cholesterol ratio predicts extensive coronary disease. Clinics. 2008;63:427-32. An abnormal ratio of triglycerides to HDL-cholesterol (TG/HDL-c) indicates an atherogenic lipid profile and a risk for the development of coronary disease. OBJECTIVE: To investigate the association between lipid levels, specifically TG/HDL-c, and the extent of coronary disease. METHODS: High-risk patients (n = 374) submitted for coronary angiography had their lipid variables measured and coronary disease extent scored by the Friesinger index. RESULTS: The subjects consisted of 220 males and 154 females, age 57.2 ± 11.1 years, with total cholesterol of 210± 50.3 mg/ dL, triglycerides of 173.8 ± 169.8 mg/dL, HDL-cholesterol (HDL-c) of 40.1 ± 12.8 mg/dL, LDL-cholesterol (LDL-c) of 137.3 ± 46.2 mg/dL, TG/HDL-c of 5.1 ± 5.3, and a Friesinger index of 6.6 ± 4.7. The relationship between the extent of coronary disease (dichotomized by a Friesenger index of 5 and lipid levels (normal vs. abnormal) was statistically significant for the following: triglycerides, odds ratio of 2.02 (1.31-3.1; p = 0.0018); HDL-c, odds ratio of 2.21 (1.42-3.43; p = 0.0005); and TG/HDL-c, odds ratio of 2.01(1.30-3.09; p = 0.0018). However, the relationship was not significant between extent of coronary disease and total cholesterol [1.25 (0.82-1.91; p = 0.33)] or LDL-c [1.47 (0.96-2.25; p = 0.0842)]. The chi-square for linear trends for Friesinger > 4 and lipid quartiles was statistically significant for triglycerides (p = 0.0017), HDL-c (p = 0.0001), and TG/HDL-c (p = 0.0018), but not for total cholesterol (p = 0.393) or LDL-c (p = 0.0568). The multivariate analysis by logistic regression OR gave 1.3 ± 0.79 (p = .0001) for TG/HDL-c, 0.779 ± 0.074 (p = .0001) for HDL-c, and 1.234 ± 0.097 (p = 0.03) for LDL. Analysis of receiver operating characteristic curves showed that only TG/HDL-c and HDL-c were useful for detecting extensive coronary disease, with the former more strongly associated with disease. CONCLUSIONS: Although some lipid variables were associated with the extent of coronary disease, the ratio of triglycerides to HDL-cholesterol showed the strongest association with extent.
Bangladesh Medical Journal, 2016
Cardiovascular Disease (CVD) is the leading cause of death worldwide, responsible for one third of death. Coronary artery Disease (CAD) is the most common cause. Dyslipidaemia is one of the major contributors of increased CAD risk. High LDL-C, high TG and low HDL-C have all been as predictors for CAD risk. TG/HDL-C ratio could be a very important, easy, non-invasive means of predicting the presence and extent of coronary atherosclerosis. The aim of this study was to evaluate the association between TG/HDL-C ratio and the extent of CAD assessed by coronary angiogram in our setting. This cross sectional analytical study has been done in the Department of Cardiology, Sir Salimullah Medical College & Mitford Hospital. A total 118 patients with newly diagnosed ACS, undergoing coronary angiogram in were selected purposively. Previous history of PCI or CABG, patients getting lipid lowering drugs, patient with congenital heart disease or vulvular heart disease was excluded. Angiographic sev...
ACI (Acta Cardiologia Indonesiana)
Background: Triglycerides (TG) as a risk factor for coronary artery disease (CAD) is still a matter of controversy but when used as a single ratio with high density lipoprotein (HDL) the predictive value for CAD is better. The TG/HDL ratio is also associated with the presence of small dense LDL (sdLDL) in the body. SdLDL is a more atherogenic LDL subfraction and has been proven to be associated with CAD progression.Aims: This study aims to find the correlation between the TG/HDL ratio and the degree of coronary lesion severity based on the Gensini score in stable non diabetic angina pectoris patients.Methods: This study was a cross sectional study conducted at Dr. Hasan Sadikin Hospital and Hasna Medika Palimanan Hospital. Subjects were non diabetic stable angina pectoris patients ≥18 years old who underwent elective coronary angiography. Blood collection for TG and HDL examination was performed after coronary angiography. Gensini scoring system was used to assess the severity of co...
Heart, 1990
Serum triglycerides, high density lipoprotein (HDL) cholesterol, and total cholesterol were measured in 698 patients examined by angiography. The ratio of HDL cholesterol to total cholesterol was significantly lower in patients with single, double, and triple vessel disease than in patients without disease. The serum concentration of triglyceride was significantly higher in patients with single, double, and triple vessel disease than in those without coronary artery disease. Similar proportion of patients with coronary artery disease and without had serum cholesterol concentrations of > 65 mmol/l, but total cholesterol was significantly higher in patients with single, double, and triple vessel disease than in those without. HDL cholesterol (<10 mmol/l), triglycerides (>2-0 mmol/l), and the ratio of HDL cholesterol to total cholesterol (<0 20) were significantly better than total cholesterol as indicators of coronary risk.
Clinical rheumatology, 2018
Ankylosing spondylitis (AS) is associated with an increased risk of atherosclerotic cardiovascular disease (ACD). The atherogenic index of plasma (AIP), which is the logarithmic transformation of the plasma triglyceride (TG) level to the high-density lipoprotein level (HDL) ratio, has been suggested to be a novel marker in the identification of atherosclerosis risk. Therefore, this study aims to determine if the AIP can act as an accurate marker for the detection of subclinical atherosclerosis. Fifty-two male patients with AS and 52 age-, gender-, and body mass index (BMI)-matched healthy control subjects were included in the study. For each patient, AIP and total cholesterol (TC)/HDL values were calculated and carotid artery intima-media thickness (cIMT) was measured. The mean (SD) cIMT and median (range) AIP values for AS patients were higher than that of the healthy control subjects (0.60 ± 0.18 vs. 0.51 ± 0.10, p = 0.003 and 0.23 [- 0.32 to 0.85] vs. 0.09 [- 0.53 to 0.49], p = 0...
Journal of Clinical Lipidology, 2011
The National Cholesterol Education Program Adult Treatment Panel guidelines have established low-density lipoprotein cholesterol (LDL-C) treatment goals, and secondary non-high-density lipoprotein (HDL)-C treatment goals for persons with hypertriglyceridemia. The use of lipid-lowering therapies, particularly statins, to achieve these goals has reduced cardiovascular disease (CVD) morbidity and mortality; however, significant residual risk for events remains. This, combined with the rising prevalence of obesity, which has shifted the risk profile of the population toward patients in whom LDL-C is less predictive of CVD events (metabolic syndrome, low HDL-C, elevated triglycerides), has increased interest in the clinical use of inflammatory and lipid biomarker assessments.
Scientific Reports
We assessed whether high triglycerides (TG) and low high-density lipoprotein cholesterol (HDL-C) levels, expressed by an increased TG/HDL-C ratio, predict coronary atherosclerotic disease (CAD) outcomes in patients with stable angina. We studied 355 patients (60 ± 9 years, 211 males) with stable angina who underwent coronary computed tomography angiography (CTA), were managed clinically and followed for 4.5 ± 0.9 years. The primary composite outcome was all-cause mortality and non-fatal myocardial infarction. At baseline, the proportion of males, patients with metabolic syndrome, diabetes and obstructive CAD increased across TG/HDL-C ratio quartiles, together with markers of insulin resistance, hepatic and adipose tissue dysfunction and myocardial damage, with no difference in total cholesterol or LDL-C. At follow-up, the global CTA risk score (HR 1.06, 95% confidence interval (CI) 1.03–1.09, P = 0.001) and the IV quartile of the TG/HDL-C ratio (HR 2.85, 95% CI 1.30–6.26, P
TURKISH JOURNAL OF MEDICAL SCIENCES, 2015
Introduction Atherosclerosis is a chronic degenerative inflammatory process that occurs in the intima layer of medium and large arteries. Atherosclerotic coronary artery disease is one of the most common causes of morbidity and mortality in developed countries (1). Age, sex, family history, diabetes, hypertension, dyslipidemia, smoking, obesity, sedentary lifestyle, and psychosocial factors can be considered as the main risk factors for atherosclerotic heart disease (2). Recent studies have identified the concentration of plasma triglyceride (TG) and triglyceride-enriched lipoprotein particles (3,4), the size of lipoprotein particles (5,6), apolipoprotein B (apo-B), lipoprotein a, homocysteine, and C-reactive protein (CRP) (7) as risk markers besides the main risk factors. Endothelial damage, oxidative modification of lipids, and inflammation are 3 main factors known to take part in the development of atherosclerosis. Lipids are the most important components of atheromatous plaque. The main source of cholesterol in the atherosclerotic plaque is the esterified cholesterol in low-density lipoprotein cholesterol (LDL-C). The main factors that determine the migration of lipoproteins into subintimal spaces are the molecular size of lipids and gradient degree (1). Although LDL-C is known as the major factor in the process of atherogenesis, the higher levels and the migration of triglyceride-enriched lipoproteins [very-low-density lipoprotein cholesterol (VLDL-C)], intermediate-density lipoprotein cholesterol (IDL-C), chylomicron remnant, and lipoprotein a into the subendothelial space through damaged vascular endothelium can also have an important role in the formation of atheromatous plaque (2). In clinical practice, total cholesterol (TC) and LDL-C levels are used to follow up dyslipidemia and evaluate the cardiovascular risk (8). In some studies, non-high-density lipoprotein cholesterol (non-HDL-C) was reported to be Background/aim: Dyslipidemia is one of the most important risk factors for coronary artery disease (CAD), and low-density lipoprotein cholesterol (LDL-C) is used to measure dyslipidemia. Non-high-density lipoprotein cholesterol (non-HDL-C) seems to be an alternative parameter to LDL-C as it is not influenced by triglyceride (TG) levels. The aim of this study is to compare non-HDL-C and LDL-C levels as risk markers in CAD patients. Materials and methods: One hundred and ten CAD patients and 42 individuals with normal coronary angiography results were included in this study. Patients were divided into 2 groups: TG < 200 mg/dL (n = 75) as group 1 and TG > 200 mg/dL (n = 35) as group 2. Total cholesterol (TC), TG, and HDL-C levels were analyzed with a Roche Modular P800 autoanalyzer. LDL-C and non-HDL-C levels were calculated. Results: There were statistically significant differences in TC, TG, HDL-C, and non-HDL-C levels when the groups were compared. Non-HDL-C levels of group 2 were statistically higher than those of group 1 and the control group. There was no significant difference in LDL-C levels between the groups. Conclusion: Non-HDL-C levels are better risk markers than LDL-C levels, especially in patients with TG > 200 mg/dL, and non-HDL-C levels should be taken into consideration when evaluating the risk of CAD.