Triglyceride/HDL ratio as a screening tool for predicting success at reducing anti-diabetic medications following weight loss.

dc.contributor.authorShantha, Ghanshyam Palamaner Subash
dc.contributor.authorKumar, Anita Ashok
dc.contributor.authorKahan, Scott
dc.contributor.authorIrukulla, Pavan Kumar
dc.contributor.authorCheskin, Lawrence Jay
dc.date.accessioned2014-04-04T15:07:02Z
dc.date.available2014-04-04T15:07:02Z
dc.date.issued2013-07-15
dc.descriptionPMC3712020en_US
dc.description.abstractBACKGROUND AND OBJECTIVES: Intentional weight loss, by reducing insulin resistance, results in both better glycemic control and decreased need for anti-diabetic medications. However, not everyone who is successful with weight loss is able to reduce anti-diabetic medication use. In this retrospective cohort study, we assessed the predictive accuracy of baseline triglyceride (TGL)/HDL ratio, a marker of insulin resistance, to screen patients for success in reducing anti-diabetic medication use with weight loss. METHODS: Case records of 121 overweight and obese attendees at two outpatient weight management centers were analyzed. The weight loss intervention consisted of a calorie-restricted diet (~1000Kcal/day deficit), a behavior modification plan, and a plan for increasing physical activity. RESULTS: Mean period of follow-up was 12.5 ± 3.5 months. By study exit, mean weight loss and mean HbA1c% reduction were 15.4 ± 5.5 kgs and 0.5 ± 0.2% respectively. 81 (67%) in the study cohort achieved at least 1 dose reduction of any anti-diabetic medication. Tests for predictive accuracy of baseline TGL/HDL ratio ≤ 3 to determine success with dose reductions of anti-diabetic medications showed a sensitivity, specificity, positive predictive value, negative predictive value, area under the curve, likelihood ratio (LR) + and LR-of 81, 83, 90, 70, 78, 4.8 and 0.2, respectively. Reproducibility of TGL/HDL ratio was acceptable. CONCLUSION: TGL/HDL ratio shows promise as an effective screening tool to determine success with dose reductions of anti-diabetic medications. The results of our study may inform the conduct of a systematic review using data from prior weight loss trials.en_US
dc.description.sponsorshipJH Libraries Open Access Funden_US
dc.identifier.citationdoi: 10.1371/journal.pone.0069285en_US
dc.identifier.issn1932-6203
dc.identifier.urihttp://jhir.library.jhu.edu/handle/1774.2/36743
dc.language.isoen_USen_US
dc.publisherPLoS Organizationen_US
dc.relation.ispartofseriesPLoS ONE;v. 8 no. 7 p. e69285
dc.subjectWeight Lossen_US
dc.subjectTriglyceridesen_US
dc.subjectLipoproteinsen_US
dc.subjectHDLen_US
dc.subjectHypoglycemic Agentsen_US
dc.subjectDrug Dosage Calculationsen_US
dc.titleTriglyceride/HDL ratio as a screening tool for predicting success at reducing anti-diabetic medications following weight loss.en_US
dc.typeArticleen_US
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