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We were somewhat surprised that Sumner et al¹ evaluated the ability of plasma triglyceride (TG) concentration and/or the plasma TG/high-density lipoprotein cholesterol (HDL-C) concentration ratio to identify insulin resistance in 98 overweight and obese African Americans. We originally validated this diagnostic approach in 258 overweight and obese individuals, 87% of whom were white.² In this ethnic group, insulin resistance is strongly correlated with both TG and HDL-C concentrations³—a prerequisite for their utility as markers of insulin resistance. As emphasized by Sumner and associates in this¹ and a companion⁴ article, African Americans tend to be more insulin resistant compared with whites but have lower plasma TG concentrations. Thus, if insulin resistance and plasma TG concentration are not closely correlated, it would seem unlikely that plasma TG concentration or TG/HDL-C ratio would be useful in identifying insulin-resistant individuals. Because Sumner et al⁴ have shown that insulin resistance accounts for no more . . . [Full Text of this Article]

AUTHOR INFORMATION
Gerald Reaven, MD; Traceu McLaughlin, MD, MS

RELATED LETTER

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The prediction of insulin resistance with serum triglyceride and high-density lipoprotein cholesterol levels in an East african population.
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Arch Intern Med 2006;166:1236-1237.
FULL TEXT