Lowering the triglyceride/high-density lipoprotein cholesterol and its association with the beneficial impact of pioglitazone on coronary atherosclerosis in the PERISCOPE study is likely due to lowering insulin resistance.

摘要

Nicholls et al. (1), based on data from the PERISCOPE (Piogli-tazone Effect on Regression of Intravascular Sonographic Coronary Obstruction Prospective Evaluation) study, reported that the favorable effects of pioglitazone on the triglyceride-to-high-density lipoprotein (trig/HDL) ratio correlated with delayed atheroma progression in diabetic patients. Nowhere in the paper do the authors recognize the association of the trig/HDL ratio with insulin resistance and the other manifestations of the metabolic syndrome. The trig/HDL ratio is a simple way to identify insulin-resistant individuals at increased risk of cardiovascular disease and has also been shown to predict the low-density lipoprotein particle size in Asian Indians (2-4).