Triglycerides-to-HDL ratio as a new marker of endothelial dysfunction in obese prepubertal children

• Published in: European journal of endocrinology Vol. 170; no. 2; pp. 173 - 180
• Main Authors: de Giorgis, Tommaso, Marcovecchio, M Loredana, Di Giovanni, Ilaria, Giannini, Cosimo, Chiavaroli, Valentina, Chiarelli, Francesco, Mohn, Angelika
• Format: Journal Article
• Language: English
• Published: Bristol Bioscientifica Ltd 01.02.2014; BioScientifica
• Subjects: Biological and medical sciences; Biomarkers - blood; Cardiovascular Diseases; Child; Cholesterol, HDL - blood; Clinical Study; Endocrinopathies; Endothelium, Vascular - physiopathology; Female; Fundamental and applied biological sciences. Psychology; Humans; Insulin Resistance; Male; Medical sciences; Metabolic diseases; Obesity; Obesity - blood; Obesity - epidemiology; Risk Factors; Triglycerides - blood; Vertebrates: endocrinology; Human; Obesity; Nutrition disorder; Biological marker; Lipids; Triglyceride; Endothelium; Prepuberty; Dysfunction; Endothelial dysfunction; Ratio; Lipoprotein HDL; Child; Endocrinology; Nutritional status
• ISSN: 0804-4643; 1479-683X
• DOI: 10.1530/EJE-13-0452

ObjectiveTo investigate whether there is an association of the triglyceride-to-HDL cholesterol (TG:HDL-C) ratio with cardiovascular risk factors and early signs of vascular damage in obese prepubertal children.Design and methodsIn 50 obese (27 boys, 7.8±1.4 years) and 37 normal-weight (20 boys; 7.3±1.5 years) prepubertal children, anthropometric measurements, oxidative stress markers (urinary isoprostanes (PGF2α (prostaglandin F2α)), soluble receptor for advanced glycation end-products (sRAGE)) and insulin sensitivity (homeostasis model assessment of insulin resistance (HOMA-IR) and whole-body insulin sensitivity index (WBISI)) were evaluated. Lipids profile was assessed and the TG:HDL-C ratio was calculated. In addition, high-resolution ultrasound was performed to assess carotid intima-media thickness (cIMT).ResultsObese children showed significantly higher values of the TG:HDL-C ratio (1.9±1.1 vs 1.2±0.6, P=0.002) compared with controls. After dividing the population in tertiles of the TG:HDL-C ratio (<1.04, 1.04–1.67, >1.67), cIMT (P=0.0003), and HOMA-IR (P=0.0001) progressively increased from the lower to the upper tertile, whereas WBISI (P=0.0003) and sRAGE (P=0.05) progressively decreased. In a regression model, the TG:HDL ratio was significantly and positively associated with cIMT (r=0.493; P=0.0005). A cutoff point for TG:HDL-C ratio of 1.12 had 81% sensitivity and 49% specificity in the identification of children with cIMT values in the upper quartile (Area under the curve values from receiver operating characteristic curves=0.633±0.065, P=0.045).ConclusionThis study confirms the reliability of the TG:HDL-C ratio as a useful marker of cardiovascular risk. Interestingly, our results underline that the TG:HDL-C ratio is directly related with early signs of vascular damage already present in prepubertal children.