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Yoshida D, Ikeda S, Shinohara K, Kazurayama M, Tanaka S, Yamaizumi M, Nagayoshi H, Toyama K, Kinugawa S. Triglyceride-Glucose Index Associated with Future Renal Function Decline in the General Population. J Gen Intern Med 2024:10.1007/s11606-024-08809-4. [PMID: 38782808 DOI: 10.1007/s11606-024-08809-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 05/09/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND The triglyceride-glucose index (TyG index), calculated as the logarithmic product of fasting triglyceride and glucose concentrations, is recognized as a simple marker of insulin resistance. However, the association between the TyG index and future decline of renal function remains unclear in the general population. OBJECTIVE To investigate whether the TyG index was associated with future decline of renal function in the general population who had not progressed to chronic kidney disease stage G2. DESIGN Retrospective longitudinal observational cohort study. PARTICIPANTS Individuals who received a population-based health checkup at JA Ehime Kouseiren Checkup Center from 2010 to 2019 (n = 134,007). Individuals without data of baseline fasting triglyceride or glucose levels, or baseline and follow-up data of estimated glomerular filtration rate (eGFR), or those with baseline eGFR < 60 mL/min/1.73 m2 were excluded. MAIN MEASURES Future renal function decline, defined as a ≥ 25% decrease in eGFR from baseline. KEY RESULTS Of 10,758 participants, 8,076 were classified into the low TyG index group (TyG index < 8.76, 1st to 3rd quartiles) and 2,682 into the high TyG index group (TyG index ≥ 8.76, 4th quartile). The mean follow-up period was 37.8 ± 23.6 months. The incidence rates of renal function decline were 0.31 and 0.69 per 100 person-years in the low and high TyG index groups, respectively. In multivariate Cox proportional hazard models, high TyG index was significantly associated with future renal function decline (hazard ratio 2.25, 95% CI 1.40-3.60). This association was consistent across subgroups stratified by age, sex, body mass index, baseline eGFR, and diagnosed hypertension, diabetes, or dyslipidemia. CONCLUSION In the general population, high TyG index was associated with future renal function decline. The TyG index may be useful in identifying individuals at high risk for future renal function decline in the setting of health checkups.
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Affiliation(s)
- Daisuke Yoshida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shota Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
- Cardiovascular Center, Steel Memorial Yawata Hospital, Fukuoka, Japan
| | - Keisuke Shinohara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | | | | | | | | | - Kensuke Toyama
- JA Ehime Kouseiren Checkup Center, Ehime, Japan
- Department of Pharmacology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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Wu Z, Huang K, Bao S, Zhang X, Li J, Kong W, Shi Y, Xie Y. The association of triglyceride-glucose-waist circumference with metabolic associated fatty liver disease and the severity of liver steatosis and fibrosis in American adults: a population-based study. Scand J Gastroenterol 2024; 59:561-569. [PMID: 38235548 DOI: 10.1080/00365521.2024.2305268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND The global obesity pandemic has led to an alarming rise in the prevalence of metabolic-associated fatty liver disease (MAFLD), making it a substantial clinical and economic burden on society. Early detection and effective treatment of MAFLD are imperative to mitigate its impact. METHODS This cross-sectional study was conducted involving 4634 adults from the National Health and Nutrition Examination Surveys (NHANES) 2017-2018 cycle. Transient elastography (TE) was used to diagnose MAFLD and assess the extent of liver steatosis and fibrosis. Multivariate logistic regression models were utilized to examine the association between the triglyceride and glucose index-waist circumference (TyG-WC) and the risk of MAFLD, liver fibrosis, and steatosis. RESULTS A positive association between TyG-WC and MAFLD persisted across all three models: model1: OR = 8.44, 95% CI: 6.85-10.38 (unadjusted), model2: OR = 8.28, 95% CI: 6.53-10.50 (partially adjusted), and model3: OR = 7.98, 95% CI: 4.11-15.46 (fully adjusted). Further investigation through interaction and stratified analysis revealed that this association was more pronounced in the non-obese and Non-Hispanic White persons groups. Moreover, a non-linear relationship analysis unveiled threshold and saturation effects between TyG-WC and MAFLD. Specifically, a TyG-WC value of approximately 600 may represent the threshold effect for MAFLD risk, while 1200 may signify the saturation effect of MAFLD risk. Finally, a robust correlation between TyG-WC and the severity of liver steatosis and fibrosis was found. CONCLUSIONS The findings suggest that the TyG-WC index exhibits excellent predictive value for MAFLD in the general American population.
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Affiliation(s)
- Zhouxiao Wu
- Health Science Center, Ningbo University, Ningbo, Zhejiang, China
- Department of Infectious Diseases, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- Department of Hepatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Kai Huang
- Department of General Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Sizeng Bao
- Department of Nephrology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Xiangyu Zhang
- Department of Nephrology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Jingwen Li
- Department of Infectious Diseases, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- Department of Hepatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Weiliang Kong
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Yanmei Shi
- Department of Infectious Diseases, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- Department of Hepatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Yilian Xie
- Department of Infectious Diseases, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- Department of Hepatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
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Li L, Xu Z, Jiang L, Zhuang L, Huang J, Liu D, Wu Q. Triglyceride-Glucose Index and Its Correlates: Associations with Serum Creatinine and Estimated Glomerular Filtration Rate in a Cross-Sectional Study from CHARLS 2011-2015. Metab Syndr Relat Disord 2024; 22:179-189. [PMID: 38133543 DOI: 10.1089/met.2023.0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Background: Chronic kidney disease (CKD) has emerged as a significant global public health challenge, and the estimated glomerular filtration rate (eGFR) is widely used due to its convenience, low cost, and broad clinical applicability. Concurrently, insulin resistance (IR) serves as a crucial marker of metabolic disturbance, and alternative indicators have garnered increasing attention in CKD research in recent years. Objective: This study aims to investigate the relationship between IR-related indices (TyG index, TyG-BMI index, and TyG-WC index) and serum creatinine levels, as well as the eGFR, with the intention of uncovering their potential roles in the assessment of renal function. Methods: We analyzed nationally representative cross-sectional data from a cohort of individuals aged 45 and above in China, comprising 11,608 participants. Participants were categorized into different groups based on quartiles of the TyG index, and multiple factors, including gender, age, lifestyle, and co-morbidities, were adjusted for using linear regression models. Results: By linear regression, TyG, TyG-BMI, and TyG-WC indices were significantly positively correlated with serum creatinine and significantly negatively correlated with eGFR. Results showed similar trends when TyG, TyG-BMI, and TyG-WC indices were used as categorical variables. In the fully adjusted model, the highest quartile of serum creatinine was higher than the first quartile for TyG, TyG-BMI, and TyG-WC indices, with β values of 2.673, 3.67, and 1.937 mg/dL, respectively; the highest quartile of eGFR was lower than the first quartile, with β values of -2.4, -2.955, and -1.823 mL/min/1.73 m2. P values were statistically significant. Conclusions: This study indicates a consistent correlation between the TyG index and its related indices with serum creatinine levels and eGFR among the middle aged and elderly population in China. These findings suggest the potential utility of these indices in early screening and management of the risk of chronic kidney disease.
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Affiliation(s)
- Lei Li
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Zichen Xu
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Luqing Jiang
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Lingdan Zhuang
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Jianjun Huang
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Daoqin Liu
- Department of Kidney Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Qiwen Wu
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
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Xiao K, Cao H, Yang B, Xv Z, Xiao L, Wang J, Ni S, Feng H, He Z, Xv L, Li J, Xv D. Association between the triglyceride glucose index and chronic total coronary occlusion: A cross-sectional study from southwest China. Nutr Metab Cardiovasc Dis 2024; 34:850-859. [PMID: 38161119 DOI: 10.1016/j.numecd.2023.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND AIM Insulin resistance (IR) plays an important role in the atherosclerotic process, and the triglyceride glucose (TyG) index is a reliable indicator of IR and is strongly associated with cardiovascular disease. However, there are few studies regarding the relationship between the TyG index and chronic total coronary occlusion (CTO). Herein, the correlation between the TyG index and CTO, as well as their interactions with other traditional cardiovascular risk factors, were investigated. METHODS AND RESULTS We enrolled 2691 patients who underwent coronary angiography at Guangyuan Central Hospital from January 2019 to October 2021. TyG index results were used to create three groups using the trichotomous method. CTO was defined as complete occlusion of the coronary artery for ≥3 months. Univariate and multivariate logistic regression models, restricted cubic splines, receiver operating characteristic (ROC) curves, and subgroup analyses was performed. A significant correlation between the TyG index and CTO was noted. The risk of CTO was increased 2.09-fold in the group with the highest TyG compared with the lowest (OR, 2.09; 95 % CI, 1.05-4.17; P = 0.036). In addition, there was a linear dose-response relationship between the TyG index and CTO (nonlinear P = 0.614). The area under the ROC curve was 0.643 (95 % CI, 0.572-0.654). Using subgroup analyses, we observed that the TyG index was associated with a significantly higher risk of CTO in males and smokers. CONCLUSIONS An elevated TyG index was related to the risk of CTO and may constitute a meaningful predictor of CTO, particularly in males and in smokers.
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Affiliation(s)
- Kaiyong Xiao
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China.
| | - Huili Cao
- Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030000, China
| | - Bin Yang
- Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030000, China
| | - Zhe Xv
- Department of Pediatric, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Lian Xiao
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Jianping Wang
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Shuiqing Ni
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Hui Feng
- Medical Laboratory Center, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Zhongwei He
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Lei Xv
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Juan Li
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Dongmei Xv
- Department of Ultrasonography, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
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Weyman-Vela Y, Guerrero-Romero F, Simental-Mendía LE. The triglycerides and glucose index is more strongly associated with metabolically healthy obesity phenotype than the lipid and obesity indices. J Endocrinol Invest 2024; 47:865-871. [PMID: 37768526 DOI: 10.1007/s40618-023-02201-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE The triglycerides and glucose (TyG) index is a reliable biomarker for estimating insulin resistance; however, evidence regarding the use of the TyG index in individuals with metabolically healthy obesity (MHO) is scarce. Thus, we examined the association between the TyG index and the MHO phenotype. METHODS Apparently healthy men and women aged 18 years or more with obesity (body mass index [BMI] ≥ 30 kg/m2) were allocated into the following groups: MHO and metabolically unhealthy obesity (MUO). The MHO phenotype was defined by obesity and the absence of the following metabolic disorders: elevated triglyceride concentrations, elevated glucose levels, elevated blood pressure, and low HDL-C. The MUO was defined by individuals with obesity and at least one of the aforementioned cardiovascular risk factors. RESULTS A total 827 individuals, 605 (73.1%) women and 222 (26.9%) men were enrolled and allocated into the MHO (n = 104) and MUO (n = 723) groups. The adjusted regression analysis by age, sex, BMI, and waist circumference showed that fasting glucose (OR = 0.90; 95% CI: 0.88-0.93), and triglycerides (OR = 0.97; 95% CI: 0.96-0.98), as well as the triglycerides/HDL-C (OR = 0.18; 95% CI: 0.13-0.26), lipid accumulation product (OR = 0.95; 95% CI: 0.93-0.96), visceral adipose index (OR = 0.38; 95% CI: 0.31-0.46), and TyG index (OR = 0.001; 95% CI: 0.000-0.004) are inversely associated with the MHO, while the HDL-C (OR = 1.10; 95% CI: 1.07-1.12) had a direct association. CONCLUSIONS Our results show that the TyG index is more strongly associated with the MHO phenotype than the lipid and obesity indices.
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Affiliation(s)
- Y Weyman-Vela
- Unidad de Investigación Biomédica, Instituto Mexicano del Seguro Social, Delegación Durango, Durango, México
| | - F Guerrero-Romero
- Unidad de Investigación Biomédica, Instituto Mexicano del Seguro Social, Delegación Durango, Durango, México
| | - L E Simental-Mendía
- Unidad de Investigación Biomédica, Instituto Mexicano del Seguro Social, Delegación Durango, Durango, México.
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Jin T, Park EY, Kim B, Oh JK. Environmental exposure to lead and cadmium are associated with triglyceride glucose index. Sci Rep 2024; 14:2496. [PMID: 38291186 PMCID: PMC10827717 DOI: 10.1038/s41598-024-52994-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/25/2024] [Indexed: 02/01/2024] Open
Abstract
The triglyceride glucose (TyG) index was suggested as a novel reliable surrogate marker for insulin resistance and related cardiovascular-metabolic diseases. We aimed to evaluate the association between the TyG index and environmental exposure to lead (Pb), mercury (Hg), and cadmium (Cd). A total of 9645 adults who enrolled in the Korea National Health and Nutrition Examination Survey in 2005, 2008-2013, and 2016 were included. Fasting plasma glucose and triglyceride levels were used to calculate the TyG index. Multivariate logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). We noted an increasing trend in the TyG index with increment of blood Pb and Cd concentrations. Participants in the highest quartile of blood Pb and Cd concentrations had higher TyG index values than those in the lowest quartile, with ORs (95% CIs) of 1.32 (1.07-1.63) and 1.29 (1.04-1.59) for Pb and Cd, respectively. Strong associations between blood Pb and Cd concentrations and the TyG index were found in men. Blood Hg concentrations did not show a significant association with the TyG index. Our study suggests that public health strategies for cardiovascular-metabolic disorder prevention should be directed toward individuals exposed to priority heavy metals.
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Affiliation(s)
- Taiyue Jin
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang-si, 10408, Gyeonggi-do, Korea
| | - Eun Young Park
- Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Korea.
| | - Byungmi Kim
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang-si, 10408, Gyeonggi-do, Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, 10408, Gyeonggi-do, Korea
| | - Jin-Kyoung Oh
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang-si, 10408, Gyeonggi-do, Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, 10408, Gyeonggi-do, Korea
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Kityo A, Lee SA. Association of cardiometabolic factors and insulin resistance surrogates with mortality in participants from the Korean Genome and Epidemiology Study. Lipids Health Dis 2023; 22:210. [PMID: 38041195 PMCID: PMC10691157 DOI: 10.1186/s12944-023-01981-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/27/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Simple biochemical and anthropometric measurements such as fasting blood glucose (FBG), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), waist circumference (WC), and body mass index (BMI) are used to formulate insulin resistance (IR) indices. Whether these indices provide new predictive information for mortality remains unknown. This study examined the relationships of biochemical, anthropometric, and IR indices with mortality risk, as well as their predictive performance. METHODS The data source was the Korean Genome and Epidemiology Study (2004-2020) involving 114,957 participants whose data were linked to death records. The IR indices- triglyceride-glucose index (TyG), TyG-BMI, TyG-WC, visceral adiposity index (VAI), lipid accumulation product (LAP), and metabolic score for insulin resistance (METS-IR) were computed using standard formulae. The associations were examined using restricted cubic splines. The predictive performance was compared using the log-likelihood ratio chi-square test. RESULTS Body mass index was U-shaped, HDL-C was reverse J-shaped, and FBG and TG levels were J-shaped associated with all-cause mortality. Results showed U-shaped (TyG), J-shaped (TyG-BMI, VAI, LAP, and METS-IR), and reverse J-shaped (TyG-WC) associations with all-cause mortality. The percentages of new predictive information for all-cause mortality explained by the FBG level, BMI, TyG-BMI, and METIR were 3.34%, 2.33%, 1.47%, and 1.37%, respectively. Other IR indices and biochemical and anthropometric measurements provided < 1.0% of new predictive information. For cardiovascular disease mortality, the FBG, BMI, METIR, TyG-BMI, and HDL-C levels explained 2.57%, 2.12%, 1.59%, 1.30%, and 1.27% of new predictive information respectively. Moreover, the risks of cancer mortality explained by FBG level, VAI, and HDL-C level were 2.05%, 1.49%, and 1.28%, respectively. CONCLUSIONS Fasting blood glucose level is a superior predictor of mortality risk and may be used as a simple predictive and preventative factor.
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Affiliation(s)
- Anthony Kityo
- Department of Preventive Medicine, School of Medicine, Kangwon National University, Gangwon, Republic of Korea
| | - Sang-Ah Lee
- Department of Preventive Medicine, School of Medicine, Kangwon National University, Gangwon, Republic of Korea.
- Interdisciplinary Graduate Program in Medical Bigdata Convergence, Kangwon National University, Gangwon, Republic of Korea.
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Mao J, Gan S, Zhou Q, Yu F, Zhou H, Lu H, Jin J, Liu Q, Deng Z. Positive correlation between lipid accumulation product index and arterial stiffness in Chinese patients with type 2 diabetes. Front Endocrinol (Lausanne) 2023; 14:1277162. [PMID: 38075069 PMCID: PMC10702222 DOI: 10.3389/fendo.2023.1277162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
Background Many studies have confirmed that lipid accumulation products (LAP) predict arterial stiffness (AS) in hypertensive patients. But there is little research on the use of LAP in identifying early atherosclerosis in patients with type 2 diabetes mellitus (T2DM). The aim of this study was to determine the relationship between the LAP index and brachial-ankle pulse wave velocity (baPWV) in Chinese patients with T2DM. Methods A total of 1471 Chinese participants with T2DM, ranging in age from 18 to 80, were included in this cross-sectional study. BaPWV measurements were used to calculate the AS. A baPWV greater than the 75th percentile (1700 cm/s) was defined as indicating increased AS. The LAP index was calculated from the combination of waist circumference (WC) and triglycerides (TG). Results According to the quartiles of the LAP index, baPWV tended to increase after adjusting for sex and age. Multiple linear regression analysis showed that the beta coefficient (β) of baPWV increased by 31.0 cm/s for each unit of lnLAP that was increased, and the 95% confidence interval (CI) was (6.5, 55.5) cm/s. In multivariate logistic regression analyses, after fully adjusting for confounders, the risk of elevated baPWV increased with each unit increase in lnLAP, with an odds ratio (OR) of 1.3 (95% CI: 1.0, 1.8). According to the generalized additive model (GAM), we found that lnLAP was positively correlated with baPWV and baPWV elevation. The results were the same for males and females. Subgroup analyses showed that the positive correlation between lnLAP and elevated baPWV did not interact across all subgroups. Conclusions In Chinese patients with T2DM, LAP was strongly and positively correlated with baPWV and elevated baPWV.
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Affiliation(s)
- Jing Mao
- Department of Medicine, University of South China, Hengyang, Hunan, China
| | - Shenglian Gan
- Department of Endocrinology, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China
| | - Quan Zhou
- Department of Science and Education, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China
| | - Fang Yu
- Department of Endocrinology, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China
| | - Haifeng Zhou
- Department of Endocrinology, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China
| | - Huilin Lu
- Department of Endocrinology, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China
| | - Jing Jin
- Department of Endocrinology, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China
| | - Qin Liu
- Department of Endocrinology, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China
| | - Zhiming Deng
- Department of Endocrinology, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China
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Li Z, Zhang M, Han L, Fu L, Wu Y, Chen H, Feng L. Counterintuitive relationship between the triglyceride glucose index and diabetic foot in diabetes patients: A cross-sectional study. PLoS One 2023; 18:e0293872. [PMID: 37922259 PMCID: PMC10624312 DOI: 10.1371/journal.pone.0293872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 10/20/2023] [Indexed: 11/05/2023] Open
Abstract
BACKGROUND Research has shown that insulin resistance (IR) is a known risk factor for diabetic foot (DF), and the triglyceride-glucose (TyG) index is a reliable and simple indicator of IR. However, less is known about the relationship between the TyG and the risk of DF. Here, we investigated the association between the TyG index and the prevalence of DF. METHODS The eligible records from the Departments of Endocrinology of Shandong Provincial Hospital Affiliated to Shandong First Medical University were screened (from December 1, 2012, to December 31, 2021), and a total of 8866 patients were enrolled. The TyG index was calculated as ln[(fasting triglycerides (mg/dL)×fasting glucose (mg/dL)/2)]. The continuous variables between the DF and the non-DF groups were compared by Student's t test or the Mann-Whitney U test, and categorical variables were compared by the chi-square test. Receiver operating characteristic curve (ROC) analysis was carried out to estimate the predictive value of the TyG index for DF. Logistic regression models were used to evaluate the associations between the quartiles of the TyG index and the risk of DF. Subgroup and sensitivity analyses were conducted. RESULTS The TyG index was significantly lower in the DF group than in the no-DF group. The logistic regression revealed that an increased TyG index was associated with a lower risk of DF after adjusting for potential confounders. In addition, an ROC analysis indicated the discriminatory ability of the TyG index in DF presence with an area under the curve (AUC) of 0.661 (95% CI 0.642-0.680, P < 0.001). Subgroup and sensitivity analysis also supported these robust results. CONCLUSIONS The TyG index was inversely and dose-dependently associated with the risk of DF in diabetes patients, indicating that elevated TyG index was a protective factor for DF. Future studies are therefore warranted to confirm our finding and to explore the detailed pathological mechanism involved in this process.
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Affiliation(s)
- Zhaoping Li
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Taian, Shandong, China
| | - Minghao Zhang
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Taian, Shandong, China
| | - Lulu Han
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Taian, Shandong, China
| | - Lili Fu
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Taian, Shandong, China
| | - Yixia Wu
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Taian, Shandong, China
| | - Haiyan Chen
- Department of Geriatric Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Taian, Shandong, China
| | - Li Feng
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Taian, Shandong, China
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Wu Z, Liu C, Ma Z, Li Z, Wang S, Chen Y, Han M, Huang S, Zhou Q, Zhang C, Hou B. A hierarchical prognostic model for Co-diabetes pancreatic adenocarcinoma. Heliyon 2023; 9:e21642. [PMID: 38027595 PMCID: PMC10663840 DOI: 10.1016/j.heliyon.2023.e21642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Co-diabetes pancreatic adenocarcinoma has a poorer prognosis than pancreatic adenocarcinoma without diabetes. This study aimed to develop a reliable prognostic model for patients with co-diabetes pancreatic adenocarcinoma. Method Overall, 169 patients with co-diabetes pancreatic adenocarcinoma were included in our study. First, the independent risk factors affecting the prognosis of patients with co-diabetes pancreatic adenocarcinoma were determined by univariate and multivariate Cox regression analyses. Based on these identified risk factors, we developed a nomogram and evaluated its predictive ability using the concordance index, receiver operating characteristic curve, calibration plot, decision curve, and net reclassification index. Results In this study, prealbumin, transferrin, carcinoembryonic antigen, distant metastasis, tumor differentiation neutrophil count, lymphocyte count and fasting blood glucose were confirmed as significant prognostic factors. Based on these predictors, a new nomogram was developed. Compared with the American Joint Committee on Cancer 8 staging system and other models, the nomogram achieved a higher concordance index in the training (0.795) and validation (0.729) queues. The area under the nomogram's curve for predicting patient survival at 0.5, 1, and 1.5 years in the training queue was >0.8. Patients were risk-stratified using the nomogram, and Kaplan-Meier survival curves of subgroups were plotted. The Kaplan-Meier curve also showed better separation than the American Joint Committee on Cancer 8 staging system, indicating that our model has a better risk hierarchical ability. Conclusions Compared to the American Joint Committee on Cancer 8 staging system and other predictive models, our model showed better predictive ability for patients with co-diabetes pancreatic adenocarcinoma. Our model will help in patients' risk stratification and improves their prognosis.
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Affiliation(s)
- Zelong Wu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
- Heyuan People's Hospital, Heyuan 517000, China
| | - Chunsheng Liu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
- Heyuan People's Hospital, Heyuan 517000, China
| | - Zuyi Ma
- Department of General Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100005, China
| | - Zhenchong Li
- German Cancer Research Center (DKFZ), Junior Clinical Cooperation Unit Translational Gastrointestinal Oncology and Preclinical Models, Heidelberg, Germany
| | - Shujie Wang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Heyuan People's Hospital, Heyuan 517000, China
| | - Yubin Chen
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Heyuan People's Hospital, Heyuan 517000, China
- South China University of Technology School of Medicine, Guangzhou 51000, China
| | - Mingqian Han
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
- Heyuan People's Hospital, Heyuan 517000, China
| | - Shanzhou Huang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
- Heyuan People's Hospital, Heyuan 517000, China
- South China University of Technology School of Medicine, Guangzhou 51000, China
| | - Qi Zhou
- Department of Liver Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
- Department of General Surgery, Hui Ya Hospital of the First Affiliated Hospital, Sun Yat-sen University, Huizhou, Guangdong 516081, China
| | - Chuanzhao Zhang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
- Heyuan People's Hospital, Heyuan 517000, China
- South China University of Technology School of Medicine, Guangzhou 51000, China
| | - Baohua Hou
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
- Heyuan People's Hospital, Heyuan 517000, China
- South China University of Technology School of Medicine, Guangzhou 51000, China
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Li X, Zhan F, Peng T, Xia Z, Li J. Association between the Triglyceride-Glucose Index and Non-Alcoholic Fatty Liver Disease in patients with Atrial Fibrillation. Eur J Med Res 2023; 28:355. [PMID: 37726807 PMCID: PMC10507838 DOI: 10.1186/s40001-023-01188-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/22/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND The triglyceride and glucose index (TyG), as a surrogate of insulin resistance (IR), is closely associated with non-alcoholic fatty liver disease (NAFLD). However, the association between the TyG index and NAFLD in atrial fibrillation (AF) is unknown. Therefore, the purpose of this study is to explore the association between the TyG index and NAFLD in AF. METHODS This retrospective study was performed at Nanchang University's Second Affiliated Hospital. The AF patients who were hospitalized from January 2021 to December 2022 were enrolled. The association between the TyG index and NAFLD in AF patients was assessed by logistic regression and restricted cubic spline analysis. The ability of TyG index for identifying NAFLD was estimated by the area under the receiver operating characteristic (ROC). RESULTS In this study, 632 people participated in the final analysis, with 176 (27.84%) having NAFLD. In the full adjustment model, there is an association between the TyG index and NAFLD [per 1 unit increment; odds ratios (ORs): 3.28; 95% confidence interval (CI) 2.14, 5.03]. Compared to the lowest tertile (TyG index < 8.29), the ORs for the highest tertile (TyG index ≥ 8.82) were 4.15 (95%CI: 2.28, 7.53). Dose-response analysis showed that the TyG index and NAFLD have a nearly linear relationship (P non-linear = 0.71). The area under the curve (AUC) of the TyG index is 0.735. CONCLUSIONS Our findings showed a significant association between the TyG index and NAFLD. The TyG index may be a good marker for predicting NAFLD in AF patients.
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Affiliation(s)
- Xiaozhong Li
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Fenfang Zhan
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Tian Peng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Zhen Xia
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
| | - Juxiang Li
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
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Sun Z, Wang K, Yun C, Bai F, Yuan X, Lee Y, Lou Q. Correlation Between the Variability of Different Obesity Indices and Diabetic Kidney Disease: A Retrospective Cohort Study Based on Populations in Taiwan. Diabetes Metab Syndr Obes 2023; 16:2791-2802. [PMID: 37720422 PMCID: PMC10504903 DOI: 10.2147/dmso.s425198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/31/2023] [Indexed: 09/19/2023] Open
Abstract
Purpose To investigate the association of five obesity indices and the variability of these indices with diabetic kidney disease (DKD) in patients with type 2 diabetes and compare the predictive validity of these markers for the risk of DKD in this large longitudinal cohort study. Patients and Methods A total of 2659 patients with type 2 diabetes who did not have DKD were enrolled between 2006 and 2019 at Lee's United Clinic in Taiwan. Data were collected for each subject, including demographic data, personal medical history, clinical parameters and calculated Body mass index (BMI), visceral adiposity index (VAI), lipid accumulation product (LAP), body roundness index (BRI) and variability of five obesity indices. Cox regression analysis was performed to determine the relationship between different obesity indicators and DKD risk. Cox's proportional hazards model was evaluated the predictive effect of obesity indices on DKD. Results The risk of developing DKD increased with an increase in the BRI, LAP, VAI, WC and BMI (all P trend<0.05), and the variability of VAI was significantly associated with DKD [HR=1.132, 95% CI (1.001, 1.281)] after adjusting for corresponding variables. BRI had the strongest predictive effect on DKD. BRI had the best predictive performance, with AUC of 0.807, 0.663 and 0.673 at 1, 3 and 5 years, respectively. Cox regression analysis of risk factors for DKD in patients stratified by BRI quartiles showed that patients in the Q4 group had the highest risk of developing DKD [HR=1.356, 95% CI (1.131, 1.626)]. Conclusion BMI, WC, VAI, LAP, BRI and VAI variability were associated with a significant increase in the risk of DKD events, and BRI was superior and alternative obesity index for predicting DKD.
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Affiliation(s)
- Zhenzhen Sun
- The First Affiliated Hospital of Hainan Medical University, Hainan Clinical Research Center for Metabolic Disease, Haikou, Hainan, People’s Republic of China
| | - Kun Wang
- The First Affiliated Hospital of Hainan Medical University, Hainan Clinical Research Center for Metabolic Disease, Haikou, Hainan, People’s Republic of China
| | - Chuan Yun
- The First Affiliated Hospital of Hainan Medical University, Hainan Clinical Research Center for Metabolic Disease, Haikou, Hainan, People’s Republic of China
| | - Fang Bai
- The First Affiliated Hospital of Hainan Medical University, Hainan Clinical Research Center for Metabolic Disease, Haikou, Hainan, People’s Republic of China
| | - Xiaodan Yuan
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Yaujiunn Lee
- Department of Endocrinology, Lee’s Clinic, Pingtung City, Pingtung County, Taiwan
| | - Qingqing Lou
- The First Affiliated Hospital of Hainan Medical University, Hainan Clinical Research Center for Metabolic Disease, Haikou, Hainan, People’s Republic of China
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Milla AMG, Chagas EBF, Miola VFB, Zanuso BDO, Guiguer EL, Araújo AC, Tofano RJ, Quesada KR, Laurindo LF, Barbalho SM. Accuracy of visceral adiposity indices and lipid accumulation products in the identification of adults at high cardiovascular risk. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2023; 35:236-242. [PMID: 37121826 DOI: 10.1016/j.arteri.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 05/02/2023]
Abstract
INTRODUCTION The lipid accumulation product (LAP) and visceral adipose index (VAI) are clinical markers of visceral obesity and were proposed as simple tools to estimate cardiovascular risk and mortality. The objective of this study was to analyze the accuracy of the VAI and LAP for high cardiovascular risk patients. METHODS A cross-sectional observational study of accuracy was carried out in 193 patients of both sexes. In addition to the variables VAI and LAP, presence of comorbidities, education, level of physical activity and anthropometric data were obtained. Cardiovascular risk was determined by the Framingham score. RESULTS No significant difference was observed in the sample in gender distribution (44.6% women; 55.4% men), 24.4% had low cardiovascular risk, 48.7% intermediate risk and 26.9% high cardiovascular risk. Linear regression analysis showed that VAI and LAP explain, respectively, only 2.4% and 5.2% of the variation in cardiovascular risk expressed by the Framingham score. The analysis of areas under the curve (AUC) for receiver operating characteristic (ROC) indicated a significant effect only of LAP to diagnose individuals with high cardiovascular risk, but with low sensitivity and specificity. CONCLUSION Our results indicate that VAI and LAP explain only a small percentage of the variation in the Framingham cardiovascular risk score. LAP index still deserves more attention in a cohort study, because, even with the limitations of a cross-sectional study, we observed an acceptable sensitivity for it so that the LAP can be used as a screening criterion for requesting more accurate tests.
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Affiliation(s)
- Ana Maria Gonçalvez Milla
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation - UNIMAR, Marília, SP, Brazil
| | - Eduardo B F Chagas
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation - UNIMAR, Marília, SP, Brazil; Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001 Marília, São Paulo, Brazil
| | - Vitor Fernando Bordin Miola
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001 Marília, São Paulo, Brazil
| | - Bárbara de Oliveira Zanuso
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001 Marília, São Paulo, Brazil
| | - Elen Landgraf Guiguer
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation - UNIMAR, Marília, SP, Brazil; Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001 Marília, São Paulo, Brazil; School of Food and Technology of Marilia (FATEC), Marilia, SP, Brazil
| | - Adriano Cressoni Araújo
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation - UNIMAR, Marília, SP, Brazil; Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001 Marília, São Paulo, Brazil
| | - Ricardo José Tofano
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation - UNIMAR, Marília, SP, Brazil; Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001 Marília, São Paulo, Brazil
| | - Karina R Quesada
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001 Marília, São Paulo, Brazil; School of Food and Technology of Marilia (FATEC), Marilia, SP, Brazil
| | - Lucas F Laurindo
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001 Marília, São Paulo, Brazil
| | - Sandra M Barbalho
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation - UNIMAR, Marília, SP, Brazil; Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001 Marília, São Paulo, Brazil; School of Food and Technology of Marilia (FATEC), Marilia, SP, Brazil.
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Liu Z, Deng B, Huang Q, Tu R, Yu F, Xia J, Feng J. Comparison of seven surrogate insulin resistance indexes for predicting the prevalence of carotid atherosclerosis in normal-weight individuals. Front Public Health 2023; 11:1241523. [PMID: 37719743 PMCID: PMC10501451 DOI: 10.3389/fpubh.2023.1241523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/18/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction The aim of this study was to assess the correlation between surrogate insulin resistance (IR) indexes and carotid atherosclerosis (CA) in normal-weight populations, as well as compared their ability to predict CA. Method A total of 26,795 middle-aged and older adult individuals with normal body weights were included. Triglyceride-glucose index (TyG), TyG-body mass index, TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), visceral adiposity index, Chinese VAI (CVAI) and lipid accumulation product (LAP) were determined using established formulas. The associations between these surrogate indexes and CA were assessed using logistic regression models and restricted cubic spline (RCS) analysis. Receiver operating characteristic curves were utilized to compare the performance of these indexes for predicting CA. Result The levels of all seven surrogate indexes of IR were significantly higher in normal-weight individuals with CA than in those without CA (p < 0.001). In the full-adjusted model, only CVAI, TyG-WC, TyG-WHtR and LAP were significantly associated with CA, with the adjusted odds ratios (95% CI) of CA being 1.25 (1.20-1.30), 1.18 (1.14-1.23), 1.20 (1.16-1.25) and 1.25 (1.18-1.32) for each one standard deviation increase in CVAI, TyG-WC, TyG-WHtR and LAP, respectively. RCS analysis revealed a significant increase in the prevalence of CA among normal-weight individuals with CVAI >89.83, LAP >28.91, TyG-WHtR >4.42 and TyG-WC >704.93. The area under the curve for CVAI was significantly greater than for other indexes (p < 0.001). Conclusion CVAI, TyG-WC, TyG-WHtR and LAP were independently associated with the prevalence of CA. Specifically, CVAI may be the most appropriate predictor of CA in normal-weight individuals.
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Affiliation(s)
- Zeyu Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bi Deng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qin Huang
- Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Ruxin Tu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fang Yu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jian Xia
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Rattanatham R, Tangpong J, Chatatikun M, Sun D, Kawakami F, Imai M, Klangbud WK. Assessment of eight insulin resistance surrogate indexes for predicting metabolic syndrome and hypertension in Thai law enforcement officers. PeerJ 2023; 11:e15463. [PMID: 37273533 PMCID: PMC10234272 DOI: 10.7717/peerj.15463] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/04/2023] [Indexed: 06/06/2023] Open
Abstract
Police officers in Thailand have an increased risk of heart disease, stroke, and type 2 diabetes, possibly due to a high prevalence of hypertension and metabolic syndrome (MetS). In this study, the researchers aimed to understand the relationship between surrogate markers of insulin resistance (IR) and the prevalence of MetS and hypertension in Thai police officers. The study included 7,852 police officer participants, of which 91.8% were men with an average age of 48.56 years. The prevalence of hypertension and MetS were found to be 51.1% and 30.8%, respectively, and the participants with MetS and hypertension were older compared to the regular group. The study looked at eight IR indices, including markers such as atherogenic index of plasma (AIP), lipid accumulation product (LAP), metabolic score for insulin resistance (METS-IR), triglyceride glucose (TyG) index, TyG index with body mass index (TyG-BMI), TyG index with waist circumference (TyG-WC), the ratio of triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-c), and visceral obesity index (VAI). These indices were found to be positively correlated with waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), and triglycerides (TG), while being negatively correlated with high-density lipoprotein cholesterol (HDL-c). In addition, the multiple regression analysis showed that higher quartiles of all IR indices were significantly associated with increased risks of MetS and hypertension. Interestingly, the IR indices were more accurate in predicting MetS (ranges 0.848 to 0.892) than traditional obesity indices, with the AUC difference at p < 0.001. Among the IR indices, TyG-WC performed the best in predicting MetS (AUC value 0.892 and Youden index 0.620). At the same time, TyG-BMI had the highest accuracy in predicting hypertension (AUC value of 0.659 and Youden index of 0.236). In addition, this study found that when two markers were combined for diagnosing metabolic syndrome, a significantly improved predictive value for disease risk was observed, as evidenced by higher AUC and Yoden index. Moreover, the IR indices were found to have higher predictive power for MetS and hypertension in younger police personnel (age < 48 years) than older personnel. In conclusion, this study highlights the importance of reducing cardiovascular disease risks among law enforcement personnel as a strategic goal to improve their health and wellness. The findings suggest that IR indices may be valuable tools in predicting MetS and hypertension in law enforcement personnel and could potentially aid in the early identification and prevention of law enforcement personnel health conditions.
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Affiliation(s)
- Rujikorn Rattanatham
- School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
- Research Excellence Center for Innovation and Health Products, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Jitbanjong Tangpong
- School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
- Research Excellence Center for Innovation and Health Products, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Moragot Chatatikun
- School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
- Center of Excellence Research for Melioidosis and Microorganisms (CERMM), Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Dali Sun
- Biomedical Engineering Program, North Dakota State University, Fargo, North Dakota, United States
| | - Fumitaka Kawakami
- Research Facility of Regenerative Medicine and Cell Design, School of Allied Health Sciences, Kitasato University, Sagamihara, Kitasato, Japan
- Department of Regulation Biochemistry, Kitasato University Graduate School of Medical Sciences, Sagamihara, Kitasato, Japan
| | - Motoki Imai
- Research Facility of Regenerative Medicine and Cell Design, School of Allied Health Sciences, Kitasato University, Sagamihara, Kitasato, Japan
- Department of Molecular Diagnostics, School of Allied Heath Sciences, Kitasato University, Sagamihara, Kitasato, Japan
| | - Wiyada Kwanhian Klangbud
- School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
- Center of Excellence Research for Melioidosis and Microorganisms (CERMM), Walailak University, Thasala, Nakhon Si Thammarat, Thailand
- Walailak University Medical Technology Clinic (Wu-MeT), Walailak University, Thasala, Nakhon Si Thammarat, Thailand
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16
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Jin J, Woo H, Jang Y, Lee WK, Kim JG, Lee IK, Park KG, Choi YK. Novel Asian-Specific Visceral Adiposity Indices Are Associated with Chronic Kidney Disease in Korean Adults. Diabetes Metab J 2023; 47:426-436. [PMID: 36872065 PMCID: PMC10244194 DOI: 10.4093/dmj.2022.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/17/2022] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND The Chinese visceral adiposity index (CVAI) and new visceral adiposity index (NVAI) are novel indices of visceral adiposity used to predict metabolic and cardiovascular diseases in Asian populations. However, the relationships of CVAI and NVAI with chronic kidney disease (CKD) have not been investigated. We aimed to characterize the relationships of CVAI and NVAI with the prevalence of CKD in Korean adults. METHODS A total of 14,068 participants in the 7th Korea National Health and Nutrition Examination Survey (6,182 men and 7,886 women) were included. Receiver operating characteristic (ROC) analyses were employed to compare the associations between indices of adiposity and CKD, and a logistic regression model was used to characterize the relationships of CVAI and NVAI with CKD prevalence. RESULTS The areas under the ROC curves for CVAI and NVAI were significantly larger than for the other indices, including the visceral adiposity index and lipid accumulation product, in both men and women (all P<0.001). In addition, high CVAI or NVAI was significantly associated with a high CKD prevalence in both men (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.31 to 3.48 in CVAI and OR, 6.47; 95% CI, 2.91 to 14.38 in NVAI, P<0.05) and women (OR, 4.87; 95% CI, 1.85 to 12.79 in CVAI and OR, 3.03; 95% CI, 1.35 to 6.82 in NVAI, P<0.05); this association remained significant after adjustment for multiple confounding factors in men and women. CONCLUSION CVAI and NVAI are positively associated with CKD prevalence in a Korean population. CVAI and NVAI may be useful for the identification of CKD in Asian populations, including in Korea.
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Affiliation(s)
- Jonghwa Jin
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Hyein Woo
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Youngeun Jang
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Won-Ki Lee
- Center of Biostatistics, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Jung-Guk Kim
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - In-Kyu Lee
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Keun-Gyu Park
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - Yeon-Kyung Choi
- Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu,
Korea
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Fornari Laurindo L, Minniti G, José Tofano R, Quesada K, Federighi Baisi Chagas E, Maria Barbalho S. Detection of Metabolic Syndrome Using Insulin Resistance Indexes: A Cross-Sectional Observational Cohort Study. ENDOCRINES 2023. [DOI: 10.3390/endocrines4020021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Insulin resistance (IR) is considered cardinal to the pathophysiology of metabolic syndrome (MetS). Previously, several simple indexes of IR calculated from biochemical and anthropometric variables have been proposed. However, these indexes are population-dependent; therefore, further studies on a global scale are necessary. The present study assessed the diagnostic accuracy of eight IR indicators, namely, METS-IR, TG-HDL-c, TyG, TyG-BMI, TyG-NC, TyG-NHtR, TyG-WC, and TyG-WHtR, in indicating MetS among a Brazilian population. For this, 268 patients (152 men and 116 women, 53–59 years of age) were included in the study, out of which 111 were diagnosed with MetS according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). All indexes achieved significant accuracy, with TyG-WC (0.849 (0.800–0.889)), TyG (0.837 (0.787–0.879)), and TG-HDL-c (0.817 (0.765–0.861)) having the highest area under the curve (AUC). Further, the most heightened diagnostic sensitivities were observed for TG-HDL-c (90.99%), TyG-WC (89.19%), and TyG-NC (84.68%), whereas the highest diagnostic specificities were noted for TyG (73.89%), TyG-WHtR (72.61%), and TyG-WC (66.88%). Thus, TyG-WC, TyG, and TG-HDL-c reached the greatest AUC values in our analyses, making them useful diagnostic indicators of MetS, and crucial for patients’ clinical management.
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Affiliation(s)
- Lucas Fornari Laurindo
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Department of Biochemistry and Pharmacology, School of Medicine, Faculdade de Medicina de Marília (FAMEMA), Avenida Monte Carmelo, 800, Marília 17519-030, SP, Brazil
| | - Giulia Minniti
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Ricardo José Tofano
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Karina Quesada
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Eduardo Federighi Baisi Chagas
- Postgraduate Program in Health and Aging, Faculdade de Medicina de Marília (FAMEMA), Avenida Monte Carmelo, 800, Marília 17519-030, SP, Brazil
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Sandra Maria Barbalho
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Department of Biochemistry and Nutrition, School of Food and Technology of Marília (FATEC), Avenida Castro Alves, 62, Marília 17500-000, SP, Brazil
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Sun J, Meng X, Huang H, Jing J, Pan Y, Mei L, Jin A, Wang Y, Wei T, Cai X. Higher visceral adiposity index and lipid accumulation product in relation to increased risk of atherosclerotic burden in community-dwelling older adults. Exp Gerontol 2023; 174:112115. [PMID: 36758647 DOI: 10.1016/j.exger.2023.112115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/02/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND AND AIMS Visceral adiposity index (VAI) and lipid accumulation product (LAP), as anthropometric indices, have been applied to predict the risk of cardiovascular diseases (CVD). However, few studies investigated the correlation between these two indicators and cardio-cerebro-vascular atherosclerosis in community populations. Our study was to explore the association of VAI and LAP with coronary, intracranial and extracranial atherosclerosis in a community-based asymptomatic middle-aged and older population. METHODS Participants without a history of CVD in the study of PRECISE (Polyvascular Evaluation for Cognitive Impairment and Vascular Events) were included. The sex-special indicators of VAI and LAP were calculated and stratified by the tertiles. The presence of plaque and coronary segmental stenosis score (SSS) were assessed by coronary computed tomography (CTA), as well as intracranial and extracranial atherosclerotic burden were evaluated by high-resolution magnetic resonance imaging (HR-MRI), respectively. Binary or ordinal logistic regression was conducted to assess the association between each of the indexes and the presence and burden of atherosclerosis. RESULTS A total of 2875 subjects were included in the final analysis. The mean age was 60.9 ± 6.6 years and 1329 (46.2 %) participants were males. Compared with the first tertile of VAI, the higher tertile was associated with the presence of plaques (T3 vs T1, OR, 1.49, 95%CI, 1.12-1.98, for males; OR, 1.64, 95%CI, 1.24-2.17, for females) and atherosclerotic burden (T3 vs T1, adjusted cOR, 1.63, 95%CI, 1.24-2.14, for males; adjusted cOR, 1.70, 95%CI, 1.29-2.24, for females) in major coronary arteries. A similar association was found for LAP. VAI level has presented an association with the extracranial atherosclerotic plaques (T3 vs T1, OR, 1.34, 95%CI, 1.02-1.77) and burden (T3 vs T1, adjusted cOR 1.32, 95 % CI 1.00-1.73) only in females. Whereas, for intracranial atherosclerosis, the results failed to show any statistically significant association. CONCLUSIONS Among community-dwelling asymptomatic older adults, VAI and LAP were associated with the presence and burden of coronary atherosclerotic plaques, while VAI presented a weaker significant association with extracranial atherosclerosis in females.
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Affiliation(s)
- Jingping Sun
- Department of Neurology, the Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China; Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Huifen Huang
- Department of Neurology, the Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China; Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China
| | - Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Lerong Mei
- Department of Neurology, the Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China; Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China
| | - Aoming Jin
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Tiemin Wei
- Department of Cardiology, the Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China.
| | - Xueli Cai
- Department of Neurology, the Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China; Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China.
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Dundar C, Terzi O, Arslan HN. Comparison of the ability of HOMA-IR, VAI, and TyG indexes to predict metabolic syndrome in children with obesity: a cross-sectional study. BMC Pediatr 2023; 23:74. [PMID: 36765298 PMCID: PMC9921359 DOI: 10.1186/s12887-023-03892-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND The increasing trend in childhood obesity needs to be closely monitored and intervened due to long-term health issues such as metabolic syndrome, cardiovascular diseases, hypertension, and type 2 diabetes. We aimed to determine and compare the cut-off values for the visceral adiposity index (VAI), triglyceride-glucose index (TyG), and HOMA-IR for predicting metabolic syndrome (MetS). METHODS This population-based cross-sectional study was conducted in May 2019 in Samsun, Turkey. The study included 169 children with obesity aged 9 and 10 years. After anthropometric and clinical evaluation, fasting blood samples were collected from the children. The areas under the curve of the visceral adiposity index, triglyceride-glucose index, and HOMA-IR were compared by receiver-operating-characteristic (ROC) analysis in predicting the MetS. RESULTS The total prevalence of MetS was 21.3% in children with obesity, and it was two times higher in girls than in boys. The mean values of TyG and VAI were significantly different in those who have and have not MetS in both genders. However, the HOMA-IR index was higher only in girls with MetS and did not differ in boys by having MetS. The VAI and the TyG index both had statistically significant cut-off values in both sexes and a larger ROC area than the HOMA-IR index in predicting MetS. CONCLUSIONS The VAI and TyG index are effective indicators in assessing the MetS risk in children with obesity. Both indexes can be considered useful tools in pediatric research and the evaluation of interventions. However, the HOMA-IR index formula needs to be developed taking into account age, gender, and ethnicity.
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Affiliation(s)
- Cihad Dundar
- Dept. of Public Health, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey.
| | - Ozlem Terzi
- grid.411049.90000 0004 0574 2310Dept. of Public Health, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Hatice Nilden Arslan
- grid.411049.90000 0004 0574 2310Dept. of Public Health, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
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Xu W, Zhao H, Han X, Liu J, Li H, Sun J, Xing A, Chen S, Wu S, Wu Y. Relationship between early-onset stroke and triglyceride-glucose index among young Chinese adults. Lipids Health Dis 2023; 22:3. [PMID: 36631854 PMCID: PMC9832803 DOI: 10.1186/s12944-023-01773-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The triglyceride-glucose index (TyG index), an alternative indicator of peripheral insulin resistance (IR), is associated with cardiovascular disease (CVD) in the general population. The aim of this research was to determine the correlation between early-onset stroke and the TyG index among young Chinese adults. METHODS Participants (age ≤ 40 years) who attended their first physical examination in Kailuan General Hospital or its 11 subsidiary hospitals between 2006 and 2012 were enrolled. The subjects were divided into four equal points according to the quartile of the TyG index, with the lowest quartile (Q1) as the reference group. A Cox proportional hazard model was employed to assess the correlation between early-onset stroke incidence and the TyG index. Restricted cubic spline analysis was further conducted to examine nonlinear associations. The TyG index was calculated as Ln [Triglyceride (TG, mg/dL) × Fasting Blood Glucose (FBG, mg/dL)/2]. RESULTS Overall, 35,999 subjects met the inclusion criteria. Their mean age was 30.8 ± 5.7 years, and 77.1% of subjects were males. During a median observation period of 11 years, 281 stroke events occurred (62 hemorrhagic strokes and 219 ischemic strokes). Compared to the Q1 group (as the lowest group), subjects in groups Q2-Q4 had significantly higher risks of early-onset stroke (P < 0.05) after adjustment for relevant confounders in the Cox proportional hazards model. Similar results were consistent with ischemic stroke. However, no significant associations were observed between the risk of hemorrhage and the baseline TyG index. The restricted cubic splines revealed that the risk of stroke progressively increased with a high TyG index ≥ 8.41. CONCLUSIONS The TyG index may be a major risk factor for early-onset stroke among young Chinese adults. A TyG index ≥ 8.41 can be used as an indicator for screening high-risk stroke groups.
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Affiliation(s)
- Wenqi Xu
- grid.459652.90000 0004 1757 7033Department of Cardiology, Kailuan General Hospital, Tangshan, 063000 China ,grid.440734.00000 0001 0707 0296Graduate School, North China University of Science and Technology, Tangshan, China
| | - Haiyan Zhao
- grid.459652.90000 0004 1757 7033Department of Cardiology, Kailuan General Hospital, Tangshan, 063000 China
| | - Xu Han
- grid.459652.90000 0004 1757 7033Department of Cardiology, Kailuan General Hospital, Tangshan, 063000 China ,grid.440734.00000 0001 0707 0296Graduate School, North China University of Science and Technology, Tangshan, China
| | - Jianrong Liu
- grid.459652.90000 0004 1757 7033Department of Cardiology, Kailuan General Hospital, Tangshan, 063000 China
| | - Haixia Li
- grid.459652.90000 0004 1757 7033Department of Cardiology, Kailuan General Hospital, Tangshan, 063000 China
| | - Junyan Sun
- grid.459652.90000 0004 1757 7033Department of Cardiology, Kailuan General Hospital, Tangshan, 063000 China
| | - Aijun Xing
- grid.459652.90000 0004 1757 7033Department of Cardiology, Kailuan General Hospital, Tangshan, 063000 China
| | - Shuohua Chen
- grid.459652.90000 0004 1757 7033Department of Cardiology, Kailuan General Hospital, Tangshan, 063000 China
| | - Shouling Wu
- grid.459652.90000 0004 1757 7033Department of Cardiology, Kailuan General Hospital, Tangshan, 063000 China
| | - Yuntao Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, 063000, China.
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Foryś E, Baran A, Dziurdzia A, Jarosz-Wójcik E, Matusik P, Gawlik A, Tomaszewski R, Zachurzok A. Are menstrual disorders in adolescent girls related to metabolic disorders? Pediatr Endocrinol Diabetes Metab 2023; 29:75-82. [PMID: 37728458 PMCID: PMC10411084 DOI: 10.5114/pedm.2023.125364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 12/05/2022] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Menstrual disorders in adolescent girls are a common clinical problem. They are often accompanied by lipid and glucose metabolism disturbances. The aim of the study was to investigate to what extent the metabolic profile of adolescent girls relates to the severity of their menstrual disorders. MATERIAL AND METHODS The study included 165 girls with menstrual disturbances and 49 regularly menstruating girls (REG) without clinical hyperandrogenism, matched for age and BMI. The subjects from the study group were divided into 2 subgroups: OLIGO - 111 girls with oligomenorrhea and SA - 54 girls with secondary amenorrhoea. In all girls, hormonal, lipid, and carbohydrate metabolism profiles were assessed. RESULTS In the SA subgroup concentrations of total cholesterol (TC) and LDL were significantly higher than in the REG and OLIGO groups. Triglyceride (TG) concentration was also the highest in the SA group and significantly higher than in the REG group. The prevalence of lipid metabolism disorders was higher in the SA group (65%) vs. the REG (40%) and OLIGO (51%) groups. The subgroups did not differ significantly in terms of fasting and OGTT glucose and insulin as well as HOMA-IR. TyG index was significantly higher in the OLIGO and SA groups than in the REG group. BMI z-score correlated with TG, LDL, fasting and 120' OGTT glucose and insulin, HOMA-IR, and TyG and negatively with HDL. No relationship between hormonal concentration and metabolic disturbances was found. CONCLUSIONS Adolescent girls with menstrual disorders are insulin resistant, regardless of PCOS diagnosis. The severity of menstrual disorders may be related to the incidence of lipid disorders in adolescent girls.
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Affiliation(s)
- Elżbieta Foryś
- Department of Pediatrics and Pediatric Endocrinology, Medical University of Silesia in Katowice, Poland
| | - Adrianna Baran
- Student Scientific Association, Department of Pediatrics and Pediatric Endocrinology, Medical University of Silesia, School of Medicine in Katowice, Poland
| | - Aleksandra Dziurdzia
- Student Scientific Association, Department of Pediatrics and Pediatric Endocrinology, Medical University of Silesia, School of Medicine in Katowice, Poland
| | - Ewelina Jarosz-Wójcik
- Student Scientific Association, Department of Pediatrics and Pediatric Endocrinology, Medical University of Silesia, School of Medicine in Katowice, Poland
| | - Paweł Matusik
- Department of Pediatrics, Pediatric Obesity and Metabolic Bone Diseases, Chair of Pediatrics and Pediatric Endocrinology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Aneta Gawlik
- Department of Pediatrics and Pediatric Endocrinology, Medical University of Silesia in Katowice, Poland
| | - Ryszard Tomaszewski
- Institute of Biomedical Engineering, Faculty of Science and Technology, University of Silesia in Katowice, Poland
- Department of Pediatric Traumatology and Orthopedy, Upper Silesian Child Centre in Katowice, Poland
| | - Agnieszka Zachurzok
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
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Xu W, Zhao H, Gao L, Guo L, Liu J, Li H, Sun J, Xing A, Chen S, Wu S, Wu Y. Association of long-term triglyceride-glucose index level and change with the risk of cardiometabolic diseases. Front Endocrinol (Lausanne) 2023; 14:1148203. [PMID: 37065738 PMCID: PMC10098344 DOI: 10.3389/fendo.2023.1148203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/16/2023] [Indexed: 04/03/2023] Open
Abstract
OBJECTIVE The triglyceride-glucose (TyG) index is considered as a pivotal factor for various metabolic, cardiovascular, and cerebrovascular diseases. However, there is currently a paucity of relevant studies on the association between long-term level and change of TyG-index and cardiometabolic diseases (CMDs) risk. We aimed to explore the risk of CMDs in relation to the long-term level and change of TyG-index. METHODS Based on the prospective cohort study, a total of 36359 subjects who were free of CMDs, had complete data of triglyceride (TG) and fasting blood glucose (FBG) and underwent four health check-ups from 2006 to 2012 consecutively were followed up for CMDs until 2021. The associations between long-term level and change of TyG-index and CMDs risk were assessed by Cox proportional hazards regression models to compute hazard ratios (HRs) and 95% confidence intervals (CIs). The TyG-index was calculated as ln [TG, mg/dL) × FBG, mg/dL)/2]. RESULTS During the median observation period of 8 years, 4685 subjects were newly diagnosed with CMDs. In multivariable-adjusted models, a graded positive association was observed between CMDs and long-term TyG-index. Compared with the Q1 group, subjects with the Q2-Q4 group had increased progressively risk of CMDs, with corresponding HRs of 1.64(1.47-1.83), 2.36(2.13-2.62), 3.15(2.84-3.49), respectively. The association was marginally attenuated, after further adjustment for the baseline TyG level. In addition, compared with stable TyG level, both loss and gain in TyG level were associated with increased CMDs risk. CONCLUSIONS Long-term elevated level and change of TyG-index are risk factors for the incident CMDs. Elevated TyG-index in the early stage remains to exert cumulative effects on the occurrence of CMDs even after accounting for the baseline TyG-index.
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Affiliation(s)
- Wenqi Xu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
- Graduate School, North China University of Science and Technology, Tangshan, Hebei, China
| | - Haiyan Zhao
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Lishu Gao
- Department of Endocrinology, Tangshan People's Hospital, Tangshan, Hebei, China
| | - Lu Guo
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
- Graduate School, North China University of Science and Technology, Tangshan, Hebei, China
| | - Jianrong Liu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Haixia Li
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Junyan Sun
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Aijun Xing
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Yuntao Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
- *Correspondence: Yuntao Wu,
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Lei L, Liang H, Qu Y, Zhong Q, Zhang Q, Dai L, Lu J, Xiao M, Zhao Z, Zhou F, Li Y, Hu G, Xiu J, Zhang X. Association between triglyceride-glucose index and worsening renal function in the elderly. Front Nutr 2022; 9:951564. [PMID: 36505264 PMCID: PMC9730025 DOI: 10.3389/fnut.2022.951564] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background Triglyceride-glucose (TyG) index is a simple marker of insulin resistance. However, insufficient data is available on whether the TyG index is associated with worsening renal function (WRF) in the elderly. Therefore, this study was designed to explore the association between the TyG index and WRF based on a community elderly cohort. Methods In this study, 7,822 elderly (aged ≥ 65 years) adults from southern China were enrolled and divided into four groups according to the TyG index quartiles. The primary endpoint was incident chronic kidney disease (CKD), defined as incident estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2. Additional endpoints included a decline in eGFR of 30% and 40% during the follow-up period. Results During the median 2.04 year follow-up period, 1,541 (19.7%) participants developed CKD. After adjusting for confounding factors, multivariable Cox regression models revealed significant associations between TyG index and incident CKD (HR per SD increase, 1.21; 95% CI: 1.14-1.29), a decline in eGFR of 30% (HR per SD increase, 1.38; 95% CI: 1.26-1.50), and decline in eGFR of 40% (HR per SD increase, 1.42; 95% CI: 1.24-1.63). Furthermore, compared with those in Q1, participants in Q4 demonstrated a higher risk of developing CKD (HR, 1.59; 95% CI: 1.35-1.88). These positive associations remained consistent across different subgroup populations. Conclusion Our study suggests a positive and independent association between the TyG index and WRF in the elderly.
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Affiliation(s)
- Li Lei
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hongbin Liang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yali Qu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Qianhong Zhong
- Department of Respiratory Medicine, The Fourth People's Hospital of Foshan (Tuberculosis Control Center of Foshan), Foshan, China
| | - Qiuxia Zhang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lei Dai
- Department of Cardiology, Nanfang Hospital Zengcheng Branch, Guangzhou, China
| | - Junyan Lu
- Department of Cardiology, Nanfang Hospital Zengcheng Branch, Guangzhou, China
| | - Min Xiao
- Department of Cardiology, Nanfang Hospital Zengcheng Branch, Guangzhou, China
| | - Zhimeng Zhao
- Department of Respiratory Medicine, The Fourth People's Hospital of Foshan (Tuberculosis Control Center of Foshan), Foshan, China
| | - Fengyun Zhou
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yun Li
- Department of Public Health Management, Zengcheng Xintang Hospital, Guangzhou, China
| | - Guifang Hu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China,*Correspondence: Guifang Hu
| | - Jiancheng Xiu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China,Department of Cardiology, Nanfang Hospital Zengcheng Branch, Guangzhou, China,Jiancheng Xiu
| | - Xinlu Zhang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China,Xinlu Zhang
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Insulin resistance in children. Curr Opin Pediatr 2022; 34:400-406. [PMID: 35796641 DOI: 10.1097/mop.0000000000001151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Insulin resistance (IR) is a clinical condition due to the decline in the efficiency of insulin promoting glucose uptake and utilization. The aim of this review is to provide an overview of the current knowledge on IR in children, focusing on its physiopathology, the most appropriate methods of measurement of IR, the assessment of risk factors, the effects of IR in children, and finally giving indications on screening and treatment. RECENT FINDINGS IR has evolved more and more to be a global public health problem associated with several chronic metabolic diseases. SUMMARY Detecting a correct measurement method and specific risk predictors, in order to reduce the incidence of IR, represents a challenging goal.
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Zhang X, Ye R, Yu C, Liu T, Chen X. Correlation Between Non-insulin-Based Insulin Resistance Indices and Increased Arterial Stiffness Measured by the Cardio–Ankle Vascular Index in Non-hypertensive Chinese Subjects: A Cross-Sectional Study. Front Cardiovasc Med 2022; 9:903307. [PMID: 35865388 PMCID: PMC9295890 DOI: 10.3389/fcvm.2022.903307] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Data are limited on the relationship between the cardio–ankle vascular index (CAVI) and non-insulin-based insulin resistance (IR) indices, including the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), fasting triglyceride and glucose index (TyG), and metabolic score for IR (METS-IR). In this study, we explored the relationship between TG/HDL-C, TyG, METS-IR, and the risk of increased arterial stiffness (CAVI ≥ 8.0) and compared their ability to detect arterial stiffness in the non-hypertensive Chinese population. A total of 3,265 non-hypertensive subjects were included. Spearman’s and partial correlation analyses were used to assess the relationship between non-insulin-based IR indices and CAVI. The correlation between these indices and the risk of a CAVI ≥ 8.0 was explored by multiple logistic regression analysis. The area under the receiver-operating characteristic curve was used to compare the ability of TG/HDL-C, TyG, and METS-IR to detect a CAVI ≥ 8.0. After adjustment for confounding factors, linear regression analysis showed that the CAVI changed by 0.092 [95% confidence interval (CI) 0.035–0.149] per standard deviation increase in TyG. While, this linear relationship was not found when analyzing TG/HDL-C and METS-IR. Multiple logistic regression analysis showed that the proportion of patients with CAVI ≥ 8.0 in the fourth quartile of TG/HDL-C [Q4 vs. Q1: odds ratio (OR) 2.434, 95% CI 1.489–3.975], TyG (Q4 vs. Q1: OR 2.346, 95% CI 1.413–3.896), and METS-IR (Q4 vs. Q1: OR 2.699, 95% CI 1.235–5.897) was significantly higher than that in the lowest quartile. The area under the curve that could discriminate CAVI ≥ 8.0 was 0.598 (95% CI 0.567–0.629) for TG/HDL-C, 0.636 (95% CI 0.606–0.667) for TyG, and 0.581 (95% CI 0.550–0.613) for METS-IR. In this study, we demonstrated a significant association between increased arterial stiffness and non-insulin-based IR indices. Among them, TyG showed better discriminatory ability than TG/HDL-C or METS-IR.
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Affiliation(s)
- Xin Zhang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Runyu Ye
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Chaoping Yu
- Department of Cardiology, Pidu District People’s Hospital, The 3rd Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Tianhu Liu
- Department of Cardiology, Pidu District People’s Hospital, The 3rd Affiliated Hospital of Chengdu Medical College, Chengdu, China
- *Correspondence: Tianhu Liu,
| | - Xiaoping Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
- Xiaoping Chen,
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Hao H, Chen Y, Xiaojuan J, Siqi Z, Hailiang C, Xiaoxing S, Qikai W, Mingquan X, Jiangzhou F, Hongfeng G. The Association Between METS-IR and Serum Ferritin Level in United States Female: A Cross-Sectional Study Based on NHANES. Front Med (Lausanne) 2022; 9:925344. [PMID: 35836938 PMCID: PMC9273928 DOI: 10.3389/fmed.2022.925344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/07/2022] [Indexed: 11/30/2022] Open
Abstract
Aim The aim of this study was to investigate the association between the metabolic score for insulin resistance (METS-IR) and serum ferritin in females from the United States. Methods We conducted a cross-sectional study with 4,182 participants from the National Health and Nutrition Examination Survey (NHANES). We used METS-IR and serum ferritin as the independent and dependent variables in this study and investigated the relationship by using multiple linear regression and verified the non-linear relationship with a smooth curve fit and threshold effect model. Results There was a positive relationship between METS-IR and serum ferritin, with an effect value of (β = 0.29, 95% CI: 0.14–0.44) in a fully adjusted model adjusted for potential confounders. This positive correlation became more significant as METS-IR increased (p for trend < 0.001). Subsequent subgroup analyses showed that sensitive cohorts were those aged ≥40 years, black, and with a body mass index (BMI) < 24.9 kg/m2. In a smoothed curve fit analysis, the correlation between METS-IR and serum ferritin was a straight linear relationship in all participants included in this study, but when stratified by age, race, and BMI, this positive correlation in the participants who were aged ≥40 years old, other race, and had a BMI < 24.9 kg/m2 was non-linear. Conclusions There was a positive association between METS-IR and serum ferritin in United States females, and this positive association was more pronounced in participants aged ≥40 years, black race and BMI < 24.9 kg/m2. This positive association was non-linear in the subgroups aged ≥40 years, white race and BMI < 24.9 kg/m2, with inflection points for METS-IR of 69.97, 67.84 and 35.84 in these respective subgroups.
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Affiliation(s)
- Han Hao
- Department of Hematology, Anhui Medical University Affiliated to Bozhou People's Hospital, Bozhou, China
| | - Yan Chen
- Department of General Practice, Wuhu City Second People‘s Hospital, Wuhu, China
| | - Ji Xiaojuan
- Department of Hematology, Anhui Medical University Affiliated to Bozhou People's Hospital, Bozhou, China
| | - Zhang Siqi
- Department of Hematology, Anhui Medical University Affiliated to Bozhou People's Hospital, Bozhou, China
| | - Chu Hailiang
- Department of Hematology, Anhui Medical University Affiliated to Bozhou People's Hospital, Bozhou, China
| | - Sun Xiaoxing
- Department of Hematology, Anhui Medical University Affiliated to Bozhou People's Hospital, Bozhou, China
| | - Wang Qikai
- Department of Hematology, Anhui Medical University Affiliated to Bozhou People's Hospital, Bozhou, China
| | - Xing Mingquan
- Department of Hematology, Anhui Medical University Affiliated to Bozhou People's Hospital, Bozhou, China
| | - Feng Jiangzhou
- Department of Hematology, Anhui Medical University Affiliated to Bozhou People's Hospital, Bozhou, China
- *Correspondence: Feng Jiangzhou
| | - Ge Hongfeng
- Department of Hematology, Anhui Medical University Affiliated to Bozhou People's Hospital, Bozhou, China
- Ge Hongfeng
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Zhang S, Wang XC, Li J, Wang XH, Wang Y, Zhang YJ, Du MY, Zhang MY, Lin JN, Li CJ. Establishment and Validation of a New Predictive Model for Insulin Resistance based on 2 Chinese Cohorts: A Cross-Sectional Study. Int J Endocrinol 2022; 2022:8968793. [PMID: 36299856 PMCID: PMC9592226 DOI: 10.1155/2022/8968793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/28/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Visceral adiposity plays a key role in the development of insulin resistance (IR), so surrogate index that can indicate visceral obesity may have higher predictive value for IR. This study aimed to establish and validate a new predictive model including indicator of visceral obesity for IR. METHODS The study population consisted of two cohorts. The derivation cohort was a group of 667 patients with newly diagnosed type 2 diabetes and the population undergoing a routine health checkup was the validation cohort. The predictive model was established by the logistic regression analysis. Its value for predicting IR was compared with other surrogate indices by the receiver operating characteristic curve. RESULTS The odds ratio (OR) of age, visceral fat area (VFA), triglyceride (TG), fasting plasma glucose (FPG), and alanine aminotransferase (ALT) for IR was 1.028 (95% CI, 1.008-1.048) (P < 0.01), 1.016 (95% CI, 1.009-1.023) (P < 0.001), 1.184 (95% CI, 1.005-1.396) (P < 0.05), 1.334 (95% CI, 1.225-1.451) (P < 0.001), and 1.021 (95% CI, 1.001-1.040) (P < 0.05). The formula of the predictive model was (0.0293 × age + 1.4892 × Ln VFA + 0.4966 × Ln TG + 2.784 × Ln FPG + 0.6906 × Ln ALT)/2. The area under the curve was the largest among all the previously reported predictors. CONCLUSIONS This study established and validated a predicting model for IR and confirmed its predictive value in comparison with other surrogate indicators, which will offer a simple and effective tool to measure IR in future large population studies.
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Affiliation(s)
- Shi Zhang
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
| | - Xin-Cheng Wang
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
| | - Jing Li
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
| | - Xiao-He Wang
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Yi Wang
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
| | - Yan-Ju Zhang
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
| | - Mei-Yang Du
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
| | | | - Jing-Na Lin
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
| | - Chun-Jun Li
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
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