The triglyceride to high-density lipoprotein cholesterol ratio may be a clinically useful indicator for hyperinsulinaemia among nondiabetic adults regardless of race/ethnicity
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The triglycerides/HDL-cholesterol (TG/HDL-C) ratio is seen as a useful clinical indicator to identify the concomitant presence of insulin resistance and dyslipidaemia, which also circumvenes the requirement for standardizing insulin assays. Studies, however, have produced conflicting findings for the association of the TG/HDL-C ratio with fasting serum insulin concentration (FSI) by race/ethnicity. Among 2,652 nondiabetic American adults, the associations of FSI, serum triglycerides, and HDL-C were analyzed using log-binomial regression analysis and receiver operating characteristics (ROC) curve analysis. When using a single cutoff point of 3.5 for the TG/HDL-C ratio, the prevalence ratio of hyperinsulinaemia was 2.16; when using race/ethnicity-specific cutoff points of 3.0 for non-Hispanic Whites and Mexican-Americans and 2.0 for non-Hispanic Blacks (as a result of the usually lower triglyceride levels seen in this ethnic group), the prevalence ratio of hyperinsulinaemia was 2.23. The area under the ROC curve of the TG/HDL-C ratio for predicting hyperinsulinaemia was 0.77 for non-Hispanic Whites, 0.75 for non-Hispanic Blacks, and 0.74 for Mexican-Americans. In conclusion, the study results demonstrate that the association of the TG/HDL-C ratio with FSI was significant among the three major ethnic groups, supporting the notion that the TG/HDL-C ratio may be a useful clinical indicator for hyperinsulinaemia among nondiabetic adults, regardless of race/ethnicity.
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