Research Article
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The predictive value of triglyceride to HDL ratio in determining coronary artery disease and plaque morphology

Year 2019, Volume: 10 Issue: 4, 467 - 473, 31.12.2019
https://doi.org/10.18663/tjcl.551119

Abstract

Aim: As
a new atherogenic index, the association of triglyceride to HDL ratio (TG /
HDL)with insulin resistance and its significance in risk and prognostic
evaluation of cardiovascular diseases have been shown in several studies. TG /
HDL ratio may be useful in predicting the presence of coronary artery disease
in the population with lowcardiovascular disease risk. In this study, we aimed
to evaluate the efficacy of TG / HDL ratio in predicting the presence of CAD
and its relationship with plaque morphology, increased coronary calcium score and
the degree of stenosisin patients who underwent computed tomographic coronary
angiography (CTCA).

Material and Methods:
This retrospective cross-sectional study included 161 consecutive patients with
low cardiovascular disease risk who were referred to CTCA between 2014-2018.

Results:CAD
was detected in 90 patients (55.9%). The TG / HDL ratio was higher in patients
with CAD (2.9 (1.7-4.7) vs. 2.6 (1.6-4.1), p = 0.05). In logistic regression
analysis, with age, in each one unit increase in TG / HDL ratio was found to
associated with 28.7% increase in probabilty of CAD. TG / HDL ratio was not
found to be statistically significant in predicting the presence of soft
plaques and severe stenosis.







Conclusıon:With advancing age,TG / HDL ratiowas found to be an effective
cardiometabolic marker as a more effective parameter than the metabolic
syndrome in predicting the presence of CAD. By providing a quantitative
assessment with this readily available ratio of dyslipidemia, a more accurate
risk assessment can be achieved and thus more individualized treatment can be
provided.

References

  • 1. Bissell MG. Triglycerides and the Risk of Coronary Heart Disease: 10 158 Incident Cases Among 262 255 Participants in 29 Western Prospective Studies. Yearbook of Pathology and Laboratory Medicine 2008; 329–30.
  • 2. Kinosian B. Cholesterol and Coronary Heart Disease: Predicting Risks by Levels and Ratios. Annals of Internal Medicine1994; 121: 641.
  • 3. Gaziano JM et al. Fasting Triglycerides, High-Density Lipoprotein, and Risk of Myocardial Infarction. Circulation 1997; 96: 2520–25.
  • 4. Salazar MR et al. Identifying cardiovascular disease risk and outcome: use of the plasma triglyceride/high-density lipoprotein cholesterol concentration ratio versus metabolic syndrome criteria. Journal of Internal Medicine 2013; 273: 595–601.
  • 5. McLaughlin T et al. Is There a Simple Way to Identify Insulin-Resistant Individuals at Increased Risk of Cardiovascular Disease? The American Journal of Cardiology 2005; 96: 399–404.
  • 6. 2013 ESC guidelines on the management of stable coronary artery disease. European Heart Journal 2013; 34: 2949–3003.
  • 7. Williams B et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Kardiol Pol 2019; 77: 71–159.
  • 8. Kendall D. American Diabetes Association Complete Guide to Diabetes: The Ultimate Home Diabetes Reference. 5th ed., Virginia: American Diabetes Association; 2000.
  • 9. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. Circulation 2002; 106: 3143–421
  • 10. Agatston AS et al. Quantification of coronary artery calcium using ultrafast computed tomography. Journal of the American College of Cardiology 1990; 15: 827–32.
  • 11. Shepherd J, Packard CJ. (2000) Lipoprotein Metabolism and Atherogenesis. In: Kita T., Yokode M. (eds) Lipoprotein Metabolism and Atherogenesis. Springer, Tokyo
  • 12. Jeppesen J. Triglycerides, High-Density Lipoprotein Cholesterol, and Risk of Ischemic Heart Disease: A View from the Copenhagen Male Study. Metabolic Syndrome and Related Disorders 2003; 1: 33–53.
  • 13. Salazar MR et al. Use of the plasma triglyceride/high-density lipoprotein cholesterol ratio to identify cardiovascular disease in hypertensive subjects. Journal of the American Society of Hypertension 2014; 8: 724–31.
  • 14. Salazar MR et al. Comparison of the abilities of the plasma triglyceride/high-density lipoprotein cholesterol ratio and the metabolic syndrome to identify insulin resistance. Diabetes and Vascular Disease Research 2013; 10: 346–52.
  • 15. Accurso A et al. Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutrition & Metabolism 2008; 5: 9.
  • 16. von Bibra H, Ströhle A, St. John Sutton M, Worm N. Dietary therapy in heart failure with preserved ejection fraction and/or left ventricular diastolic dysfunction in patients with metabolic syndrome. International Journal of Cardiology 2017; 234: 7–15.
  • 17. von Bibra H, Saha S, Hapfelmeier A, Müller G, Schwarz PEH. Impact of the Triglyceride/High-Density Lipoprotein Cholesterol Ratio and the Hypertriglyceremic-Waist Phenotype to Predict the Metabolic Syndrome and Insulin Resistance. Horm. Metab. Res. 2017; 49: 542–49.
  • 18. Sung K-C, Reaven G, Kim S. Ability of the plasma concentration ratio of triglyceride/high-density lipoprotein cholesterol to identify increased cardio-metabolic risk in an east Asian population. Diabetes Research and Clinical Practice 2014; 105: 96–101.
  • 19. Hermans MP, Ahn SA, Rousseau MF. The atherogenic dyslipidemia ratio [log(TG)/HDL-C] is associated with residual vascular risk, beta-cell function loss and microangiopathy in type 2 diabetes females. Lipids Health Dis. 2012; 11: 132.
  • 20. Urbina EM et al. Triglyceride to HDL-C Ratio and Increased Arterial Stiffness in Children, Adolescents, and Young Adults. Pedıatrics 2013; 131: 1082–90.
  • 21. da Luz PL, Favarato D, Faria-Neto JR, Lemos P, Chagas ACP. High ratio of triglycerides to HDL-cholesterol predicts extensive coronary disease. Clinics 2008; 63: 427–32.
  • 22. Bittner V et al. The triglyceride/high-density lipoprotein cholesterol ratio predicts all-cause mortality in women with suspected myocardial ischemia: a report from the Women’s Ischemia Syndrome Evaluation (WISE). Am. Heart J. 2009; 157: 548–55
  • 23. Wan K et al. The association between triglyceride/high-density lipoprotein cholesterol ratio and all-cause mortality in acute coronary syndrome after coronary revascularization. PLoS One 2015; 10: 0123521.

Trigliserit/HDL oranının, koroner arter hastalığı varlığını ve plak morfolojisini öngördürmedeki yeri

Year 2019, Volume: 10 Issue: 4, 467 - 473, 31.12.2019
https://doi.org/10.18663/tjcl.551119

Abstract

Amaç:
Yeni bir aterojenik indeks olarak, trigliserid HDL oranının (TG/HDL), insülin
rezistansı ile ilişkisi ve kardiyovasküler hastalıklarda risk ve prognostik
değerlendirmedeki önemi çeşitli çalışmalarda gösterilmiştir. TG/HDL oranı,
düşük kardiyovasküler hastalık riskine sahip populasyonda koroner arter hastalığı
varlığını öngördürmede faydalı olabilir. Bu çalışmamızda TG/HDL oranının
bilgisayarlı tomografik koroner anjiyografi (BTKA) planlanan hastalarda KAH
varlığını öngördürmedeki etkinliği ve bu oranın plak morfolojisi, artmış
koroner kalsiyum skoru ve stenoz derecesi ile ilişkisini değerlendirmeyi
amaçladık.

Gereç ve Yöntemler:
Bu retrospektif kesitsel çalışmaya düşük kardiyovasküler riski olup, 2014-2018
tarihleri arasında BTKA’ya refere edilen ardışık 161 hasta dahil edildi.

Bulgular: 90
hastada (%55.9) KAH saptandı. TG/HDL oranı KAH olan hastalarda yüksekti (2.9
(1.7-4.7)’e karşı 2.6 (1.6-4.1), p=0.05). Lojistik regresyon analizinde, yaş
ile birlikte, TG/HDL oranında her bir birim artış,KAH ihtimalinde%28.7 artış
ile ilişkili saptandı. Yumuşak plak varlığını ve ciddi darlığı öngördürmede
TG/HDL oranı istatistiksel olarak anlamlı bir parametre olarak saptanmadı.







Sonuç: İlerleyen yaşın yanında, TG/HDL oranı KAH varlığını öngördürmede
metabolik sendrom varlığından daha etkin bir parametre olarak saptanmış ve
etkin bir kardiyometabolik belirteç olduğu gösterilmiştir. Bu kolaylıkla elde
edilebilen dislipidemi oranı ile niceliksel değerlendirme sağlanarak daha doğru
risk değerlendirilmesi ve böylelikle daha bireyselleştirilmiş tedavi
sağlanabilir.

References

  • 1. Bissell MG. Triglycerides and the Risk of Coronary Heart Disease: 10 158 Incident Cases Among 262 255 Participants in 29 Western Prospective Studies. Yearbook of Pathology and Laboratory Medicine 2008; 329–30.
  • 2. Kinosian B. Cholesterol and Coronary Heart Disease: Predicting Risks by Levels and Ratios. Annals of Internal Medicine1994; 121: 641.
  • 3. Gaziano JM et al. Fasting Triglycerides, High-Density Lipoprotein, and Risk of Myocardial Infarction. Circulation 1997; 96: 2520–25.
  • 4. Salazar MR et al. Identifying cardiovascular disease risk and outcome: use of the plasma triglyceride/high-density lipoprotein cholesterol concentration ratio versus metabolic syndrome criteria. Journal of Internal Medicine 2013; 273: 595–601.
  • 5. McLaughlin T et al. Is There a Simple Way to Identify Insulin-Resistant Individuals at Increased Risk of Cardiovascular Disease? The American Journal of Cardiology 2005; 96: 399–404.
  • 6. 2013 ESC guidelines on the management of stable coronary artery disease. European Heart Journal 2013; 34: 2949–3003.
  • 7. Williams B et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Kardiol Pol 2019; 77: 71–159.
  • 8. Kendall D. American Diabetes Association Complete Guide to Diabetes: The Ultimate Home Diabetes Reference. 5th ed., Virginia: American Diabetes Association; 2000.
  • 9. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. Circulation 2002; 106: 3143–421
  • 10. Agatston AS et al. Quantification of coronary artery calcium using ultrafast computed tomography. Journal of the American College of Cardiology 1990; 15: 827–32.
  • 11. Shepherd J, Packard CJ. (2000) Lipoprotein Metabolism and Atherogenesis. In: Kita T., Yokode M. (eds) Lipoprotein Metabolism and Atherogenesis. Springer, Tokyo
  • 12. Jeppesen J. Triglycerides, High-Density Lipoprotein Cholesterol, and Risk of Ischemic Heart Disease: A View from the Copenhagen Male Study. Metabolic Syndrome and Related Disorders 2003; 1: 33–53.
  • 13. Salazar MR et al. Use of the plasma triglyceride/high-density lipoprotein cholesterol ratio to identify cardiovascular disease in hypertensive subjects. Journal of the American Society of Hypertension 2014; 8: 724–31.
  • 14. Salazar MR et al. Comparison of the abilities of the plasma triglyceride/high-density lipoprotein cholesterol ratio and the metabolic syndrome to identify insulin resistance. Diabetes and Vascular Disease Research 2013; 10: 346–52.
  • 15. Accurso A et al. Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutrition & Metabolism 2008; 5: 9.
  • 16. von Bibra H, Ströhle A, St. John Sutton M, Worm N. Dietary therapy in heart failure with preserved ejection fraction and/or left ventricular diastolic dysfunction in patients with metabolic syndrome. International Journal of Cardiology 2017; 234: 7–15.
  • 17. von Bibra H, Saha S, Hapfelmeier A, Müller G, Schwarz PEH. Impact of the Triglyceride/High-Density Lipoprotein Cholesterol Ratio and the Hypertriglyceremic-Waist Phenotype to Predict the Metabolic Syndrome and Insulin Resistance. Horm. Metab. Res. 2017; 49: 542–49.
  • 18. Sung K-C, Reaven G, Kim S. Ability of the plasma concentration ratio of triglyceride/high-density lipoprotein cholesterol to identify increased cardio-metabolic risk in an east Asian population. Diabetes Research and Clinical Practice 2014; 105: 96–101.
  • 19. Hermans MP, Ahn SA, Rousseau MF. The atherogenic dyslipidemia ratio [log(TG)/HDL-C] is associated with residual vascular risk, beta-cell function loss and microangiopathy in type 2 diabetes females. Lipids Health Dis. 2012; 11: 132.
  • 20. Urbina EM et al. Triglyceride to HDL-C Ratio and Increased Arterial Stiffness in Children, Adolescents, and Young Adults. Pedıatrics 2013; 131: 1082–90.
  • 21. da Luz PL, Favarato D, Faria-Neto JR, Lemos P, Chagas ACP. High ratio of triglycerides to HDL-cholesterol predicts extensive coronary disease. Clinics 2008; 63: 427–32.
  • 22. Bittner V et al. The triglyceride/high-density lipoprotein cholesterol ratio predicts all-cause mortality in women with suspected myocardial ischemia: a report from the Women’s Ischemia Syndrome Evaluation (WISE). Am. Heart J. 2009; 157: 548–55
  • 23. Wan K et al. The association between triglyceride/high-density lipoprotein cholesterol ratio and all-cause mortality in acute coronary syndrome after coronary revascularization. PLoS One 2015; 10: 0123521.
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Orıgınal Artıcle
Authors

Elif Hande Özcan Çetin 0000-0003-3859-5866

Mehmet Serkan Cetin 0000-0002-3983-0496

Hasan Can Könte This is me

Nezaket Merve Yaman This is me

Bahar Tekın Tak

Firdevs Aysenur Ekizler

Özcan Özeke

Serkan Topaloglu This is me

Dursun Aras

Publication Date December 31, 2019
Published in Issue Year 2019 Volume: 10 Issue: 4

Cite

APA Özcan Çetin, E. H., Cetin, M. S., Könte, H. C., Yaman, N. M., et al. (2019). Trigliserit/HDL oranının, koroner arter hastalığı varlığını ve plak morfolojisini öngördürmedeki yeri. Turkish Journal of Clinics and Laboratory, 10(4), 467-473. https://doi.org/10.18663/tjcl.551119
AMA Özcan Çetin EH, Cetin MS, Könte HC, Yaman NM, Tekın Tak B, Ekizler FA, Özeke Ö, Topaloglu S, Aras D. Trigliserit/HDL oranının, koroner arter hastalığı varlığını ve plak morfolojisini öngördürmedeki yeri. TJCL. December 2019;10(4):467-473. doi:10.18663/tjcl.551119
Chicago Özcan Çetin, Elif Hande, Mehmet Serkan Cetin, Hasan Can Könte, Nezaket Merve Yaman, Bahar Tekın Tak, Firdevs Aysenur Ekizler, Özcan Özeke, Serkan Topaloglu, and Dursun Aras. “Trigliserit/HDL oranının, Koroner Arter hastalığı varlığını Ve Plak Morfolojisini öngördürmedeki Yeri”. Turkish Journal of Clinics and Laboratory 10, no. 4 (December 2019): 467-73. https://doi.org/10.18663/tjcl.551119.
EndNote Özcan Çetin EH, Cetin MS, Könte HC, Yaman NM, Tekın Tak B, Ekizler FA, Özeke Ö, Topaloglu S, Aras D (December 1, 2019) Trigliserit/HDL oranının, koroner arter hastalığı varlığını ve plak morfolojisini öngördürmedeki yeri. Turkish Journal of Clinics and Laboratory 10 4 467–473.
IEEE E. H. Özcan Çetin, M. S. Cetin, H. C. Könte, N. M. Yaman, B. Tekın Tak, F. A. Ekizler, Ö. Özeke, S. Topaloglu, and D. Aras, “Trigliserit/HDL oranının, koroner arter hastalığı varlığını ve plak morfolojisini öngördürmedeki yeri”, TJCL, vol. 10, no. 4, pp. 467–473, 2019, doi: 10.18663/tjcl.551119.
ISNAD Özcan Çetin, Elif Hande et al. “Trigliserit/HDL oranının, Koroner Arter hastalığı varlığını Ve Plak Morfolojisini öngördürmedeki Yeri”. Turkish Journal of Clinics and Laboratory 10/4 (December 2019), 467-473. https://doi.org/10.18663/tjcl.551119.
JAMA Özcan Çetin EH, Cetin MS, Könte HC, Yaman NM, Tekın Tak B, Ekizler FA, Özeke Ö, Topaloglu S, Aras D. Trigliserit/HDL oranının, koroner arter hastalığı varlığını ve plak morfolojisini öngördürmedeki yeri. TJCL. 2019;10:467–473.
MLA Özcan Çetin, Elif Hande et al. “Trigliserit/HDL oranının, Koroner Arter hastalığı varlığını Ve Plak Morfolojisini öngördürmedeki Yeri”. Turkish Journal of Clinics and Laboratory, vol. 10, no. 4, 2019, pp. 467-73, doi:10.18663/tjcl.551119.
Vancouver Özcan Çetin EH, Cetin MS, Könte HC, Yaman NM, Tekın Tak B, Ekizler FA, Özeke Ö, Topaloglu S, Aras D. Trigliserit/HDL oranının, koroner arter hastalığı varlığını ve plak morfolojisini öngördürmedeki yeri. TJCL. 2019;10(4):467-73.


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