Acta Diabetologica

, Volume 53, Issue 3, pp 493–498 | Cite as

Triglycerides-to-HDL cholesterol ratio as screening tool for impaired glucose tolerance in obese children and adolescents

  • Melania MancoEmail author
  • Graziano Grugni
  • Mario Di Pietro
  • Antonio Balsamo
  • Stefania Di Candia
  • Giuseppe Stefano Morino
  • Adriana Franzese
  • Procolo Di Bonito
  • Claudio Maffeis
  • Giuliana Valerio
Original Article



To identify metabolic phenotypes at increased risk of impaired glucose tolerance (IGT) in Italian overweight/obese children (n = 148, age 5–10 years) and adolescents (n = 531, age 10–17.9 year).


Phenotypes were defined as follows: obesity by the 95th cut-points of the Center for Disease Control body mass index reference standards, impaired fasting glucose (fasting plasma glucose ≥100 mg/dl), high circulating triglycerides (TG), TG/HDL cholesterol ≥2.2, waist-to-height ratio (WTHR) >0.6, and combination of the latter with high TG or TG/HDL cholesterol ≥2.2.


In the 148 obese children, TG/HDL-C ≥ 2.2 (OR 20.19; 95 % CI 2.50–163.28, p = 0.005) and the combination of TG/HDL-C ≥ 2.2 and WTHR > 0.60 (OR 14.97; 95 % CI 2.18–102.76, p = 0.006) were significantly associated with IGT. In the 531 adolescents, TG/HDL-C ≥ 2.2 (OR 1.991; 95 % CI 1.243–3.191, p = 0.004) and the combination with WTHR > 0.60 (OR 2.24; 95 % CI 1.29–3.87, p = 0.004) were associated with significantly increased risk of IGT. In the whole sample, having high TG levels according to the NIH National Heart, Lung and Blood Institute Expert Panel was not associated with an increased risk of presenting IGT.


TG/HDL-C ratio can be useful, particularly in children, to identify obese young patients at risk of IGT. Its accuracy as screening tool in a general population needs to be verified. The combination of TG/HDL-C ratio and WTHR > 0.6 did not improve prediction. Having high TG according to the NIH definition was not associated with increased risk of developing IGT.


Children Impaired glucose tolerance Pediatric obesity Triglycerides-to-HDL cholesterol ratio Waist 



Body mass index


Blood pressure


Fasting blood glucose


Impaired fasting glucose


Impaired glucose tolerance


High-density lipoprotein cholesterol


Oral glucose tolerance test


Type 2 diabetes


Triglycerides-to-HDL cholesterol ratio


Waist-to-height ratio


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and animal rights disclosure

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all patients for being included in the study.


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Copyright information

© Springer-Verlag Italia 2015

Authors and Affiliations

  • Melania Manco
    • 1
    Email author
  • Graziano Grugni
    • 2
  • Mario Di Pietro
    • 3
  • Antonio Balsamo
    • 4
  • Stefania Di Candia
    • 5
  • Giuseppe Stefano Morino
    • 1
  • Adriana Franzese
    • 6
  • Procolo Di Bonito
    • 7
  • Claudio Maffeis
    • 8
  • Giuliana Valerio
    • 9
  1. 1.Area di Ricerca Malattie Multifattoriali, Obesità e DiabeteOspedale Pediatrico Bambino GesùRomeItaly
  2. 2.Divisione di AuxologiaIstituto Auxologico ItalianoPiancavallo, VerbaniaItaly
  3. 3.Dipartimento materno-infantileOspedale San LiberatoreAtri, TeramoItaly
  4. 4.Dipartimento di Scienze Mediche e Chirurgiche, Programma di Endocrinologia Pediatrica, Unità Operativa di PediatriaUniversità di BolognaBolognaItaly
  5. 5.Dipartimento di Pediatria, Istituto Scientifico San RaffaeleMilano and Azienda Sanitaria Locale 2Melegnano, MilanItaly
  6. 6.Dipartimento di Scienze Mediche TraslazionaliUniversità degli Studi di Napoli Federico IINaplesItaly
  7. 7.Dipartimento di Medicina InternaOspedale Santa Maria delle GraziePozzuoli, NapoliItaly
  8. 8.Pediatria ad Indirizzo Diabetologico e Malattie del MetabolismoUniversità di VeronaVeronaItaly
  9. 9.Dipartimento di Scienze Motorie e del BenessereUniversità degli Studi di Napoli ParthenopeNaplesItaly

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