Background: The superiority of TG/HDL-C and LDL-C/HDL-C ratios in predicting CVD risk is a matter of debates. Thus, the objective of this study was to compare TG/HDL-C and LDL-C to HDL-C ratios in predicting the risk of CVD events.
Methods: In a population-based cross-sectional study, 567 representative participants aged 40 years or older were entered in the study in Babol, North of Iran. The demographic data, anthropometric measures, and the cardio metabolic risk factors were measured. The individual risk of CVD events was assessed by ACC/AHA risk model. ROC analysis was applied to estimate the diagnostic accuracy and the optimal cut-off points of TG/HDL-C and LDL-C/HDL-C ratios.
Results: The AUC of TG/HDL-C and LDL-C/HDL-C ratios were rather similar and both parameters significantly predicted CVD risk in men comparably, and TG/HDL-C at optimal cutoff point of 3.6 produced 75% sensitivity and 39% specificity. However,in women TG/HDL-C with AUC of 0.65( p=0.091) at optimal cutoff value of 3.4 produced a sensitivity of 82% and specificity of 51%. The LDL-C/HDL-C ratio had no discriminative ability in predicting CVD risk in women. The adjusted OR of TG/HDL-C at 2nd quartile was significant (OR=3.22, 95% CI:1.25-8.29) and a greater association was found with 3rd and 4rth quartiles.
Conclusion: Both TG/HDL-C and LDL-C/HDL-C ratios comparably predict CVD risk in men, whereas in women only TG/ HDL-C is a significant predictor but not LDL-C/HDL-C.
Keywords: Cardiovascular risk; HDL- cholesterol; LDL-cholesterol; LDL-cholesterol/HDL-cholesterol ratio; Triglyceride; Triglyceride/HDL-cholesterol ratio.
Conflict of interest statement
The authors declare that there is no conflict of interest.
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- Ford ES. The metabolic syndrome and mortality from cardiovascular disease and all causes: findings from the National Health and Nutrition Examination Survey II Mortality Study. Atherosclerosis. 2004;173:309–14. - PubMed
- Lakka HM, Laakasonen DF, Laaka TA, et al. The metabolic syndrome and total cardiovascular disease mortality in middle age men. JAMA. 2002;288:2709–16. - PubMed
- Hajian-Tilaki KO, Jalali F. Changing patterns of cardiovascular risk factors in hospitalized patients with acute myocardial infarction in Babol, Iran. Kuwait Med J. 2007;39:243–7.
- Ministry of Health, Medical Education of Iran. A report of survey of Iranian health. Tehran. 1997;p