PREDICTING INSULIN RESISTANCE USING THE TRIGLYCERIDE-TO-HIGH DENSITY LIPOPROTEIN RATIO IN EGYPTIAN ADULTS

Abstract

There are several directly and indirect methods to assess insulin resistance. The gold standard method was the hyperinsulinemic-euglycemic clamp (glucose clamp) technique. Although HOMA (homeostatic model assessment) IR has been widely used in study of metabolic syndrome, Lack of standardized insulin assay has limited it is clinically assay. Triglycride-TO-High Denisity Lipoprotein ratio (TG/HDL) has been advocated as simple clinical indicator of insulin resistance, also it has been evaluated as predictor of diabetes and coronary heart disease.
Aim of the Work: To develop simple predictive method to evaluate insulin resistance using TG and HDL.
Patient and Methods: A total of 95 person were included in this study and divided in to five groups as follow: Group (1): 19 healthy Persons aged 45.4 + 11.2, Group (2): 19 Non diabetic high risk patients without cardiovascular complication aged 56.9 + 10.5, Group (3): 19 Non diabetic with high risk patients with cardiovascular complication aged 62.2 + 13.7, Group (4): 19 Diabetic patients without cardiovascular complication aged 60 + 16.7 and Group (5): 19 Diabetic patients with cardiovascular complication aged 63.9 + 12.2. All subjects were subjected to the following: Full history taking, full general examination, BMI, Waist circumference, HbA1C, Triglyceride, total cholesterol, HDL-C, LDL-C. Fasting insulin, Fasting blood sugar and HOMA-IR.
Results: the highest percentage of HOMA among the studied groups was in group 5 (94.7%) (5.8+2.6, P < 0.001) followed by group 4 (78.9%) (3.3 + 1.2, P <0.001) then group 3 (5.3%) (1.52 + 0.55, P <0.001) then other groups. There were highly significant positive correlation between HOMA & TG/HDL in group 4 & 5 (P <0.05) and insignificant correlation in group 1, 2&3.
Conclusions: There is a significant association between HOMA- IR and TG/HDL ratio suggesting that elevated TG/HDL ratio can be used to predict the presence of insulin resistance.