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      Can the Plasma Concentration Ratio of Triglyceride/High-Density Lipoprotein Cholesterol Identify Individuals at High Risk of Cardiovascular Disease During 40-Year Follow-Up?

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          Abstract

          Background: The plasma concentration ratio of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) is a simple way to estimate insulin resistance. We aimed to evaluate the TG/HDL-C ratio as a simple clinical way to identify apparently healthy individuals with insulin resistance and enhanced risk of future cardiovascular disease (CVD).

          Methods: One thousand seven hundred twenty men, aged 50 years, free from diabetes and CVD when evaluated at baseline in 1970–1974 were followed for 40 years regarding incident CVD (myocardial infarction and/or ischemic stroke, n = 576).

          Results: Participants with a high TG/HDL-C ratio (highest quartile >1.8) at baseline were more insulin resistant, with a significantly more adverse cardiometabolic risk profile ( P < 0.001) at baseline, compared with those with a lower ratio. This group also showed an increased risk of CVD [hazard ratio, HR 1.47 (95% confidence interval 1.26–1.93) P < 0.001]. Fourteen percent of subjects with metabolic syndrome, in whom insulin resistance is increased, were also at enhanced CVD risk [HR 1.75 (1.42–2.16) P < 0.001].

          Conclusions: Twenty-five percent of apparently healthy 50-year-old men with the highest TG/HDL-C plasma concentration ratio had a significantly more adverse cardiometabolic profile at baseline, and developed more CVD over the next 40 years, compared with those not meeting this cut point. Determining the TG/HDL-C ratio in middle-aged men provided a simple and potentially clinically useful way to identify increased risk of developing CVD in persons free of diabetes or manifest CVD.

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          Author and article information

          Journal
          Metab Syndr Relat Disord
          Metab Syndr Relat Disord
          met
          Metabolic Syndrome and Related Disorders
          Mary Ann Liebert, Inc., publishers (140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA )
          1540-4196
          1557-8518
          01 October 2018
          28 September 2018
          : 16
          : 8
          : 433-439
          Affiliations
          [ 1 ]Department of Medical Sciences, Uppsala University , Uppsala, Sweden.
          [ 2 ]Department of Medicine, Stanford University , Stanford, California.
          [ 3 ]School of Health and Social Sciences, Dalarna University , Falun, Sweden.
          [ 4 ]Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Huddinge, Sweden.
          [ 5 ]Department of Public Care, Uppsala University , Uppsala, Sweden.
          Author notes
          [ * ]

          Present affiliation: Swedish Medical Product Agency, Uppsala, Sweden.

          [ † ]

          Deceased.

          [*]Address correspondence to: Lars Lind, MD, PhD, Uppsala University, Department of Medical Sciences, Uppsala University Hospital, Uppsala SE-751 85, Sweden lars.lind@ 123456medsci.uu.se
          Article
          PMC6913120 PMC6913120 6913120 10.1089/met.2018.0058
          10.1089/met.2018.0058
          6913120
          30183521
          5c0cb52f-bf63-4026-a902-e179449b3790
          Copyright 2018, Mary Ann Liebert, Inc., publishers
          History
          Page count
          Figures: 3, Tables: 2, References: 28, Pages: 7
          Categories
          Original Articles

          prospective,cardiovascular disease,HDL-cholesterol,metabolic syndrome,triglycerides

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