Evaluation of the chylomicron-TG to VLDL-TG ratio for type I hyperlipoproteinemia diagnostic.

Abstract

BACKGROUND:

The aim of this study is to confirm the diagnostic performance of the Chylomicron to very low-density lipoproteins triglycerides (CM/VLDL-TG) ratio, the triglycerides to cholesterol ratio (TG/TC) and a dichotomic rule including the tryglycerides to apolipoprotein B (TG/APOB) ratio for the presence of Type I hyperlipoproteinemia (HPLI) in patients with severe hypertriglyceridemia (sHTG) that were at high risk for familial chylomicronemia syndrome (FCS).

METHODS:

Two cohorts (derivation and validation) of patients with sHTG were included in the study. Anthropometric, clinical, biochemical and genetic data were obtained. The CM/VLDL-TG, TG/TC and TG/APOB ratios were calculated. Finally, a diagnostic performance study was developed to establish sensitivity, specificity and cut-offs by a ROC curve analysis in the derivation cohort as well as agreement and predictive values in the validation cohort.

RESULTS:

Patients with FCS in both cohorts showed an earlier presence in pancreatitis, greater number of acute pancreatitis episodes and lower BMI. FCS patients also showed higher ratios of CM/VLDL-TG, TG/TC and TG/APOB ratios, whereas their HDL-C, LDL-C and APOB levels were lower than in non-FCS patients. Sensitivity and agreement were low for both the TG/TC and TG/APOB ratios, although predictive values were good. The CM/VLDL-TG ratio showed greatest sensitivity, specificity, agreement and predictive values for cut-off of 3.8 and 4.5.

CONCLUSIONS:

Our results suggest that in subjects at high risk of FCS a total serum TG/TC ratio or TG/APOB ratio are feasible to initially screen for HLPI; however, a CM/VLDL-TG ratio ≥4.5 is a better diagnostic criterion for HPLI.

• Authors: José Rioja, María-José Ariza, Natalia García-Casares, Inmaculada Coca-Prieto, Teresa Arrobas, Ovidio Muñiz-Grijalvo, Alipio Mangas, Daiana Ibarretxe, Miguel Ángel Sánchez-Chaparro, Pedro Valdivielso
• Journal: European journal of clinical investigation (Eur J Clin Invest) Vol. 50 Issue 12 Pg. e13345 (Dec 2020) ISSN: 1365-2362 [Electronic] England
• PMID: 32649781 (Publication Type: Journal Article)
• Copyright: © 2020 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

Chemical References

• Apolipoproteins B
• Cholesterol, HDL
• Cholesterol, LDL
• Chylomicrons
• Lipoproteins, VLDL
• Triglycerides
• very low density lipoprotein triglyceride
• Cholesterol

Topics

• Adolescent
• Adult
• Apolipoproteins B (blood)
• Body Mass Index
• Cholesterol (blood)
• Cholesterol, HDL (blood)
• Cholesterol, LDL (blood)
• Chylomicrons (blood)
• Female
• Humans
• Hyperlipoproteinemia Type I (blood, diagnosis, epidemiology)
• Hypertriglyceridemia (blood)
• Lipoproteins, VLDL (blood)
• Male
• Middle Aged
• Pancreatitis (epidemiology)
• ROC Curve
• Recurrence
• Reproducibility of Results
• Sensitivity and Specificity
• Triglycerides (blood)
• Young Adult