Abstract 442: Correlates of the Triglyceride/HDL Cholesterol Ratio: The Very Large Database of Lipids (VLDL-4)

Background The Triglyceride/HDL Cholesterol Ratio (TG/HDL-C) is predictive of atherosclerosis and vascular disease risk. It is frequently elevated in the metabolic syndrome and diabetes and tracks with measures of insulin resistance.

Methods We investigated the correlates of TG/HDL-C in 3,609 serial subjects of the 1,340,614 U.S. adults from the VLDL dataset who had apoB, hsCRP, serum insulin levels, hemoglobin A1C (A1C) measurements in addition to ultracentrifugation lipid measurement by VAP method (Atherotech, Birmingham, AL). A continuous LDL density parameter (LLDR) was calculated as the natural log of the ratio of dense to buoyant LDL-C subfractions. Remnant lipoprotein cholesterol (RLP-C) was defined as dense remnant VLDL3-C + IDL-C. TG/HDL-C was modeled using multiple linear regression.

Results The strongest correlates of TG/HDL-C in model 1 were serum insulin, RLP-C, LLDR and Lp(a)-C with overall model r=0.801, adjusted r2=0.641, p<0.001. Model 2 substituted dense VLDL3-C and IDL-C individually as independent variables in lieu of their sum, RLP-C; overall model r=0.855, adjusted r2=0.730, p<0.001. IDL-C was inversely correlated while VLDL3-C was more strongly and positively associated with TG/HDL-C. A1C was not significantly correlated in the multivariate models (Table).

Summary TG/HDL-C ratio represents a composite of metabolic and lipid atherosclerosis risk markers including insulin levels, LDL density, RLP-C, lp(a)-C, homocysteine, gender and apoB.