TY - JOUR T1 - Trigliserit/HDL oranının, koroner arter hastalığı varlığını ve plak morfolojisini öngördürmedeki yeri TT - The predictive value of triglyceride to HDL ratio in determining coronary artery disease and plaque morphology AU - Özcan Çetin, Elif Hande AU - Cetin, Mehmet Serkan AU - Könte, Hasan Can AU - Yaman, Nezaket Merve AU - Tekın Tak, Bahar AU - Ekizler, Firdevs Aysenur AU - Özeke, Özcan AU - Topaloglu, Serkan AU - Aras, Dursun PY - 2019 DA - December DO - 10.18663/tjcl.551119 JF - Turkish Journal of Clinics and Laboratory JO - TJCL PB - DNT Ortadoğu Yayıncılık A.Ş. WT - DergiPark SN - 2149-8296 SP - 467 EP - 473 VL - 10 IS - 4 LA - tr AB - Amaç:Yeni bir aterojenik indeks olarak, trigliserid HDL oranının (TG/HDL), insülinrezistansı ile ilişkisi ve kardiyovasküler hastalıklarda risk ve prognostikdeğerlendirmedeki önemi çeşitli çalışmalarda gösterilmiştir. TG/HDL oranı,düşük kardiyovasküler hastalık riskine sahip populasyonda koroner arter hastalığıvarlığını öngördürmede faydalı olabilir. Bu çalışmamızda TG/HDL oranınınbilgisayarlı tomografik koroner anjiyografi (BTKA) planlanan hastalarda KAHvarlığını öngördürmedeki etkinliği ve bu oranın plak morfolojisi, artmışkoroner kalsiyum skoru ve stenoz derecesi ile ilişkisini değerlendirmeyiamaçladık.Gereç ve Yöntemler:Bu retrospektif kesitsel çalışmaya düşük kardiyovasküler riski olup, 2014-2018tarihleri arasında BTKA’ya refere edilen ardışık 161 hasta dahil edildi.Bulgular: 90hastada (%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, yaşile birlikte, TG/HDL oranında her bir birim artış,KAH ihtimalinde%28.7 artışile ilişkili saptandı. Yumuşak plak varlığını ve ciddi darlığı öngördürmedeTG/HDL oranı istatistiksel olarak anlamlı bir parametre olarak saptanmadı. Sonuç: İlerleyen yaşın yanında, TG/HDL oranı KAH varlığını öngördürmedemetabolik sendrom varlığından daha etkin bir parametre olarak saptanmış veetkin bir kardiyometabolik belirteç olduğu gösterilmiştir. Bu kolaylıkla eldeedilebilen dislipidemi oranı ile niceliksel değerlendirme sağlanarak daha doğrurisk değerlendirilmesi ve böylelikle daha bireyselleştirilmiş tedavisağlanabilir. KW - Trigliserid HDL oranı; Koroner Arter Hastalığı; Koroner Kalsiyum Skoru; Bilgisayarlı Tomografik Koroner Anjiyografi N2 - Aim: Asa new atherogenic index, the association of triglyceride to HDL ratio (TG /HDL)with insulin resistance and its significance in risk and prognosticevaluation of cardiovascular diseases have been shown in several studies. TG /HDL ratio may be useful in predicting the presence of coronary artery diseasein the population with lowcardiovascular disease risk. In this study, we aimedto evaluate the efficacy of TG / HDL ratio in predicting the presence of CADand its relationship with plaque morphology, increased coronary calcium score andthe degree of stenosisin patients who underwent computed tomographic coronaryangiography (CTCA).Material and Methods:This retrospective cross-sectional study included 161 consecutive patients withlow cardiovascular disease risk who were referred to CTCA between 2014-2018.Results:CADwas detected in 90 patients (55.9%). The TG / HDL ratio was higher in patientswith CAD (2.9 (1.7-4.7) vs. 2.6 (1.6-4.1), p = 0.05). In logistic regressionanalysis, with age, in each one unit increase in TG / HDL ratio was found toassociated with 28.7% increase in probabilty of CAD. TG / HDL ratio was notfound to be statistically significant in predicting the presence of softplaques and severe stenosis.Conclusıon:With advancing age,TG / HDL ratiowas found to be an effectivecardiometabolic marker as a more effective parameter than the metabolicsyndrome in predicting the presence of CAD. By providing a quantitativeassessment with this readily available ratio of dyslipidemia, a more accuraterisk assessment can be achieved and thus more individualized treatment can beprovided. CR - 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. CR - 2. Kinosian B. Cholesterol and Coronary Heart Disease: Predicting Risks by Levels and Ratios. Annals of Internal Medicine1994; 121: 641. CR - 3. Gaziano JM et al. Fasting Triglycerides, High-Density Lipoprotein, and Risk of Myocardial Infarction. Circulation 1997; 96: 2520–25. CR - 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. CR - 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. CR - 6. 2013 ESC guidelines on the management of stable coronary artery disease. European Heart Journal 2013; 34: 2949–3003. CR - 7. Williams B et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Kardiol Pol 2019; 77: 71–159. CR - 8. Kendall D. American Diabetes Association Complete Guide to Diabetes: The Ultimate Home Diabetes Reference. 5th ed., Virginia: American Diabetes Association; 2000. CR - 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 CR - 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. CR - 11. Shepherd J, Packard CJ. (2000) Lipoprotein Metabolism and Atherogenesis. In: Kita T., Yokode M. (eds) Lipoprotein Metabolism and Atherogenesis. Springer, Tokyo CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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 CR - 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. UR - https://doi.org/10.18663/tjcl.551119 L1 - https://dergipark.org.tr/tr/download/article-file/913371 ER -