Triglyceride–to–HDL Cholesterol Ratio in the Dyslipidemic Classification of Type 2 Diabetes
- Ana María Wägner, MD, PHD1,
- Antonio Pérez, MD, PHD1,
- Jose Luis Sánchez-Quesada, PHD2 and
- Jordi Ordóñez-Llanos, MD, PHD23
- 1Endocrinology Department, Hospital Sant Pau, Barcelona, Spain
- 2Biochemistry Department, Hospital Sant Pau, Barcelona, Spain
- 3Biochemistry Department, Universitat Autònoma de Barcelona, Barcelona, Spain
- Address correspondencereprint requests to Ana Ma Wägner, Steno Diabetes Center, Niels Steensens vej 2. 2820 Gentofte, Denmark. E-mail: awgn{at}steno.dk
Although LDL cholesterol is the main target in the treatment of diabetic dyslipidemia, it does not fully account for the cardiovascular risk associated with diabetes, neither alone nor in combination with triglycerides and HDL cholesterol. On the other hand, diabetic dyslipidemia also includes an overall increase in atherogenic particles identifiable, by measuring apolipoprotein B (apoB), and a predominance of small, dense LDL particles (phenotype B). The latter, although associated with increased cardiovascular risk, is not routinely assessed because its measurement is not available to most clinical laboratories. Therefore, easily measurable predictors of LDL size, such as triglycerides or LDL cholesterol/apoB and triglyceride–to–HDL cholesterol ratios, have been proposed, with the latter being suggested as the best surrogate (1,2,3). However, no study has been conducted that compares all of these predictors.
The aim of the present study is to evaluate the triglyceride–to–HDL cholesterol ratio, non-HDL cholesterol, and apoB to predict LDL phenotype and to assess them in the risk classification of patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS
A total of 107 type 2 diabetic patients (68% male, age 59 ± 10 years [means ± SD], time since diagnosis 8.5 years [range 0–37], HbA1c 7.35% [3.7–16]) were consecutively included in the study. None of the patients were taking drugs or were in situations (not related to diabetes) known to affect lipoprotein metabolism.
Total cholesterol and triglycerides were measured by enzymatic methods and HDL cholesterol by a direct method (Roche Diagnostics, Basel, Switzerland). Hypertriglyceridemia was defined by triglycerides >2.25 mmol/l (4, …
