The platelet to high density lipoprotein ‐cholesterol ratio is a valid biomarker of nascent metabolic syndrome

Aims The metabolic syndrome (MetS) is a major global problem, and inflammation and insulin resistance appear to be key underpinnings in this cardio‐metabolic cluster. MetS predisposes to an increased risk of diabetes and atherosclerotic cardiovascular disease (ASCVD). It has a procoagulant diathesis which included increased platelet activity and impaired fibrinolysis. High density lipoprotein (HDL) appears to be anti‐thrombotic. Accordingly, we examined the ratios between platelets to HDL‐cholesterol(C) and adiponectin (Adipo) in patients with nascent MetS without the confounding of diabetes, ASCVD and smoking to determine their validity as biomarkers of MetS. Methods Patients with nascent MetS (n = 58) and matched controls (n = 44) were recruited. Fasting blood samples were obtained for complete blood counts, basic metabolic panel, lipids, insulin, and Adipo. Ratios of platelets to HDL‐C and Adipo were calculated. Results Following adjustment for adiposity, only the platelet: HDL ratio was significantly increased in MetS and increased with severity of MetS. Receiver operating characteristic curve analysis showed that the platelet: HDL‐C area under the curve (AUC) significantly added to both platelets and platelet lymphocyte ratio AUCs. Also the platelet: HDL‐C ratio correlated with all cardio‐metabolic features of MetS, high sensitivity C‐reactive protein, insulin resistance chemerin, and leptin. Conclusions The ratio of platelets: HDL‐C is significantly increased in patients with nascent MetS and appear to be a valid biomarker of MetS. It could also emerge as a biomarker for athero‐thrombotic risk. However, these preliminary findings need confirmation in large prospective studies.