Association Between Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Insulin Resistance in Mongolian Adults

Introduction: While the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) is widely used to identify insulin resistance, its clinical utility can be cumbersome. An alternative, the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL) ratio, offers simplicity but may exhibit variability across different populations. This study aimed to investigate its association with HOMA-IR adjusting for waist circumference among Mongolian adults. Materials and Methods: This cross-sectional study, conducted at the Mongolian National University of Medical Sciences Hospital, included 365 participants over 35 who participated in health check-up examinations (mean age 46.8 +/- 8.8 years, 37.0% male). Waist circumference was categorized into tertiles. Associations between the TG/HDL ratio and HOMA-IR were meticulously assessed within the waist circumference tertiles (0- 33.3%, 33.4- 66.6%, and 66.7- 100%), ensuring a comprehensive understanding of the data. Results: A significant positive correlation (r = 0.391, p = 0.019) was observed between the TG/HDL ratio and HOMA-IR levels in all participants. Analyses by waist circumference tertiles revealed a progressively stronger correlation (ranging from r = 0.241 to 0.469) with increasing waist circumference (p < 0.05). The diagnostic accuracy of the TG/HDL ratio in identifying insulin resistance was assessed using HOMA-IR thresholds of 2.0 and 2.5, yielding AUC values of 0.693 and 0.746, respectively. When considering waist circumference thresholds (> 90 cm for men and > 80 cm for women), TG/HDL ratio thresholds of 1.2 (sensitivity 56%, specificity 90%) in men and 0.69 (sensitivity 46%, specificity 80%) in women were identified. Conclusion: The study indicates that the TG/HDL ratio, adjusted for waist circumference, could be a useful marker for insulin resistance in Mongolian adults, supporting its potential in clinical practice.