Assessment of Apo-B and TG/HDL-C Ratio as Indicators of Insulin Resistance in Patients with Metabolic Syndrome

Objectives: The aim of the present study was to assess Apolipoprotein B (Apo-B) and Triglyceride/High Density Lipoprotein Cholesterol (TG/HDL-C) ratio as indicators of insulin resistance (IR) with Homeostasis Model of assessment of insulin resistance (HOMA IR)) in metabolic syndrome patients .

Study Design: Observational and prospective.

Place and Duration of Study: The study was carried out in Department of Biochemistry and Department of Medicine, MGM Medical College, Navi-Mumbai from March 2012 to June 2013.

Methodology: Total 110 normal subjects and patients were recruited in the study after obtaining informed written consent. They were divided in to two groups. Group I was healthy controls (n=50) and Group II included subjects with MS (n=60) as per NCEP ATP III criteria. Anthropometric measurements & biochemical analysis was performed in all subjects. IR was defined by HOMA IR. Simple & multiple regression analysis were used to obtain relationship between IR (HOMA IR) using TG/HDL-C (model -1) and Apo-B (Model-2) as independent variables.

Result: There were statistically significant differences in anthropometric, glycemic and lipid parameters between the control and study group (p<0.0001).The regression model between HOMA IR and TG/HDL-C ratio showed a positive correlation, (r=0.29, p < 0.05). HOMA IR & Apo-B also showed a significantly positive correlation (0. 41, p < 0.001). But combined multivariate analysis indicated that Apo-B is a better predictor of IR compared to TG/HDL-C ratio.

Conclusion: We concluded in our study that Apo-B may be a better predictor of IR than TG/HDL-C and hence could be adopted in routine laboratory practice as a lipid marker for prediction of insulin resistance (IR) in metabolic syndrome patients at an early stage.