Triglyceride to HDL-C ratio and increased arterial stiffness in children, adolescents, and young adults

• Published in: Pediatrics (Evanston) 2013-04, Vol.131 (4), p.e1082-e1090
• Main Authors: Urbina, Elaine M, Khoury, Philip R, McCoy, Connie E, Dolan, Lawrence M, Daniels, Stephen R, Kimball, Thomas R
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Arteriosclerosis - blood; Arteriosclerosis - diagnosis; Arteriosclerosis - etiology; Arteriosclerosis - physiopathology; Atherosclerosis; Biomarkers - blood; Cardiovascular diseases; Care and treatment; Child; Children & youth; Cholesterol; Cholesterol, HDL - blood; Cross-Sectional Studies; Diagnosis; Dyslipidemias; Female; Health aspects; Humans; Linear Models; Lipids; Lipoproteins; Male; Multivariate Analysis; Obesity - blood; Obesity - complications; Obesity - physiopathology; Pediatrics; Risk Assessment; Risk Factors; Teenagers; Triglycerides - blood; Vascular Stiffness; Young Adult; Youth
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2012-1726

Lipid levels are linked to early atherosclerosis. Risk stratification may be improved by using triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), which relates to arterial stiffness in adults. We tested whether TG/HDL-C was an independent predictor of arterial stiffness in youth. Subjects 10 to 26 years old (mean 18.9 years, 39% male, 56% non-Caucasian, n = 893) had laboratory, anthropometric, blood pressure, and arterial stiffness data collected (brachial distensibility, augmentation index, carotid-femoral pulse-wave velocity). Subjects were stratified into tertiles of TG/HDL-C (low, n = 227; mid, n = 288; high, n = 379). There was a progressive rise in cardiovascular (CV) risk factors and arterial stiffness across TG/HDL-C ratio. The high TG/HDL-C ratio group had the stiffest vessels (all P < .03 by analysis of variance). TG/HDL-C as a continuous variable was an independent determinant of brachial distensibility in CV risk factor adjusted model and for carotid-femoral pulse-wave velocity in obese subjects, with trend for higher augmentation index. TG/HDL-C, an estimate of small, dense low-density lipoprotein cholesterol, is an independent determinant of arterial stiffness in adolescents and young adults, especially in obese youth. These data suggest that use of TG/HDL-C may be helpful in identifying young adults requiring aggressive intervention to prevent atherosclerotic CV diseases.