Ratio hdl
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Understanding the Ratio of HDL Cholesterol: Insights from Recent Research
HDL Subclass Ratio and Metabolic Syndrome
HDL2-C/HDL3-C Ratio and Insulin Resistance
The ratio of high-density lipoprotein 2 cholesterol (HDL2-C) to high-density lipoprotein 3 cholesterol (HDL3-C) has been found to be significantly associated with insulin resistance and metabolic syndrome (MetS) components. In a study involving 1155 Japanese subjects, it was observed that as the number of MetS components increased, the HDL2-C/HDL3-C ratio and high-molecular-weight adiponectin (HMW-Ad) levels decreased, while the homeostasis model assessment of insulin resistance (HOMA-IR) increased. The HDL2-C/HDL3-C ratio showed a strong positive correlation with HDL-C levels and moderate negative correlations with body mass index (BMI), waist circumference, and triglyceride levels.
Total-to-HDL Cholesterol Ratio and Cardiovascular Risk
The total cholesterol (TC) to HDL cholesterol ratio is another important metric for assessing cardiovascular risk. A pooled analysis of 458 population-based studies revealed that while mean total cholesterol levels have increased in Asian countries, the total-to-HDL cholesterol ratio has declined in Japan, South Korea, and most Western countries. This decline is associated with a reduced risk of coronary heart disease. Additionally, the ARIC study highlighted that individuals with discordant TC/HDL cholesterol ratios (higher TC/HDL despite lower LDL and non-HDL cholesterol) had a significantly higher risk of atherosclerotic cardiovascular disease.
HDL Subpopulations and Their Functional Implications
HDL Subfractions and Apolipoprotein Ratios
HDL particles are heterogeneous and can be subfractionated based on their density. Research has shown that the A-I/A-II molar ratio of HDL varies with its density, indicating the presence of different HDL subpopulations. These subpopulations have distinct cholesterol and apolipoprotein compositions, which may influence their functionality in lipid metabolism and cardiovascular protection.
HDL-C/HDL-P Ratio and Reverse Cholesterol Transport
The HDL-C/HDL-P (high-density lipoprotein particle) ratio has been proposed as a measure of reverse cholesterol transport rather than HDL functionality. This ratio may not fully capture the diverse roles of HDL in cardiovascular health, suggesting the need for more comprehensive metrics to evaluate HDL functionality.
Triglyceride-to-HDL Cholesterol Ratio and Insulin Sensitivity
TG/HDL-C Ratio as a Marker of Insulin Resistance
The triglyceride-to-HDL cholesterol (TG/HDL-C) ratio is a useful marker for assessing insulin resistance and metabolic health. Studies have shown that a higher TG/HDL-C ratio is associated with increased risk of obesity, metabolic syndrome, and insulin resistance. This ratio also correlates with other lipid profile components, such as remnant lipoprotein particle cholesterol (RLP-C) and LDL density, indicating a more atherogenic lipid phenotype .
TG/HDL-C Ratio in Pediatric Populations
In children and adolescents, the TG/HDL-C ratio has been linked to early signs of vascular changes and cardiometabolic risk factors, including nonalcoholic fatty liver disease (NAFLD). Higher TG/HDL-C ratios were associated with increased carotid artery intima-media thickness (cIMT), insulin resistance, and elevated blood pressure, highlighting its potential as a predictive marker for future cardiovascular risk.
Conclusion
The ratio of HDL cholesterol, whether in the form of HDL2-C/HDL3-C, total-to-HDL cholesterol, or TG/HDL-C, provides valuable insights into metabolic health and cardiovascular risk. These ratios are associated with various metabolic and cardiovascular conditions, emphasizing the importance of comprehensive lipid profiling in clinical practice. Understanding these relationships can aid in the early identification and management of individuals at risk for metabolic syndrome and cardiovascular diseases.
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