NEW YORK (Reuters Health) – The ratio of triglycerides to HDL cholesterol (TG/HDL) predicts first coronary events in men regardless of body-mass index, say researchers in the November 15th American Journal of Cardiology.

“TG/HDL reflects an underlying metabolism closely related to insulin resistance and obesity,” Dr. Alberto Cordero from Hospital Universitario de San Juan, Alicante, Spain told Reuters Health in an email.

Dr. Cordero and his colleagues investigated the usefulness of TG/HDL as a predictor of a first coronary event (myocardial infarction, unstable angina, or ischemia detected on electrocardiography) in active male workers, independently of obesity. Their data came from 208 men with a first coronary event and 2080 control subjects. The overall mean age was close to 50 years.

The authors found that fasting glucose and TG/HDL were the only parameters that differed significantly between cases and controls with normal body-mass indices.

Among overweight subjects, fasting glucose, total cholesterol, rates of diabetes, and rates of hypertension were significantly higher in cases than in controls.

Among obese cases and controls, TG/HDL and metabolic syndrome were the only parameters that differed.

TG/HDL was significantly higher in cases than in controls in each category of body-mass index, the researchers note.

On multivariate analysis, higher TG/HDL values increased the risk of a first coronary event by 47%, whereas the risk of a first coronary event was increased to a lesser extent by higher LDL cholesterol values. The impact of metabolic syndrome and hypertension was not significant.

Each 1-standard deviation increment in TG/HDL was associated with a 75% increase in the risk of a first coronary event, after adjustment for smoking, blood pressure, body-mass index, and LDL cholesterol level.

“We recommend using this ratio in addition to other risk factors and believing that it is the ratio with higher predictive value,” Dr. Cordero said.

Reference:
Am J Cardiol 2009;104:1393-1397.