Introduction This study aimed to determine whether triglyceride/high-density lipoprotein cholesterol (TG/HDL-c) ratio, which has been shown to be an innovative proxy marker of atherogenic indicator in the human plasma, and an indicator of the metabolic syndrome (MetS) and insulin resistance (IR), can predict systolic hypertension (SHT), diastolic hypertension (DHT), diabetic fasting plasma glucose (dFPG), hypertriglyceridemia (HTG), hypercholesterolemia (HCHOL) low high-density lipoprotein-cholesterol (HDL-c) and high low-density cholesterol (LDL-c) in the Nigerian adolescent population living in metropolitan Lagos, Southwest Nigeria. Methods A dietary and nutritional survey (DNS) was conducted from October 2007 to March 2010. A total of 650 adolescent participants were recruited using a four-stage stratified sampling method but statistical analysis was restricted to the 613 who had complete anthropometric and clinical data. The sensitivity, specificity, and distance to the corner on the receiver operating characteristic (ROC) curve in each TG/HDL level were calculated. The shortest distance in the ROC curves was used to determine the optimal cutoff of the TG/HDL-c ratio for detecting MetS, Systolic and diastolic hypertension and diabetes. Results In all the subjects, the median TG/HDL-c ratio was significantly higher (P-value <000001) only among those with, than those without MetS (8.2 vs 3.0), those with and without hypertriglyceridemia (4.2 vs 1.3), hypercholesterolemia (5.3 vs 2.8) low high-density lipoprotein-cholesterol (7.2 vs 2.5) and high low-density lipoprotein-cholesterol (3.3 vs 1.8, P-value=0.0001). The prevalence of systolic hypertension, diabetic FPG, total cholesterol and LDL-c was higher with higher TG/HDL-c ratio while that of HDL-c was lower with higher TG/HDL-c in all subjects. TG/HDL-c ratio was strong in predicting dyslipidemia, especially hypertriglyceridemia and hypercholesterolemia in early and mid-adolescents and cardiometabolic risk factors of two or more in adolescents. An inverse relationship was observed between the stages of adolescence and cutoffs for MetS. Conclusions TG/HDL-c ratio effectively predicted MetS, hypertriglyceridemia and hypercholesterolemia among early and mid-adolescent Nigerians. As a tool, the TG/HDL-c ratio should be considered for the initial prediction of MetS and some of its dyslipidimic components. Further studies are needed to confirm findings in this study.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

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The present study was approved by the Ethics Committee of the Nigerian Institute of Medical Research, Yaba Lagos (NIMR IRB (IRB/18/062 of 4th February 2019). Written and verbally informed consent were obtained from the parents of the participants and the study participants respectively.

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