Triglycerides-to-HDL ratio as a new marker of endothelial dysfunction in obese prepubertal children

Abstract Objective: To investigate whether there is an association of the triglyceride-to-HDL cholesterol (TG:HDL-C) ratio with cardiovascular risk factors and early signs of vascular damage in obese prepubertal children. Design and methods: In 50 obese (27 boys, 7.8G1.4 years) and 37 normal-weight (20 boys; 7.3G1.5 years) prepubertal children, anthropometric measurements, oxidative stress markers (urinary isoprostanes (PGF2a (prostaglandin F2a)), soluble receptor for advanced glycation end-products (sRAGE)) and insulin sensitivity (homeostasis model assessment of insulin resistance (HOMA-IR) and whole-body insulin sensitivity index (WBISI)) were evaluated. Lipids profile was assessed and the TG:HDL-C ratio was calculated. In addition, high-resolution ultrasound was performed to assess carotid intima-media thickness (cIMT). Results: Obese children showed significantly higher values of the TG:HDL-C ratio (1.9G1.1 vs 1.2G0.6, PZ0.002) compared with controls. After dividing the population in tertiles of the TG:HDL-C ratio (!1.04, 1.04-1.67,O1.67), cIMT (PZ0.0003), and HOMA-IR (PZ0.0001) progressively increased from the lower to the upper tertile, whereas WBISI (PZ0.0003) and sRAGE (PZ0.05) progressively decreased. In a regression model, the TG:HDL ratio was significantly and positively associated with cIMT (rZ0.493; PZ0.0005). A cutoff point for TG:HDL-C ratio of 1.12 had 81% sensitivity and 49% specificity in the identification of children with cIMT values in the upper quartile (Area under the curve values from receiver operating characteristic curvesZ0.633G0.065, PZ0.045). Conclusion: This study confirms the reliability of the TG:HDL-C ratio as a useful marker of cardiovascular risk. Interestingly, our results underline that the TG:HDL-C ratio is directly related with early signs of vascular damage already present in prepubertal children.