Association between maternal lipid profiles and lipid ratios in early to middle pregnancy as well as their dynamic changes and gestational diabetes mellitus.

BACKGROUND: Unfavourable lipid and glucose levels may play a crucial role in the pathogenesis of gestational diabetes mellitus (GDM). However, there is a lack of prospective studies on the relationship between lipid profiles, lipid ratios and GDM during pregnancy. AIMS: To prospectively investigate the relationship between lipid profile and lipid ratios in early and mid-pregnancy and their pattern of change from early to mid-pregnancy and the risk of GDM. METHODS: This nested case-control study was based on maternal and child healthcare hospitals from Fujian Province, China. We included pregnant women who delivered in the hospital from January 2021 to June 2023. Lipid profiles (TC, TG, ApoA1, ApoB, HDL-c, LDL-c) and fasting glucose were measured before 14 weeks of gestation and between 20 and 28 weeks of gestation, and lipid ratios (triglyceride glucose index, TG/HDL-c and TC/HDL-c) was constructed. Logistic regression was used to assess the relationship between lipid profile, lipid ratios and GDM. RESULTS: Of 1586 pregnant women, 741 were diagnosed with GDM. After adjusting for potential confounders, TG, ApoA1, ApoB, LDL-c, triglyceride glucose index, TG/HDL-c, and TC/HDL-c in early pregnancy were positively associated with the risk of GDM (odds ratios [95% CI] for extreme interquartile comparisons were 2.040 (1.468-2.843), 1.506 (1.091-2.082), 1.529 (1.110-2.107), 1.504 (1.086-2.086), 1.952 (1.398-2.731), 2.127 (1.526-2.971), and 2.370 (1.700-3.312), all trend P < 0.05). HDL-c was negatively associated with the risk of GDM (0.639: 0.459-0.889, trend P all less than 0.05). Similarly, in mid-pregnancy, lower levels of HDL-c, higher levels of triglyceride glucose index, TG/HDL-c ratio, and TC/HDL-c ratio were associated with increased risk of GDM (all trends P < 0.05). Stably high levels (both ≥ median for early and mid-pregnancy) of triglyceride glucose index, TG/HDL-c and TC/HDL-c were associated with increased risk of GDM (OR [95% CI]: 2.369 (1.438-3.940), 1.588 (1.077-2.341), 1.921 (1.309-2.829), respectively). The opposite was true for HDL-c, where stable high levels were negatively associated with GDM risk (OR [95% CI]: 0.599 (0.405-0.883)). CONCLUSION: Increases in triglyceride glucose index, TG/HDL-c ratio, and TC/HDL-c ratio in early and mid-pregnancy, as well as their stable high levels from early to mid-pregnancy, are associated with a higher risk of GDM. In contrast, increased levels of HDL-c, both in early and mid-pregnancy, and their stable high levels from early to mid-pregnancy were associated with a lower risk of GDM. That highlighted their possible clinical relevance in identifying those at high risk of GDM.

Circulating Metabolome and White Matter Hyperintensities in Women and Men.

BACKGROUND: White matter hyperintensities (WMH), identified on T2-weighted magnetic resonance images of the human brain as areas of enhanced brightness, are a major risk factor of stroke, dementia, and death. There are no large-scale studies testing associations between WMH and circulating metabolites. METHODS: We studied up to 9290 individuals (50.7% female, average age 61 years) from 15 populations of 8 community-based cohorts. WMH volume was quantified from T2-weighted or fluid-attenuated inversion recovery images or as hypointensities on T1-weighted images. Circulating metabolomic measures were assessed with mass spectrometry and nuclear magnetic resonance spectroscopy. Associations between WMH and metabolomic measures were tested by fitting linear regression models in the pooled sample and in sex-stratified and statin treatment-stratified subsamples. Our basic models were adjusted for age, sex, age×sex, and technical covariates, and our fully adjusted models were also adjusted for statin treatment, hypertension, type 2 diabetes, smoking, body mass index, and estimated glomerular filtration rate. Population-specific results were meta-analyzed using the fixed-effect inverse variance-weighted method. Associations with false discovery rate (FDR)-adjusted P values (PFDR)<0.05 were considered significant. RESULTS: In the meta-analysis of results from the basic models, we identified 30 metabolomic measures associated with WMH (PFDR<0.05), 7 of which remained significant in the fully adjusted models. The most significant association was with higher level of hydroxyphenylpyruvate in men (PFDR.full.adj=1.40×10-7) and in both the pooled sample (PFDR.full.adj=1.66×10-4) and statin-untreated (PFDR.full.adj=1.65×10-6) subsample. In men, hydroxyphenylpyruvate explained 3% to 14% of variance in WMH. In men and the pooled sample, WMH were also associated with lower levels of lysophosphatidylcholines and hydroxysphingomyelins and a larger diameter of low-density lipoprotein particles, likely arising from higher triglyceride to total lipids and lower cholesteryl ester to total lipids ratios within these particles. In women, the only significant association was with higher level of glucuronate (PFDR=0.047). CONCLUSIONS: Circulating metabolomic measures, including multiple lipid measures (eg, lysophosphatidylcholines, hydroxysphingomyelins, low-density lipoprotein size and composition) and nonlipid metabolites (eg, hydroxyphenylpyruvate, glucuronate), associate with WMH in a general population of middle-aged and older adults. Some metabolomic measures show marked sex specificities and explain a sizable proportion of WMH variance.

Evaluation of the value of conventional and unconventional lipid parameters for predicting the risk of diabetes in a non-diabetic population.

BACKGROUND: Conventional and unconventional lipid parameters are associated with diabetes risk, the comparative studies on lipid parameters for predicting future diabetes risk, however, are still extremely limited, and the value of conventional and unconventional lipid parameters in predicting future diabetes has not been evaluated. This study was designed to determine the predictive value of conventional and unconventional lipid parameters for the future development of diabetes. METHODS: The study was a longitudinal follow-up study of 15,464 participants with baseline normoglycemia. At baseline, conventional lipid parameters such as low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) were measured/calculated, and unconventional lipid parameters such as non-HDL-C, remnant cholesterol (RC), LDL/HDL-C ratio, TG/HDL-C ratio, non-HDL/HDL-C ratio, TC/HDL-C ratio and RC/HDL-C ratio were calculated. Hazard ratio (HR) and 95% confidence interval (CI) were estimated by Cox proportional hazard regression adjusting for demographic and diabetes-related risk factors. The predictive value and threshold fluctuation intervals of baseline conventional and unconventional lipid parameters for future diabetes were evaluated by the time-dependent receiver operator characteristics (ROC) curve. RESULTS: The incidence rate of diabetes was 3.93 per 1000 person-years during an average follow-up period of 6.13 years. In the baseline non-diabetic population, only TG and HDL-C among the conventional lipid parameters were associated with future diabetes risk, while all the unconventional lipid parameters except non-HDL-C were significantly associated with future diabetes risk. In contrast, unconventional lipid parameters reflected diabetes risk better than conventional lipid parameters, and RC/HDL-C ratio was the best lipid parameter to reflect the risk of diabetes (HR: 6.75, 95% CI 2.40-18.98). Sensitivity analysis further verified the robustness of this result. Also, time-dependent ROC curve analysis showed that RC, non-HDL/HDL-C ratio, and TC/HDL-C ratio were the best lipid parameters for predicting the risk of medium-and long-term diabetes. CONCLUSIONS: Unconventional lipid parameters generally outperform conventional lipid parameters in assessing and predicting future diabetes risk. It is suggested that unconventional lipid parameters should also be routinely evaluated in clinical practice.

Effects of dietary carbohydrate/lipid ratios on non-specific immune responses, antioxidant capacity, hepatopancreas and intestines histology, and expression of TLR-MAPK/NF-κB signaling pathway-related genes of Procambarus clarkii.

To investigate the effects of dietary carbohydrate/lipid (CHO: L) ratios on non-specific immune responses, antioxidant capacity, and expression of TLR-MAPK/NF-κB signaling pathway-related genes of red swamp crayfish (Procambarus clarkii). Four isonitrogenous and isoenergetic diets containing different CHO: L ratios were formulated. The results showed that the group with a CHO: L ratio of 5.94 had better growth performance (P < 0.05). The highest T-AOC, CAT, and SOD activities and the lowest MDA content in hemolymph and hepatopancreas were observed in the group with a CHO: L ratio of 5.94 (P < 0.05). The lowest activities of ALT, AST, ACP, AKP, and ALB in the hemolymph were observed in CHO: L ratio 5.94 group (P < 0.05), while the highest LZM activity, TP, and GLB content were observed in CHO: L 5.94 group (P < 0.05). The highest mRNA expression levels of tlr3, myd88, and mapk3, and the lowest mRNA expression levels of nf-kb α, nf-kb ß, nf-kb p105, and traf6 were observed in the CHO: L of 5.94 group (P < 0.05). The highest mRNA expression levels of immune-related genes were observed in the CHO: L of 5.94 group (P < 0.05). Overall, these results indicated that the optimum dietary CHO: L ratio is vital in promoting growth and enhancing antioxidants and immunity to maintain red swamp crayfish's intestinal and hepatopancreas health status. In conclusion, the diets with a CHO:L ratio of 5.94 (approximately 36.23% carbohydrate and 6.10% lipid) is optimal for juvenile red swamp crayfish's physiological condition and health status.

The relationship between body mass index, blood pressure, and atherosclerosis risk factors in type 1 and 2 diabetic patients from northwestern Algeria.

Objective. The present work was framed to study the relationship between body mass index (BMI), blood pressure, and atherosclerosis risk factors on the basis of three lipid ratios in type 1 (T1D) and type 2 diabetic (T2D) patients. Methods. A prospective, comparative, and cross-sectional study was performed at the level of three health facilities in Sidi-Bel-Abbes city (north-western Algeria). Anthropometric parameters, systolic and diastolic blood pressures, and lipid profiles were assessed in adults T1D and T2D patients over a period of eleven months. Individual atherogenic risk factors were estimated based on lipid ratios in relation to corpulence and hypertension. Results. From the total 237 adult diabetic patients, 90 T1D and 147 T2D ones were involved in the study. Total cholesterol (TC)/high-density lipoprotein (HDL) and triglycerides (TG)/HDL ratios were significantly higher in normal weight T2D comparing to T1D. The TC/HDL ratio was significantly higher (p=0.046) in obese men. Nevertheless, no significant differences were revealed in low-density lipoprotein (LDL)/HDL ratio between T1D and T2D patients. Higher TC/HDL ratios were observed in T2D patients (males and females) with normal blood pressure (systolic blood pressure, SBP ≤13.5 mmHg and diastolic blood pressure, DBP ≤8 mmHg) comparing to T1D patients. Likewise, the LDL/HDL ratio was significantly higher in T2D men with normal DBP (p=0.044). Conclusion. The lipid ratios constitute good indices while managing diabetes. It is also recommended to screen T1D and T2D patients for hypertension, dyslipidemia, and obesity and initiate the management at early stages to prevent the related complications, such as atherosclerosis, as a priority.

The role of non-HDL cholesterol and atherogenic indices in predicting poor glycemic control among type 2 diabetic patients in Basrah, Iraq.

BACKGROUND: Dyslipidaemia is frequently associated with type 2 diabetes mellitus and it is the major contributor to cardiovascular diseases among type 2 diabetic patients. Despite the fact that several researches have proven the association between glycemic control and dylipidemia in type 2 diabetic patients, the results are rather varied. OBJECTIVES: The aim of the study is to investigate the clinical relevance of lipid profile as predictive biochemical model for glycemic control in type 2 diabetic patients. METHODS: A cross-sectional study including 329 type 2 diabetic patients was done in Al-Sadr Teaching Hospital, Basrah, Iraq. Brief history, clinical examination, and investigations including fasting plasma glucose, lipid profile, and glycosylated hemoglobin were done. HbA1c >7% was considered as poor glycemic control. Receiver operator characteristics (ROC) analysis and logistic regression analysis were used to evaluate the association between lipid profile and HbA1c level. RESULTS: Out of 329 diabetic patients, 278 (84.5%) showed poor glycemic control. The univariate analysis showed a significant association between lipid parameters and poor glycemic control. ROC and logistic regression analyses found that TC/HDL (OR: 4.94; 95% CI: 2.35-10.41; P < 0.001) and LDL/HDL (OR: 4.63; 95% CI: 1.96-10.98; P < 0.001) were the only significant independent predictors of glycemic control, while non-HDL cholesterol was a weak predictor of glycemic control despite its significant association (P = 0.02). CONCLUSION: LDL/HDL and TC/HDL ratios reveal promising indicators for predicting glycemic control in type 2 diabetic patients.

The association of lipid ratios with hyperuricemia in a rural Chinese hypertensive population.

BACKGROUND: Current studies support lipid ratios [the total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio; the triglyceride (TG)/HDL-C ratio; the low-density lipoprotein cholesterol (LDL -C)/HDL-C ratio; and non-HDL-C] as reliable indicators of cardiovascular disease, stroke, and diabetes. However, whether lipid ratios could serve as markers for hyperuricemia (HUA) remains unclear due to limited research. This study aimed to explore the association between lipid ratios and HUA in hypertensive patients. METHODS: The data from 14,227 Chinese hypertensive individuals in the study were analyzed. Multiple logistic regression analysis and smooth curve fitting models examined the relationship between lipid ratios and HUA. RESULTS: The results showed positive associations between the lipid ratios and HUA (all P < 0.001). Furthermore, lipid ratios were converted from continuous variables to tertiles. Compared to the lowest tertile, the fully adjusted ORs (95 % CI) of the TC/HDL-C ratio, the TG/HDL-C ratio, the LDL-C/HDL-C ratio, and non-HDL-C in the highest tertile were 1.79 (1.62, 1.99), 2.09 (1.88, 2.32), 1.67 (1.51, 1.86), and 1.93 (1.74, 2.13), respectively (all P < 0.001). CONCLUSIONS: The study suggested that high lipid ratios (TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio, and non-HDL-C) are associated with HUA in a Chinese hypertensive population. This study's findings further expand the scope of the application of lipid ratios. These novel and essential results suggest that lipid ratio profiles might be potential and valuable markers for HUA. TRIAL REGISTRATION: No. ChiCTR1800017274. Registered July 20, 2018.

Composition-function analysis of HDL subpopulations: influence of lipid composition on particle functionality.

The composition-function relationship of HDL particles and its effects on the mechanisms driving coronary heart disease (CHD) is poorly understood. We tested the hypothesis that the functionality of HDL particles is significantly influenced by their lipid composition. Using a novel 3D-separation method, we isolated five different-sized HDL subpopulations from CHD patients who had low preß-1 functionality (low-F) (ABCA1-dependent cholesterol-efflux normalized for preß-1 concentration) and controls who had either low-F or high preß-1 functionality (high-F). Molecular numbers of apoA-I, apoA-II, and eight major lipid classes were determined in each subpopulation by LC-MS. The average number of lipid molecules decreased from 422 in the large spherical α-1 particles to 57 in the small discoid preß-1 particles. With decreasing particle size, the relative concentration of free cholesterol (FC) decreased in α-mobility but not in preß-1 particles. Preß-1 particles contained more lipids than predicted; 30% of which were neutral lipids (cholesteryl ester and triglyceride), indicating that these particles were mainly remodeled from larger particles not newly synthesized. There were significant correlations between HDL-particle functionality and the concentrations of several lipids. Unexpectedly, the phospholipid:FC ratio was significantly correlated with large-HDL-particle functionality but not with preß-1 functionality. There was significant positive correlation between particle functionality and total lipids in high-F controls, indicating that the lipid-binding capacity of apoA-I plays a major role in the cholesterol efflux capacity of HDL particles. Functionality and lipid composition of HDL particles are significantly correlated and probably both are influenced by the lipid-binding capacity of apoA-I.

Importance of lipid ratios for predicting intracranial atherosclerotic stenosis.

BACKGROUND: This study aims to investigate the association of lipid ratios with intracranial atherosclerotic stenosis (ICAS) in a Chinese population. METHODS: This cross-sectional study included 658 consecutive patients with ischemic stroke. Intracranial and extracranial arteries were evaluated for atherosclerotic stenosis using digital subtraction angiography or computed tomography angiography. Lipid ratios [total cholesterol (TC)/high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG)/HDL-C, low-density lipoprotein-cholesterol (LDL-C)/HDL-C, non-high-density lipoprotein-cholesterol (non-HDL-C)/HDL-C, remnant cholesterol (RC)/HDL-C, apolipoprotein B (apo B)/apolipoprotein A-I (apo A-I), and apo B/HDL-C] were calculated. RESULTS: The TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C, apo B/HDL-C and apo B/apo A-I ratios (all P < 0.05) were significantly associated with ICAS but not with extracranial atherosclerotic stenosis after adjustment for confounding factors. Receiver operating characteristic (ROC) curves analysis revealed that the apo B/apo A-I ratio had the largest area under the ROC curve (AUC) among lipid levels alone and for lipid ratios (AUC = 0.588). Lipid ratios had higher AUC values than those for lipid levels alone for the identification of ICAS. CONCLUSION: The TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C apo B/HDL-C, and apo B/apo A-I ratios were significantly related to ICAS risk. Compared with the other variables tested, the apo B/apo A-I ratio appeared to be a better discriminator for identifying ICAS risk in stroke patients.

Nutritional regulation of pyruvate kinase and phosphoenolpyruvate carboxykinase at the enzymatic and molecular levels in cobia Rachycentron canadum.

Despite being a carnivorous fish species, cobia (Rachycentron canadum) can utilize high levels of dietary carbohydrate (up to 360 g kg-1). By contrast, rainbow trout (also carnivorous) cannot, due to the absence of molecular induction of glycolytic enzyme and inhibition of gluconeogenic enzyme gene expressions such as pyruvate kinase (PK) and phosphoenolpyruvate carboxykinase (PEPCK). We hypothesized that this phenomenon is species-specific and will not be observed in cobia. Our results show that, at the molecular level, the mRNA abundance of the important glycolytic (PK) and gluconeogenic (PEPCK) enzymes in cobia liver are regulated by dietary carbohydrate-to-lipid (CHO:L) ratios and nutritional status (fed, unfed, and refed). Significantly upregulated hepatic PK and depressed PEPCK gene expressions were observed when the fish were fed with an increasing CHO/L-ratio diet or were refed. However, in contrast to gene expression, there was no significant effect of dietary CHO/L ratios on PK enzyme activity. The decrease in PEPCK activity was significantly found between low CHO/L ratio and high CHO/L ratio diets, whereas the moderate CHO/L ratio group showed intermediate values. But PEPCK activity appeared to be independent of nutritional status. These results suggest that nutritional regulation is obvious, at least at the molecular level, in the key hepatic enzymes (PK and PEPCK) of the glucose metabolism pathway, in response to different dietary CHO/L ratios and to the transition from being starved to fed. Determining whether other key enzymes involved in hepatic glucose metabolism contribute to glucose tolerance in cobia is necessary for further investigation of this phenomenon at the enzymatic and molecular levels.

Relation of four nontraditional lipid profiles to diabetes in rural Chinese H-type hypertension population.

BACKGROUND: Mounting evidence suggested that nontraditional lipid profiles have been recognized as a reliable indicator for unfavorable cardiovascular events. The purpose of this study was to explore the role of nontraditional lipid profiles as potential clinical indices for the assessment of prevalent diabetes in rural Chinese H-type hypertension population. METHODS: During 2012 to 2013, we conducted a large cross-sectional study of 2944 H-type hypertension participants (≥35 years of age) from rural areas in northeast China. Subjects underwent accurate assessment of lipid profiles, fasting plasma glucose (FPG), homocysteine (Hcy) according to standard protocols. RESULTS: The proportion of diabetes showed a graded and linear increase across the quartiles for all four nontraditional lipid parameters. Nontraditional lipid variables were independent determinants of FPG, and its correlation for TG/HDL-C was strongest, whether potential confounders were adjusted or not. Multivariable logistic regression analysis established that the highest triglycerides (TG)/ high-density lipoprotein cholesterol (HDL-C) quartile manifested the largest ORs of prevalent diabetes (OR: 3.275, 95%CI: 2.109-5.087) compared with the lowest quartile. The fully adjusted ORs (95%CI) were 2.753 (1.783-4.252), 2.178 (1.415-2.351), 1.648 (1.097-2.478) for the top quartile of total cholesterol (TC)/HDL-C, low-density lipoprotein cholesterol (LDL-C)/HDL-C, and non-high-density lipoprotein cholesterol (non-HDL-C), respectively. On the basis of the area under receiver-operating characteristic curve (AUC), TG/HDL-C showed the optimal discriminating power for diabetes (AUC: 0.684, 95% CI: 0.650-0.718). CONCLUSIONS: Nontraditional lipid profiles (TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C) were all consistently and independently correlated with prevalent diabetes among the H-type hypertension population in rural China. TG/HDL-C was prone to be more profitable in assessing the risk of prevalent diabetes and should be encouraged as an effective clinical tool for monitoring and targeted intervention of diabetes in H-type hypertension adults.

Utility of serum lipid ratios for predicting incident type 2 diabetes: the Isfahan Diabetes Prevention Study.

BACKGROUND: In this study, we evaluate the association between triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio and total cholesterol (TC) to HDL (TC/HDL) ratio and the risks of type 2 diabetes (T2D) in an Iranian high-risk population. METHODS: We analysed 7-year follow-up data (n = 1771) in non-diabetic first-degree relatives of consecutive patients with T2D 30-70 years old. The primary outcome was the diagnosis of T2D based on repeated oral glucose tolerance tests. We used Cox proportional hazard models to estimate hazard ratio for incident T2D across tertiles of TG/HDL and TC/HDL ratios and plotted a receiver operating characteristic (ROC) curve to assess discrimination. RESULTS: The highest tertile of TG/HDL and TC/HDL ratios compared with the lowest tertile was not associated with T2D in age- and gender-adjusted models (HR 0.99, 95% CI: 0.88, 1.11 for TG/HDL ratio and 1.10, 95% CI: 0.97, 1.23 for TC/HDL ratio). Further adjustment for waist circumference or body mass index, fasting plasma glucose, and low-density lipoprotein cholesterol did not appreciably alter the hazard ratio compared with the age- and gender-adjusted model. The area under the ROC curve for TG/HDL ratio was 57.7% (95% CI: 54.0, 61.5) and for TC/HDL ratio was 55.1% (95% CI: 51.2, 59.0). CONCLUSIONS: TG/HDL and TC/HDL ratios were not robust predictors of T2D in high-risk individuals in Iran. Copyright © 2015 John Wiley & Sons, Ltd.

The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio as a predictor of insulin resistance but not of ß cell function in a Chinese population with different glucose tolerance status.

BACKGROUND: Triglyceride/high-density lipoprotein-cholesterol (TG/HDL-C) ratio was a surrogate marker of IR; however, the relationship of TG/HDL-C with IR might vary by ethnicity. This study aims to investigate whether lipid ratios-TG/HDL-C, cholesterol/high-density lipoprotein-cholesterol (TC/HDL-C) ratio, low-density lipoprotein-cholesterol/high-density lipoprotein-cholesterol (LDL-C/HDL-C)) could be potential clinical markers of insulin resistance (IR) and ß cell function and further to explore the optimal cut-offs in a Chinese population with different levels of glucose tolerance. METHODS: Four hundred seventy-nine subjects without a history of diabetes underwent a 75 g 2 h Oral Glucose Tolerance Test (OGTT). New-onset diabetes (n = 101), pre-diabetes (n = 186), and normal glucose tolerance (n = 192) were screened. IR was defined by HOMA-IR > 2.69. Based on indices (HOMA-ß, early-phase disposition index [DI30], (ΔIns30/ΔGlu30)/HOMA-IR and total-phase index [DI120]) that indicated different phases of insulin secretion, the subjects were divided into two groups, and the lower group was defined as having inadequate ß cell compensation. Logistic regression models and accurate estimates of the areas under receiver operating characteristic curves (AUROC) were obtained. RESULTS: In all of the subjects, TG/HDL, TC/HDL-C, LDL-C/HDL-C, and TG were significantly associated with IR. The AUROCs of TG/HDL-C and TG were 0.71 (95 % CI: 0.66-0.75) and 0.71 (95 % CI: 0.65-0.75), respectively. The optimal cut-offs of TG/HDL-C and TG for IR diagnosis were 1.11 and 1.33 mmol/L, respectively. The AUROCs of TC/HDL-C and LDL-C/HDL-C were 0.66 and 0.65, respectively, but they were not acceptable for IR diagnosis. TG/HDL-C,LDL-C/HDL-C and TG were significantly associated with HOMA-ß, but AUROCs were less than 0.50; therefore, the lipid ratios could not be predictors of basal ß cell dysfunction. None of the lipid ratios was associated with early-phase insulin secretion. Only TG/HDL-C and TG were significantly correlated with total-phase insulin secretion, but they also were not acceptable predictors of total-phase insulin secretion (0.60 < AUROC < 0.70). CONCLUSIONS: In a Chinese population with different levels of glucose tolerance, TG/HDL-C and TG could be the predictors of IR. The lipid ratios could not be reliable makers of ß cell function in the population.

Use of lipid ratios to predict vascular target organ damage in youth.

BACKGROUND: Elevated lipid levels are risk factors for early atherosclerosis. Lipid ratios have emerged as potentially stronger predictors of adverse cardiovascular changes and atherogenic cholesterol. Risk stratification in youth with obesity or type 2 diabetes may be improved by using lipid ratios. We sought to determine if lipid ratios would identify abnormalities in arterial structure and stiffness in adolescents and young adults. METHODS: A total of 762 youth aged 10-24 years had laboratory, anthropometric, blood pressure, and carotid intima-media thickness and arterial stiffness data collected. Subjects were stratified into tertiles (low, mid, high) of lipid ratios and non-high-density lipoprotein cholesterol (HDL-C). Vascular outcomes by tertile were assessed by analyses of variance. General linear models were constructed for each lipid value and included demographics, risk factors, and vascular measures. Correlations between lipid markers, vascular measures, and low-density lipoprotein (LDL) particle size and number were conducted. RESULTS: There was a progressive increase in arterial thickness and stiffness across all three lipid ratios and non-HDL-C. The triglyceride to HDL-C (TG/HDL-C) ratio remained an independent predictor of arterial thickness and stiffness after adjusting for other cardiovascular risk factors. TG/HDL-C had the highest correlations with arterial stiffness and small, dense LDL. CONCLUSIONS: Arterial stiffness is increased in youth with high lipid ratios with TG/HDL-C being the most consistent marker of vascular changes. These data suggest that identification of high TG/HDL-C in these individuals may lead to earlier intervention to prevent atherosclerotic cardiovascular disease.

The association between lipid parameters and erectile dysfunction: a two-sample Mendelian randomization and case-control study.

PURPOSE: Lipid parameters have been shown to have significant predictive value for cardiovascular disease, but few studies have evaluated their correlation with erectile dysfunction (ED) in young men. METHODS: The case-control study encompassed 186 young ED patients (ages 20-40) and 186 healthy controls. Lipid parameters, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), TC/HDL ratio, TG/HDL ratio, and LDL-C/HDL-C ratio, were assessed in all participants. The International Index of Erectile Function (IIEF-5) scores were collected for all participants to evaluate erectile status. Multivariate logistic regression analysis was utilized to appraise the association of lipid-related parameters with ED. Single-nucleotide polymorphisms (SNPs) significantly correlated with lipid parameters (TC, TG, LDL-C, HDL-C) were selected from genome-wide association studies (GWAS) as instrumental variables (IV) (P < 5.0 × 10-8). Summary data for ED was gathered from a GWAS with a sample size of (n = 17,353 cases/28,210 controls). The inverse variance weighted (IVW) method was employed as the primary mendelian randomization (MR) analysis method to assess causal effects. Causal estimates were represented as odds ratios (OR) with 95% confidence intervals (CI). RESULTS: Results from the case-control study revealed that, when compared with the control group, levels of LDL-C, TG, UA, LDL-C/HDL-C, TG/HDL-C, and TC/HDL-C in the ED group were significantly elevated (P < 0.01), while HDL-C was significantly decreased (P < 0.01) in the ED group. Multivariate logistic regression analysis indicated LDL-C/HDL-C as a risk factor for both the incidence and severity of ED (P < 0.001). Two-sample MR analysis demonstrated no significant causal correlation between lipid parameters-LDL-C (OR, 0.98, 95% CI, 0.88-1.08, P = 0.616), HDL-C (OR, 1.07, 95% CI: 0.96-1.19, P = 0.249), TC (OR, 1.07, 95% CI, 0.96-1.18, P = 0.208), TG (OR, 0.98, 95% CI, 0.80-1.13, P = 0.579) -and an increased risk of ED (all P > 0.05). CONCLUSIONS: The case-control analysis ascertained a significant association between LDL-C, HDL-C, LDL-C/HDL-C, and ED and its severity. However, results from the MR study do not support a causal role of lipid parameters in ED.

Remnant cholesterol is more positively related to diabetes, prediabetes, and insulin resistance than conventional lipid parameters and lipid ratios: A multicenter, large sample survey.

BACKGROUND: Not many large-sample investigations are available that compare the potency of the relationship of remnant cholesterol (RC) and other lipid parameters with diabetes and prediabetes. The goals of our study are to discover the relationship between RC and prediabetes, diabetes, and insulin resistance (IR) and to investigate RC, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), TC/HDL-C, LDL-C/HDL-C, and TG/HDL-C, which are the lipid parameters that are most positively related to diabetes, prediabetes, and IR. METHODS: This research enrolled 36 684 subjects from China's eight provinces. We employed multiple logistic regression analysis for testing the relationship between lipid parameters and diabetes, prediabetes, and IR. RESULTS: After adjusting for potential confounders, and comparing the results with other lipid parameters, the positive relationship between RC and diabetes (odds ratio [OR] 1.417, 95% confidence interval [CI]: 1.345-1.492), prediabetes (OR 1.555, 95% CI: 1.438-1.628), and IR (OR 1.488, 95% CI: 1.404-1.577) was highest. RC was still related to diabetes, prediabetes, and IR even when TG <2.3 mmol/L (diabetes: OR 1.256, 95% CI: 1.135-1.390; prediabetes: OR 1.503, 95% CI: 1.342-1.684; and IR: OR 1.278, 95% CI: 1.140-1.433), LDL-C <2.6 mmol/L (diabetes: OR 1.306, 95% CI: 1.203-1.418; prediabetes: OR 1.597, 95% CI: 1.418-1.798; and IR: OR 1.552, 95% CI: 1.416-1.701), or HDL-C ≥1 mmol/L (diabetes: OR 1.456, 95% CI: 1.366-1.550; prediabetes: OR 1.553, 95% CI: 1.421-1.697; and IR: OR 1.490, 95% CI: 1.389-1.598). CONCLUSION: RC is more positively related to diabetes, prediabetes, and IR than conventional lipids and lipid ratios in the general population, the relationships between RC and diabetes, prediabetes, and IR are stable, even if HDL-C, LDL-C, or TG are at appropriate levels.

Serum lipid ratios as novel prognostic biomarkers for patients with locally advanced breast cancer treated with neoadjuvant therapy.

OBJECTIVES: To investigate the association between lipid ratios and survival outcomes in patients with locally advanced breast cancer (LABC) undergoing neoadjuvant chemotherapy. METHOD: This retrospective study included patients with LABC receiving neoadjuvant chemotherapy. Serum lipid levels were prospectively measured at baseline. Associations of triglyceride to total cholesterol (TG/TC), triglyceride to high-density lipoprotein (TG/HDL) and triglyceride to low-density lipoprotein (TG/LDL) ratios with prognosis were evaluated. RESULTS: Patients with high TG/TC (adjusted hazard ratio [aHR] = 2.47, 95% CI: 1.10, 5.56, p = 0.029), TG/HDL (aHR = 2.73, 95% CI: 1.16, 6.41, p = 0.021) and TG/LDL (aHR = 2.50, 95% CI: 1.11, 5.65, p = 0.027) ratios were more likely to experience disease-free survival (DFS) events. Subgroup analysis suggested that the prognostic impact of lipid ratios was more pronounced in patients with negative HER2 status or those at a high risk of recurrence (e.g. clinical stage III, Ki67 > 30%). Additionally, higher lipid ratios tended to indicate early DFS events (0 ~ 2 years) (TG/TC p = 0.021, TG/HDL p = 0.046, TG/LDL p < 0.001), and the TG/LDL ratio demonstrated the best predictive efficacy (TG/TC vs. TG/HDL vs. TG/LDL, 1-year AUC: 0.724 vs. 0.676 vs. 0.846, 2-year AUC: 0.653 vs. 0.638 vs. 0.708). CONCLUSION: Baseline serum TG/TC, TG/HDL and TG/LDL ratios were independent prognostic factors in patients with LABC undergoing neoadjuvant therapy. However, their utility in predicting the early DFS events warrants further investigation. CLINICAL TRIAL REGISTRATION: NCT05621564.

The predictive value of TyG and lipid ratios on the development of complications and hyperuricemia in patients with type 2 diabetes mellitus.

Investigate the predictive value of TyG and lipid ratios on the development of complications and HUA in patients with T2DM. A retrospective cross-sectional study involving 9488 T2DM patients was conducted. They were divided into HUA and NUA group base on SUA level and divided into with and without complications groups according to the diagnosis of the endocrinologist. Necessary information and biochemical parameters were recorded during outpatient visit. TyG index and lipid ratios were calculated, and statistical analysis was carried out to correlate the calculated values and HUA using SPSS version 26.0 for Windows. TyG and lipid ratios were significantly higher in T2DM with HUA or with complications than those with NUA or without complications (p < 0.05). Regression analysis adjusting for confounding factors found TyG (adjusted OR = 1.54; 95% CI: 1.31-1.82; p < 0.05), TG/HDL-C (adjusted OR = 1.21; 95% CI: 1.04-1.40; p < 0.05) and TC/HDL (adjusted OR = 1.36; 95% CI: 1.17-1.57; p < 0.05) was risk factor of HUA in T2DM patients. TyG (adjusted OR = 1.21; 95% CI: 1.02-1.44; p < 0.05), TG/HDL (adjusted OR = 1.19; 95% CI: 1.03-1.38; p < 0.05) and Apo A/Apo B (adjusted OR = 1.41; 95% CI: 1.26-1.58; p < 0.05) was risk factor of complications in T2DM patients. TyG, TG/HDL-C, and TC/HDL can be used as early sensitive target in the occurrence of HUA in T2DM patients and TyG was the most influential risk factor. TyG, TG/HDL-C, and Apo A/Apo B can be used as early sensitive target in the occurrence of complications in T2DM patients and Apo A/Apo B was the most influential risk factor.

Clinical and Diagnostic Value of High-Density Lipoprotein-Based Inflammatory Indices and Lipid Ratios in Young Adults with Schizophrenia.

Purpose: This study aimed to assess High-density Lipoprotein (HDL)-based Inflammatory Indices and lipid profile changes in antipsychotic-naive first-episode schizophrenia (AN-FES) patients, chronic schizophrenia (CS) patients, and explore the clinical and predictive value of these parameters for schizophrenia. Patients and Methods: The study cohort included 52 AN-FES patients, 46 CS patients, and 52 healthy controls (HCs), with an average age of 24 years. Upon admission, patients underwent complete blood count and lipid profile analyses. Various ratios were calculated, including neutrophil-to-HDL (NHR), monocyte-to-HDL (MHR), lymphocyte-to-HDL (LHR), and platelet-to-HDL (PHR), as well as lipid ratios like triglycerides/HDL, non-HDL/HDL, total cholesterol/HDL, and low-density lipoprotein/HDL. For the AN-FES group, these evaluations were repeated after two months of treatment with atypical antipsychotics. Statistical analyses included correlation analysis, Receiver Operating Characteristic (ROC) curve analysis, and univariate and multivariate regression. Results: Compared to HCs, CS patients exhibited significantly higher MHR and NHR values, while AN-FES patients showed elevated levels of PHR, MHR, and NHR. No significant differences were observed in LHR or lipid ratios across the three groups. In the AN-FES cohort, MHR correlated positively with neutrophil counts, and NHR with monocyte counts. Additionally, white blood cell counts were positively associated with both MHR and NHR. Following treatment, NHR levels decreased, whereas TG/HDL ratios increased, with MHR and PHR remaining elevated. ROC analysis highlighted NHR as the most diagnostically valuable parameter (AUC = 0.799), with 86.5% specificity at an optimal cutoff of 3.534, outperforming MHR and PHR. Regression analyses recognized NHR (OR=2.225) as an independent risk factor for schizophrenia, even after adjusting for confounders. Conclusion: HDL-based inflammatory indices, particularly NHR, may serve as valuable diagnostic and prognostic markers in young adults with schizophrenia, even though significant alterations in lipid ratios were not observed in this demographic.

Association of Serum Bilirubin and Lipid Ratio (Total Cholesterol/(High-Density Lipoprotein + Bilirubin)) in Coronary Artery Disease: A Case-Control Study at a Tertiary Care Hospital.

INTRODUCTION: Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide, particularly in industrialized societies. The aim of the study was to investigate the potential association between lipid ratios and CAD risk and explore their diagnostic performance compared to traditional lipid profile parameters and total bilirubin levels. METHODS: A total of 50 cases with CAD and 50 controls without CAD were recruited. Clinical data, including age, gender, comorbidities, blood pressure, glucose levels, smoking history, cardiovascular examination findings, and electrocardiogram (ECG) results, were collected. Lipid profile parameters (total cholesterol (TC), high-density lipoproteins (HDL), low-density lipoproteins (LDL), and triglycerides) and total bilirubin levels were measured. Lipid ratios, including cholesterol (CHO)/HDL, LDL/HDL, HDL + bilirubin, LDL/(HDL + bilirubin), and TC/(HDL + bilirubin), were calculated. RESULTS: Significant differences were observed between cases and controls for comorbidities, including hypertension, diabetes, and obesity (p = 0.025), and ECG findings (p < 0.001). Lipid profile parameters were significantly different between cases and controls (p < 0.001). Lipid ratios also showed significant differences (p < 0.001) and demonstrated high sensitivity and specificity in identifying CAD. Among the ratios, LDL/HDL had the highest area under the curve (AUC) of 0.977, followed by CHO/HDL (AUC = 0.913), LDL/(HDL + bilirubin) (AUC = 0.903), and TC/(HDL + bilirubin) (AUC = 0.807). Total bilirubin alone did not show a significant association with CAD (AUC = 0.590, p = 0.119). CONCLUSION: Lipid ratios (CHO/HDL, LDL/HDL, HDL + bilirubin, LDL/(HDL + bilirubin), and TC/(HDL + bilirubin)) showed promising potential as predictors of CAD, outperforming traditional lipid profile parameters and total bilirubin levels. These ratios could serve as valuable diagnostic tools in identifying individuals at higher risk of CAD.