Association between triglyceride/HDL cholesterol ratio and carotid atherosclerosis in postmenopausal middle-aged women

Walter Masson, Daniel Siniawski, Martín Lobo, Graciela Molinero, Melina Huerín
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引用次数: 16

Abstract

Background and objective

The triglyceride/HDL cholesterol ratio, as a surrogate marker of insulin resistance, may be associated to presence of subclinical carotid atherosclerosis in postmenopausal women. The aim of this study was to explore this association.

Patients and methods

Women (last menstrual period  2 years) in primary prevention up to 65 years of age were recruited. Association between the triglyceride/HDL cholesterol (HDL-C) ratio and presence of carotid plaque, assessed by ultrasonography, was analyzed. ROC analysis was performed, determining the precision of this ratio to detect carotid plaque.

Results

A total of 332 women (age 57 ± 5 years) were recruited. Triglyceride/HDL-C ratio was 2.35 ± 1.6. Prevalence of carotid plaque was 29%. Women with carotid plaque had higher triglyceride/HDL-C ratios (3.33 ± 1.96 vs. 2.1 ± 1.2, p < 0.001) than women with no carotid plaque. A positive relationship was seen between quintiles of this ratio and prevalence of carotid plaque (p < 0.001). Regardless of other risk factors, women with higher triglyceride/HDL-C ratios were more likely to have carotid plaque (odds ratio 1.47, 95% confidence interval 1.20–1.79, p < 0.001). The area under the curve of the triglyceride/HDL-C ratio to detect carotid plaque was 0.71 (95% confidence interval 0.65 to 0.76), and the optimal cut-off point was 2.04.

Conclusions

In postmenopausal women in primary prevention, insulin resistance, estimated from the triglyceride/HDL-C ratio, was independently associated to a greater probability of carotid plaque. A value of such ratio greater than 2 may be used for assessing cardiovascular risk in this particular group of women.

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绝经后中年妇女甘油三酯/HDL胆固醇比值与颈动脉粥样硬化的关系
背景与目的甘油三酯/HDL胆固醇比值作为胰岛素抵抗的替代指标,可能与绝经后妇女亚临床颈动脉粥样硬化的存在有关。本研究的目的是探索这种联系。患者和方法招募65岁以下初级预防女性(末次月经≥2年)。通过超声评估,分析甘油三酯/高密度脂蛋白胆固醇(HDL-C)比率与颈动脉斑块存在之间的关系。进行ROC分析,确定该比率检测颈动脉斑块的精度。结果共招募332名女性(年龄57±5岁)。甘油三酯/HDL-C比值为2.35±1.6。颈动脉斑块的患病率为29%。有颈动脉斑块的女性的甘油三酯/HDL-C比率(3.33±1.96 vs.2.1±1.2,p<0.001)高于无颈动脉斑块女性。该比率的五分位数与颈动脉斑块的患病率之间存在正相关(p<0.001),甘油三酯/HDL-C比值较高的女性更有可能出现颈动脉斑块(比值比1.47,95%置信区间1.20-1.79,p<;0.001)。甘油三酯/HDL-C比值检测颈动脉斑块的曲线下面积为0.71(95%置信区间0.65-0.76),最佳分界点为2.04,根据甘油三酯/HDL-C比率估计的胰岛素抵抗与颈动脉斑块的更大概率独立相关。这种比率大于2的值可用于评估这一特定女性群体的心血管风险。
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