Can We Use the Triglyceride/HDL Ratio to Determine Insulin Resistance in Obesity Screening and Follow-Up in Primary Care?

INTRODUCTION: Obese patients are followed up with periodic laboratory tests. Insulin resistance is also a parameter used in these tests. There is a need for parameters that can determine insulin resistance more easily and practically. The aim of our study is to investigate the discriminative power of triglyceride (Tg) and triglyceride/high-density lipoprotein cholesterol ratio (Tg/HDL) for Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in our patient population by examining the laboratory findings.
METHODS: In this retrospective study, the laboratory data of patients who applied to the Family Medicine Obesity Polyclinic of Düzce University Hospital between April 2018 and April 2019 with the desire to lose weight and/or have healthy lifestyle suggestions were examined.
RESULTS: Of the 512 patients included in our study, 66.40% (n=340) were female and 33.59% (n=172) were male. In the examination performed on patients grouped according to their Body Mass Index (BMI), Total cholesterol, HDL, Low-density lipoprotein (LDL), Tg, HOMA-IR, Insulin and Tg/HDL ratios were significantly different between the groups. The cut-off value in the ROC analysis of the Tg/HDL parameter between patients with and without insulin resistance was found to be 2.29 with 66% sensitivity and 55% specificity (AUC: 0.634, p<0.001). In Spearman's correlation analysis of Tg/HDL and HOMA-IR, both parameters were found to have a statistically significant correlation (r: 0.248; p< 0.000).
DISCUSSION AND CONCLUSION: The significant relationship between the high Tg/HDL ratio and HOMA-IR detected in the results of our study shows that the Tg/HDL ratio can be used as a practical tool to evaluate insulin resistance in obese patients.