본문 바로가기
KERD
논문KCI 등재

The triglyceride-to-high density lipoprotein cholesterol ratio in overweight Korean children and adolescents

2

조회

0

다운로드

2

인용

0

참고문헌

키워드

주제분류소아과학

초록

Purpose: The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio has recently been reported as a biomarker of cardiometabolic risk in obese children and adolescents. The purpose of this study is to describe the TG/HDL-C ratio and related factors in overweight and normal weight Korean children and to evaluate whether the high TG/HDL-C ratio is associated with insulin resistance in overweight children and adolescents. Methods: Data from 255 overweight (aged 8.7±2.0 years) and 514 normal weight (aged 8.9±1.8 years) children and adolescents were evaluated. Glucose, insulin, total cholesterol (TC), HDL-C and TG levels were measured after overnight fasting, and the TG/HDL-C ratio, non–HDL-C and the homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Results: The TG/HDL-C ratio was higher in overweight group compared to normal weight group (P<0.001). Among overweight children and adolescents, alanine aminotransferase (P=0.018), non–HDL-C (P<0.001), and HOMA-IR (P=0.004) were different between the TG/HDL-C ratio tertile groups. The prevalence of elevated HOMA-IR was increased with increasing TG/HDL-C ratio tertiles (P for trend=0.003). On regression analysis adjusted for age and sex, the BMI (β=0.402, P=0.001) and TG/HDL-C ratio (β=0.251, P=0.014) were independently associated with HOMA-IR (adjusted R2=0.324). The TG/HDL-C ratio of 2.0 or more showed higher sensitivity (55.6%) and specificity (72.9%), when compared to TC (≥200 mg/dL), non–HDL-C (≥145 mg/dL), and LDL-C (≥130 mg/dL) for identifying overweight children with elevated HOMA-IR. Conclusion: The TG/HDL-C ratio is independently associated with insulin resistance in overweight children and adolescents, and it can be useful in identifying those at higher cardiometabolic risk.

Abstract

Purpose: The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio has recently been reported as a biomarker of cardiometabolic risk in obese children and adolescents. The purpose of this study is to describe the TG/HDL-C ratio and related factors in overweight and normal weight Korean children and to evaluate whether the high TG/HDL-C ratio is associated with insulin resistance in overweight children and adolescents. Methods: Data from 255 overweight (aged 8.7±2.0 years) and 514 normal weight (aged 8.9±1.8 years) children and adolescents were evaluated. Glucose, insulin, total cholesterol (TC), HDL-C and TG levels were measured after overnight fasting, and the TG/HDL-C ratio, non–HDL-C and the homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Results: The TG/HDL-C ratio was higher in overweight group compared to normal weight group (P<0.001). Among overweight children and adolescents, alanine aminotransferase (P=0.018), non–HDL-C (P<0.001), and HOMA-IR (P=0.004) were different between the TG/HDL-C ratio tertile groups. The prevalence of elevated HOMA-IR was increased with increasing TG/HDL-C ratio tertiles (P for trend=0.003). On regression analysis adjusted for age and sex, the BMI (β=0.402, P=0.001) and TG/HDL-C ratio (β=0.251, P=0.014) were independently associated with HOMA-IR (adjusted R2=0.324). The TG/HDL-C ratio of 2.0 or more showed higher sensitivity (55.6%) and specificity (72.9%), when compared to TC (≥200 mg/dL), non–HDL-C (≥145 mg/dL), and LDL-C (≥130 mg/dL) for identifying overweight children with elevated HOMA-IR. Conclusion: The TG/HDL-C ratio is independently associated with insulin resistance in overweight children and adolescents, and it can be useful in identifying those at higher cardiometabolic risk.

참고문헌 (31)

  1. Han JC, "Childhood obesity", Lancet, 375, pp.1737~1748 (2010)
  2. Elmaoğulları S, "Prevalence of dyslipidemia and associated factors in obese children and adolescents", J Clin Res Pediatr Endocrinol, 7, pp.228~234 (2015)
  3. Lobstein T, "Obesity in children and young people: a crisis in public health", Obes Rev, 5(Suppl 1), pp.4~104 (2004)
  4. Berenson GS, "Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study", N Engl J Med, 338, pp.1650~1656 (1998)
  5. McGill HC, "Are pediatricians responsible for prevention of adult cardiovascular disease", Nat Clin Pract Cardiovasc Med, 6, pp.10~11 (2009)
  6. Boullart AC, "Serum triglycerides and risk of cardiovascular disease", Biochim Biophys Acta, 1821, pp.867~875 (2012)
  7. Budoff M, "Triglycerides and triglyceride-rich lipoproteins in the causal pathway of cardiovascular disease", Am J Cardiol, 118, pp.138~145 (2016)
  8. Manco M, "Triglycerides-to-HDL cholesterol ratio as screening tool for impaired glucose tolerance in obese children and adolescents", Acta Diabetol, 53, pp.493~498 (2016)
  9. Giannini C, "The triglyceride-to-HDL cholesterol ratio:association with insulin resistance in obese youths of different ethnic backgrounds", Diabetes Care, 34, pp.1869~1874 (2011)
  10. de Giorgis T, "Triglycerides-to-HDL ratio as a new marker of endothelial dysfunction in obese prepubertal children", Eur J Endocrinol, 170, pp.173~180 (2013)
  11. Musso C, "Cardiometabolic risk factors as apolipoprotein B, triglyceride", HDL-cholesterol ratio and C-reactive protein, in adolescents with and without obesity: cross-sectional study in middle class suburban children, 2011, pp.12(3 Pt 2), 229~234
  12. Pacifico L, "Association of serum triglycerideto- HDL cholesterol ratio with carotid artery intima-media thickness, insulin resistance and nonalcoholic fatty liver disease in children and adolescents", Nutr Metab Cardiovasc Dis, 24, pp.737~743 (2014)
  13. 문진수, "2007 한국 소아 청소년 성장도표 : 개발 과정과 전망", Korean Journal of Pediatrics, 51(1), pp.1~25 (2008), 대한소아과학회
  14. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, "Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report", Pediatrics, 128(Suppl 5), pp.S213~S256 (2011)
  15. Friedewald WT, "Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge", Clin Chem, 18, pp.499~502 (1972)
  16. Benuck I, "Point: The rationale for universal lipid screening and treatment in children", J Clin Lipidol, 9(5 Suppl), pp.S93~S100 (2015)
  17. Vilela BS, "The HOMA-Adiponectin (HOMAAD) closely mirrors the HOMA-IR index in the Screening of Insulin Resistance in the Brazilian Metabolic Syndrome Study (BRAMS)", PLoS One, 11, pp.e0158751~ (2016)
  18. Matthews DR, "Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man", Diabetologia, 28, pp.412~419 (1985)
  19. Wittrup HH, "Lipoprotein lipase mutations, plasma lipids and lipoproteins, and risk of ischemic heart disease. A meta-analysis", Circulation, 99, pp.2901~2907 (1999)
  20. Cholesterol Treatment Trialists' (CTT) Collaborators, "Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a metaanalysis", Lancet, 371, pp.117~125 (2008)
  21. Kavey RE, "Beyond cholesterol: the atherogenic consequences of combined dyslipidemia", J Pediatr, 161, pp.977~979 (2012)
  22. Otvos JD, "Clinical implications of discordance between low-density lipoprotein cholesterol and particle number", J Clin Lipidol, 5, pp.105~113 (2011)
  23. Berneis KK, "Metabolic origins and clinical significance of LDL heterogeneity", J Lipid Res, 43, pp.1363~1379 (2002)
  24. Burns SF, "Surrogate lipid markers for small dense low-density lipoprotein particles in overweight youth", J Pediatr, 161, pp.991~996 (2012)
  25. Miller M, "Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association", Circulation, 123, pp.2292~2333 (2011)
  26. Di Bonito P, "Comparison of non-HDL-cholesterol versus triglycerides-to-HDL-cholesterol ratio in relation to cardiometabolic risk factors and preclinical organ damage in overweight", obese children: the CARITALY study, 2015, pp.25, 489~494
  27. Lim H, "Association between obesity and metabolic co-morbidities among children and adolescents in South Korea based on national data", BMC Public Health, 14, pp.279~ (2014)
  28. Geoffrey R Simon, "2014 recommendations for pediatric preventive health care", Pediatrics, 133, pp.568~570 (2014)
  29. van Wijk JP, "Normalization of daytime triglyceridemia by simvastatin in fasting normotriglyceridemic patients with premature coronary sclerosis", Atherosclerosis, 171, pp.109~116 (2003)
  30. Nordestgaard BG, "Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women", JAMA, 298, pp.299~308 (2007)
  31. Nofer JR, "Hyperlipidemia and cardiovascular disease: triglycerides - a revival of cardiovascular risk factor", Curr Opin Lipidol, 22, pp.319~321 (2011)

관련 논문AI추천

Risk assessment of metabolic syndrome in adolescents using the triglyceride/high-density lipoprotein cholesterol ratio and the total cholesterol/high-density lipoprotein cholesterol ratio김신혜, Ji-Hyun Jung, Mi-Jung Park, Shou-Yu Chu대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2019 · 제24권 제1호The cutoff values of indirect indices for measuring insulin resistance for metabolic syndrome in Korean children and adolescents김유진, 김준우, 박상후, 임민지, 한헌석대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2016 · 제21권 제3호한국 청소년의 HOMA-IR과 대사 위험 요소와의 연관성김신혜, 박미정, 서유진, 이선근대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2011 · 제14권 제4호Age-related insulin resistance changes in children and adolescents and its impact on the accuracy of diagnosis of metabolic syndromeAhn Yoon Ji, Cho Sung Yoon, Han Kyung-Do, Im Minji, Kim Insung, Lee Kyu-Na, Sung Juyoung대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2025 · 제30권 제4호Waist- to-Height Ratio as an Index for Cardiometabolic Risk in Adolescents: Results from the 1998−2008 KNHANES박미정, 유은경, 정인혁, Sangshin Park연세대학교의과대학 · Yonsei Medical Journal2016 · 제57권 제3호Comparison of different criteria for the definition of insulin resistance and its relationship to metabolic risk in children and adolescentsAhn Moon Bae, Choi Yu Jung, Cho Kyoung Soon, Cho Won Kyoung, Jung Min Ho, Kim Seul Ki, Kim Shin Hee, Lee Seon Hwa, Suh Byung-Kyu대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2020 · 제25권 제4호

이 간행물의 다른 논문 (10건)