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. 2023 Sep 16;12(18):6005.
doi: 10.3390/jcm12186005.

The TG/HDL-c Lipid Ratio as a Cardiovascular Risk Marker in a Mexican Urban Middle-Class Population: Do We Need a Risk Score Tailored for Mexicans?

Yolanda Martínez-Marroquín  1 , Alejandra Meaney  2 , Virginia Samaniego-Méndez  2 , Nayelli Nájera  3 , Guillermo Ceballos  3 , Carlos Fernández-Barros  4 , Eduardo Meaney  3
Affiliations

The TG/HDL-c Lipid Ratio as a Cardiovascular Risk Marker in a Mexican Urban Middle-Class Population: Do We Need a Risk Score Tailored for Mexicans?

Yolanda Martínez-Marroquín et al. J Clin Med. .

Abstract

Introduction: Risk scores are essential in primary prevention to detect high-risk patients. The most common scores exclude hypertriglyceridemia and abdominal obesity in their risk assessment. We examined the triglyceride/HDL-cholesterol (TG/HDL-c) ratio as a cardiovascular (CV) risk marker in a middle-class urban Mexican population sample.

Aim: Our aim was to test the concept of a scoring system reflecting Mexican population characteristics.

Methods: A total of 2602 healthy adults from the Lindavista primary prevention program were considered, evaluating gender, age, blood pressure, smoking, body mass index, waist circumference, lipid profile, and fasting glucose. According to the abnormality, a score from -3 to +3 was assigned.

Results: The summation of eleven variables yielded the Lindavista score (LS), which was calibrated versus the TG/HDL ratio and ACC ASCVD Risk Estimator Plus score to determine its correlation with risk categories. The TG/HDL-c ratio had a linear correlation with LS and high-risk ACC ASCVD categories.

Conclusions: Compared with LS and TG/HDL-c, the ACC ASCVD system underestimates the high-risk category. The high prevalence of obesity and lipid triad in the Mexican population requires a scale that considers those traits. The TG/HDL-c ratio is a practical, easy, and economical instrument to categorize risk in Mexicans.

Keywords: Lindavista study; TG/HDL-c ratio; cardiovascular risk categories; risk scales.

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Conflict of interest statement

G Ceballos is a stockholder of Epirium Inc., San Diego, USA

Figures

Figure 1
Figure 1
Calibration of the Lindavista score, correlating it with the TG/HDL index. The TG/HDL ratio values were compared with the Lindavista score values divided into quartiles to calibrate the meaning of LS sums. Dotted perpendicular lines represent the quartile values of LS. Meanwhile, the solid horizontal lines express the correspondence between LS estimations and the TG/HDL-c index values. The TG/HDL-c index figures < 3.3, 3.3–4.6, 4.7–6, and >6 correspond to each quartile distribution. It is remarkable the straight linear correlation between both variables.
Figure 2
Figure 2
Calibration of the Lindavista score, correlating it with the ASCVD REP score. The correlation between ASCVD REP and quartiles of LS scores is also linear. Both scales coincide with low and borderline risk categories, but the US score system underestimates the LS intermediate and high risk. Most summations corresponding to upper-quartile LS summation correspond to intermediate ACC ASCVD risk.
Figure 3
Figure 3
ASCVD REP score correlation with TH/HDL index. Solid horizontal lines correspond to TG/HDL-c risk groups, while dotted perpendicular lines express the four classical ASCVD REP risk groups. Although both variables are linearly correlated and fit correctly into the low-risk categories, the ACC ASCVD REP score grossly underestimates the highest risks.
See this image and copyright information in PMC

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