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Fasting triglyceride and the triglyceride-HDL cholesterol ratio are not markers of insulin resistance in African Americans.
Arch Intern Med. 2005 Jun 27; 165(12):1395-400.AI

Abstract

BACKGROUND

The "lipid criteria" consist of a triglyceride (TG) level of 130 mg/dL (1.47 mmol/L) or greater and a ratio of TG to high-density lipoprotein cholesterol (HDL-C) of 3 or greater. In Caucasians, the lipid criteria predict insulin resistance in individuals with a body mass index (BMI) of 25 kg/m(2) or greater. Our goal was to determine whether TG levels or TG-HDL-C ratio predicted insulin resistance in African Americans with a BMI of 25 kg/m(2) or more.

METHODS

Of 125 African Americans, the 98 with a BMI of 25 kg/m(2) or more participated. All subjects had frequently sampled intravenous glucose tolerance tests with insulin resistance determined by the insulin sensitivity index. Subjects were divided into the following tertiles by insulin sensitivity: 12.8 to 4.3, 4.2 to 2.3, and 2.2 to 0.2 mU/L per minute. Insulin resistance was defined as being in the third tertile. Across tertiles, the distribution of variables was compared by 1-way analysis of variance. Areas under the receiver operating characteristic curve were determined to identify variables that predicted insulin resistance.

RESULTS

Fasting insulin level, BMI, and waist circumference increased across tertiles (all P<.01), but TG levels and TG-HDL-C ratio did not (all P>/=.3). The mean +/- SE areas under the curves for fasting insulin, BMI, and waist circumference were 0.85 +/- 0.04, 0.72 +/- 0.05, and 0.71 +/- 0.05, respectively. For TG level and TG-HDL-C ratio, the areas under the curves were 0.55 +/- 0.06 and 0.56 +/- 0.06, respectively, meaning that the true-positive rate was nearly equal to the false-positive rate. Therefore, they could not be used as markers of insulin resistance. Furthermore, 17 subjects met the lipid criteria but only 7 were in the insulin-resistant tertile, making the sensitivity of these criteria to identify insulin resistance only 17%.

CONCLUSION

In African Americans, TG levels and TG-HDL-C ratio are not reliable markers of insulin resistance.

Authors+Show Affiliations

Clincial Endocrinology Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA. AnneS@intra.niddk.nih.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15983289

Citation

Sumner, Anne E., et al. "Fasting Triglyceride and the triglyceride-HDL Cholesterol Ratio Are Not Markers of Insulin Resistance in African Americans." Archives of Internal Medicine, vol. 165, no. 12, 2005, pp. 1395-400.
Sumner AE, Finley KB, Genovese DJ, et al. Fasting triglyceride and the triglyceride-HDL cholesterol ratio are not markers of insulin resistance in African Americans. Arch Intern Med. 2005;165(12):1395-400.
Sumner, A. E., Finley, K. B., Genovese, D. J., Criqui, M. H., & Boston, R. C. (2005). Fasting triglyceride and the triglyceride-HDL cholesterol ratio are not markers of insulin resistance in African Americans. Archives of Internal Medicine, 165(12), 1395-400.
Sumner AE, et al. Fasting Triglyceride and the triglyceride-HDL Cholesterol Ratio Are Not Markers of Insulin Resistance in African Americans. Arch Intern Med. 2005 Jun 27;165(12):1395-400. PubMed PMID: 15983289.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fasting triglyceride and the triglyceride-HDL cholesterol ratio are not markers of insulin resistance in African Americans. AU - Sumner,Anne E, AU - Finley,Karl B, AU - Genovese,David J, AU - Criqui,Michael H, AU - Boston,Raymond C, PY - 2005/6/29/pubmed PY - 2005/7/22/medline PY - 2005/6/29/entrez SP - 1395 EP - 400 JF - Archives of internal medicine JO - Arch Intern Med VL - 165 IS - 12 N2 - BACKGROUND: The "lipid criteria" consist of a triglyceride (TG) level of 130 mg/dL (1.47 mmol/L) or greater and a ratio of TG to high-density lipoprotein cholesterol (HDL-C) of 3 or greater. In Caucasians, the lipid criteria predict insulin resistance in individuals with a body mass index (BMI) of 25 kg/m(2) or greater. Our goal was to determine whether TG levels or TG-HDL-C ratio predicted insulin resistance in African Americans with a BMI of 25 kg/m(2) or more. METHODS: Of 125 African Americans, the 98 with a BMI of 25 kg/m(2) or more participated. All subjects had frequently sampled intravenous glucose tolerance tests with insulin resistance determined by the insulin sensitivity index. Subjects were divided into the following tertiles by insulin sensitivity: 12.8 to 4.3, 4.2 to 2.3, and 2.2 to 0.2 mU/L per minute. Insulin resistance was defined as being in the third tertile. Across tertiles, the distribution of variables was compared by 1-way analysis of variance. Areas under the receiver operating characteristic curve were determined to identify variables that predicted insulin resistance. RESULTS: Fasting insulin level, BMI, and waist circumference increased across tertiles (all P<.01), but TG levels and TG-HDL-C ratio did not (all P>/=.3). The mean +/- SE areas under the curves for fasting insulin, BMI, and waist circumference were 0.85 +/- 0.04, 0.72 +/- 0.05, and 0.71 +/- 0.05, respectively. For TG level and TG-HDL-C ratio, the areas under the curves were 0.55 +/- 0.06 and 0.56 +/- 0.06, respectively, meaning that the true-positive rate was nearly equal to the false-positive rate. Therefore, they could not be used as markers of insulin resistance. Furthermore, 17 subjects met the lipid criteria but only 7 were in the insulin-resistant tertile, making the sensitivity of these criteria to identify insulin resistance only 17%. CONCLUSION: In African Americans, TG levels and TG-HDL-C ratio are not reliable markers of insulin resistance. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/15983289/Fasting_triglyceride_and_the_triglyceride_HDL_cholesterol_ratio_are_not_markers_of_insulin_resistance_in_African_Americans_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.165.12.1395 DB - PRIME DP - Unbound Medicine ER -