BACKGROUND
Idiopathic pulmonary arterial hypertension (IPAH) patients are characterized by elevated
triglyceride (TG)-to-
HDL cholesterol (HDL-C) ratio, which has been proposed to be an important prognostic factor in this population. The mechanism of this phenomenon remains unknown. We therefore investigated the potential determinants of increased TG/HDL-C ratio in IPAH patients. MATERIAL AND METHODS We prospectively recruited consecutive clinically stable IPAH patients between January 2016 and February 2017. Patients with diabetes or using
statins were excluded. Anthropometric measurements included body mass index (BMI) and skinfold thickness; body fat mass was calculated using age and sex-specific equations. We assessed
lipid profile, homeostatic model assessment of
insulin resistance (HOMA-IR), serum
adipokine levels (
adiponectin,
resistin,
leptin, and
visfatin), and circulating
cytokines (IL-1β, IL-6, MCP-1, and TNF-α). RESULTS We assessed 47 IPAH patients: 9 of them had been diagnosed with diabetes and 10 were treated with
statins; therefore, were excluded them from further analysis. Age, sex distribution, and BMI were similar irrespectively of TG/HDL-C ratio. Patients with increased TG/HDL-C ratio (>3) as compared to patients with TG/HDL-C ≤3 were characterized by higher levels of IL-1β, MCP-1, and
IL-6. TG level was correlated with IL-1β (R=0.76, p<0.001),
IL-6 (R=0.52, p=0.005), TNF-α (R=0.62, p<0.001), and MCP-1 (R=0.63, p<0.001). IL-1β was also inversely correlated with HDL-C (R=-0.44, p=0.02). We found no differences in concentration of fasting
glucose,
insulin, HOMA-IR, body fat content, or
adipokine levels between patients with higher and lower TG/HDL-C ratios. CONCLUSIONS In IPAH patients, elevated TG/HDL-C ratio is a marker of systemic
inflammation.