Triglycerides/HDL cholesterol: utility for the detection of obese subjects with risk for diabetes mellitus type 2 and cardiovascular diseases

In Argentina, the prevalence of obesity has increased considerably and type 2 diabetes mellitus (DMT2) reaches 12.7%. Obesity presents heterogeneity and the increase in abdominal fat may include hypertriglyceridemia, hyperglycemia, decrease in HDL-C, increases in apolipoprotein B (Apo B), increase in small and dense LDL lipoproteins, hyperinsulinemia, insulin resistance (IR), chronic inflammatory state, prothrombotic state and other metabolic alterations, which have been included in the so-called metabolic syndrome with 20 to 40% prevalence. Insulin resistance is present in 10 to 25% of the population and is associated with these alterations. The determination of IR is complex; it needs hospitalization and must be performed by specialists. In the laboratory, it can be estimated through insulin dosing, but it is not standardized, so it is necessary to have simple and accessible techniques. The triglycerides (TG)/HDL cholesterol (HDL-C) ratio can be an option using TG/C-HDL cutoff values >= 2.5 in women and >= 3.5 in men. It is significantly associated with IR and CVD and has good specificity but low discriminating power. So when it is present and there is a risk of T2DM or cardiovascular disease, CVD should be complemented with the calculation of non-HDL cholesterol or Apo B and the remaining cholesterol. Considering the pandemic of obesity and DMT2 and the high frequency of CVD, the TG/C-HDL ratio marker should be reported by the biochemical-clinical laboratory.