Triglyceride/low-density-lipoprotein cholesterol ratio is the most valuable predictor for increased small, dense LDL in type 2 diabetes patients

Type 2 diabetes patients are at increased risk of arteriosclerosis. This can be related to increasing in small, dense low-density lipoprotein (sd-LDL). Non–high-density-lipoprotein cholesterol (non–HDL-C) is supposed to be useful for predicting arteriosclerosis along with sd-LDL elevation; however, there is a lack of data to conclude whether the ratio of triglyceride /low-density lipoprotein cholesterol (TG/LDL-C) is a valuable predictor for sd-LDL. Gen Ouchi and colleagues have conducted a study published in Lipid in Health and Disease Journal under the title “Triglyceride/low-density lipoprotein cholesterol ratio is the most valuable predictor for increased small, dense LDL in type 2 diabetes patients”. The summary of this article is given below.

Objective:

To investigate whether the ratio of TG/LDL-C can be the valuable predictor for increased sd-LDL.

Method:

110 type 2 diabetes patients with hypertriglyceridemia were investigated. Patients were not treated with fibrates, but statins were used for 47 patients. LDL-C was measured by the direct method. LDL migration index (LDL-MI) was calculated using electrophoresis, and a value ≥0.400 was considered for an increase in sd-LDL. Simple regression analyses were conducted between LDL-MI and lipid markers. The area under the curve (AUC), specificity, sensitivity, and cut-off point were determined by receiver operating characteristic curves of lipid markers for predicting high LDL-MI.

Findings:

The study reports the benefits of the TG/LDL-C ratio as a predictive marker for higher sd-LDL in patients with type 2 diabetes and hypertriglyceridemia. TG/LDL-C ratio is the first proposed formula that is considered appropriate for the evaluation of sd LDL and TG-rich lipoproteins. TGs were positively associated with LDL-MI, and LDL fraction (PAG). While LDL C was negatively associated with LDL-MI. Even if LDL-C is low or within the normal range, the high values of sd-LDL can be calculated by the relative ratio with TGs.

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