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TG/HDL-C Ratio for Predicting Insulin Resistance in Obese Children from Beijing, China
Tian Zhang1, Fangfang Duan2, Yi Qian1
1Department of Paediatric Internal Medicine, Beijing Jishuitan Hospital, Capital Medical University, Beijing, 100035, China.
Insights
The triglycerides to HDL-C ratio effectively predicts insulin resistance in obese Chinese children. Age-specific thresholds for this ratio were identified, offering a valuable biomarker for early detection.
Area of Science:
- Pediatric Endocrinology
- Metabolic Syndrome Research
- Biomarker Discovery
Background:
- International studies link the triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio with insulin resistance in overweight/obese children.
- Limited data exists on this association specifically within the Chinese pediatric population.
Purpose of the Study:
- To investigate the utility of the TG/HDL-C ratio as a biomarker for insulin resistance (IR) in obese children residing in Beijing.
- To establish age-specific diagnostic thresholds for IR using the TG/HDL-C ratio in this cohort.
Main Methods:
- A cross-sectional study involving 262 obese children from a pediatric outpatient clinic.
- Data collection included medical history, clinical examination, and laboratory tests (blood lipids, glucose, insulin, HbA1c).
- Children were stratified into age groups (6-9 and 10-13.5 years) and assessed for IR using the homeostatic model assessment for IR (HOMA-IR).
Main Results:
- The TG/HDL-C ratio was significantly higher in children with IR across both age groups (p < 0.001).
- A positive correlation was observed between the TG/HDL-C ratio and HOMA-IR in both age strata (p < 0.05).
- Age-specific cut-off values for the TG/HDL-C ratio demonstrated moderate diagnostic accuracy (AUCs of 0.734 for 6-9 years and 0.724 for 10-13.5 years).
Conclusions:
- The TG/HDL-C ratio serves as a practical predictor of insulin resistance in obese children in Beijing.
- Distinct age-dependent thresholds (≥0.645 for 6-9 years; ≥0.725 for 10-13.5 years) were identified.
- These thresholds are lower than those reported internationally, suggesting potential ethnic or environmental differences.
Background:
International studies have found that the blood triglycerides to highdensity lipoproteins (TG/HDL-C) ratio predicted insulin resistance in children with overweight and obesity. However, there is a lack of such reports on children from China.
Objective:
The objective of this study is to explore the ability of the TG/HDL-C ratio as a blood biomarker for insulin resistance (IR) in obese children in Beijing.
Methods:
We evaluated 262 children with obesity from our paediatric outpatient clinic in a cross-sectional study. Detailed medical histories of all children were ascertained, as were clinical examination and laboratory test results, including blood lipids, fasting glucose, insulin, and glycated haemoglobin. We divided them into age groups of 6-9 and 10-13.5 years and then into IR and non-IR groups based on the homeostatic model assessment for IR (HOMA-IR). Analysis was accomplished with SPSS software (version 22.0).
Results:
The TG/HDL-C ratio was higher in children with IR in the 6-9 and 10-13.5-year age groups (p < 0.001). Univariate and multivariate analyses displayed that the TG/HDL-C ratio and HOMA-IR were correlated in the 6-9 and 10-13.5-year-old groups (p < 0.05). In the 6-9-yearold group, IR identified by a TG/HDL-C ratio ≥ 0.645 had a sensitivity, specificity, and an area under the curve (AUC) of 79.1%, 60.9%, and 0.734, respectively. In the 10-13.5-year-old group, IR identified by a TG/HDL-C ratio ≥ 0.725 had a sensitivity, specificity, and an AUC of 79.4%, 62.9%, and 0.724, respectively.
Conclusion:
We showed the application of the TG/HDL-C ratio to predict insulin resistance in obese children in Beijing with different diagnostic thresholds based on age (6-9-year-old group with TG/HDL-C ≥ 0.645; 10-13.5-year-old group with TG/HDL-C ≥ 0.725), which were lower compared with the diagnostic threshold for insulin resistance in children reported in other countries.
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