Association between triglyceride/HDL cholesterol ratio and carotid atherosclerosis in postmenopausal middle-aged women

Abstract

Background and objective

The triglyceride/HDL cholesterol ratio, as a surrogate marker of insulin resistance, may be associated to presence of subclinical carotid atherosclerosis in postmenopausal women. The aim of this study was to explore this association.

Patients and methods

Women (last menstrual period ≥ 2 years) in primary prevention up to 65 years of age were recruited. Association between the triglyceride/HDL cholesterol (HDL-C) ratio and presence of carotid plaque, assessed by ultrasonography, was analyzed. ROC analysis was performed, determining the precision of this ratio to detect carotid plaque.

Results

A total of 332 women (age 57 ± 5 years) were recruited. Triglyceride/HDL-C ratio was 2.35 ± 1.6. Prevalence of carotid plaque was 29%. Women with carotid plaque had higher triglyceride/HDL-C ratios (3.33 ± 1.96 vs. 2.1 ± 1.2, p < 0.001) than women with no carotid plaque. A positive relationship was seen between quintiles of this ratio and prevalence of carotid plaque (p < 0.001). Regardless of other risk factors, women with higher triglyceride/HDL-C ratios were more likely to have carotid plaque (odds ratio 1.47, 95% confidence interval 1.20–1.79, p < 0.001). The area under the curve of the triglyceride/HDL-C ratio to detect carotid plaque was 0.71 (95% confidence interval 0.65 to 0.76), and the optimal cut-off point was 2.04.

Conclusions

In postmenopausal women in primary prevention, insulin resistance, estimated from the triglyceride/HDL-C ratio, was independently associated to a greater probability of carotid plaque. A value of such ratio greater than 2 may be used for assessing cardiovascular risk in this particular group of women.