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Utility of the Triglyceride and HDL Cholesterol Index in Older Persons in Colombia
Carolina Murgueitio Guzmán1,2,3, Jesús Andrés Beltrán España1,2,3,4, Ángel Alberto García Peña1,2,3,4
1Department of Internal Medicine Pontificia Universidad Javeriana Bogotá Colombia.
Insights
The triglyceride-to-HDL cholesterol (TG/HDL-c) index effectively identifies cardiometabolic risk in older adults, showing strong associations with diabetes and metabolic syndrome. This lipid ratio is a valuable tool for assessing cardiovascular disease risk in elderly populations.
Area of Science:
- Cardiovascular Medicine
- Metabolic Health
- Gerontology
Background:
- Lipid metabolism alterations contribute to atherogenesis and atherosclerotic cardiovascular diseases.
- The triglyceride-to-HDL cholesterol (TG/HDL-c) index is a common cardiovascular disease risk assessment tool.
- The effectiveness of the TG/HDL-c index in older adults requires further investigation.
Purpose of the Study:
- To evaluate the association and predictive capacity of the TG/HDL-c index for cardiometabolic risk factors in older adults.
- To assess the TG/HDL-c index's utility in identifying diabetes and metabolic syndrome in the elderly.
- To determine the discriminatory performance of the TG/HDL-c index for various cardiometabolic conditions.
Main Methods:
- Cross-sectional analysis of adults aged ≥60 years from the SABE Colombian study.
- Logistic regression models to examine associations between TG/HDL-c index and diabetes or metabolic syndrome.
- Receiver operating characteristic (ROC) curves to assess discriminatory capacity and Youden index for optimal cut-off points.
Main Results:
- The TG/HDL-c index was independently associated with diabetes (aOR 1.25) and metabolic syndrome (aOR 2.82) in 23,694 older adults (median age 69).
- The index showed good discriminatory performance for diabetes (AUC 0.89) and metabolic syndrome (AUC 0.86).
- Discriminatory performance was limited for hypertension, prediabetes, cardiovascular disease, and cerebrovascular disease (AUC range 0.52-0.67).
Conclusions:
- The TG/HDL-c index is independently associated with diabetes and metabolic syndrome in older adults.
- The index demonstrates good discriminatory performance for these conditions in a nationally representative sample.
- Further longitudinal studies are needed to validate findings and establish the prognostic value for clinical decision-making in elderly populations.
Background:
Alterations in lipid metabolism are key contributors to the development of atherogenesis and the increasing prevalence of atherosclerotic cardiovascular diseases, including coronary artery disease, peripheral arterial disease, and cerebrovascular disease. The triglyceride-to-HDL cholesterol (TG/HDL-c) index is commonly used to assess cardiovascular disease risk; however, its effectiveness in older adults remains unclear.
Methods:
This study evaluated the association and predictive capacity of the TG/HDL-c index for cardiometabolic risk factors in older adults from the SABE Colombian study. A cross-sectional analysis was performed among adults aged ≥ 60 years from the national SABE survey. Univariable and multivariable logistic regression models were constructed to examine associations between the TG/HDL-c index and diabetes or metabolic syndrome, adjusting for age, sex, BMI, smoking, diet, and physical activity. Discriminatory capacity was assessed using receiver operating characteristic curves, and optimal cut-off points were determined using the Youden index.
Results:
A total of 23,694 participants with a median age of 69 years were included; 57.3% were women. The TG/HDL-c index was independently associated with both diabetes (adjusted OR per 1 SD: 1.25; 95% CI: 1.13-1.37; p < 0.001) and metabolic syndrome (adjusted OR per 1 SD: 2.82; 95% CI: 2.46-3.22; p < 0.001). The index demonstrated a good discriminatory performance for diabetes (AUC = 0.89; 95% CI: 0.86-0.93; cut-off = 9.17; sensitivity = 0.81; specificity = 0.90) and metabolic syndrome (AUC = 0.86; 95% CI: 0.85-0.88; cut-off = 8.81; sensitivity = 0.71; specificity = 0.92). In contrast, discriminatory performance was limited for hypertension, prediabetes, cardiovascular disease, and cerebrovascular disease (AUC range 0.52-0.67).
Conclusions:
The TG/HDL-c index was independently associated with diabetes and metabolic syndrome and demonstrated good discriminatory performance in this nationally representative sample of older adults. Although these results highlight its potential utility for identifying individuals at higher cardiometabolic risk, further longitudinal studies are needed to validate these findings and determine the prognostic value of TG/HDL-c for clinical decision-making in elderly populations.
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