The DOI matches its Crossref record; 27 of the 27 references it cites were found in a registry or an index.
Fasting triglyceride and the triglyceride-HDL cholesterol ratio are not markers of insulin resistance in African Americans.
Abstract
BACKGROUND: The "lipid criteria" consist of a triglyceride (TG) level of 130 mg/dL (1.47 mmol/L) or greater and a ratio of TG to high-density lipoprotein cholesterol (HDL-C) of 3 or greater. In Caucasians, the lipid criteria predict insulin resistance in individuals with a body mass index (BMI) of 25 kg/m(2) or greater. Our goal was to determine whether TG levels or TG-HDL-C ratio predicted insulin resistance in African Americans with a BMI of 25 kg/m(2) or more. METHODS: Of 125 African Americans, the 98 with a BMI of 25 kg/m(2) or more participated. All subjects had frequently sampled intravenous glucose tolerance tests with insulin resistance determined by the insulin sensitivity index. Subjects were divided into the following tertiles by insulin sensitivity: 12.8 to 4.3, 4.2 to 2.3, and 2.2 to 0.2 mU/L per minute. Insulin resistance was defined as being in the third tertile. Across tertiles, the distribution of variables was compared by 1-way analysis of variance. Areas under the receiver operating characteristic curve were determined to identify variables that predicted insulin resistance. RESULTS: Fasting insulin level, BMI, and waist circumference increased across tertiles (all P<.01), but TG levels and TG-HDL-C ratio did not (all P>/=.3). The mean +/- SE areas under the curves for fasting insulin, BMI, and waist circumference were 0.85 +/- 0.04, 0.72 +/- 0.05, and 0.71 +/- 0.05, respectively. For TG level and TG-HDL-C ratio, the areas under the curves were 0.55 +/- 0.06 and 0.56 +/- 0.06, respectively, meaning that the true-positive rate was nearly equal to the false-positive rate. Therefore, they could not be used as markers of insulin resistance. Furthermore, 17 subjects met the lipid criteria but only 7 were in the insulin-resistant tertile, making the sensitivity of these criteria to identify insulin resistance only 17%. CONCLUSION: In African Americans, TG levels and TG-HDL-C ratio are not reliable markers of insulin resistance.
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“In African-Americans, low triglyceride levels occur in the context of severe insulin resistance (72).”
From Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline (2012) · cites this paper as [72]
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Metadata
- Authors
- Sumner, A. E., Finley, K. B., Genovese, D. J., Criqui, M. H., & Boston, R. C.
- Affiliations
- National Institutes of Health (US)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2005-06-27
- Volume
- 165
- Issue
- 12
- Pages
- 1395
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2072843742
- Cited by
- 230
- References
- 26
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 8 · 2023: 8 · 2022: 13 · 2021: 12 · 2020: 13 · 2019: 13 · 2018: 6 · 2017: 9 · 2016: 14 · 2015: 8 · 2014: 12 · 2013: 7 · 2012: 16
- FWCI
- 7.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Keywords
- insulin resistance, triglycerides, triglyceride to HDL cholesterol ratio, African Americans, insulin sensitivity index, fasting insulin, waist circumference, body mass index, diagnostic biomarkers, insulin resistance screening
- MeSH terms
- Adult, Black or African American, Cross-Sectional Studies, Fasting, Female, Humans, Insulin Resistance, Cholesterol, HDL, Male, Middle Aged, ROC Curve, Triglycerides, Reproducibility of Results, Body Mass Index, Waist-Hip Ratio
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