TG/HDL-C ratio as a risk marker for metabolic syndrome and atherosclerosis in adolescents aged 15-18 years in Indonesia

Dwi Sarbini* -  Department of Nutrition Science, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia
Siti Zulaekah -  Department of Nutrition Science, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia
Sudrajah Wirajati Kisnawaty -  Department of Nutrition Science, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia
Farida Nur Isnaeni -  Department of Nutrition Science, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia
Winda Wahyu Pratiwi -  Department of Nutrition Science, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia
Maya Sukmawati -  Department of Nutrition Science, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia
Sharla Apsarini -  Department of Nutrition Science, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia
DOI : 10.30867/action.v10i1.2280

Supp. File(s): common.other common.other common.other Research Materials
Metabolic syndrome is characterized by high levels of triglycerides, blood glucose, and blood pressure, along with low high-density lipoprotein cholesterol (HDL-C) and central obesity. The TG/HDL-C ratio is a quick and cost-effective marker of dyslipidemia and insulin resistance, increasing the risk of atherosclerosis. However, most studies on TG/HDL-C ratio in Indonesia have been limited to adolescent populations with distinct metabolic profiles and health risks. This study aimed to assess the correlation between metabolic syndrome risk and TG/HDL-C ratio as a marker of atherosclerosis risk in adolescents. This cross-sectional study was conducted at Batik 1 Senior High School Surakarta from October 2023 to March 2024. A total of 65 adolescents were selected using simple random sampling. The observed data included body mass index (BMI), waist circumference, blood pressure, fasting blood glucose, triglycerides, HDL-C, metabolic syndrome risk, and atherosclerosis risk. Pearson and Spearman correlation tests were used for statistical analysis. The results showed A significant correlation was observed between TG/HDL-C ratio and atherosclerosis risk (p= 0,000), waist circumference (p= 0,009), systolic blood pressure (p= 0,001), and diastolic blood pressure (p= 0,000). However, no significant correlation was found between fasting blood glucose level (p= 0,905) and BAZ (p= 0,405). In conclusion, TG/HDL-C ratio can serve as a valuable indicator for assessing metabolic syndrome risk in adolescents, allowing for early intervention to reduce the risk of atherosclerosis.

Supplement Files

Keywords : Adolescents, atherosclerosis, TG/HDL-C ratio, MetS

  1. Agbaje, A. O. (2024). The Interactive Effects of Sedentary Time, Physical Activity, and Fat Mass on Insulin Resistance in the Young Population. The Journal of Clinical Endocrinology & Metabolism, 110(1), 117–131. https://doi.org/10.1210/clinem/dgae135
  2. Ahmad, A., Banda, V. A., Wati, E., Dodja, K. P. P., & Patmawati, T. A. (2023). Gaya Hidup Remaja terhadap Penyakit Tidak Menular: Literatur Review. Jurnal Kesehatan Masyarakat Indonesia (JKMI), 1(2), 66–73. https://doi.org/10.62017/jkmi.v1i2.646
  3. Al-Domi, H., & Al-Shorman, A. (2019). Increased waist circumference is associated with subclinical atherosclerosis in schoolchildren. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 13(1), 264–269. https://doi.org/https://doi.org/10.1016/j.dsx.2018.09.004
  4. Alamnia, T. T., Tesfaye, W., Abrha, S., & Kelly, M. (2021). Metabolic risk factors for non-communicable diseases in Ethiopia: A systematic review and meta-analysis. BMJ Open, 11(11), 1–16. https://doi.org/10.1136/bmjopen-2021-049565
  5. Anriyani, F., Syafei, A., & Dewi, N. S. (2024). Determinan Kejadian Obesitas Pada Remaja. INNOVATIVE: Journal of Social Science Research, 4(3), 17154–17171. https://doi.org/https://doi.org/10.31004/innovative.v4i3.11147
  6. Assuncao, S. N. F. de, Sorte, N. C. A. B., Alves, C. de A. D., Mendes, P. S. A., Alves, C. R. B., & Silva, L. R. (2018). Glucose alteration and insulin resistance in asymtomatic obese children and adolescents. Jornal de Pediatria, 94(3), 268–272. https://doi.org/10.1016/j.jped.2017.06.008
  7. Awujoola, A. O., Torga, A. P., Valencia, J. E., Alemneh, H., Prince, O. P., & Kant, S. P. (2024). Utility of the TG/HDL-C Ratio in Estimating Pediatric Cardiometabolic Risk in a Community Hospital. Children, 11(11), 3–12. https://doi.org/10.3390/children11111277
  8. Bekele, G. E., & Thupayagale-Tshweneagae, G. (2020). Prevalence and associated factors of metabolic syndrome and its individual components among adolescents. International Journal of Public Health Science, 9(1), 46–56. https://doi.org/10.11591/ijphs.v9i1.20383
  9. Bjornstad, P., & Eckel, R. H. (2019). Pathogenesis of Lipid Disorders in Insulin Resistance: A Brief Review. Cuur Diab Rep, 18(12), 127–141. https://doi.org/10.1007/s11892-018-1101-6.
  10. Chu, S. Y., Jung, J. H., Park, M. J., & Kim, S. H. (2019). Risk assessment of metabolic syndrome in adolescents using the triglyceride/high-density lipoprotein cholesterol ratio and the total cholesterol/high-density lipoprotein cholesterol ratio. Annals of Pediatric Endocrinology and Metabolism, 24(1), 41–48. https://doi.org/10.6065/apem.2019.24.1.41
  11. Deusdará, R., Souza, A. de M., & Szklo, M. (2022). Association between Obesity, Overweight, Elevated Waist Circumference, and Insulin Resistance Markers among Brazilian Adolescent Student. Nutrients, 14(17), 3487. https://doi.org/doi.org/10.3390/nu14173487
  12. Dhindsa, D. S., Sandesara, P. B., Shapiro, M. D., & Wong, N. D. (2020). The Evolving Understanding and Approach to Residual Cardiovascular Risk Management. Frontiers in Cardiovascular Medicine, 7(May). https://doi.org/10.3389/fcvm.2020.00088
  13. IDF. (2023). The IDF Consensus Worldwide Definition of the Metabolic Syndrome. IDF Communications. https://doi.org/10.1016/B978-0-323-85732-1.00044-X
  14. Iwani, A. K. N. Z., Jalaludin, M. Y., Yahya, A., Mansor, F., Md Zain, F., Hong, J. Y. H., Zin, R. M. W. M., & Mokhtar, A. H. (2022). TG: HDL-C Ratio as Insulin Resistance Marker for Metabolic Syndrome in Children With Obesity. Frontiers in Endocrinology, 13(March), 1–12. https://doi.org/10.3389/fendo.2022.852290
  15. Kartika, J., Sari, S. N., Rahma Sari, I. P., Romadhona, S. B., & Putri, N. C. M. (2024). Edukasi Pentingnya Pencegahan Penyakit Tidak Menular (Ptm) Pada Siswa-Siswi Man 1 Muara Enim. Jurnal Ilmu Keperawatan Dan Kebidanan, 15(1), 87–93. https://doi.org/10.26751/jikk.v15i1.2183
  16. Kasim, S. S., Ibrahim, N., Malek, S., Ibrahim, K. S., Aziz, M. F., Song, C., Chia, Y. C., Ramli, A. S., Negishi, K., & Mat Nasir, N. (2023). Validation of the general Framingham Risk Score (FRS), SCORE2, revised PCE and WHO CVD risk scores in an Asian population. The Lancet Regional Health - Western Pacific, 35, 1–13. https://doi.org/10.1016/j.lanwpc.2023.100742
  17. Kemenkes RI. (2018). Hasil Utama Riskesdas 2018.
  18. Kemenkes RI. (2020). Peraturan Menteri Kesehatan Republik Indonesia Nomor 2 Tahun 2020 Tentang Standar Antropometri Anak. Menteri Kesehatan Republik Indonesia, 10(2), 1–78.
  19. Khalida, R., & Sjaf, S. (2021). Hubungan Kondisi Sosial Ekonomi Pemilik UMKM Dengan Persepsi Terhadap Karakteristik Sociopreneur. Jurnal Sains Komunikasi Dan Pengembangan Masyarakat [JSKPM], 5(5), 619–646. https://doi.org/10.29244/jskpm.v5i5.878
  20. Kong, P., Cui, Z. Y., Huang, X. F., Zhang, D. D., Guo, R. J., & Han, M. (2022). Inflammation and atherosclerosis: signaling pathways and therapeutic intervention. Signal Transduction and Targeted Therapy, 7(1). https://doi.org/10.1038/s41392-022-00955-7
  21. Kosmas, C. E., Rodriguez Polanco, S., Bousvarou, M. D., Papakonstantinou, E. J., Peña Genao, E., Guzman, E., & Kostara, C. E. (2023). The Triglyceride/High-Density Lipoprotein Cholesterol (TG/HDL-C) Ratio as a Risk Marker for Metabolic Syndrome and Cardiovascular Disease. Diagnostics, 13(5). https://doi.org/10.3390/diagnostics13050929
  22. Kurube, C. M. F., Widjaja, N. A., & Ardianah, E. (2023). Sleep duration and insulin resistance in obese adolescents with metabolic syndrome: is there a correlation? Acta Biomedica, 94(4), 1–8. https://doi.org/10.23750/abm.v94i4.14142
  23. Kusumawati, Y. (2017). Pengembangan Kegiatan Posyandu Lansia Anthurium Di Surakarta. Warta LPM, 19(2), 125–133. https://doi.org/10.23917/warta.v19i2.2738
  24. Leksono, A. P., Dieny, F. F., Noer, E. R., & Margawati, A. (2022). Night eating syndrome, pola tidur, dan kebiasaan konsumsi sugar-sweetened beverage berdasarkan tipe metabolik pada mahasiswa obese. AcTion: Aceh Nutrition Journal, 7(2), 136. https://doi.org/10.30867/action.v7i2.617
  25. Lumbantobing, A. N., Suandy, S., & Lubis, I. A. (2022). Hubungan indeks massa tubuh dengan rasio TG/HDL pada pasien diabetes mellitus tipe 2. Jurnal Prima Medika Sains, 4(1), 11–16. https://doi.org/10.34012/jpms.v4i1.2283
  26. Maharani, A., Ghinan Sholih, M., Studi Farmasi, P., Ilmu Kesehatan, F., & Singaperbangsa Karawang, U. (2024). Literature Review: Faktor Risiko Penyebab Diabetes Melitus Tipe II Pada Remaja. Jurnal Sehat Mandiri, 19(1), 185–197.
  27. Mahumud, R. A., Sahle, B. W., Owusu-Addo, E., Chen, W., Morton, R. L., & Renzaho, A. M. N. (2021). Association of dietary intake, physical activity, and sedentary behaviours with overweight and obesity among 282,213 adolescents in 89 low and middle income to high-income countries. International Journal of Obesity, 45(11), 2404–2418. https://doi.org/10.1038/s41366-021-00908-0
  28. Nasruddin, N. I., Saimin, J., & Tosepu, R. (2022). Korelasi indeks massa tubuh terhadap rasio trigliserida dan high-density lipoprotein-cholesterol pada wanita usia subur dengan obesitas. Jurnal Gizi Klinik Indonesia, 18(3), 126. https://doi.org/10.22146/ijcn.69245
  29. Nurhidayati, N., Irawan, I. R., & Sudikno, S. (2022). Hubungan Obesitas Dengan Profil Lipid Pada Remaja Di Indonesia. Ournal of Nutrition and Food Research, 45(1), 35–46. https://doi.org/10.22435/pgm.v45i1.6081
  30. Nurzakiah, Hadju, V., Jafar, N., Indriasari, R., Sirajuddin, S., Amiruddin, R., Studi Keperawatan, P., Tinggi Ilmu Kesehatan Masyarakat Baramuli Pinrang, S., Studi Gizi, P., Kesehatan Masyarakat Universitas Hasanuddin, F., Epidemiogi, J., Poros Pinrang-Polman, J., & Selatan, S. (2021). Literatur Review : Pengaruh Pola Makan Terhadap Sindrom Metabolik. Jurnal Kajian Dan Pengembangan Kesehatan Masyarakat, 1(2), 215–224.
  31. PERKENI. (2021). Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 Dewasa di Indonesia 2021. PB PERKENI. www.ginasthma.org.
  32. Radetti, G., Grugni, G., Lupi, F., Fanolla, A., Caroli, D., Bondesan, A., & Sartorio, A. (2022). High Tg/HDL-Cholesterol Ratio Highlights a Higher Risk of Metabolic Syndrome in Children and Adolescents with Severe Obesity. Journal of Clinical Medicine, 11(15). https://doi.org/10.3390/jcm11154488
  33. Rafsanjani, M. S., Asriati, A., Kholidha, A. N., & Alifariki, L. O. (2019). Hubungan Kadar High Density Lipoprotein (HDL) Dengan Kejadian Hipertensi. Jurnal Profesi Medika : Jurnal Kedokteran Dan Kesehatan, 13(2), 74–81. https://doi.org/10.33533/jpm.v13i2.1274
  34. Rezapour, M., Shahesmaeili, A., Hossinzadeh, A., Zahedi, R., & Najafipour, H. (2018). Comparison of Lipid Ratios to Identify Metabolis Syndrome. IRANIAN MEDICINE, 21(12), 572–577.
  35. Sarbini, D. W. I., Huriyati, E. M. Y., Sadewa, H., & Wahyuningsih, M. S. H. (2019). The effect of rosella (Hibiscus sabdariffa linn) on insulin resistance in patients with type 2 diabetes mellitus: A randomized clinical trial. International Journal of Pharmaceutical Research, 11, 547–557.
  36. Shaumi, N. R. F., & Achmad, E. K. (2019). Kajian Literatur: Faktor Risiko Hipertensi pada Remaja di Indonesia. Media Penelitian Dan Pengembangan Kesehatan, 29(2), 115–122. https://doi.org/10.22435/mpk.v29i2.1106
  37. Silvanni, N. M., Aron, P. M., & Nafiah, N. A. (2024). Association of Tryglyceride/High-Density Lipoprotein Ratio (TG/HDL Ratio) to Specific Risk Factors of Diabetes and Prediabetes. Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease, 06(04), 163–167. https://doi.org/10.32734/jetromi.v6i4.17394
  38. Sutrisna, E., Trisharyanti, I., Munawaroh, R., & . S. (2016). Antioxidant and Antidiabetic Activity of 70% Ethanolic Extract of Syzygium Polyanthum (Wight) Leaf From Indonesia. International Journal of Research in Ayurveda & Pharmacy, 7(2), 214–216. https://doi.org/10.7897/2277-4343.07290
  39. Tani, S., Imatake, K., Suzuki, Y., Yagi, T., Takahashi, A., Matsumoto, N., & Okumura, Y. (2021). Combined Higher Frequency Fish Consumption and Healthy Lifestyle May Lower the Triglyceride/HDL-C Ratio in Middle-Aged Japanese Males: Anti-Atherosclerotic Effect of Fish Consumption. Annals of Nutrition and Metabolism, 78(3), 166–176. https://doi.org/10.1159/000521446
  40. Vourdoumpa, A., Paltoglou, G., Manou, M., Mantzou, E., Kassari, P., Papadopoulou, M., Kolaitis, G., & Charmandari, E. (2024). Improvement in Symptoms of Depression and Anxiety and Cardiometabolic Risk Factors in Children and Adolescents with Overweight and Obesity Following the Implementation of a Multidisciplinary Personalized Lifestyle Intervention Program. Nutrients , 16(21), 1–19. https://doi.org/10.3390/nu16213710
  41. Wang, L., Yan, N., Zhang, M., Pan, R., Dang, Y., & Niu, Y. (2022). The association between blood glucose levels and lipids or lipid ratios in type 2 diabetes patients: A cross-sectional study. Frontiers in Endocrinology, 13(September), 1–10. https://doi.org/10.3389/fendo.2022.969080
  42. WHO. (2021). Obesity and Overweight. Who.Int. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
  43. Yi, Q., Hu, H., & Zeng, Q. (2023). Association of triglycerides to high density lipoprotein cholesterol ratio with hypertension in Chinese adults: a cross-sectional study. Clinical and Experimental Hypertension, 45(1). https://doi.org/10.1080/10641963.2023.2195996

Open Access Copyright (c) 2025 Dwi Sarbini, Siti Zulaekah, Sudrajah Warajati Kisnawaty, Farida Nur Isnaeni, Winda Wahyu Pratiwi, Maya Sukamawati, Sharla Apsarini
Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

AcTion: Aceh Nutrition Journal
Published by: Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health.
Soekarno-Hatta Street, No. 168. Health Polytechnic of Aceh, Aceh Besar, 23352. Telp/Fax: 0651 46126 / 0651 46121.
Website: https://gizipoltekkesaceh.ac.id/
E-mail: jurnal6121@gmail.com

e-issn: 2548-5741, p-issn: 2527-3310

All content is licensed under a: Creative Commons Attribution ShareAlike 4.0 International License

View My Stats

Get a feed by atom here, RRS2 here and OAI Links here