TG/HDL ratio is the strongest predictor of insulin resistance syndrome which is the root cause or strongest cause of atherosclerotic morbidity and mortality. Not LDL!
Endothelial dysfunction increases as arteries become stiff and microvascular vessels become less able to normally promote flow mediated dilation to increase metabolism and function of cells, tissues and organs, like the heart, brain and kidneys.
Study table 1. As ratio increases every parameter of metabolic syndrome increases.
Blood pressure, fatty liver, diabetes, etc correlates.
I suspect sleep apnea also correlates and the ratio improves with cpap.
Mediterranean diet, exercise, vagal nerve stimulation, 12 hours of fasting REDUCE RISK EXPONENTIALLY. This means that small changes in ratio produces greater rewards for atherosclerosis prevention.
Compare ACE/ARB to metoprolol. The former reduces diabetes (insulin resistance syndrome) 9% and the latter increases diabetes risk 9%. It follows that endothelial dysfunction, arterial stiffness, heart failure, stroke, dementia and acute coronary syndrome mean occurrence is therefore shifted toward or away from disease.
The Mediterranean diet studies show an 8 fold reduction in coronary artery disease
( 2% vs 16%.) Does a 9% downward shift in diabetes risk (18% from metoprolol) result in. fold or 800% reduction in coronary artery disease, a non linear result that costs the same. Lifestyle changes cost next to nothing and therefore is priceless.
This study also informs about the non linear relationship or exponential increase (or decrease) in risk. Small changes and small costs are exponentially beneficial. TG/HDL ratio is a useful biomarker of right track wrong track.
401 K is exponentially increased at retirement from strongest to weakest by time (start early), interest rate (aggressive but safe asset allocation model) and capital ( invest all lose money up to maximum.)
Knowing where the leverage in any system allows minimum effort to achieve Herculean outcomes.
Triglyceride to high-density lipoprotein cholesterol (HDL-C) ratio and arterial stiffness in Japanese population: a secondary analysis based on a cross-sectional study
Lipids in Health and Disease201817:130
© The Author(s). 2018
- Received: 20 November 2017
- Accepted: 14 May 2018
- Published: 29 May 2018
Background
Previous studies have revealed that triglyceride to high-density lipoprotein cholesterol (HDL-C) ratio (henceforth TG/HDL-C) is one of major risk factors of cardiovascular diseases, insulin resistance and metabolism syndrome. However, there are fewer scientific dissertations about the correlation between TG/HDL-C and bapWV. This study was undertaken to investigate the relationship between Triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio and brachial-ankle pulse wave velocity (baPWV) in Japanese.
Methods
The present study was a cross-sectional study. 912 Japanese men and women, aging 24−84 years old, received a health medical a health check-up program including the results from baPWV inspection and various standardized questionnaire in a health examination Center in Japan. Main outcome measures included TG/HDL-C ratio, baPWV, fatty liver, postmenopausal status. Abdominal ultrasonography was used to diagnose fatty liver. Postmenopausal state was defined as beginning 1 year after the cessation of menses. It was noted that the entire study was completed by Fukuda et al., and uploaded the data to the DATADRYAD website. The author only used this data for secondary analysis.
Results
After adjusting potential confounders (age, sex, BMI, SBP, DBP, AST, ALT, GGT, uric acid, fasting glucose, TC, LDL, eGFR, smoking and exercise status, fatty liver, alcohol consumption and ABI), non-linear relationship was detected between TG/HDL-C and baPWV, whose point was 5.6. The effect sizes and the confidence intervals on the left and right sides of inflection point were 12.7 (1.9 to 23.5) and − 16.7 (− 36.8 to 3.3), respectively. Subgroup analysis showed, in participants with excessive alcohol consumption (more than 280 g/week), that TG/HDL-C had a negative correlation with BAPWV (β = − 30.7, 95%CI (− 53.1, − 8.4)), and the P for interaction was less than 0.05,
Conclusion
The relationship between TG/HDL-C and baPWV is non-linear. TG/HDL-C was positively related with baPWV when TG/HDL-C is less than 5.6. In addition, while the trend is opposite in excessive alcoholic subjects.
Brachial-ankle pulse wave velocity (baPWV) is served as an indicator to quantify arterial stiffness []. As an independent risk factor of cardiovascular events, baPWV is used in clinical for early evaluating the functions and structural changes of vascular wall [, ]. Despite of the fact that western countries have not fully accepted baPWV, more and more publications on this research methodology came from these countries since 2009 []. Atherosclerosis Risk in Communities (ARIC) study and the Bogalusa Heart Study, the two large-scale studies in U. S, have used baPWV as indicator to assess arterial stiffness [, ].
Previous studies have revealed that triglyceride to high-density lipoprotein cholesterol (HDL-C) ratio (henceforth TG/HDL-C) is one of major risk factors of cardiovascular diseases, insulin resistance and metabolism syndrome [, , , , , ]. Some scholars consider that TG/HDL-C can better predict vascular risk than either does []. However, there are fewer scientific dissertations about the correlation between TG/HDL-C and bapWV. In only a few dissertations [, , ], as authors used the TG/HDL for analyzing categorical variables. In addition, they used GLM as a sole method of data analysis, in which the independent variables and dependent variables must be linear. But in biomedical research, connection between exposures and outcomes may be non-linear. In that case, researchers need a more effective method to deal with non-linear relationship.
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