My colleagues and I appreciate the comments of Reaven and McLaughlin regarding our article.1 We were aware of an earlier publication by McLaughlin and colleagues2 in which they found that TG and the TG/HDL-C ratio were excellent markers of insulin resistance in individuals with a body mass index (calculated as weight in kilograms divided by the square of height in meters) of greater than 25. The ethnic composition of 258 individuals in their study was 87% white, 1% African American, and 12% other ethnicities. Thus, we thought it was important to apply the criteria that they found to work well in the diagnosis of insulin resistance in whites to a larger group of African Americans. Of note, the discussion by McLaughlin et al2 recommends further testing in African Americans.
Sumner AE. Why the Plasma TG/HDL-C Concentration Ratio Does Not Predict Insulin Resistance in African Americans—Reply. Arch Intern Med. 2006;166(2):249-250. doi:10.1001/archinte.166.2.249-b