Skip to main content
SpringerLink
Log in

Triglycerides (TG) to High-Density Lipoprotein (HDL-c) Ratio (TG/HDL-c Ratio) as a Marker of Cardio-Metabolic Risk

TG/HDL-c Ratio and Cardiovascular Risk

  • Living reference work entry
  • First Online:
Biomarkers in Cardiovascular Disease

  • 191 Accesses

Abstract

Cardiovascular diseases represent the main cause of mortality and morbidity worldwide. Several metabolic conditions, as obesity, diabetes, metabolic syndrome, hypertension, and hypercholesterolemia, seem to play a pivotal role in the pathogenesis of cardiovascular diseases.

During the last 20 years, different surrogate markers have been proposed as possible tools not only to identify and to evaluate the progression of cardiovascular disease but also to recognize precocious stages of different cardio-metabolic diseases in general population.

One of the most promising biomarker is the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-c) ratio that has been proposed as a new emerging marker able both to reflect the cardio-metabolic status and to predict the increased risk of developing metabolic and cardiovascular complications in adults as well as in children. In fact, several evidences demonstrated the TG/HDL-c ratio is well related not only with current cardio-metabolic diseases, but it seems to be able to predict the risk to develop cardiovascular accidents.

The goal of this book chapter is to describe the potential role of TG/HDL-c ratio as a marker to evaluate and to predict cardiovascular and metabolic diseases in adults and in children.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Abbreviations

AD:

Atherogenic dyslipidemia

CHD:

Cardiovascular heart diseases

cIMT:

Carotid intima-media thickness

CVD:

Cardiovascular diseases

HDL-c:

High-density lipoprotein cholesterol

HOMA-IR:

Homeostasis model assessment

IR:

Insulin resistance

LDL-c:

Low-density lipoprotein cholesterol

TC:

Total cholesterol

TG:

Triglycerides

TG/HDL-c:

Triglyceride-to-high-density lipoprotein cholesterol

WBISI:

Whole-body insulin sensitivity index

References

  • Arca M, Pigna G, Favoccia C. Mechanisms of diabetic dyslipidemia: relevance for atherogenesis. Curr Vasc Pharmacol. 2012;10(6):684–6.

    Article  CAS  PubMed  Google Scholar 

  • Austin MA, King MC, Vranizan KV, Krauss RM. Atherogenic lipoprotein phenotype. A proposed genetic marker for coronary heart disease risk. Circulation. 1990;82:495–506.

    Article  CAS  PubMed  Google Scholar 

  • Castelli WP. Lipids, risk factors and ischaemic heart disease. Atherosclerosis. 1996;124(Suppl):S1–9.

    Article  CAS  PubMed  Google Scholar 

  • Chapman MJ, Cardiovascular diseases. Introduction. Atheroscler Suppl. 2010;11(3):1–2 doi: 10.1016/S1567-5688(10)02169-0.

    Google Scholar 

  • Chapman MJ, Ginsberg NH, Amarenco P, Andreotti F, Borè J, Catapano LA, Descamps SO, Fisher E, Kovanen TP, Kuivenhoven JA, Lesnik P, Masana L, Nordestgaard GB, Ray KK, Reiner Z, Taskinen MR, Tokgözoglu L, Tybjærg-Hansen A, Watts GF, for the European Atherosclerosis Society Consensus Panel. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management. Eur Heart J. 2011;32:1345–61.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Cohn JN. Introduction to surrogate markers. Circulation. 2004;109(Suppl IV):IV-20–1.

    Google Scholar 

  • Cote AT, Harris KC, Panagiotopoulos C, Sandor GGS, Devlin AM. Childhood obesity and cardiovascular dysfunction. J Am Coll Cardiol. 2013;62:1309–19.

    Article  PubMed  Google Scholar 

  • da Luz PL, Favarato D, Faria-Neto Jr JR, Lemos P, Chagas AC. High ratio of triglycerides to HDL-cholesterol predicts extensive coronary disease. Clinics. 2008;63(4):427–32.

    Article  PubMed Central  PubMed  Google Scholar 

  • Davis TM. Ethnic diversity in type 2 diabetes. Diabet Med Suppl. 2008;2:52–6.

    Article  Google Scholar 

  • Dawber TRKW, Kannel WB, Revotskie N, Stokes J, Kagan A, Gordon T. Some factors associated with the development of coronary heart disease: six years’ follow- up experience in the Framingham study. Am J Public Health Nation Health. 1959;49:1349–56.

    Article  CAS  Google Scholar 

  • de Giorgis, T, Marcovecchio, ML, Di Giovanni, I, Giannini, C, Chiavaroli, V, Chiarelli, F, Mohn, A. Triglycerides-to-HDL ratio as a new marker of endothelial dysfunction in obese prepubertal children. Eur J Endocrinol. 2013;170(2):173–80.

    Google Scholar 

  • Di Bonito P, Moio N, Scilla C, Cavuto L, Sibilio G, Sanguigno E, Forziato C, Saitta F, Iardino MR, Di Carluccio C, Capaldo B. Usefulness of the high triglyceride-to- HDL cholesterol ratio to identify cardiometabolic risk factors and preclinical signs of organ damage in outpatient children. Diabetes Care. 2012;35:158–62.

    Article  PubMed Central  PubMed  Google Scholar 

  • Eeg-Olofsson K, Gudbjörnsdottir S, Eliasson B, Zethelius B, Cederholm J, NDR. The triglycerides-to-HDL-cholesterol ratio and cardiovascular disease risk in obese patients with type 2 diabetes: an observational study from the Swedish National Diabetes Register (NDR). Diabetes Res Clin Pract. 2014;106(1):136–44.

    Article  CAS  PubMed  Google Scholar 

  • Gasevic D, Frohlich J, Mancini JGB, Lear SA. Clinical usefulness of lipid ratios to identify men and women with metabolic syndrome: a cross-sectional study. Lipids Health Dis. 2014;13:159.

    Article  PubMed Central  PubMed  Google Scholar 

  • Giannini C, Santoro N, Caprio S, Kim G, Lartaud D, Shaw M, Pierpont B, Weiss R. The triglyceride-to-HDL cholesterol ratio: association with insulin resistance in obese youths of different ethnic backgrounds. Diabetes Care. 2011;34(8):1869–74.

    Article  PubMed Central  PubMed  Google Scholar 

  • Go AS, Mozaffarian D, Roger VL, the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics – 2013 update: a report from the American Heart Association. Circulation. 2013;127:e6–245.

    Article  PubMed  Google Scholar 

  • Kannel WB, Vasan RS, Keyes MJ, Sullivan LM, Robins SJ. Usefulness of the triglyceride-high-density lipoprotein versus the cholesterol-high-density lipoprotein ratio for predicting insulin resistance and cardiometabolic risk (from the Framingham Offspring Cohort). Am J Cardiol. 2008;101(4):497–501.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Lau DC, Douketis JD, Morrison KM, Obesity Canada Clinical Practice Guidelines Expert Panel 2006. Canadian clinical practice guidelines on the management and prevention of obesity in adults and children. CMAJ. 2007;176(8):S1–13.

    Article  PubMed Central  PubMed  Google Scholar 

  • Li S, Chen W, Srinivasan SR, Xu J, Berenson GJ. Relation of childhood obesity/cardiometabolic phenotypes to adult cardiometabolic profile. The Bogalusa Heart Study. Am J Epidemiol. 2012;176(Suppl):S142–9.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2095–128.

    Article  PubMed  Google Scholar 

  • Mahmood SS, Levy D, Vasan RS, Wang TJ. The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective. Lancet. 2014;383(9921):999–1008.

    Article  PubMed Central  PubMed  Google Scholar 

  • Manninen V, Tenkanen L, Koskinen P, Huttunen JK, Mänttäri M, Heinonen OP, Frick MH. Joint effects of serum triglyceride and LDL cholesterol and HDL cholesterol concentrations on coronary heart disease risk in the Helsinki Heart Study. Implications for treatment. Circulation. 1992;85(1):37–45.

    Article  CAS  PubMed  Google Scholar 

  • Murphy SL, Xu JQ, Kochanek KD. Deaths: final data for 2010. Natl Vital Stat Rep. 2013;61(4):1–117.

    PubMed  Google Scholar 

  • Musso C, Graffigna M, Soutelo J, Honfi M, Ledesma L, Miksztowicz V, Pazos M, Migliano M, Schreier LE, Berg GA. Cardiometabolic risk factors as apolipoprotein B, triglyceride/HDL-cholesterol ratio and C-reactive protein, in adolescents with and without obesity: cross-sectional study in middle class suburban children. Pediatr Diabetes. 2011;12(3 Pt 2):229–34.

    Article  CAS  PubMed  Google Scholar 

  • Musunuru K. Atherogenic dyslipidemia: cardiovascular risk and dietary intervention. Lipids. 2010;45(10):907–14.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Nordestgaard GB, Varbo A. Triglycerides and cardiovascular disease. Lancet. 2014;384:626–35.

    Article  CAS  PubMed  Google Scholar 

  • Preiss D, Sattar N. Lipids, lipid modifying agents and cardiovascular risk: a review of the evidence. Clin Endocrinol. 2009;70:815–28.

    Article  CAS  Google Scholar 

  • Quijada Z, Paoli M, Zerpa Y, Camacho N, Cichetti R, Villarroel V, Arata-Bellabarba G, Lanes R. The triglyceride/HDL-cholesterol ratio as a marker of cardiovascular risk in obese children; association with traditional and emergent risk factors. Pediatr Diabetes. 2008;9(5):464–71.

    Article  CAS  PubMed  Google Scholar 

  • Rader JD, Hoving GK. HDL and cardiovascular disease. Lancet. 2014;384:618–25.

    Article  CAS  PubMed  Google Scholar 

  • Radtke T, Khattab K, Eser P, Kriemler S, Saner H, Wilhelm M. Puberty and microvascular function in healthy children and adolescents. J Pediatr. 2012;161(5):887–91.

    Article  PubMed  Google Scholar 

  • Rosenson RS. Low high-density lipoprotein cholesterol disorders and cardiovascular risk: contribution of associated low-density lipoprotein subclass abnormalities. Curr Opin Cardiol. 2005;20(4):313–7.

    Article  PubMed  Google Scholar 

  • Salazar MR, Carbajal HA, Espeche W, Leiva Sisnieguez CE, Balbín E, Dulbecco CA, Aizpurúa M, Marillet AG, Reaven GM. Relation among the plasma triglyceride/high-density lipoprotein cholesterol concentration ratio, insulin resistance, and associated cardio-metabolic risk factors in men and women. Am J Cardiol. 2012;109(12):1749–53.

    Article  CAS  PubMed  Google Scholar 

  • Sirimarco G, Labreuche J, Bruckert E, Goldstein LB, Fox KM, Rothwell PM, Amarenco P, PERFORM and SPARCL Investigators and Committees. Atherogenic dyslipidemia and residual cardiovascular risk in statin-treated patients. Stroke. 2014;45(5):1429–36.

    Article  CAS  PubMed  Google Scholar 

  • The World Health Organization. The European health report 2012: charting the way to well-being. Copenhagen: World Health Organization Regional Office for Europe; 2012.

    Google Scholar 

  • Urbina ME, Khoury RP, McCoy EC, Dolan ML, Daniels RS, Kimball RT. Triglyceride to HDL-C ratio and increased arterial stiffness in children. Adolescents Young Adults Pediatr. 2013;131:e1082–90.

    Google Scholar 

  • Wu L, Parhofer KG. Diabetic dyslipidemia. Metabolisms. 2014;63(12):1469–79.

    Article  CAS  Google Scholar 

  • Yang, D, Liu, X, Xiang, M. The correlation between lipids ratio and degree of coronary artery stenosis. High Blood Press Cardiovasc Prev. 2011;18(2):53–6. Eur J Endocrinol. 21;170(2):173–80.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Chieti, Ospedale Policlinico Via dei Vestini 5, 66100, Chieti, Italy

    Tommaso de Giorgis & Angelika Mohn

  2. Clinical Research Center, University of Chieti, Ospedale Policlinico Via dei Vestini 5, 66100, Chieti, Italy

    Tommaso de Giorgis & Angelika Mohn

Authors
  1. Tommaso de Giorgis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Angelika Mohn
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Angelika Mohn .

Editor information

Editors and Affiliations

  1. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

  2. Sciences Division, King's College, London, United Kingdom

    Victor R. Preedy

Definitions

Arterial stiffness

Is an age-related process that occurs when the elastic fibers within the arterial wall (elastin) begin to fray due to mechanical stress. Increased arterial stiffness is associated with an increased risk of cardiovascular events.

Arteriosclerosis

Is the thickening, hardening, and loss of elasticity of the walls of arteries. It should not be confused with atherosclerosis, which is a specific form of arteriosclerosis caused by the buildup of fatty plaques and cholesterol in the artery.

Atherosclerosis

Is a specific form of arteriosclerosis in which an artery wall thickens as a result of invasion and accumulation of white blood cells, remnants of dead cells, cholesterol, and triglycerides. Atherosclerosis is therefore a syndrome affecting arterial blood vessels due to a chronic inflammatory response of white blood cells in the walls of arteries. This is promoted by low-density lipoproteins (LDL-c, plasma proteins that carry cholesterol and triglycerides) without adequate removal of fats and cholesterol from the macrophages by functional high-density lipoproteins (HDL-c). It is commonly referred to as a “hardening” or furring of the arteries. It is caused by the formation of multiple athermanous plaques within the arteries.

Atherogenic dyslipidemia

Is a risk-conferring lipid/lipoprotein profile characterized by a higher proportion of small LDL particles, reduced HDL-C levels, and increased values of triglycerides.

Carotid intima-media (cIMT)

Also called intimal-medial thickness, is a measurement of the thickness of tunica intima and tunica media, the innermost two layers of the wall of an artery. The measurement is usually made by external ultrasound and occasionally by internal, invasive ultrasound catheters; see intravascular ultrasound. Measurements of the wall thickness of blood vessels can also be done using other imaging modalities.

Dyslipidemia

Is an abnormal elevation of plasma total cholesterol, triglycerides (TGs), or low high-density lipoprotein level that contributes to the development of atherosclerosis. Causes may be primary (genetic) or secondary.

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media Dordrecht

About this entry

Cite this entry

de Giorgis, T., Mohn, A. (2015). Triglycerides (TG) to High-Density Lipoprotein (HDL-c) Ratio (TG/HDL-c Ratio) as a Marker of Cardio-Metabolic Risk. In: Patel, V., Preedy, V. (eds) Biomarkers in Cardiovascular Disease. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7741-5_21-1

Download citation

  • DOI: https://doi.org/10.1007/978-94-007-7741-5_21-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Dordrecht

  • Online ISBN: 978-94-007-7741-5

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

Publish with us

Policies and ethics

Search

Navigation