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

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Abstract

Aims

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).

Methods

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.

Results

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.

Conclusions

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.

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Abbreviations

BMI:

Body mass index

BP:

Blood pressure

FBG:

Fasting blood glucose

IFG:

Impaired fasting glucose

IGT:

Impaired glucose tolerance

HDL-C:

High-density lipoprotein cholesterol

OGTT:

Oral glucose tolerance test

T2D:

Type 2 diabetes

TG/HDL-C:

Triglycerides-to-HDL cholesterol ratio

WTHR:

Waist-to-height ratio

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Author information

Authors and Affiliations

  1. Area di Ricerca Malattie Multifattoriali, Obesità e Diabete, Ospedale Pediatrico Bambino Gesù, Rome, Italy

    Melania Manco & Giuseppe Stefano Morino

  2. Divisione di Auxologia, Istituto Auxologico Italiano, Piancavallo, Verbania, Italy

    Graziano Grugni

  3. Dipartimento materno-infantile, Ospedale San Liberatore, Atri, Teramo, Italy

    Mario Di Pietro

  4. Dipartimento di Scienze Mediche e Chirurgiche, Programma di Endocrinologia Pediatrica, Unità Operativa di Pediatria, Università di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy

    Antonio Balsamo

  5. Dipartimento di Pediatria, Istituto Scientifico San Raffaele, Milano and Azienda Sanitaria Locale 2, Melegnano, Milan, Italy

    Stefania Di Candia

  6. Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy

    Adriana Franzese

  7. Dipartimento di Medicina Interna, Ospedale Santa Maria delle Grazie, Pozzuoli, Napoli, Italy

    Procolo Di Bonito

  8. Pediatria ad Indirizzo Diabetologico e Malattie del Metabolismo, Università di Verona, Verona, Italy

    Claudio Maffeis

  9. Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, Naples, Italy

    Giuliana Valerio

Authors
  1. Melania Manco
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  2. Graziano Grugni
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  3. Mario Di Pietro
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  4. Antonio Balsamo
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  5. Stefania Di Candia
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  6. Giuseppe Stefano Morino
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  7. Adriana Franzese
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  8. Procolo Di Bonito
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  9. Claudio Maffeis
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  10. Giuliana Valerio
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Corresponding author

Correspondence to Melania Manco.

Ethics declarations

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.

Additional information

Managed by Massimo Porta.

On the behalf of the Childhood Obesity Group of the Italian Society of Paediatric Endocrinology and Diabetology. See study members referred in “Appendix” section.

Appendix

Appendix

Childhood Obesity Group of the Italian Society of Paediatric Endocrinology and Diabetology: Nicola Corciulo, MD, Ospedale S. Cuore di Gesù Gallipoli, Lecce; Maria Rosaria Licenziati, MD, Dipartimento di Pediatria, AORN Santobono-Pausilipon, Napoli. Anita Morandi, MD, Pediatria ad Indirizzo Diabetologico e Malattie del Metabolismo, Università di Verona, Verona; Beatrice Moro, MD, Ospedale Civile Piove di Sacco, Padova; Alessandro Sartorio, MD, Divisione di Auxologia, Istituto Auxologico Italiano, Piancavallo, Verbania; Rita Tanas, MD, Azienda Ospedaliero-Universitaria Arcispedale S. Anna, Ferrara.

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Manco, M., Grugni, G., Di Pietro, M. et al. Triglycerides-to-HDL cholesterol ratio as screening tool for impaired glucose tolerance in obese children and adolescents. Acta Diabetol 53, 493–498 (2016). https://doi.org/10.1007/s00592-015-0824-y

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  • DOI: https://doi.org/10.1007/s00592-015-0824-y

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