J Nutr Health.  2019 Jun;52(3):268-276. 10.4163/jnh.2019.52.3.268.

The correlation between triglyceride to HDL cholesterol ratio and metabolic syndrome, nutrition intake in Korean adults: Korean National Health and Nutrition Examination Survey 2016

• Kim Y
• Han AL

• KMID: 2450424
• DOI: http://doi.org/10.4163/jnh.2019.52.3.268

Abstract

PURPOSE
Metabolic syndrome causes diabetes and increases the risk of cardiovascular disease. This study examined the correlation between metabolic syndrome, nutrition intake, and triglyceride (TG)/high-density lipoprotein (HDL) cholesterol ratio.
METHODS
Using the data from the 7th KNHANES (2016), this study was conducted on healthy adults aged 19 and older. The components and existence of metabolic syndrome and nutrition intake were independent variables and the TG/HDLcholesterol ratio was a dependent variable. A complex sample logistic progress test was used with age, sex, smoking, and drinking frequency corrected.
RESULTS
The TG/HDLcholesterol ratio of people with metabolic syndrome was as high as 1.314 on average, compared to people without metabolic syndrome (p < 0.0001). Among each component of metabolic syndrome, the TG/HDL cholesterol ratio had a significant association with fasting blood glucose, TG, HDL cholesterol, and waist circumference (p < 0.05). Only energy and carbohydrate intake were significantly related to the TG/HDLcholesterol ratio (p < 0.05).
CONCLUSION
The TG/HDLcholesterol ratio is associated with each component of metabolic syndrome, but in particular, it is positively correlated with the presence of metabolic syndrome. Lower energy intakehad a positive correlation with the TG/HDLcholesterol ratio. These results show that metabolic syndrome can be predicted using the TG/HDLcholesterol ratio, and a diet strategy through nutrition and health education is necessary to prevent metabolic syndrome.

Keyword

metabolic syndrome; triglyceride/high-density lipoprotein cholesterol ratio; nutrition intake; Korean National Health and Nutrition Examination Survey

MeSH Terms

Adult*
Blood Glucose
Cardiovascular Diseases
Cholesterol
Cholesterol, HDL*
Diet
Drinking
Fasting
Health Education
Humans
Lipoproteins
Nutrition Surveys*
Smoke
Smoking
Triglycerides*
Waist Circumference
Blood Glucose
Cholesterol
Cholesterol, HDL
Lipoproteins
Smoke

Reference

1. Sharrett AR, Ballantyne CM, Coady SA, Heiss G, Sorlie PD, Catellier D, et al. Coronary heart disease prediction from lipoprotein cholesterol levels, triglycerides, lipoprotein(a), apolipoproteins A-I and B, and HDL density subfractions: the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 2001; 104(10):1108–1113.

2. Laaksonen DE, Lakka HM, Niskanen LK, Kaplan GA, Salonen JT, Lakka TA. Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol. 2002; 156(11):1070–1077.

3. Hanson RL, Imperatore G, Bennett PH, Knowler WC. Components of the “metabolic syndrome” and incidence of type 2 diabetes. Diabetes. 2002; 51(10):3120–3127.

4. Ford ES, Li C, Sattar N. Metabolic syndrome and incident diabetes: current state of the evidence. Diabetes Care. 2008; 31(9):1898–1904.

5. Da Luz PL, Favarato D, Faria-Neto JR Jr, Lemos P, Chagas AC. High ratio of triglycerides to HDL-cholesterol ratio predicts extensive coronary disease. Clinics (Sao Paulo). 2008; 63(4):427–432.

6. Boizel R, Benhamou PY, Lardy B, Laporte F, Foulon T, Halimi S. Ratio of triglycerides to HDL cholesterol is an indicator of LDL particle size in patients with type 2 diabetes and normal HDL cholesterol levels. Diabetes Care. 2000; 23(11):1679–1685.

7. Dobiásová M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL)). Clin Biochem. 2001; 34(7):583–588.

8. Özkaya İ, Bavunoglu I, Tunçkale A. Body mass index and waist circumference affect lipid parameters negatively in Turkish women. Am J Public Health Res. 2014; 2(6):226–231.

9. Park HR, Shin SR, Han AL, Jeong YJ. The correlation between the triglyceride to high density lipoprotein cholesterol ratio and computed tomography-measured visceral fat and cardiovascular disease risk factors in local adult male subjects. Korean J Fam Med. 2015; 36(6):335–340.

10. Rezapour M, Shahesmaeili A, Hossinzadeh A, Zahedi R, Najafipour H, Gozashti MH. Comparison of lipid ratios to identify metabolic syndrome. Arch Iran Med. 2018; 21(12):572–577.

11. Krawczyk M, Rumińska M, Witkowska-Sędek E, Majcher A, Pyrżak B. Usefulness of the triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C) in prediction of metabolic syndrome in Polish obese children and adolescents. Acta Biochim Pol. 2018; 65(4):605–611.

12. Gu Z, Zhu P, Wang Q, He H, Xu J, Zhang L, et al. Obesity and lipid-related parameters for predicting metabolic syndrome in Chinese elderly population. Lipids Health Dis. 2018; 17(1):289.

13. Hong SB, Shin KA. Significance of non HDL-cholesterol and triglyceride to HDL-cholesterol ratio as predictors for metabolic syndrome among Korean elderly. Korean J Clin Lab Sci. 2018; 50(3):245–252.

14. Park BM, Ryu HS. Relationship between metabolic syndrome and the triglyceride/high-density lipoprotein-cholesterol ratio in male office workers. J Korean Public Health Nurs. 2017; 31(2):376–388.

15. Song S, Lee JE. Dietary patterns related to triglyceride and high-density lipoprotein cholesterol and the incidence of type 2 diabetes in Korean men and women. Nutrients. 2018; 11(1):8.

16. Hashimoto Y, Tanaka M, Miki A, Kobayashi Y, Wada S, Kuwahata M, et al. Intake of carbohydrate to fiber ratio is a useful marker for metabolic syndrome in patients with type 2 diabetes: a cross-sectional study. Ann Nutr Metab. 2018; 72(4):329–335.

17. Ide K, Koshizaka M, Tokuyama H, Tokuyama T, Ishikawa T, Maezawa Y, et al. N-3 polyunsaturated fatty acids improve lipoprotein particle size and concentration in Japanese patients with type 2 diabetes and hypertriglyceridemia: a pilot study. Lipids Health Dis. 2018; 17(1):51.

18. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation. 2005; 112(17):2735–2752.

19. Lee S, Park HS, Kim SM, Kwon HS, Kim DY, Kim DJ, et al. Cut-off points of waist circumference for defining abdominal obesity in the Korean population. Korean J Obes. 2006; 15(1):1–9.

20. Matsuzawa Y. Adiponectin: a key player in obesity related disorders. Curr Pharm Des. 2010; 16(17):1896–1901.

21. Stofkova A. Resistin and visfatin: regulators of insulin sensitivity, inflammation and immunity. Endocr Regul. 2010; 44(1):25–36.

22. Girman CJ, Rhodes T, Mercuri M, Pyörälä K, Kjekshus J, Pedersen TR, et al. The metabolic syndrome and risk of major coronary events in the Scandinavian Simvastatin Survival Study (4S) and the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS). Am J Cardiol. 2004; 93(2):136–141.

23. He S, Wang S, Chen X, Jiang L, Peng Y, Li L, et al. Higher ratio of triglyceride to high-density lipoprotein cholesterol may predispose to diabetes mellitus: 15-year prospective study in a general population. Metabolism. 2012; 61(1):30–36.

24. Uruska A, Zozulinska-Ziolkiewicz D, Niedzwiecki P, Pietrzak M, Wierusz-Wysocka B. TG/HDL-C ratio and visceral adiposity index may be useful in assessment of insulin resistance in adults with type 1 diabetes in clinical practice. J Clin Lipidol. 2018; 12(3):734–740.

25. Kim JS, Kang HT, Shim JY, Lee HR. The association between the triglyceride to high-density lipoprotein cholesterol ratio with insulin resistance (HOMA-IR) in the general Korean population: based on the National Health and Nutrition Examination Survey in 2007-2009. Diabetes Res Clin Pract. 2012; 97(1):132–138.

26. McLaughlin T, Abbasi F, Cheal K, Chu J, Lamendola C, Reaven G. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med. 2003; 139(10):802–809.

27. Sumner AE, Finley KB, Genovese DJ, Criqui MH, Boston RC. Fasting triglyceride and the triglyceride-HDL cholesterol ratio are not markers of insulin resistance in African Americans. Arch Intern Med. 2005; 165(12):1395–1400.

28. Hanak V, Munoz J, Teague J, Stanley A Jr, Bittner V. Accuracy of the triglyceride to high-density lipoprotein cholesterol ratio for prediction of the low-density lipoprotein phenotype B. Am J Cardiol. 2004; 94(2):219–222.

29. Al-Daghri NM, Al-Attas OS, Wani K, Sabico S, Alokail MS. Serum uric acid to creatinine ratio and risk of metabolic syndrome in Saudi type 2 diabetic patients. Sci Rep. 2017; 7(1):12104.

30. Korsmo-Haugen HK, Brurberg KG, Mann J, Aas AM. Carbohydrate quantity in the dietary management of type 2 diabetes: a systematic review and meta-analysis. Diabetes Obes Metab. 2019; 21(1):15–27.

31. Iwase H, Tanaka M, Kobayashi Y, Wada S, Kuwahata M, Kido Y, et al. Lower vegetable protein intake and higher dietary acid load associated with lower carbohydrate intake are risk factors for metabolic syndrome in patients with type 2 diabetes: post-hoc analysis of a cross-sectional study. J Diabetes Investig. 2015; 6(4):465–472.

32. World Health Organization. Diet, nutrition, and the prevention of chronic diseases. Geneva: World Health Organization;2003.

33. Jung MS, Bae JH, Kim YH. Relationships between dietary intake and serum lipid profile of subjects who visited health promotion center. J Korean Soc Food Sci Nutr. 2008; 37(12):1583–1588.

34. Siri PW, Krauss RM. Influence of dietary carbohydrate and fat on LDL and HDL particle distributions. Curr Atheroscler Rep. 2005; 7(6):455–459.

35. Choi YH, Song TH. Correlation of anthropometric data, nutrient intakes and serum lipids in premenopausal and postmenopausal women Korean. J Food Nutr. 2013; 26(3):476–484.