Journal List > J Nutr Health > v.52(3) > 1128193

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

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.

Figures and Tables

Table 1

General characteristic according to the TG/HDL cholesterol ratio

jnh-52-268-i001

HbA1c, hemoglobin A1c; TG, Triglyceride; HDL, high density lipoprotein; LDL, low density lipoprotein; BMI, body mass index; hsCRP, highly sensitive C-reactive protein. Values are presented as mean ± Standard deviation or unweighted numbers (weighted %).

Percentages were weighted using the Korean National Health and Nutrition Examination Survey 2016 sampling weights.

*p-value was taken by complex sample Rao-Scott adjusted chi-square test or complex sample generalized linear model T test.

Table 2

TG/HDL cholesterol ratio according to the metabolic components and existence

jnh-52-268-i002

TG, Triglyceride; HDL, high density lipoprotein

*p-value was taken by complex samples logistic regression test.

Table 3

Adjusted correlation of TG/HDL cholesterol ratio and the metabolic syndrome

jnh-52-268-i003

TG, Triglyceride; HDL, high density lipoprotein

Adjust for age, sex and smoking status, alcohol drinking frequency

*p-value was taken by complex samples logistic regression test.

Table 4

Correlation of TG/HDL cholesterol ratio and the dietary intake

jnh-52-268-i004

N-3 fatty acid: n-3 polyunsaturated fatty acid

*p-value was taken by complex samples logistic regression test.

Notes

This work was supported by grants from Wonkwang University.

References

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.
crossref
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.
crossref
4. Ford ES, Li C, Sattar N. Metabolic syndrome and incident diabetes: current state of the evidence. Diabetes Care. 2008; 31(9):1898–1904.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
21. Stofkova A. Resistin and visfatin: regulators of insulin sensitivity, inflammation and immunity. Endocr Regul. 2010; 44(1):25–36.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
crossref
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.
TOOLS
ORCID iDs

Youngjon Kim
https://orcid.org/0000-0002-0445-526X

A Lum Han
https://orcid.org/0000-0002-6509-7953

Similar articles