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Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Research Article

TG/HDL-C Ratio for Predicting Insulin Resistance in Obese Children from Beijing, China

Author(s): Tian Zhang, Fangfang Duan, Yi Qian, Jin Zhang, Huihui Sun and Naijun Wan*

Volume 24, Issue 9, 2024

Published on: 01 November, 2023

Page: [1101 - 1109] Pages: 9

DOI: 10.2174/0118715303245154231023104618

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Abstract

Background: International studies have found that the blood triglycerides to highdensity lipoproteins (TG/HDL-C) ratio predicted insulin resistance in children with overweight and obesity. However, there is a lack of such reports on children from China.

Objective: The objective of this study is to explore the ability of the TG/HDL-C ratio as a blood biomarker for insulin resistance (IR) in obese children in Beijing.

Methods: We evaluated 262 children with obesity from our paediatric outpatient clinic in a cross-sectional study. Detailed medical histories of all children were ascertained, as were clinical examination and laboratory test results, including blood lipids, fasting glucose, insulin, and glycated haemoglobin. We divided them into age groups of 6-9 and 10-13.5 years and then into IR and non-IR groups based on the homeostatic model assessment for IR (HOMA-IR). Analysis was accomplished with SPSS software (version 22.0).

Results: The TG/HDL-C ratio was higher in children with IR in the 6-9 and 10-13.5-year age groups (p < 0.001). Univariate and multivariate analyses displayed that the TG/HDL-C ratio and HOMA-IR were correlated in the 6-9 and 10-13.5-year-old groups (p < 0.05). In the 6-9-yearold group, IR identified by a TG/HDL-C ratio ≥ 0.645 had a sensitivity, specificity, and an area under the curve (AUC) of 79.1%, 60.9%, and 0.734, respectively. In the 10–13.5-year-old group, IR identified by a TG/HDL-C ratio ≥ 0.725 had a sensitivity, specificity, and an AUC of 79.4%, 62.9%, and 0.724, respectively.

Conclusion: We showed the application of the TG/HDL-C ratio to predict insulin resistance in obese children in Beijing with different diagnostic thresholds based on age (6-9-year-old group with TG/HDL-C ≥ 0.645; 10–13.5-year-old group with TG/HDL-C ≥ 0.725), which were lower compared with the diagnostic threshold for insulin resistance in children reported in other countries.

Keywords: Obesity, children, TG/HDL-C ratio, insulin resistance, HOMA-IR, triglycerides, high-density lipoproteins.

Graphical Abstract
[1]
Dong, Y.; Jan, C.; Ma, Y.; Dong, B.; Zou, Z.; Yang, Y.; Xu, R.; Song, Y.; Ma, J.; Sawyer, S.M.; Patton, G.C. Economic development and the nutritional status of Chinese school-aged children and adolescents from 1995 to 2014: An analysis of five successive national surveys. Lancet Diabetes Endocrinol., 2019, 7(4), 288-299.
[http://dx.doi.org/10.1016/S2213-8587(19)30075-0] [PMID: 30902266]
[2]
Li, L.; Wang, H.J.; Ouyang, Y.F. Nutritional status of adolescents in nine Chinese provinces in 2000-2018. Chin J. Sch. Health., 2021, 42(12), 1789-1792.
[3]
Dündar, İ.; Akıncı, A. Prevalence of type 2 diabetes mellitus, metabolic syndrome, and related morbidities in overweight and obese children. J. Pediatr. Endocrinol. Metab., 2022, 35(4), 435-441.
[http://dx.doi.org/10.1515/jpem-2021-0271] [PMID: 35026882]
[4]
Diabetes Branch of Chinese Medical Association Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2020 Edition). Chin. J. Diabetes., 2021, 13(4), 315-409.
[5]
Bhosle, D.D.; Sayyed, A.; Bhagat, A. Homeostasis model assessment of insulin resistance (HOMA-IR) in the diagnosis of insulin resistance and prediabetes. J Med Sci. Clin. Res., 2016, 4(9), 12705-12710.
[http://dx.doi.org/10.18535/jmscr/v4i9.65]
[6]
Peplies, J.; Börnhorst, C.; Günther, K.; Fraterman, A.; Russo, P.; Veidebaum, T.; Tornaritis, M.; De Henauw, S.; Marild, S.; Molnar, D.; Moreno, L.A.; Ahrens, W. Longitudinal associations of lifestyle factors and weight status with insulin resistance (HOMA-IR) in preadolescent children: The large prospective cohort study IDEFICS. Int. J. Behav. Nutr. Phys. Act., 2016, 13(1), 97.
[http://dx.doi.org/10.1186/s12966-016-0424-4] [PMID: 27590045]
[7]
Iwani, N.A.K.Z.; Jalaludin, M.Y.; Zin, R.M.W.M.; Fuziah, M.Z.; Hong, J.Y.H.; Abqariyah, Y.; Mokhtar, A.H.; Wan Nazaimoon, W.M. Triglyceride to HDL-C ratio is associated with insulin resistance in overweight and obese children. Sci. Rep., 2017, 7(1), 40055.
[http://dx.doi.org/10.1038/srep40055] [PMID: 28059134]
[8]
Behiry, E.G.; El Nady, N.M. AbdEl Haie, O.M.; Mattar, M.K.; Magdy, A. Evaluation of TG-HDL ratio instead of HOMA ratio as insulin resistance marker in overweight and children with obesity. Endocr. Metab. Immune Disord. Drug Targets, 2019, 19(5), 676-682.
[http://dx.doi.org/10.2174/1871530319666190121123535] [PMID: 30663576]
[9]
Gasevic, D.; Frohlich, J.; Mancini, G.B.J.; Lear, S.A. The association between triglyceride to high-density-lipoprotein cholesterol ratio and insulin resistance in a multiethnic primary prevention cohort. Metabolism, 2012, 61(4), 583-589.
[http://dx.doi.org/10.1016/j.metabol.2011.09.009] [PMID: 22075272]
[10]
Ren, X.; Chen, Z.; Zheng, S.; Han, T.; Li, Y.; Liu, W.; Hu, Y. Association between triglyceride to HDL-C ratio (TG/HDL-C) and insulin resistance in Chinese patients with newly diagnosed type 2 diabetes mellitus. PLoS One, 2016, 11(4), e0154345.
[http://dx.doi.org/10.1371/journal.pone.0154345] [PMID: 27115999]
[11]
WS/T 586-2018 screening for overweight and obesity in school-age children and adolescents; Standards Press of China: Beijing, 2018.
[12]
Li, H.; Ji, C.Y.; Zong, X.N.; Zhang, Y.Q. (Body mass index growth curves for Chinese children and adolescents aged 0 to 18 years). Zhonghua Er Ke Za Zhi, 2009, 47(7), 493-498.
[PMID: 19951508]
[13]
Li, H.; Ji, C.Y.; Zong, X.N. Standardized growth curves for height and weight of children and adolescents aged 0-18 years in China. Zhonghua Er Ke Za Zhi, 2009, 47(7), 487-492.
[PMID: 19951507]
[14]
Copeland, K.C.; Zeitler, P.; Geffner, M.; Guandalini, C.; Higgins, J.; Hirst, K.; Kaufman, F.R.; Linder, B.; Marcovina, S.; McGuigan, P.; Pyle, L.; Tamborlane, W.; Willi, S. Characteristics of adolescents and youth with recent-onset type 2 diabetes: The TODAY cohort at baseline. J. Clin. Endocrinol. Metab., 2011, 96(1), 159-167.
[http://dx.doi.org/10.1210/jc.2010-1642] [PMID: 20962021]
[15]
Haffner, S.M.; D’Agostino, R., Jr; Mykkänen, L.; Tracy, R.; Howard, B.; Rewers, M.; Selby, J.; Savage, P.J.; Saad, M.F. Insulin sensitivity in subjects with type 2 diabetes. Relationship to cardiovascular risk factors: The Insulin Resistance Atherosclerosis Study. Diabetes Care, 1999, 22(4), 562-568.
[http://dx.doi.org/10.2337/diacare.22.4.562] [PMID: 10189532]
[16]
Freeman, A.M. Pennings, N Insulin Resistance; StatPearls Publishing: Treasure Island, FL, 2023.
[17]
Hirschler, V.; Maccallini, G.; Sanchez, M.; Gonzalez, C.; Molinari, C. Association between triglyceride to HDL-C ratio and insulin resistance in indigenous Argentinean children. Pediatr. Diabetes, 2015, 16(8), 606-612.
[http://dx.doi.org/10.1111/pedi.12228] [PMID: 25303644]
[18]
Freeman, A.M.; Pennings, N. Insulin resistance; StatPearls Publishing: USA, 2022.
[19]
Bacopoulou, F.; Efthymiou, V.; Landis, G.; Rentoumis, A.; Chrousos, G.P. Waist circumference, waist-to-hip ratio and waist-to-height ratio reference percentiles for abdominal obesity among Greek adolescents. BMC Pediatr., 2015, 15(1), 50.
[http://dx.doi.org/10.1186/s12887-015-0366-z] [PMID: 25935716]
[20]
Vajravelu, M.E.; Kindler, J.M.; Zemel, B.S.; Jawad, A.; Koren, D.; Brar, P.; Brooks, L.J.; Reiner, J.; Levitt Katz, L.E. Visceral adiposity is related to insulin sensitivity and inflammation in adolescents with obesity and mild sleep disordered breathing. J. Pediatr. Endocrinol. Metab., 2022, 35(8), 1069-1077.
[http://dx.doi.org/10.1515/jpem-2021-0745] [PMID: 35822712]
[21]
Liu, X.Y.; Wu, Q.Y.; Chen, Z.H.; Yan, G.Y.; Lu, Y.; Dai, H.J.; Li, Y.; Yang, P.T.; Yuan, H. Elevated triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio increased risk of hyperuricemia: A 4-year cohort study in China. Endocrine, 2020, 68(1), 71-80.
[http://dx.doi.org/10.1007/s12020-019-02176-5] [PMID: 31940133]
[22]
Park, J.M.; Lee, J.Y.; Dong, J.J.; Lee, D.C.; Lee, Y.J. Association between the triglyceride to high-density lipoprotein cholesterol ratio and insulin resistance in Korean adolescents: A nationwide population-based study. J. Pediatr. Endocrinol. Metab., 2016, 29(11), 1259-1265.
[http://dx.doi.org/10.1515/jpem-2016-0244] [PMID: 27740931]

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