Relationship between Serum Lipoprotein Ratios and Insulin Resistance in Obesity
Open Access
- 1 December 2004
- journal article
- Published by Oxford University Press (OUP) in Clinical Chemistry
- Vol. 50 (12), 2316-2322
- https://doi.org/10.1373/clinchem.2004.037556
Abstract
Background: The fasting serum lipid profile [triglycerides (TGs), total cholesterol (TC), and LDL- and HDL-cholesterol (LDL-C and HDL-C)] is used to calculate lipid ratios (TC/HDL-C, LDL-C/HDL-C, TG/HDL-C) that allow identification of individuals at increased risk for cardiovascular disease. Because these individuals are also frequently insulin resistant, this study analyzed the relationships between lipid ratios and insulin sensitivity. Methods: In 132 obese [mean (SE) body mass index, 37.5 (0.6) kg/m2] outpatients without known diabetes mellitus, fasting serum lipid profiles and 75-g oral glucose tolerance tests were performed. Insulin sensitivity was assessed from surrogate estimates for fasting (QUICKI) and dynamic (OGIS) conditions. Results: After exclusion of other endocrine diseases (n = 35), the remaining patients were classified as glucose tolerant (n = 56), glucose intolerant (n = 22), or as having type 2 diabetes (n = 19). QUICKI and OGIS indicated severe insulin resistance in all individuals with type 2 diabetes and impaired glucose tolerance compared with glucose-tolerant individuals: QUICKI, glucose tolerant, 0.302 (0.002); glucose intolerant, 0.290 (0.002); type 2 diabetes, 0.281 (0.005); P <0.001; OGIS (mL · m−2 · min−1), glucose tolerant, 343 (7), glucose intolerant, 293 (9); type 2 diabetes, 256 (12); P <0.001. Serum TG (P <0.005) and TG/HDL-C ratios (P <0.05) were increased in individuals with impaired glucose tolerance. TG/HDL-C ratios negatively correlated with QUICKI (r = −0.370; P < 0.001) and OGIS (r = −0.333; P < 0.005) in nondiabetic individuals (glucose tolerant plus glucose intolerant), but not in patients with type 2 diabetes (not significant). Conclusions: This study demonstrates that the TG/HDL-C ratio positively correlates with insulin resistance in severely obese nondiabetic individuals.Keywords
This publication has 31 references indexed in Scilit:
- Novel Risk Factors for Systemic AtherosclerosisJAMA, 2001
- Obesity as a medical problemNature, 2000
- Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom prospective diabetes study (UKPDS: 23)BMJ, 1998
- Fasting Triglycerides, High-Density Lipoprotein, and Risk of Myocardial InfarctionCell Metabolism, 1997
- Cholesterol and Coronary Heart Disease: Predicting Risks by Levels and RatiosAnnals of Internal Medicine, 1994
- A Prospective Study of Cholesterol, Apolipoproteins, and the Risk of Myocardial InfarctionNew England Journal of Medicine, 1991
- Role of Insulin Resistance in Human DiseaseDiabetes, 1988
- Incidence of Coronary Heart Disease and Lipoprotein Cholesterol LevelsJAMA, 1986
- Overall and coronary heart disease mortality rates in relation to major risk factors in 325,348 men screened for the MRFITAmerican Heart Journal, 1986
- High density lipoprotein as a protective factor against coronary heart diseaseAmerican Journal Of Medicine, 1977