Background and aims: To determine whether triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C), which has been shown to be an indicator of the metabolic syndrome (MetS) and insulin resistance, can predict coronary heart disease (CHD) independently of total cholesterol (TC) and other risk factors in an Iranian population with a high prevalence of MetS and low HDL-C.
Methods and results: Between February 1999 and August 2001, 1824 men > or =40 years old, free of clinical cardiovascular diseases at baseline, were followed. Baseline measurements included serum level of TC, HDL-C, TG and risk factors for CHD including age, systolic and diastolic blood pressure, body mass index, waist circumference, diabetes, smoking and a family history of premature cardiovascular diseases. During a median follow up of 6.5 years until March 2007 (11,316 person-years at risk), a total of 163 new CHD events (27 fatal and 136 nonfatal) occurred. The prevalence of MetS in subjects with TG/HDL-C > or =6.9 (top quartile) reached 63.6% versus 3.0% in those with TG/HDL-C <2.8 (low quartile). According to a stepwise Cox proportional hazard model, including TG and TG/HDL-C quartiles, with TC and other risk factors, men in the top quartile of TG/HDL-C relative to the first quartile had a significant hazard ratio (HR) of 1.75 (95% CI, 1.02-3.00), while TG did not remain in the model.
Conclusion: The evaluation of TG/HDL-C ratio should be considered for CHD risk prediction in our male population with a high prevalence of MetS.