ESPE Abstracts

Background: Dyslipidaemia is related with the initiation and progression of atherosclerosis in children, and the total cholesterol (TC) and non-high density lipoprotein cholesterol (non-HDL-C) are commonly used screening tools for identifying children with dyslipidaemia. The triglyceride-to-high density lipoprotein cholesterol (TG/HDL-C) ratio has recently been reported as a marker of insulin resistance in obese children and adolescents.

Objective and hypotheses: To describe the TG/HDL-C ratio and related factors in overweight and normal weight Korean children.

Method: Data from 405 Korean children (144 overweight children, aged 9.1±1.9 years, and 261 normal weight children, aged 8.8±1.8 years) were retrospectively evaluated. Glucose, insulin, TC, HDL-C and TG levels were measured after overnight fasting, and the TG/HDL-C ratio, non-HDL-C (TC – HDL-C) and homeostasis model assessment of insulin resistance (HOMA-IR, insulin (μU/ml) × glucose (mmol/l)/22.5) were calculated. Overweight was defined by BMI ≧85th percentile. Hypertriglyceridemia was defined by TG≧130 mg/dl (≧10 years of age) or ≧100 mg/dl (<10 years of age), and hypo-HDL-cholesterolemia was defined by HDL-C<40 mg/dl.

Results: Overweight children showed higher TG (100.0±69.6 vs 73.9±40.0 mg/dl, P<0.001) and lower HDL-C (52.1±11.3 vs 57.9±10.8 mg/dl, P<0.001) levels than normal weight children. The prevalence of hypertriglyceridemia (35.4% vs 13.8%, P<0.001) and hypo-HDL-cholesterolemia (13.2% vs 3.1%, P<0.001) was increased in overweight children compared to normal weight children. The TG/HDL-C ratio was higher in overweight group than normal weight group (2.16±2.06 vs 1.35±0.87, P<0.001), and the TG/HDL-C ratio correlated with HOMA-IR after adjusting for age and sex (r=0.567, P<0.001). The sensitivity of TC ≧200 mg/dl and non-HDL-C≧145 mg/dl for identifying those with TG/HDL-C ratio≧3 was 8.2% and 23.4% respectively.

Conclusion: The TG/HDL-C ratio is increased in overweight children, and it seems to be related with parameters of insulin resistance. However, the TC and non-HDL-C is not a sensitive screening tool or identifying those with increased TC/HDL-C ratio.