Cited by 169Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsLipid metabolism and disorders

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Accuracy of the triglyceride to high-density lipoprotein cholesterol ratio for prediction of the low-density lipoprotein phenotype B

Hanak, Viktor, Munoz, Julian, Teague, Joe, Stanley, Alfred, Bittner, Vera·2004·The American Journal of Cardiology

DOI 10.1016/j.amjcard.2004.03.069

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Abstract

This study examined the accuracy of a triglyceride/high-density lipoprotein (HDL) cholesterol ratio of 3.8 for the prediction of low-density lipoprotein (LDL) phenotype B. The ratio of 3.8 was based on Adult Treatment Panel recommendations for normal fasting triglycerides (<150 mg/dl) and HDL cholesterol (>40 mg/dl). Fasting blood samples were obtained from 658 patients. LDL phenotype analysis was performed by nuclear magnetic resonance spectroscopy. A triglyceride/HDL cholesterol ratio of 3.8 divided the distribution of LDL phenotypes with 79% (95% confidence interval [CI] 74 to 83) of phenotype B greater than and 81% (95% CI 77 to 85) of phenotype A less than the ratio of 3.8. The ratio was reliable for identifying LDL phenotype B in men and women.

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Method
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BackgroundInfluential
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Background
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The Relationship between the Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Metabolic Syndrome
Shin, H.-G., Kim, Y.-K., Kim, Y., Jung, Y.-H., & Kang, H. (2017) · Korean Journal of Family Medicine · doi:10.4082/kjfm.2017.38.6.352 · Cited by 28
Comment on: Triglyceride-to-HDL cholesterol ratio: Predictive value for CHD severity and new-onset heart failure
İşçen, S., & Zhenyue, C. (2013) · Herz · doi:10.1007/s00059-013-3840-0 · Cited by 28
A specific plasma lipid signature associated with high triglycerides and low HDL cholesterol identifies residual CAD risk in patients with chronic coronary syndrome
Giorgi, N. D., Michelucci, E., Smit, J. M., Scholte, A. J. H. A., Mahdiui, M. E., Knuuti, J. M., Buechel, R. R., Teresińska, A., Pizzi, M. N., Roque, A., et al. (2021) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2021.11.013 · Cited by 26
Classification of LDL Phenotypes by 4 Methods of Determining Lipoprotein Particle Size
Sninsky, J. J., Rowland, C. M., Baca, A. M., Caulfield, M. P., & Superko, H. R. (2013) · Journal of Investigative Medicine · doi:10.2310/jim.0b013e31829d9d17 · Cited by 26
“We confirmed previous reports that TG, HDL-C, and TG/ HDL-C ratio are correlated with peak LDL size.(33,34) This correlation was stronger when peak LDL size was determined by IM than by sGGE or NMR.”
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Is Shift Work Associated with Lipid Disturbances and Increased Insulin Resistance?
Alefishat, E. A., & Farha, R. K. A. (2015) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2015.0052 · Cited by 25
Triglyceride/High‐Density Lipoprotein Cholesterol Ratio Is Associated with In‐Hospital Mortality in Acute Type B Aortic Dissection
Zhou, Y., Yang, G., He, H., Pan, X., Peng, W., & Chai, X. (2020) · BioMed Research International · doi:10.1155/2020/5419846 · Cited by 24
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Increase in Standard Cholesterol and Large HDL Particle Subclasses in Antiretroviral-Naïve Patients Prescribed Efavirenz Compared to Atazanavir/Ritonavir
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Cardiovascular Risk in Xavante Indigenous Population
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Relationship between dyslipidemia and albuminuria in prediabetic adults: The Korea National Health and Nutrition Examination Survey 2011–2012
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“8) and high LDL-C to HDL-C ratio (LDLC/HDL-C[2) as lipid abnormalities [4, 17–19].”
Background
Regulation of Serum Sphingolipids in Andean Children Born and Living at High Altitude (3775 m)
Barbacini, P., Casas, J., Torretta, E., Capitanio, D., Maccallini, G., Hirschler, V., & Gelfi, C. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20112835 · Cited by 22
Triglyceride/HDL-Cholesterol Ratio as an Index of Intracranial Atherosclerosis in Nonstroke Individuals
Woo, M.-H., Lee, K. O., Chung, D., Choi, J.-W., Kim, S.-H., & Oh, S. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2020.504219 · Cited by 24
“In addition, THR was shown a better predictor of LDL particle size than LDL-C in nondiabetic patients (18, 37, 42, 43).”
Background
High triglyceride to HDL cholesterol ratio is associated with increased coronary heart disease among White but not Black adults
Tejera, C. H., Minnier, J., Fazio, S., Safford, M. M., Colantonio, L. D., Irvin, M. R., Howard, V. J., Zakai, N. A., & Pamir, N. (2021) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2021.100198 · Cited by 21
Relationship between alcohol consumption and serum lipid levels in elderly Korean men
Park, H., & Kim, K. (2011) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2011.08.014 · Cited by 23
Comparison of Lipid-Related Ratios for Prediction of Chronic Kidney Disease Stage 3 or More in Korean Adults
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“Increased levels of small and dense LDL-C particles, which are highly atherogenic, are associated with elevated TG/HDL-C (25, 26).”
Background
Incidence and predictors of chronic kidney disease in type-II diabetes mellitus patients attending at the Amhara region referral hospitals, Ethiopia: A follow-up study
Ahmed, M. A., Ferede, Y. M., & Takele, W. W. (2022) · PLoS ONE · doi:10.1371/journal.pone.0263138 · Cited by 24
“Low level of High-Density Lipoprotein (HDL): < 40 mg/dl and<50mg/dl for male and female, respectively, otherwise declared to be normal [35].”
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Reducing vascular events risk in patients with dyslipidaemia: an update for clinicians
Hermans, M. P., & Fruchart, J. (2011) · Therapeutic Advances in Chronic Disease · doi:10.1177/2040622311413952 · Cited by 20
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Impact of triglycerides on lipid and lipoprotein biology in women
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Dietary Inflammatory Index is Associated with Excessive Body Weight and Dietary Patterns in Subjects with Cardiometabolic Risk
Meneguelli, T. S., Hinkelmann, J. V., de Novaes, J. F., Rosa, C. D. O. B., Filgueiras, M. D. S., Silveira, B. K. S., Shivappa, N., Hébert, J. R., & Hermsdorff, H. H. M. (2019) · Journal of Food and Nutrition Research · doi:10.12691/jfnr-7-7-2 · Cited by 19
“Triglyceride-glucose (TyG) index was calculated according to the formula: Ln [fasting triglycerides (mg/dL) x fasting plasma glucose (mg/dL)/2] and Homeostasis model assessment of insulin resistance (HOMA-IR) by the formula: [(fasting glucose (mg/dL)) x (fasting insulin (μU/mL))] / 405 [36-39].”
Method
Is Triglyseride/ HDL Ratio A Reliable Screening Test for Assesment of Atherosclerotic Risk in Patients With Chronic Inflammatory Diseases?
Keleş, N. (2016) · Northern Clinics of Istanbul · doi:10.14744/nci.2016.52824 · Cited by 18
“Recently, use of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio has been recommended as a simple method to determine insulin resistance and cardiometabolic risk in healthy individuals [7, 8, 9, 10, 11].”
Method
“Traditional” and “Healthy” Dietary Patterns Are Associated with Low Cardiometabolic Risk in Brazilian Subjects
Silveira, B. K. S., de Novaes, J. F., Reis, N. D. A., Lourenço, L. P., Capobiango, A. H. M., Ribeiro, S. A. V., & Hermsdorff, H. H. M. (2018) · Cardiology Research and Practice · doi:10.1155/2018/4585412 · Cited by 18
Triglyceride profile in dyslipidaemia of type 2 diabetes mellitus.
Khan, S. R., Ayub, N., Nawab, S., & Shamsi, T. S. (2008) · PubMed · Cited by 18
The performance of triglyceride to high-density lipoprotein cholesterol ratio in acute coronary syndromes using a diagnostic decision tree
Krintus, M., Kuligowska-Prusińska, M., Laskowska, E., Janiszewska, E., & Kubica, J. (2015) · Cited by 17
Cardiovascular risk estimated in individuals with multiple sclerosis: A case-control study
Albuquerque, L. D. S., Damasceno, N. R. T., Maia, F. N., de Carvalho, B. M., Maia, C. S. C., D’Almeida, J. A. C., & de Melo, M. L. P. (2021) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2021.103133 · Cited by 19
Plasma Levels of Acylation-Stimulating Protein Are Strongly Predicted by Waist/Hip Ratio and Correlate with Decreased LDL Size in Men
Saleh, J., Wahab, R. A., Farhan, H., Al-Amri, I. S., & Cianflone, K. (2013) · ISRN Obesity · doi:10.1155/2013/342802 · Cited by 16
Relevance of the triglyceride-to-high-density lipoprotein cholesterol ratio as an important lipid fraction in apparently healthy, young, and middle-aged Indian men
Kohli, A., Siddhu, A., Pandey, R. M., & Reddy, K. (2016) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.196020 · Cited by 16
“8, based on recommended levels of normal fasting TG (<150 mg/dL) and normal HDL‐C (≥40 mg/dL), the ratio cutoff used in practice varies slightly with different populations, ethnicities, and medical history.[9,12,18] In addition, keeping in view the measurement errors that are likely to be there and the greater day‐to‐…”
BackgroundMethod
ENHO, RXRA, and LXRA polymorphisms and dyslipidaemia, related comorbidities and survival in haemodialysis patients
Grzegorzewska, A. E., Niepolski, L., Świderska, M. K., Mostowska, A., Stolarek, I., Warchol, W. J., Figlerowicz, M., & Jagodziński, P. P. (2018) · BMC Medical Genetics · doi:10.1186/s12881-018-0708-4 · Cited by 15
Relationship Between Dyslipidemia and Albuminuria in Hypertensive Adults
Lee, S.-H., Kim, D., Kim, Y., Roh, Y. K., Ju, S.-Y., Nam, H.-Y., Nam, G. E., Choi, J.-S., Lee, J.-E., Sang, J.-E., et al. (2016) · Medicine · doi:10.1097/md.0000000000003224 · Cited by 14
Platelet Acetyl-CoA Carboxylase Phosphorylation
Kautbally, S., Lepropre, S., Onselaer, M.-B., Lerigoleur, A., Ginion, A., de Meester, C., Ambroise, J., Boudjeltia, K. Z., Octave, M., Wéra, O., et al. (2019) · JACC Basic to Translational Science · doi:10.1016/j.jacbts.2019.04.005 · Cited by 14
“TG/HDL-C ratio, a well-known atherogenic marker, indicates LDL particle size (16), while TGs were shown to correlate with plasma oxLDL levels”
Background
Noninvasive detection of coronary artery disease--challenges for prevention of disease and clinical events
da Luz, P. L., Bertini, P. J., & Favarato, D. (2005) · Clinics · doi:10.1590/s1807-59322005000500011 · Cited by 13
Lipid Variables Related to the Extent and Severity of Coronary Artery Disease in Non-Diabetic Turkish Cypriots.
Conkbayır, C., Ayça, B., & Ökçün, E. Ö. B. (2015) · PubMed Central · Cited by 13
Cystatin C, CRP, Log TG/HDLc and Metabolic Syndrome are Associated with Microalbuminuria in Hypertension
Moura, R. D. S. D. S. E. S., Vasconcelos, D. F., Freitas, E., de Moura, F. J. D., Rosa, T. T., & Veiga, J. P. R. (2013) · Arquivos Brasileiros de Cardiologia · doi:10.5935/abc.20130210 · Cited by 13
Genome-Wide Association Study Reveals Four Loci for Lipid Ratios in the Korean Population and the Constitutional Subgroup
Kim, T., Park, A. Y., Baek, Y., & Cha, S. (2017) · PLoS ONE · doi:10.1371/journal.pone.0168137 · Cited by 13
Ratio of triglyceride to high-density lipoprotein cholesterol and risk of major cardiovascular events in kidney transplant recipients
Kim, J. E., Yu, M., Kim, Y. C., Min, S., Ha, J., Lee, J. P., Kim, D. K., Oh, K., Joo, K. W., Ahn, C., et al. (2019) · Clinical and Experimental Nephrology · doi:10.1007/s10157-019-01776-9 · Cited by 12
Higher testosterone is associated with higher HDL-cholesterol and lower triglyceride concentrations in older women: an observational study
Davis, S. R., Azene, Z. N., Tonkin, A. M., Woods, R. L., McNeil, J. J., & Islam, R. M. (2024) · Climacteric · doi:10.1080/13697137.2024.2310530 · Cited by 12
“…convenient to them, as opposed to a single laboratory. the measurement of total cholesterol, HDl-c and tg has been internationally standardized [50], and nata accreditation ensures laboratories use assays traceable to internationally recognized standard reference materials. therefore, we do…”
Background
Effect of short term administration of konjac glucomannan hydrolysates on adult blood lipid parameters and glucose concentrations
Suwannaporn, P., Tester, R. F., Al‐Ghazzewi, F. H., & Artitdit, P. (2015) · Nutrition & Food Science · doi:10.1108/nfs-02-2015-0012 · Cited by 12
Triglyceride–to–HDL Cholesterol Ratio in the Dyslipidemic Classification of Type 2 Diabetes
Wägner, A. M., Pérez, A., Sánchez‐Quesada, J. L., & Ordóñez‐Llanos, J. (2005) · Diabetes Care · doi:10.2337/diacare.28.7.1798 · Cited by 12
“Previously described cutoff points were used (1,2,6), as well as that calculated from the regression equation obtained from the samples included in the present study: triglyceride–to–HDL cholesterol ratio 42.”
BackgroundMethod
Triglyceride to high-density lipoprotein cholesterol ratio predicts cardiovascular events in maintenance hemodialysis patients
Hasegawa, A., Kojima, F., Ueda, M., Tanaka, Y., & Nitta, K. (2016) · Renal Replacement Therapy · doi:10.1186/s41100-016-0069-4 · Cited by 12
“The cut-off value of TG/HDL-C ratio in prediction of CV event in our study was much lower than that in the previous studies [29, 31].”
Result
Lipid changes 8 years post gastric bypass in adolescents with severe obesity (FABS-5+ study)
Shah, A. S., Jenkins, T. M., Gao, Z., Daniels, S. R., Urbina, E. M., Kirk, S., Siegel, R., & Inge, T. H. (2017) · International Journal of Obesity · doi:10.1038/ijo.2017.141 · Cited by 12
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Association of Dietary Patterns with Cardiovascular and Kidney Phenotypes in an Uruguayan Population Cohort
Moliterno, P., Donangelo, C. M., Borgarello, L., Pécora, M., Olascoaga, A., Noboa, O. A., & Boggia, J. G. (2021) · Nutrients · doi:10.3390/nu13072213 · Cited by 11
“The TG/HDLc ratio was calculated as an index of cardiovascular risk [24].”
BackgroundMethodInfluential
Assessment of the validity of the frequently used lipid indices for predicting LDL peak particle diameter in a large cohort of 1955 normal and dyslipidemic subjects
Décary, S., Dumont, G., Lamarche, B., Hogue, J., Tremblay, A. J., Bergeron, J., & Couture, P. (2009) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2009.11.010 · Cited by 11
Cross-sectional and prospective study of the effects of GH therapy on metabolic panel in children with GH deficiency
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A 10-year follow-up study of demographic and cardiometabolic factors in HIV-infected South Africans
Phalane, E., Fourie, C. M. T., Mels, C. M. C., & Schutte, A. E. (2019) · Cardiovascular journal of South Africa/Cardiovascular journal of Southern Africa · doi:10.5830/cvja-2019-034 · Cited by 10
Impact of high triglyceride/high-density lipoprotein cholesterol ratio (insulin resistance) in ST-segment elevation myocardial infarction
Chen, H., Lee, W., Fang, H., Fang, C.-Y., Chen, C.-J., Yang, C., & Wu, C. (2020) · Medicine · doi:10.1097/md.0000000000022848 · Cited by 10
“A high TG/HDL-C ratio is also correlated with LDL phenotype B,([8]) and small HDL particles,([9]) and is also associated with increased arterial stiffness and impaired heart rate recovery after exercise.”
Background

Authors: Hanak, V., Munoz, J., Teague, J., Stanley, A., & Bittner, V.
Affiliations: Carraway Methodist Medical Center (US)
University of Alabama at Birmingham (US)
Corresponding author: Hanak, Viktor
ORCID: Bittner, Vera
Venue: The American Journal of Cardiology
Publisher: Elsevier BV
Published: 2004-07
Volume: 94
Issue: 2
Pages: 219-222
ISSN: 0002-9149 (ISSN-L)
DOI: 10.1016/j.amjcard.2004.03.069
OpenAlex: W1981002254
Cited by: 167
References: 11
Citations by year: 2026: 1 · 2025: 3 · 2024: 6 · 2023: 3 · 2022: 10 · 2021: 12 · 2020: 9 · 2019: 12 · 2018: 9 · 2017: 7 · 2016: 6 · 2015: 17 · 2014: 9 · 2013: 13 · 2012: 13
FWCI: 3.03
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The American Journal of Cardiology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
Keywords: triglyceride to HDL cholesterol ratio, LDL particle size, NMR spectroscopy, dyslipidemia, fasting triglycerides, HDL cholesterol, diagnostic accuracy
MeSH terms: Aged, Female, Humans, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Magnetic Resonance Spectroscopy, Particle Size, Phenotype, Sensitivity and Specificity, Triglycerides, Logistic Models

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Accuracy of the triglyceride to high-density lipoprotein cholesterol ratio for prediction of the low-density lipoprotein phenotype B

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