Background
High triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) are important
cardiovascular risk factors. The exact prognostic value of the TG/HDL-C ratio, a marker
for cardiovascular events, is currently unknown among Iranians so this study sought
to determine the optimal cutoff point for the TG/HDL-C ratio in predicting cardiovascular
disease events in the Iranian population.
Method
The Isfahan Cohort Study (ICS) is an ongoing, longitudinal, population-based study
that was originally conducted on adults aged ≥35 years, living in urban and rural
areas of three districts in central Iran. After 10 years of follow-up, 5431 participants
were re-evaluated using a standard protocol similar to the one used for baseline.
At both measurements, participants underwent medical interviews, physical examinations,
and fasting blood measurements. “High-risk” subjects were defined by the discrimination
power of indices, which were assessed using receiver operating characteristic (ROC)
analysis; the optimal cutoff point value for each index was then derived.
Results
The mean age of the participants was 50.7 ± 11.6 years. The TG/HDL-C ratio, at a threshold
of 3.68, was used to screen for cardiovascular events among the study population.
Subjects were divided into two groups (“low” and “high” risk) according to the TG/HDL-C
concentration ratio at baseline. A slightly higher number of high-risk individuals
were identified using the European cutoff points of 63.7% in comparison with the ICS
cutoff points of 49.5%. The unadjusted hazard ratio (HR) was greatest in high-risk
individuals identified by the ICS cutoff points (HR = 1.54, 95% CI [1.33–1.79]) vs
European cutoff points (HR = 1.38, 95% [1.17–1.63]). There were no remarkable changes
after adjusting for differences in sex and age (HR = 1.58, 95% CI [1.36–1.84] vs HR = 1.44,
95% CI [1.22–1.71]) for the ICS and European cutoff points, respectively.
Conclusion
The threshold of TG/HDL ≥3.68 is the optimal cutoff point for predicting cardiovascular
events in Iranian individuals.
Keywords
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Article info
Publication history
Published online: October 24, 2015
Accepted:
October 14,
2015
Received:
May 14,
2015
Identification
Copyright
© 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.
