Tohoku J. Exp. Med., 2022 January, 256(1)

Comparison of Lipid-Derived Markers for Metabolic Syndrome in Youth: Triglyceride/HDL Cholesterol Ratio, Triglyceride-Glucose Index, and non-HDL Cholesterol

Jieun Lee,1 Young Ah Lee,2,3 Seong Yong Lee,2,4 Choong Ho Shin2,3 and Jae Hyun Kim2,5

1Departmentn of Pediatrics, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
2Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
3Department of Pediatrics, Seoul National University Children‘s Hospital, Seoul National University College of Medicine, Seoul, Korea
4Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
5Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea

Triglyceride/high-density lipoprotein (HDL) cholesterol ratio (TG/HDL-C), triglyceride-glucose index (TyG), and non-HDL cholesterol level (non-HDL-C) have been proposed as surrogate markers for predicting metabolic syndrome (MetS). This study investigated whether these lipid-derived surrogate markers can predict MetS in Korean children and adolescents. Data from 1,814 participants were analyzed from the 2013-2016 Korean National Health and Nutrition Examination Survey. MetS was defined using three sets of criteria: Cook et al. (MetS1), de Ferranti et al. (MetS2), and the International Diabetes Federation (MetS3). The prevalence of MetS1, MetS2, and MetS3 was 4.6%, 11.3%, and 2.7%, respectively. In receiver operating characteristic curve analysis of MetS and lipid-derived surrogate markers, TG/HDL-C (0.937 for MetS1, 0.894 for MetS2, and 0.897 for MetS3) had the largest area under the curve (AUC), followed by TyG (0.906 for MetS1, 0.864 for MetS2, and 0.887 for MetS3), and non-HDL-C (0.752 for MetS1, 0.708 for MetS2, and 0.703 for MetS3) (all P < 0.001). The cutoff values for detecting MetS with TG/HDL-C, TyG, and non-HDL-C were 2.64, 8.52, and 111.6 for MetS1; 2.23, 8.47, and 110.7 for MetS2; and 2.64, 8.74, and 110.8 for MetS3, respectively. In conclusion, TG/HDL-C and TyG were similarly predictive of MetS. We propose using TG/HDL-C and TyG as surrogate markers for assessing MetS in Korean children and adolescents.

Keywords —— adolescents; metabolic syndrome; triglyceride-glucose index; triglyceride to high-density lipoprotein cholesterol ratio

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Tohoku J. Exp. Med 2022, 256, 53-62.

Correspondence: Jae Hyun Kim, M.D., Ph.D., Department of Pediatrics, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 13620, South Korea.

e-mail: pedendo@snubh.org