Evaluation of triglyceride/high-density lipoprotein ratio as a surrogate marker for insulin resistance in healthy young males

Background: Insulin resistance (IR) is the major underlying mechanism responsible for metabolic syndrome and HOMA-IR2 is a validated marker of IR. Fasting lipid profile, including triglyceride (TG) and high-density lipoprotein (HDL) cholesterol routinely feature in the outpatient investigation list. Utility of TG/HDL ratio as a surrogate marker for IR was thus studied in healthy young males. Materials and Methods: This cross-sectional study involved 71 young males aged 18-35 years who came for a routine health check in a fasting state. Height, weight, waist circumference were recorded. Fasting plasma glucose (FPG) and lipid profile reports were collected from the laboratory database. Fasting insulin (FI) was estimated by enzyme-linked immunosorbent assay. Body mass index (kg/m²), TG/HDL, TC/HDL, and HOMA-IR2 were calculated. Results: Mean TG/HDL ratio was 3.73 ± 2.03 and HOMA IR2 was above the standard cut off of ≥2.5 units. Subjects were further divided into two groups based on FPG values. TG, low-density lipoprotein, total cholesterol, TG/HDL, TC/HDL, FI and HOMA-IR2 were found to be higher in the pre-diabetes with impaired fasting glycemic subjects. Overall, a statistically significant positive correlation was seen (P = 0.01, r = 0.284) between TG/HDL and HOMA-IR2. Conclusion: TG/HDL ratio was significantly associated with IR and it could be used as an indicator of IR especially in prediabetic subjects having impaired fasting glucose.