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Liu M, Yang X, Jiang Y, Zhong W, Xu Y, Zhang G, Fang Q, Shen X. The role of triglyceride-glucose index in the differential diagnosis of atherosclerotic stroke and cardiogenic stroke. BMC Cardiovasc Disord 2024; 24:295. [PMID: 38851694 PMCID: PMC11162012 DOI: 10.1186/s12872-024-03857-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/25/2024] [Indexed: 06/10/2024] Open
Abstract
OBJECTIVE This study aims to investigate the role of the triglyceride glucose (TyG) index in differentiating cardiogenic stroke (CE) from large atherosclerotic stroke (LAA). METHOD In this retrospective study, patients with acute ischemic stroke were recruited from the First Affiliated Hospital of Soochow University, Lianyungang Second People's Hospital and Lianyungang First People's Hospital. Their general data, medical history and laboratory indicators were collected and TyG index was calculated. Groups were classified by the TyG index quartile to compare the differences between groups. Logistic regression was utilized to assess the relationship between the TyG index and LAA. The receiver operating characteristic curve (ROC) curve was used to evaluate the diagnostic efficiency of the TyG index in differentiating LAA from CE. RESULT The study recruited 1149 patients. After adjusting for several identified risk factors, groups TyG-Q2, TyG-Q3, and TyG-Q4 had a higher risk of developing LAA compared to group TyG-Q1(odds ratio (OR) = 1.63,95% confidence interval (CI) = 1.11-2.39, OR = 1.72,95%CI = 1.16-2.55, OR = 2.06,95%CI = 1.36-3.09). TyG has certain diagnostic value in distinguishing LAA from CE(AUC = 0.595, 95%CI0.566-0.623;P<0.001). CONCLUSION Summarily, the TyG index has slight significance in the identification of LAA and CE; it is particularly a marker for their preliminary identification.
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Affiliation(s)
- Mengqian Liu
- Department of Geriatrics, Lianyungang Hospital Affifiliated to Jiangsu University (Lianyungang Second People's Hospital), Lianyungang, China
| | - Xiaoyun Yang
- Department of Geriatrics, Lianyungang Hospital Affifiliated to Jiangsu University (Lianyungang Second People's Hospital), Lianyungang, China
| | - Yi Jiang
- Department of Geriatrics, Bengbu Medical College Clinical College of Lianyungang Second People's Hospital, Lianyungang, China
| | - Wen Zhong
- Department of Geriatrics, Lianyungang Hospital Affifiliated to Jiangsu University (Lianyungang Second People's Hospital), Lianyungang, China
| | - Yiwen Xu
- Department of Infectious Disease, The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Guanghui Zhang
- Department of Neurology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China.
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Xiaozhu Shen
- Department of Geriatrics, Lianyungang Hospital Affifiliated to Jiangsu University (Lianyungang Second People's Hospital), Lianyungang, China.
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Sun C, Hu L, Li X, Zhang X, Chen J, Li D, Zhang J, Liu L, Wu M. Triglyceride-glucose index's link to cardiovascular outcomes post-percutaneous coronary intervention in China: a meta-analysis. ESC Heart Fail 2024; 11:1317-1328. [PMID: 38246749 PMCID: PMC11098636 DOI: 10.1002/ehf2.14679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/05/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
Percutaneous coronary intervention (PCI) addresses myocardial ischaemia, but a significant subset of patients encounter major adverse cardiovascular events (MACE) post-treatment. This meta-analysis investigated the relationship between the post-PCI triglyceride-glucose (TyG) index and MACE. Comprehensive searches of the Embase, PubMed, Cochrane Library, and Web of Science databases were conducted up to 3 March 2023, using relevant keywords. The effect size was determined based on I2 statistic using random-effects models. Cluster-robust standard errors crafted the dose-response curve, and the GRADE Evaluation Scale was employed to rate the quality of evidence. The group with the highest TyG index had significantly higher post-PCI MACE rates than the lowest index group, with hazard ratios (HRs) of 2.04 (95% CI 1.65-2.52; I2 = 77%). Each unit increase in TyG index corresponded to HRs of 1.82 for MACE (95% CI 1.34-2.46; I2 = 92%), 2.57 for non-fatal MI (95% CI 1.49-4.41; I2 = 63%), and 2.06 for revascularization (95% CI 1.23-3.50; I2 = 90%). A linear relationship between TyG index and MACE risk was established (R2 = 0.6114). For all-cause mortality, the HR was 1.93 (95% CI 1.35-2.75; I2 = 50%), indicating a higher mortality risk with elevated TyG index. The GRADE assessment yielded high certainty for non-fatal MI but low certainty for all-cause mortality, revascularization, and MACE. The TyG index may predict risks of post-PCI MACE, all-cause mortality, non-fatal MI, and revascularization, with varied levels of certainty. A potential linear association between the TyG index and MACE post-PCI was identified. Future research should validate these findings.
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Affiliation(s)
- ChangXin Sun
- Beijing University of Chinese MedicineBeijingChina
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - LanQing Hu
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - XiaoYa Li
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - XiaoNan Zhang
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - JiYe Chen
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - DeXiu Li
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - JingYi Zhang
- Beijing University of Chinese MedicineBeijingChina
| | - LongTao Liu
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - Min Wu
- China Academy of Chinese Medical SciencesGuang'anmen HospitalBeijingChina
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Yu XR, Du JL, Jiang M, Ren Y, Zhang FL, Kong FL, Li FE. Correlation of TyG-BMI and TyG-WC with severity and short-term outcome in new-onset acute ischemic stroke. Front Endocrinol (Lausanne) 2024; 15:1327903. [PMID: 38846495 PMCID: PMC11153697 DOI: 10.3389/fendo.2024.1327903] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/09/2024] [Indexed: 06/09/2024] Open
Abstract
Objectives To research the connection between the indexes of the indexes of triglyceride-glucose (TyG) combined with obesity indices and the initial neurological severity and short-term outcome of new-onset acute ischemic stroke. Methods Data of patients with acute ischemic stroke admitted to the Stroke Ward of the Affiliated Hospital of Beihua University from November 2021 to October 2023, were collected. The two indexes were calculated by combining TyG and obesity indices: TyG-body mass index (TyG-BMI) and TyG-waist circumference (TyG-WC). The National Institute of Health Stroke Scale (NIHSS) was used to assess and group patients with neurological deficits within 24 hours of admission: mild stroke (NIHSS ≤5) and moderate-severe stroke (NIHSS >5). Short-term prognosis was evaluated using the modified Rankin Scale (mRS) at discharge or 14 days after onset of the disease and grouped: good outcome (mRS ≤2) and poor outcome (mRS >2). According to the quartiles of TyG-BMI and TyG-WC, the patients were placed into four groups: Q1, Q2, Q3 and Q4. Multi-factor logistic regression analysis was utilized to evaluate the correlation of TyG-BMI and TyG-WC with the severity and short-term outcome. Results The study included 456 patients. After adjusting for multiple variables, the results showed that compared with the quartile 1, patients in quartile 4 of TyG-BMI had a reduced risk of moderate-severe stroke [Q4: OR: 0.407, 95%CI (0.185-0.894), P = 0.025]; Patients in quartiles 2, 3 and 4 of TyG-BMI had sequentially lower risk of short-term adverse outcomes [Q2: OR: 0.394, 95%CI (0.215-0.722), P = 0.003; Q3: OR: 0.324, 95%CI (0.163-0.642), P = 0.001; Q4: OR: 0.158, 95%CI (0.027-0.349), P <0.001]; Patients in quartiles 3 and 4 of TyG-WC had sequentially lower risk of moderate-severe stroke [Q3: OR: 0.355, 95%CI (0.173-0.728), P = 0.005; Q4: OR: 0.140, 95%CI (0.056-0.351), P <0.001]; Patients in quartiles 3 and 4 of TyG-WC had sequentially lower risk of short-term adverse outcomes [Q3: OR: 0.350, 95%CI (0.175-0.700), P = 0.003; Q4: OR: 0.178, 95%CI (0.071-0.451), P <0.001]. Conclusions TyG-WC and TyG-BMI were correlated with the severity and short-term outcome of new-onset acute ischemic stroke. As TyG-WC and TyG-BMI increased, stroke severity decreased and short-term outcome was better.
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Affiliation(s)
- Xin-Rui Yu
- Postgraduate Department, School of Clinical Medicine, Beihua University, Jilin, China
| | - Jing-Lu Du
- Postgraduate Department, School of Clinical Medicine, Beihua University, Jilin, China
| | - Mei Jiang
- Postgraduate Department, School of Clinical Medicine, Beihua University, Jilin, China
| | - Yuan Ren
- Postgraduate Department, School of Clinical Medicine, Beihua University, Jilin, China
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Fu-Liang Zhang
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Fan-Li Kong
- Department of Pathophysiology, School of Basic Medicine, Beihua University, Jilin, China
| | - Feng-E. Li
- Neurology Department, the Affiliated Hospital of Beihua University, Jilin, China
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Zhang C, Wang H, Li Y, Wang X, Han Y, Gao X, Lai Y, Wang C, Teng W, Shan Z. Association between the triglyceride-glucose index and thyroid disorders: a cross-sectional survey and Mendelian randomization analysis. Endocrine 2024:10.1007/s12020-024-03858-5. [PMID: 38782862 DOI: 10.1007/s12020-024-03858-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/30/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Metabolic diseases are associated with thyroid disorders. Insulin resistance is the common pathological basis of metabolic diseases. We explored the relationship between the triglyceride-glucose (TyG) index, a simple insulin-resistance marker, and thyroid disorders. METHODS Eligible TIDE (Thyroid Diseases, Iodine Status and Diabetes Epidemiology) subjects (n = 47,710) were screened with inclusion/exclusion criteria. Thyroid disorder prevalence among different TyG index groups was stratified by sex. Logistic regression evaluated the correlation between the TyG index and thyroid disorders. Multiple linear regression evaluated the association between the TyG index and TSH. Additionally, two-sample Mendelian randomization (MR) using published genome-wide association study data evaluated causality in the association between the TyG index and TSH. RESULTS Men and women with greater TyG indices had a significantly greater prevalence of thyroid disorders than individuals with the lowest quartile (Q1) of TyG index (p < 0.05). Following adjustment for confounding factors, we observed that a greater TyG index significantly increased the risk of subclinical hypothyroidism in men and women (men: Q2: odds ratio (OR) [95% confidence interval (CI)] = 1.22 [1.07-1.38], p = 0.002; Q3: OR [95% CI] = 1.28 [1.12-1.45], p < 0.001; Q4: OR [95% CI] = 1.29 [1.12-1.50], p = 0.001; women: Q2: OR [95% CI] = 1.25 [1.12-1.39], p < 0.001; Q3: OR [95% CI] = 1.47 [1.31-1.64], p < 0.001; Q4: OR [95% CI] = 1.61 [1.43-1.82], p < 0.001). Only among women was the highest TyG index quartile associated with hypothyroidism (OR [95% CI] = 1.70 [1.15-2.50], p = 0.007). Additionally, in men, the association exists only in the more than adequate iodine intake population. In women, the relationship between the TyG index and thyroid disorders disappears after menopause. Furthermore, the TyG index exhibited a linear positive correlation with TSH levels. The MR analysis results revealed a causal relationship between a genetically determined greater TyG index and increased TSH (inverse-variance weighting (IVW): OR [95% CI] = 1.14 [1.02-1.28], p = 0.020); however, this causal relationship disappeared after adjusting for BMI in multivariable MR (MVMR) analysis (MVMR-IVW: OR 1.03, 95% CI 0.87-1.22, p = 0.739). CONCLUSIONS A greater TyG index is associated with hypothyroidism and subclinical hypothyroidism and varies by sex and menopausal status. MR analysis demonstrated that the causal relationship between a genetically determined greater TyG index and elevated TSH levels is confounded or mediated by BMI.
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Affiliation(s)
- Chenyu Zhang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Haoyu Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Yongze Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Xichang Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Yutong Han
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Xiaotong Gao
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Yaxin Lai
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Chuyuan Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Weiping Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China.
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Wang W, Yang J, Wang K, Niu J, Liu Y, Ge H. Association between the triglyceride-glucose index and in-hospital major adverse cardiovascular events in patients with acute coronary syndrome: results from the Improving Care for Cardiovascular Disease in China (CCC)-Acute Coronary Syndrome project. Cardiovasc Diabetol 2024; 23:170. [PMID: 38750553 PMCID: PMC11097581 DOI: 10.1186/s12933-024-02270-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 05/07/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVE Although the TyG index is a reliable predictor of insulin resistance (IR) and cardiovascular disease, its effectiveness in predicting major adverse cardiac events in hospitalized acute coronary syndrome (ACS) patients has not been validated in large-scale studies. In this study, we aimed to explore the association between the TyG index and the occurrence of MACEs during hospitalization. METHODS We recruited ACS patients from the CCC-ACS (Improving Cardiovascular Care in China-ACS) database and calculated the TyG index using the formula ln(fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). These patients were classified into four groups based on quartiles of the TyG index. The primary endpoint was the occurrence of MACEs during hospitalization, encompassing all-cause mortality, cardiac arrest, myocardial infarction (MI), and stroke. We performed Cox proportional hazards regression analysis to clarify the correlation between the TyG index and the risk of in-hospital MACEs among patients diagnosed with ACS. Additionally, we explored this relationship across various subgroups. RESULTS A total of 101,113 patients were ultimately included, and 2759 in-hospital MACEs were recorded, with 1554 (49.1%) cases of all-cause mortality, 601 (21.8%) cases of cardiac arrest, 251 (9.1%) cases of MI, and 353 (12.8%) cases of stroke. After adjusting for confounders, patients in TyG index quartile groups 3 and 4 showed increased risks of in-hospital MACEs compared to those in quartile group 1 [HR = 1.253, 95% CI 1.121-1.400 and HR = 1.604, 95% CI 1.437-1.791, respectively; p value for trend < 0.001], especially in patients with STEMI or renal insufficiency. Moreover, we found interactions between the TyG index and age, sex, diabetes status, renal insufficiency status, and previous PCI (all p values for interactions < 0.05). CONCLUSIONS In patients with ACS, the TyG index was an independent predictor of in-hospital MACEs. Special vigilance should be exercised in females, elderly individuals, and patients with renal insufficiency.
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Affiliation(s)
- Wenjie Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Avenue #2, Chaoyang District, 100029, Beijing, People's Republic of China
| | - Jiaxin Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Avenue #2, Chaoyang District, 100029, Beijing, People's Republic of China
| | - Kexin Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Avenue #2, Chaoyang District, 100029, Beijing, People's Republic of China
| | - Jialong Niu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Avenue #2, Chaoyang District, 100029, Beijing, People's Republic of China
| | - Yixuan Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Avenue #2, Chaoyang District, 100029, Beijing, People's Republic of China
| | - Hailong Ge
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Avenue #2, Chaoyang District, 100029, Beijing, People's Republic of China.
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Liu C, Liang D. The association between the triglyceride-glucose index and the risk of cardiovascular disease in US population aged ≤ 65 years with prediabetes or diabetes: a population-based study. Cardiovasc Diabetol 2024; 23:168. [PMID: 38741118 DOI: 10.1186/s12933-024-02261-8] [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: 02/21/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The relationship between the triglyceride-glucose (TyG) index and the risk of cardiovascular disease (CVD) in the U.S. population under 65 years of age with diabetes or prediabetes is unknown. The purpose of this study was to investigate the relationship between baseline TyG index and CVD risk in U.S. patients under 65 years of age with diabetes or prediabetes. METHODS We used data from the 2003-2018 National Health and Nutrition Examination Survey (NHANES). Multivariate regression analysis models were constructed to explore the relationship between baseline TyG index and CVD risk. Nonlinear correlations were explored using restricted cubic splines. Subgroup analysis and interaction tests were also conducted. RESULTS The study enrolled a total of 4340 participants with diabetes or pre-diabetes, with a mean TyG index of 9.02 ± 0.02. The overall average prevalence of CVD was 10.38%. Participants in the higher TyG quartiles showed high rates of CVD (Quartile 1: 7.35%; Quartile 2: 10.04%; Quartile 3: 10.71%; Quartile 4: 13.65%). For CVD, a possible association between the TyG index and the risk of CVD was observed. Our findings suggested a linear association between the TyG index and the risk of CVD. The results revealed a U-shaped relationship between the TyG index and both the risk of CVD (P nonlinear = 0.02583) and CHF (P nonlinear = 0.0208) in individuals with diabetes. Subgroup analysis and the interaction term indicated that there was no significant difference among different stratifications. Our study also revealed a positive association between the TyG index and comorbid MetS in the U.S. population under 65 years of age with prediabetes or diabetes. CONCLUSIONS A higher TyG index was linked to an increased likelihood of CVD in the U.S. population aged ≤ 65 years with prediabetes and diabetes. Besides, TyG index assessment will contribute to more convenient and effective screening of high-risk individuals in patients with MetS. Future studies should explore whether interventions targeting the TyG index may improve clinical outcomes in these patients.
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Affiliation(s)
- Chang Liu
- School of Medicine, Nankai University, Tianjin, China
| | - Dan Liang
- Department of Endocrine, People's Hospital of Chongqing Liang Jiang New Area, Chongqing, China.
- The West China College of Medicine, Sichuan University, Chengdu, China.
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Xu M, Wang W, Cheng J, Qu H, Xu M, Wang L. Effects of mitochondrial dysfunction on cellular function: Role in atherosclerosis. Biomed Pharmacother 2024; 174:116587. [PMID: 38636397 DOI: 10.1016/j.biopha.2024.116587] [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: 12/20/2023] [Revised: 04/02/2024] [Accepted: 04/10/2024] [Indexed: 04/20/2024] Open
Abstract
Atherosclerosis, an immunoinflammatory disease of medium and large arteries, is associated with life-threatening clinical events, such as acute coronary syndromes and stroke. Chronic inflammation and impaired lipoprotein metabolism are considered to be among the leading causes of atherosclerosis, while numerous risk factors, including arterial hypertension, diabetes mellitus, obesity, and aging, can contribute to the development of the disease. In recent years, emerging evidence has underlined the key role of mitochondrial dysfunction in the pathogenesis of atherosclerosis. Mitochondrial dysfunction is believed to result in an increase in reactive oxygen species, leading to oxidative stress, chronic inflammation, and intracellular lipid deposition, all of which can contribute to the pathogenesis of atherosclerosis. Critical cells, including endothelial cells, vascular smooth muscle cells, and macrophages, play an important role in atherosclerosis. Mitochondrial function is also involved in maintaining the normal function of these cells. To better understand the relationship between mitochondrial dysfunction and atherosclerosis, this review summarizes the findings of recent studies and discusses the role of mitochondrial dysfunction in the risk factors and critical cells of atherosclerosis. FACTS: OPEN QUESTIONS.
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Affiliation(s)
- Minwen Xu
- Clinical Skills Center, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Wenjun Wang
- Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Jingpei Cheng
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou 341000, China; Basic Medical College, Gannan Medical University, Ganzhou 341000, China
| | - Hongen Qu
- Gannan Normal University, Ganzhou 341000, China.
| | - Minjuan Xu
- Department of Obstetrics and Gynecology, Ganzhou People's Hospital, Ganzhou 341000, China.
| | - Liefeng Wang
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou 341000, China; Basic Medical College, Gannan Medical University, Ganzhou 341000, China.
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Qin Y, Qiao Y, Yan G, Wang D, Tang C. Relationship between indices of insulin resistance and incident type 2 diabetes mellitus in Chinese adults. Endocrine 2024:10.1007/s12020-024-03830-3. [PMID: 38642289 DOI: 10.1007/s12020-024-03830-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/09/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Insulin resistance (IR) is a pivotal pathogenesis characteristic of type 2 diabetes mellitus (T2DM). The current study aimed to explore the association between triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-c), triglyceride-glucose (TyG), and triglyceride glucose-body mass index (TyG-BMI), and T2DM incidence. METHODS A total of 116,855 Chinese adults aged over 20 without diabetes were included. Multivariate Cox regression analysis and restricted cubic spine were utilized to investigate the association between IR indicators and T2DM. The T2DM risk across different quartiles of IR parameters was compared using Kaplan-Meier curves. The receiver operating characteristic analysis was used to investigate the predictive potential of each IR indicator for future T2DM. RESULTS A total of 2685 participants developed T2DM during a median follow-up of 2.98 years. The adjusted hazard ratios (HR) of incident T2DM were 1.177, 2.766, and 1.1018 for TG/HDL-c, TyG, and TyG-BMI, respectively. There were significant increasing trends of T2DM across the quartiles of TG/HDL-c, TyG, and TyG-BMI. The HRs of new-onset T2DM in the highest quartiles versus the lowest quartile of TG/HDL-c, TyG, and TyG-BMI were 3.298, 8.402, and 8.468. RCS revealed the nonlinear relationship between IR and T2DM risk. The correlations between IR and T2DM were more pronounced in subjects aged <40. TyG-BMI had the highest predictive value for incident T2DM (AUC = 0.774), with a cut-off value of 213.289. CONCLUSION TG/HDL-c, TyG, and TyG-BMI index were all significantly positively associated with higher risk for future T2DM. Baseline TyG-BMI level had high predictive value for the identification of T2DM.
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Affiliation(s)
- Yuhan Qin
- Department of Cardiology, Zhongda Hospital Affiliated to Southeast University, Nanjing, China
| | - Yong Qiao
- Department of Cardiology, Zhongda Hospital Affiliated to Southeast University, Nanjing, China.
| | - Gaoliang Yan
- Department of Cardiology, Zhongda Hospital Affiliated to Southeast University, Nanjing, China
| | - Dong Wang
- Department of Cardiology, Zhongda Hospital Affiliated to Southeast University, Nanjing, China
| | - Chengchun Tang
- Department of Cardiology, Zhongda Hospital Affiliated to Southeast University, Nanjing, China.
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Sun M, Liu M, Zhang F, Sang L, Song Y, Li P, Liu S, Yang H, Ma L, Cao J, Mi W, Ma Y. Triglyceride-glucose index predicts postoperative delirium in elderly patients with type 2 diabetes mellitus: a retrospective cohort study. Lipids Health Dis 2024; 23:107. [PMID: 38622624 PMCID: PMC11017528 DOI: 10.1186/s12944-024-02084-2] [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: 11/27/2023] [Accepted: 03/20/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Postoperative delirium (POD) is more prevalent among elderly patients with type 2 diabetes mellitus (T2DM). Insulin resistance (IR) can be assessed using the triglyceride-glucose (TyG) index, a novel biomarker. This study aims to investigate the predictive potential of the TyG index for POD in elderly patients with T2DM. MATERIALS AND METHODS Elderly patients (≥ 65) with T2DM who underwent non-neurosurgery and non-cardiac surgery were enrolled. Univariate and multivariate logistic regression analyses were conducted to assess the association between the TyG index and POD. Additionally, subgroup analyses were performed to compare the sex-specific differences in the predictive ability of the TyG index for POD. RESULTS A total of 4566 patients were included in this retrospective cohort. The receiver operating characteristic (ROC) curve analysis determined the optimal cut-off value for the TyG index to be 8.678. In the univariate model, a TyG index > 8.678 exhibited an odds ratio (OR) of 1.668 (95% CI: 1.210-2.324, P = 0.002) for predicting POD. In the multivariate regression models, the ORs were 1.590 (95% CI: 1.133-2.252, P < 0.008), 1.661 (95% CI: 1.199-2.325, P < 0.003), and 1.603 (95% CI: 1.137-2.283, P = 0.008) for different models. Subgroup analyses demonstrated that the predictive ability of the TyG index was more pronounced in females compared to males. CONCLUSION The TyG index shows promise as a novel biomarker for predicting the occurrence of POD in elderly surgical patients with T2DM.
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Affiliation(s)
- Miao Sun
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100730, China
- Nation Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100730, China
| | - Min Liu
- Nation Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100730, China
- Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Faqiang Zhang
- Nation Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100730, China
- Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - Lijuan Sang
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100730, China
| | - Yuxiang Song
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100730, China
| | - Peng Li
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100730, China
| | - Siyuan Liu
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100730, China
| | - Huikai Yang
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100730, China
| | - Libin Ma
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100730, China
| | - Jiangbei Cao
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100730, China
| | - Weidong Mi
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100730, China.
- Nation Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100730, China.
| | - Yulong Ma
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100730, China.
- Nation Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100730, China.
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Tusongtuoheti X, Shu Y, Huang G, Mao Y. Predicting the risk of subclinical atherosclerosis based on interpretable machine models in a Chinese T2DM population. Front Endocrinol (Lausanne) 2024; 15:1332982. [PMID: 38476673 PMCID: PMC10929018 DOI: 10.3389/fendo.2024.1332982] [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: 11/04/2023] [Accepted: 02/07/2024] [Indexed: 03/14/2024] Open
Abstract
Background Cardiovascular disease (CVD) has emerged as a global public health concern. Identifying and preventing subclinical atherosclerosis (SCAS), an early indicator of CVD, is critical for improving cardiovascular outcomes. This study aimed to construct interpretable machine learning models for predicting SCAS risk in type 2 diabetes mellitus (T2DM) patients. Methods This study included 3084 T2DM individuals who received health care at Zhenhai Lianhua Hospital, Ningbo, China, from January 2018 to December 2022. The least absolute shrinkage and selection operator combined with random forest-recursive feature elimination were used to screen for characteristic variables. Linear discriminant analysis, logistic regression, Naive Bayes, random forest, support vector machine, and extreme gradient boosting were employed in constructing risk prediction models for SCAS in T2DM patients. The area under the receiver operating characteristic curve (AUC) was employed to assess the predictive capacity of the model through 10-fold cross-validation. Additionally, the SHapley Additive exPlanations were utilized to interpret the best-performing model. Results The percentage of SCAS was 38.46% (n=1186) in the study population. Fourteen variables, including age, white blood cell count, and basophil count, were identified as independent risk factors for SCAS. Nine predictors, including age, albumin, and total protein, were screened for the construction of risk prediction models. After validation, the random forest model exhibited the best clinical predictive value in the training set with an AUC of 0.729 (95% CI: 0.709-0.749), and it also demonstrated good predictive value in the internal validation set [AUC: 0.715 (95% CI: 0.688-0.742)]. The model interpretation revealed that age, albumin, total protein, total cholesterol, and serum creatinine were the top five variables contributing to the prediction model. Conclusion The construction of SCAS risk models based on the Chinese T2DM population contributes to its early prevention and intervention, which would reduce the incidence of adverse cardiovascular prognostic events.
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Affiliation(s)
- Ximisinuer Tusongtuoheti
- Department of Endocrinology, The First Affiliated Hospital of Ningbo University, Ningbo University, Ningbo, China
- Health Science Center, Ningbo University, Ningbo, China
| | - Yimeng Shu
- Department of Endocrinology, The First Affiliated Hospital of Ningbo University, Ningbo University, Ningbo, China
- Health Science Center, Ningbo University, Ningbo, China
| | - Guoqing Huang
- Department of Endocrinology, The First Affiliated Hospital of Ningbo University, Ningbo University, Ningbo, China
- Health Science Center, Ningbo University, Ningbo, China
| | - Yushan Mao
- Department of Endocrinology, The First Affiliated Hospital of Ningbo University, Ningbo University, Ningbo, China
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11
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Haring B, Schumacher H, Mancia G, Teo KK, Lonn EM, Mahfoud F, Schmieder R, Mann JFE, Sliwa K, Yusuf S, Böhm M. Triglyceride-glucose index, low-density lipoprotein levels, and cardiovascular outcomes in chronic stable cardiovascular disease: results from the ONTARGET and TRANSCEND trials. Eur J Prev Cardiol 2024; 31:311-319. [PMID: 37890035 DOI: 10.1093/eurjpc/zwad340] [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: 09/19/2023] [Revised: 09/22/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023]
Abstract
AIMS The triglyceride-glucose index (TyG) has been proposed as an alternative to insulin resistance and as a predictor of cardiovascular outcomes. Little is known on its role in chronic stable cardiovascular disease and its predictive power at controlled low density lipoprotein (LDL) levels. METHODS AND RESULTS Our study population consisted of 29 960 participants in the ONTARGET and TRANSCEND trials that enrolled patients with known atherosclerotic disease. Triglycerides and glucose were measured at baseline. TyG was calculated as the logarithmized product of fasting triglycerides and glucose divided by 2. The primary endpoint of both trials was a composite of cardiovascular death, myocardial infarction, stroke, or hospitalization for heart failure. The secondary endpoint was all-cause death and the components of the primary endpoint. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) with extensive covariate adjustment for demographic, medical history, and lifestyle factors. During a mean follow-up of 4.3 years, 4895 primary endpoints and 3571 all-cause deaths occurred. In fully adjusted models, individuals in the highest compared to the lowest quartile of the TyG index were at higher risk for the primary endpoint (HR 1.14; 95% CI 1.05-1.25) and for myocardial infarction (HR 1.30; 95% CI 1.11-1.53). A higher TyG index did not associate with the primary endpoint in individuals with LDL levels < 100 mg/dL. CONCLUSION A higher TyG index is associated with a modestly increased cardiovascular risk in chronic stable cardiovascular disease. This association is largely attenuated when LDL levels are controlled. REGISTRATION www.clinicaltrials.gov: NCT00153101.
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Affiliation(s)
- Bernhard Haring
- Department of Medicine III, Saarland University, Kirrberger Strasse 100, 66421 Homburg, Germany
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Giuseppe Mancia
- Instituto Clinico Universitario Policlinico di Monza, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, Milano, Italy
| | - Koon K Teo
- Population Health Research Institute, McMaster University, and Hamilton Health Sciences, Hamilton, Canada
| | - Eva M Lonn
- Population Health Research Institute, McMaster University, and Hamilton Health Sciences, Hamilton, Canada
| | - Felix Mahfoud
- Department of Medicine III, Saarland University, Kirrberger Strasse 100, 66421 Homburg, Germany
| | - Roland Schmieder
- Department of Nephrology and Hypertension, Friedrich-Alexander University, Erlangen, Germany
| | - Johannes F E Mann
- KfH Kidney Centre, München, Germany
- Department of Nephrology and Hypertension, Friedrich-Alexander University, Erlangen, Germany
| | - Karen Sliwa
- Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa & IIDMM, University of Cape Town, Cape Town, South Africa
| | - Salim Yusuf
- Population Health Research Institute, McMaster University, and Hamilton Health Sciences, Hamilton, Canada
| | - Michael Böhm
- Department of Medicine III, Saarland University, Kirrberger Strasse 100, 66421 Homburg, Germany
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12
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Alavi Tabatabaei G, Mohammadifard N, Rafiee H, Nouri F, Maghami Mehr A, Najafian J, Sadeghi M, Boshtam M, Roohafza H, Haghighatdoost F, Taheri M, Sarrafzadegan N. Association of the triglyceride glucose index with all-cause and cardiovascular mortality in a general population of Iranian adults. Cardiovasc Diabetol 2024; 23:66. [PMID: 38347581 PMCID: PMC10863153 DOI: 10.1186/s12933-024-02148-8] [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: 10/21/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The triglyceride glucose (TyG) index is a new and low-cost marker to determine insulin resistant which may be a predictor of cardiovascular disease (CVD). Although available evidence showed that its association with CVD mortality (CVM) and all-cause mortality (ACM) may differ in different populations, scarce data are available in this regard specially in low and middle-income countries. PURPOSE To examine the association between TyG index and risk of CVM and ACM in Iranians. METHODS This prospective cohort study included 5432 adults (age ≥ 35 years) with no history of CVD events. Fasting glucose and triglyceride were measured at baseline in all participants and TyG index was calculated. Cox frailty model was used to calculate hazard ratios (HRs) for CVM and ACM across the tertiles of TyG index. RESULTS After a median follow-up of 11.25 years, a total number of 191 cardiovascular deaths, and 487 all-cause mortality was recorded. The risk of both CVM and ACM increased across the tertiles of TyG index. In the adjusted model for lifestyle and metabolic variables, the risks of ACM and CVM increased by 41% (95% CI 1.11, 1.81; P for trend = 0.005) and 64% (95% CI 1.07, 2.50; P for trend = 0.024), respectively. However, adjustment for diabetes mellitus disappeared the significance for both ACM and CVM. These associations may vary by sex. TyG was not related to the risk of non-CVD mortality. CONCLUSION The predicting value of TyG index for ACM and CVM might be mediated by diabetes status. Further studies are required to confirm these findings.
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Affiliation(s)
- Ghazaal Alavi Tabatabaei
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, P. O. Box: 81745-15, Isfahan, Iran
| | - Noushin Mohammadifard
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Rafiee
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouri
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, P. O. Box: 81745-15, Isfahan, Iran
| | | | - Jamshid Najafian
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Boshtam
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, P. O. Box: 81745-15, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, P. O. Box: 81745-15, Isfahan, Iran.
| | - Marzieh Taheri
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, P. O. Box: 81745-15, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, P. O. Box: 81745-15, Isfahan, Iran
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada
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13
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Tian N, Song L, Hou T, Fa W, Dong Y, Liu R, Ren Y, Liu C, Zhu M, Zhang H, Wang Y, Cong L, Du Y, Qiu C. Association of Triglyceride-Glucose Index With Cognitive Function and Brain Atrophy: A Population-Based Study. Am J Geriatr Psychiatry 2024; 32:151-162. [PMID: 37827915 DOI: 10.1016/j.jagp.2023.09.007] [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: 07/18/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE To investigate the associations of triglyceride-glucose (TyG) index, a reliable surrogate marker for insulin resistance, with the function of various cognitive domains and brain structures among older adults. DESIGN A population-based cross-sectional study. SETTING Older adults living in the rural communities in China. PARTICIPANTS About 4,541 rural-dwelling dementia-free participants (age ≥65 years; 56.37% women) undertook examinations in March-September 2018 for MIND-China. MEASUREMENTS TyG index was calculated as ln[fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. A neuropsychological test battery was used to assess memory, attention, verbal fluency, and executive function. Volumetric brain measures were assessed on magnetic resonance imaging (MRI) in a subsample (n = 1,019). Data were analyzed with restricted cubic spline and multivariable general linear models. RESULTS An inverted J-shaped association was observed between TyG index and z-scores of multiple cognitive domains, such that among individuals with TyG index ≥8.57 (median), a higher TyG index was significantly associated with lower z-scores of memory, attention, verbal fluency, executive function, and global cognition (all p < 0.05); among people with TyG index <8.57, a higher TyG index was significantly associated with a higher executive function z-score (p < 0.05), but not with any of the other examined cognitive domains. In the MRI subsample, a higher TyG index was significantly associated with lower volumes of total brain tissue, gray matter, and white matter as well as greater cerebrospinal fluid volume (p < 0.05), but not with white matter hyperintensity volume. CONCLUSIONS Insulin resistance, as indicated by a high TyG index, was associated with poor function in multiple cognitive domains and global brain atrophy.
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Affiliation(s)
- Na Tian
- Department of Neurology (NT, LS, TH, WF, YD, RL, CL, MZ, HZ, YW, LC, YD, CQ), Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China; Shandong Provincial Clinical Research Center for Neurological Diseases (NT, LS, TH, YD, RL, CL, MZ, HZ, YW, LC, YD), Jinan, Shandong 250021, P.R. China; Medical Science and Technology Innovation Center (NT, YD), Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, P.R. China
| | - Lin Song
- Department of Neurology (NT, LS, TH, WF, YD, RL, CL, MZ, HZ, YW, LC, YD, CQ), Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China; Shandong Provincial Clinical Research Center for Neurological Diseases (NT, LS, TH, YD, RL, CL, MZ, HZ, YW, LC, YD), Jinan, Shandong 250021, P.R. China
| | - Tingting Hou
- Department of Neurology (NT, LS, TH, WF, YD, RL, CL, MZ, HZ, YW, LC, YD, CQ), Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China; Shandong Provincial Clinical Research Center for Neurological Diseases (NT, LS, TH, YD, RL, CL, MZ, HZ, YW, LC, YD), Jinan, Shandong 250021, P.R. China
| | - Wenxin Fa
- Department of Neurology (NT, LS, TH, WF, YD, RL, CL, MZ, HZ, YW, LC, YD, CQ), Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
| | - Yi Dong
- Department of Neurology (NT, LS, TH, WF, YD, RL, CL, MZ, HZ, YW, LC, YD, CQ), Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China; Shandong Provincial Clinical Research Center for Neurological Diseases (NT, LS, TH, YD, RL, CL, MZ, HZ, YW, LC, YD), Jinan, Shandong 250021, P.R. China
| | - Rui Liu
- Department of Neurology (NT, LS, TH, WF, YD, RL, CL, MZ, HZ, YW, LC, YD, CQ), Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China; Shandong Provincial Clinical Research Center for Neurological Diseases (NT, LS, TH, YD, RL, CL, MZ, HZ, YW, LC, YD), Jinan, Shandong 250021, P.R. China
| | - Yifei Ren
- Department of Neurology (YR, YD), Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, P.R. China
| | - Cuicui Liu
- Department of Neurology (NT, LS, TH, WF, YD, RL, CL, MZ, HZ, YW, LC, YD, CQ), Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China; Shandong Provincial Clinical Research Center for Neurological Diseases (NT, LS, TH, YD, RL, CL, MZ, HZ, YW, LC, YD), Jinan, Shandong 250021, P.R. China
| | - Min Zhu
- Department of Neurology (NT, LS, TH, WF, YD, RL, CL, MZ, HZ, YW, LC, YD, CQ), Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China; Shandong Provincial Clinical Research Center for Neurological Diseases (NT, LS, TH, YD, RL, CL, MZ, HZ, YW, LC, YD), Jinan, Shandong 250021, P.R. China
| | - Heng Zhang
- Department of Neurology (NT, LS, TH, WF, YD, RL, CL, MZ, HZ, YW, LC, YD, CQ), Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China; Shandong Provincial Clinical Research Center for Neurological Diseases (NT, LS, TH, YD, RL, CL, MZ, HZ, YW, LC, YD), Jinan, Shandong 250021, P.R. China
| | - Yongxiang Wang
- Department of Neurology (NT, LS, TH, WF, YD, RL, CL, MZ, HZ, YW, LC, YD, CQ), Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China; Shandong Provincial Clinical Research Center for Neurological Diseases (NT, LS, TH, YD, RL, CL, MZ, HZ, YW, LC, YD), Jinan, Shandong 250021, P.R. China; Institute of Brain Science and Brain-Inspired Research (YW, YD), Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, P.R. China; Aging Research Center and Center for Alzheimer Research (YW, CQ), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet-Stockholm University, 17165 Solna, Sweden
| | - Lin Cong
- Department of Neurology (NT, LS, TH, WF, YD, RL, CL, MZ, HZ, YW, LC, YD, CQ), Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China; Shandong Provincial Clinical Research Center for Neurological Diseases (NT, LS, TH, YD, RL, CL, MZ, HZ, YW, LC, YD), Jinan, Shandong 250021, P.R. China
| | - Yifeng Du
- Department of Neurology (NT, LS, TH, WF, YD, RL, CL, MZ, HZ, YW, LC, YD, CQ), Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China; Shandong Provincial Clinical Research Center for Neurological Diseases (NT, LS, TH, YD, RL, CL, MZ, HZ, YW, LC, YD), Jinan, Shandong 250021, P.R. China; Medical Science and Technology Innovation Center (NT, YD), Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, P.R. China; Department of Neurology (YR, YD), Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, P.R. China; Institute of Brain Science and Brain-Inspired Research (YW, YD), Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, P.R. China.
| | - Chengxuan Qiu
- Department of Neurology (NT, LS, TH, WF, YD, RL, CL, MZ, HZ, YW, LC, YD, CQ), Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China; Aging Research Center and Center for Alzheimer Research (YW, CQ), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet-Stockholm University, 17165 Solna, Sweden
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Guo D, Wu Z, Xue F, Chen S, Ran X, Zhang C, Yang J. Association between the triglyceride-glucose index and impaired cardiovascular fitness in non-diabetic young population. Cardiovasc Diabetol 2024; 23:39. [PMID: 38245734 PMCID: PMC10800072 DOI: 10.1186/s12933-023-02089-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/09/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index has been linked to the onset, progression, and prognosis of cardiovascular disease (CVD) in middle-aged and elderly individuals. Nevertheless, the relationship between the TyG index and impaired cardiovascular fitness (CVF) remains unexplored in non-diabetic young population. METHODS We used data from the National Health and Nutrition Examination Survey (NHANES) study (1999-2004) to conduct a cross-sectional study of 3364 participants who completed an examination of CVF. Impaired CVF was defined as low and moderate CVF levels determined by estimated maximal oxygen consumption (Vo2max), based on sex- and age-specific criteria. The TyG index was calculated by [Formula: see text]. RESULTS The age (median with interquartile range) of the study population was 28 (19-37) years, and the TyG index (median ± standard deviation) was 8.36 ± 0.52. A significant association between the TyG index and impaired CVF was found in multivariable logistical regression analysis (per 1-unit increase in the TyG index: OR, 1.46; 95% Cl 1.13-1.90). A dose‒response relationship between the TyG index and impaired CVF was presented by restricted cubic splines (RCS). A significant interaction (p = 0.027) between sex and the TyG index for impaired CVF was found in the population aged < 20 years. CONCLUSIONS In non-diabetic young population, individuals with higher TyG index values are at an increased likelihood of encountering impaired CVF. Furthermore, sex may exert an impact on CVF, as males tend to be more susceptible to impaired CVF under comparable TyG index conditions.
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Affiliation(s)
- Dachuan Guo
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Zhenguo Wu
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Fei Xue
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Sha Chen
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Xiangzhen Ran
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Cheng Zhang
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China.
| | - Jianmin Yang
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China.
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15
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Liu M, Pan J, Meng K, Wang Y, Sun X, Ma L, Yu X. Triglyceride-glucose body mass index predicts prognosis in patients with ST-elevation myocardial infarction. Sci Rep 2024; 14:976. [PMID: 38200157 PMCID: PMC10782013 DOI: 10.1038/s41598-023-51136-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024] Open
Abstract
Triglyceride glycemic-body mass index (TyG-BMI) is a simple and reliable surrogate for insulin resistance (IR). However, it is still unclear if TyG-BMI has any predictive value in patients having percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). The purpose of this study was to examine the TyG-BMI index's prognostic significance and predictive power in patients with STEMI. The study comprised a total of 2648 consecutive STEMI patients who underwent PCI. The primary endpoint was the occurrence of major adverse cardiovascular events (MACE), defined as the combination of all-cause death, nonfatal myocardial infarction, nonfatal stroke, and coronary revascularization. The TyG-BMI index was formulated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2] × BMI. 193 patients in all experienced MACE over a median follow-up of 14.7 months. There was a statistically significant difference between the Kaplan-Meier survival curves for the TyG-BMI index tertiles (log-rank test, p = 0.019) for the cumulative incidence of MACE. The adjusted HRs for the incidence of MACE in the middle and highest quartiles of the TyG-BMI index compared with the lowest quartile were 1.37 (95% CI 0.92, 2.03) and 1.53 (95% CI 1.02, 2.29), respectively, in the fully adjusted Cox regression model. At six months, one year, and three years, the TyG-BMI area under the curve (AUC) for predicting MACE was 0.691, 0.666, and 0.637, respectively. Additionally, adding the TyG-BMI index to the risk prediction model enhanced outcome prediction. In STEMI patients undergoing PCI, TyG-BMI was independently linked to MACE. TyG-BMI could be a simple and solid way to assess MACE risk and prognosis.
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Affiliation(s)
- Ming Liu
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
- Department of Cardiology, Anhui Provincial Hospital Affiliated of Anhui Medical University, Hefei, 230001, Anhui, China
| | - Jianyuan Pan
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Ke Meng
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Yuwei Wang
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Xueqing Sun
- The Second Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Likun Ma
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
| | - Xiaofan Yu
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
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Shali S, Luo L, Yao K, Sun X, Wu H, Zhang S, Xu L, Gao W, Li J, Qian J, Zheng Y, Dai Y, Ge J. Triglyceride-glucose index is associated with severe obstructive coronary artery disease and atherosclerotic target lesion failure among young adults. Cardiovasc Diabetol 2023; 22:283. [PMID: 37865782 PMCID: PMC10590519 DOI: 10.1186/s12933-023-02004-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/23/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND Early diagnosis and treatment effectiveness of early-onset coronary artery disease (EOCAD) are crucial, and non-invasive predictive biomarkers are needed for young adults. We aimed to evaluate the usefulness of the triglyceride-glucose (TyG) index, a novel marker of insulin resistance, in identifying young CAD patients and predicting their risk of developing target lesion failure (TLF). METHODS We recruited EOCAD patients (luminal narrowing ≥ 70%) and controls free from CAD (luminal narrowing < 30%), both aged 45 years or younger, from 38 hospitals in China between 2017 and 2020. EOCAD patients who underwent successful percutaneous coronary intervention were followed for incident TLF. TyG index was defined as Ln [fasting triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2]. We used logistic regression and Cox proportional hazards modeling to evaluate the association of TyG index with prevalent EOCAD and incident TLF, respectively. The discriminatory ability of TyG index was assessed by the area under the receiver-operating characteristic curve (AUC). RESULTS Among the included 1513 EOCAD patients (39.6 ± 4.4 years, 95.4% male) and 1513 age-matched controls (39.0 ± 4.4 years, 46.4% male), TyG index was positively associated with the prevalence of EOCAD (adjusted odds ratio: 1.40, 95% confidence interval [CI] 1.23-1.60, per standard deviation [SD] increase in TyG index). The addition of TyG index to an empirical risk model provided an improvement in diagnostic ability for EOCAD, with a net reclassification improvement of 0.10 (95% CI 0.03-0.17, p = 0.005). During a medium of 33 month (IQR: 31-34 months) follow-up, 43 (3.3%) patients experienced TLF. Multivariate Cox regression model revealed that TyG index was an independent risk factor for TLF (adjusted hazard ratio [HR]: 2.410, 95% CI 1.07-5.42 comparing the top to bottom TyG index tertile groups; HR: 1.30, 95% CI 1.01-1.73, per SD increase in TyG index). Compared with a model of conventional risk factors alone, the addition of the TyG index modestly improved the AUC (0.722-0.734, p = 0.04) to predict TLF. CONCLUSIONS TyG index is positively associated with prevalent EOCAD and incident TLF. TyG index appeared to be a valuable component of future efforts to improve CAD risk stratification and TLF outcome prediction among young adults.
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Affiliation(s)
- Shalaimaiti Shali
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Lingfeng Luo
- Human Phenome Institute, Fudan University, Shanghai, 200433, China
| | - Kang Yao
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Xiangdong Sun
- Department of Cardiology, Xinyang Central Hospital, Xinyang Normal University, Xinyang, Henan, 464000, China
| | - Hongyi Wu
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Shuning Zhang
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Lili Xu
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Wei Gao
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Jianxuan Li
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Juying Qian
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Yan Zheng
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, Shanghai, 200032, China.
- Human Phenome Institute, Fudan University, Shanghai, 200433, China.
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, 20438, China.
| | - Yuxiang Dai
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, Shanghai, 200032, China.
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China.
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, Shanghai, 200032, China.
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China.
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Wang X, Ji X, Yu J, Wang F. Correlation between TyG index and coronary atherosclerosis assessed by CCTA in elderly male patients: a cross-sectional study. Diabetol Metab Syndr 2023; 15:176. [PMID: 37612763 PMCID: PMC10463758 DOI: 10.1186/s13098-023-01145-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/03/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Age is a major risk factor associated with the complexity of coronary artery disease (CAD), and the prognosis of elderly patients with coronary heart disease is relatively poor. Metabolic disturbances are prevalent in the elderly population and contribute to CAD morbidity and mortality. This study aimed to investigate the relationship between the triglyceride-glucose (TyG) index and total coronary atherosclerotic burden assessed non-invasively by Coronary Computed Tomography Angiogram (CCTA) in the elderly population. METHODS This retrospective cross-sectional study involved 427 patients who underwent CCTA. The patients were divided into two groups based on their Leiden score: ≥5 and < 5. Comparisons between groups were conducted using t-tests or Mann-Whitney U tests for continuous variables and chi-square tests for categorical variables. The correlation between TyG and Leiden score was assessed using Spearman's rank correlation coefficient. Univariable and multivariable logistic regression analyses were performed to assess the role of TyG in atherosclerosis risk, using clinical variables previously shown to independently predict a high Leiden score. RESULTS The levels of age and HbA1c% were significantly higher in patients with Leiden score ≥ 5. Patients with Leiden score ≥ 5 showed no significant difference in TyG index compared to those with Leiden score < 5. Pearson correlation analysis showed that HbA1c% (r = 0.44, p < 0.01), age (r = 0.34, p < 0.01), and FBG (r = 0.15, p = 0.01) were positively correlated with Leiden score, while TyG index had no correlation with Leiden score (r = 0.05, p = 0.42). Multiple linear regression analysis showed that HbA1c% (β = 2.92, 95%CI: 2.25-3.56, P < 0.01) was positively correlated with Leiden score, while TyG index had no correlation with Leiden score (β = 0.73, 95%CI: -3.27-4.72, P < 0.01). HbA1c% was found to be an influential factor for obstructive CVD (β = 1.86, 95%CI: 1.50-2.29, P < 0.01), while TyG index was not an independent risk factor for obstructive CVD (β = 0.39, 95%CI: 0.12-1.32, P = 0.13). CONCLUSION The TyG index did not show any significant correlation with the Leiden score and obstructive CVD as a risk factor in elderly male population. On the other hand, HbA1c% was identified as an influential factor for both the Leiden score and obstructive CVD.
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Affiliation(s)
- Xiaona Wang
- Department of Cardiology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xinqiang Ji
- Chinese PLA Medical School, Beijing, 100853, China
| | - Jianhui Yu
- Department of Cardiology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Fan Wang
- Department of Cardiology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China.
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Ghorbani Z, Mirmohammadali SN, Shoaibinobarian N, Rosenkranz SK, Arami S, Hekmatdoost A, Mahdavi-Roshan M. Insulin resistance surrogate markers and risk of hyperuricemia among patients with and without coronary artery disease: a cross-sectional study. Front Nutr 2023; 10:1048675. [PMID: 37671195 PMCID: PMC10475726 DOI: 10.3389/fnut.2023.1048675] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 08/04/2023] [Indexed: 09/07/2023] Open
Abstract
Background Although emerging evidence emphasizes the associations between both insulin resistance and hyperuricemia with coronary artery disease (CAD) risk, no definite relationship has yet been established. In this respect, time-efficient and affordable methods to estimate insulin resistance (IR) status, and to predict risk of hyperuricemia, are needed. Thus, the goal of this investigation was to examine the associations between IR, as assessed by novel surrogate markers [triglyceride-glucose (TyG) and TyG-body mass index (TyG-BMI)], and risk of hyperuricemia in patients with and without diagnosed CAD. Methods This cross-sectional study used data from the medical records of 1,170 patients who were referred to the cardiology outpatient clinic. Medical records, anthropometrics, and serum analytes were determined at the initial visit. Hyperuricemia was defined as serum uric acid ≥ 5.6 mg/dL. IR was estimated through surrogate markers (TyG and TyG-BMI). Multiple regression analysis was performed to assess the relationship between these indices and odds of hyperuricemia among patients with and without CAD. Results Overall, 814 angiographically-confirmed CAD cases (mean age (SD) = 52 (8)yrs) were compared with 356 patients without CAD (mean age (SD) = 48 (8)yr). There were positive associations between TyG and TyG-BMI indices and odds of hyperuricemia in CAD patients after controlling for confounders (adjusted odds ratio (aOR) = 1.60; 95%CI: 1.02-2.51; p-value = 0.036; and aOR = 1.83; 95%CI: 1.24-2.70; p-value = 0.002, third tertiles for TYG and TYG-BMI, respectively). Conclusion The present findings suggest that higher levels of the IR surrogate markers, TyG and TyG-BMI, are associated with higher odds of hyperuricemia in patients with CAD. However, given the cross-sectional design of this study, the sensitivity and specificity of these novel markers could not be determined for confirming the diagnosis of IR and hyperuricemia, further studies are needed to determine such outcomes and to confirm the current findings.
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Affiliation(s)
- Zeinab Ghorbani
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Department of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Nargeskhatoon Shoaibinobarian
- Department of Nutrition, School of Medical Sciences and Technologies, Islamic Azad University, Science and Research Branch, Tehran, Iran
| | - Sara K. Rosenkranz
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Samira Arami
- Department of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Azita Hekmatdoost
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marjan Mahdavi-Roshan
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Department of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Mirjalili SR, Soltani S, Heidari Meybodi Z, Marques-Vidal P, Kraemer A, Sarebanhassanabadi M. An innovative model for predicting coronary heart disease using triglyceride-glucose index: a machine learning-based cohort study. Cardiovasc Diabetol 2023; 22:200. [PMID: 37542255 PMCID: PMC10403891 DOI: 10.1186/s12933-023-01939-9] [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: 06/01/2023] [Accepted: 07/24/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Various predictive models have been developed for predicting the incidence of coronary heart disease (CHD), but none of them has had optimal predictive value. Although these models consider diabetes as an important CHD risk factor, they do not consider insulin resistance or triglyceride (TG). The unsatisfactory performance of these prediction models may be attributed to the ignoring of these factors despite their proven effects on CHD. We decided to modify standard CHD predictive models through machine learning to determine whether the triglyceride-glucose index (TyG-index, a logarithmized combination of fasting blood sugar (FBS) and TG that demonstrates insulin resistance) functions better than diabetes as a CHD predictor. METHODS Two-thousand participants of a community-based Iranian population, aged 20-74 years, were investigated with a mean follow-up of 9.9 years (range: 7.6-12.2). The association between the TyG-index and CHD was investigated using multivariate Cox proportional hazard models. By selecting common components of previously validated CHD risk scores, we developed machine learning models for predicting CHD. The TyG-index was substituted for diabetes in CHD prediction models. All components of machine learning models were explained in terms of how they affect CHD prediction. CHD-predicting TyG-index cut-off points were calculated. RESULTS The incidence of CHD was 14.5%. Compared to the lowest quartile of the TyG-index, the fourth quartile had a fully adjusted hazard ratio of 2.32 (confidence interval [CI] 1.16-4.68, p-trend 0.04). A TyG-index > 8.42 had the highest negative predictive value for CHD. The TyG-index-based support vector machine (SVM) performed significantly better than diabetes-based SVM for predicting CHD. The TyG-index was not only more important than diabetes in predicting CHD; it was the most important factor after age in machine learning models. CONCLUSION We recommend using the TyG-index in clinical practice and predictive models to identify individuals at risk of developing CHD and to aid in its prevention.
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Affiliation(s)
- Seyed Reza Mirjalili
- Yazd Cardiovascular Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sepideh Soltani
- Yazd Cardiovascular Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Heidari Meybodi
- Yazd Cardiovascular Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Pedro Marques-Vidal
- Department of Internal Medicine, BH10-642, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Alexander Kraemer
- Department of Health Sciences, Bielefeld University, Bielefeld, Germany
| | - Mohammadtaghi Sarebanhassanabadi
- Yazd Cardiovascular Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Han Y, Zhou Z, Zhang Y, Zhao G, Xu B. The Association of Surrogates of Insulin Resistance with Hyperuricemia among Middle-Aged and Older Individuals: A Population-Based Nationwide Cohort Study. Nutrients 2023; 15:3139. [PMID: 37513557 PMCID: PMC10385684 DOI: 10.3390/nu15143139] [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: 06/20/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
The triglyceride-glucose (TyG) index, triglyceride-to-high-density-lipoprotein-cholesterol (TG/HDL-C) ratio, metabolic score for insulin resistance (METS-IR) and TyG with body mass index (TyG-BMI) have been proposed as indicators of insulin resistance (IR). This study aimed to explore the association between these IR surrogates and their longitudinal variation with the development of hyperuricemia in a middle-aged and older Chinese population. Data from the China Health and Retirement Longitudinal Study (CHARLS) was used to identify 5269 participants aged ≥45 years. Logistic regression was used to assess the effect of IR surrogates and their variations on the risk of hyperuricemia. After four years of follow-up, 517 (9.81%) participants developed incident hyperuricemia. Increased baseline values of TyG, TG/HDL, METS-IR, and TyG-BMI were all significantly associated with higher risks of hyperuricemia. Compared to individuals with maintained low levels of IR surrogates, those with low-to-high and maintained high variation patterns had a significantly higher risk of hyperuricemia. These four IR surrogates have comparable predictive ability for hyperuricemia. This study provides evidence of the associations between IR and hyperuricemia. Early intervention among middle-aged and elderly Chinese individuals with high IR levels may effectively reduce the burden of hyperuricemia.
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Affiliation(s)
- Yutong Han
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
- Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai 200032, China
| | - Zonglei Zhou
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yuge Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
- Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai 200032, China
| | - Genming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
- Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai 200032, China
| | - Biao Xu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
- Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai 200032, China
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Zhu Q, Zhang T, Cheang I, Lu X, Shi M, Zhu X, Liao S, Gao R, Li X, Yao W. Negative association between triglyceride glucose index and BMI-adjusted skeletal muscle mass index in hypertensive adults. BMC Musculoskelet Disord 2023; 24:571. [PMID: 37442968 DOI: 10.1186/s12891-023-06700-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The triglyceride glucose (TyG) index, an indicator of insulin resistance, is often associated with adverse outcomes in various cardiovascular diseases, while hypertension is associated with an increased risk of cardiovascular diseases. As the loss of muscle mass in people with hypertension is poorly understood, the current study aimed to explore the relationship between TyG index and muscle mass in hypertensive population. METHODS We analyzed data from hypertensive adult participants in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. The TyG index and body mass index (BMI)-adjusted skeletal muscle mass index (SMI) were calculated and the relationship between the two was evaluated using multivariable linear regression and restricted cubic spline (RCS) regression models. RESULTS A total of 1633 participants in the dataset were included for the final analysis. In the multivariable regression analysis, the adjusted β of SMI with a 95% confidence interval (CI) for the highest TyG index quartile was - 5.27 (- 9.79 to - 0.75), compared with the lowest quartile. A negative linear relationship between TyG index and SMI was plotted by RCS regression (nonlinear P = 0.128). Stratified models of non-smoking women of different ages also demonstrated that SMI decreased as TyG index increased (all P for trend < 0.05). CONCLUSION This linear and negative correlation between TyG index and SMI in hypertensive patients suggests that insulin resistance adversely affects muscle mass.
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Affiliation(s)
- Qingqing Zhu
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Ting Zhang
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Iokfai Cheang
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Xinyi Lu
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Mengsha Shi
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Xu Zhu
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Shengen Liao
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Rongrong Gao
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Xinli Li
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China.
| | - Wenming Yao
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China.
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22
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Tsai KZ, Huang WC, Chang YC, Kwon Y, Sui X, Lavie CJ, Lin GM. Localized periodontitis severity associated with carotid intima-media thickness in young adults: CHIEF atherosclerosis study. Sci Rep 2023; 13:10523. [PMID: 37386122 PMCID: PMC10310726 DOI: 10.1038/s41598-023-37840-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/28/2023] [Indexed: 07/01/2023] Open
Abstract
This study aimed to investigate the association of periodontitis with subclinical atherosclerosis in young adults. In total, 486 non-diabetic military personnel were included in Taiwan. Carotid intima-media thickness (cIMT) was assessed utilizing sonography for subclinical atherosclerosis. Periodontitis severity was defined based on the 2017 US/European consensus. Mean cIMT was compared by analysis of covariance (ANCOVA), and multiple logistic regression model was used to determine the association of periodontitis severity and the highest quintile of cIMT (≥ 0.8 mm) with adjustments for age, sex, metabolic risk factors and leukocyte counts. The mean cIMT increased in those with greater stages (periodontal health (N = 349): 0.65 mm, Stage I (N = 41): 0.72 mm, Stage II (N = 57): 0.74 mm and Stage III: 0.76 mm, respectively, p < 0.01). In multiple logistic regression, a dose-response association from Stage I to Stage III periodontitis for cIMT ≥ 0.8 mm was also found [ORs and 95% CIs 1.41 (0.60-3.29), 1.62 (0.79-3.31) and 3.20 (1.42-7.18)]. Leucocyte counts ≥ 7.6 × 103/µL (the highest quintile) was associated with cIMT ≥ 0.8 mm [OR 1.86 (1.11-3.12)], while no association existed for other metabolic risk factors. In conclusion, severe periodontitis and leukocyte counts are independent risk factors of increased cIMT, emphasizing the critical role of inflammation in subclinical atherosclerosis.
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Affiliation(s)
- Kun-Zhe Tsai
- Department of Internal Medicine, Hualien Armed Forces General Hospital, No. 100, Jinfeng St., Hualien City, 970, Taiwan
- Department of Stomatology of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Wei-Chun Huang
- Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yun-Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung, 406, Taiwan
| | - Younghoon Kwon
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Gen-Min Lin
- Department of Internal Medicine, Hualien Armed Forces General Hospital, No. 100, Jinfeng St., Hualien City, 970, Taiwan.
- Department of Internal Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
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Yu Y, Wang J, Ding L, Huang H, Cheng S, Deng Y, Gu M, Cai C, Ning X, Chen X, Niu H, Hua W. Sex differences in the nonlinear association of triglyceride glucose index with all-cause and cardiovascular mortality in the general population. Diabetol Metab Syndr 2023; 15:136. [PMID: 37349808 DOI: 10.1186/s13098-023-01117-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 06/17/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND The evidence on the association between the triglyceride glucose (TyG) index and the risk of death in the general population remains controversial. This study aims to investigate the relationship between the TyG index and all-cause and cardiovascular mortality in the general population, with a focus on sex differences. METHODS This prospective cohort study analyzed data from the National Health and Nutrition Examination Survey (1999-2002), comprising 7,851 US adults. The study employed multivariate Cox proportional hazards regression and two-segment Cox hazard regression models to evaluate the sex-specific differences in the relationship between the TyG index and all-cause and cardiovascular mortality. RESULTS After 11,623 person-years of follow-up, there were 539 deaths, with 10.56% due to all-cause mortality and 2.87% due to cardiovascular mortality. After adjusting for multiple variables, our study found a U-shaped association of the TyG index with all-cause and cardiovascular mortality, with inflection points at 9.36 and 9.52. A significant sex difference was observed in the association between the TyG index and mortality. Below the inflection point, the relationship between the TyG index and mortality was consistent in males and females. However, above the inflection point, only males exhibited a positive association between the TyG index and all-cause mortality (adjusted hazard risk [HR], 1.62, 95% confidence interval [CI], 1.24-2.12) and cardiovascular mortality (adjusted HR, 2.28, 95% CI, 1.32-3.92). CONCLUSIONS Our study showed a U-shaped association between the TyG index and all-cause and cardiovascular mortality in the general population. Furthermore, sex differences were observed in the association between the TyG index and mortality once it exceeded a certain threshold.
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Affiliation(s)
- Yu Yu
- Cardiac Arrhythmia Center, Department of Cardiology, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Wang
- Cardiac Arrhythmia Center, Department of Cardiology, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ligang Ding
- Cardiac Arrhythmia Center, Department of Cardiology, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Huang
- Cardiac Arrhythmia Center, Department of Cardiology, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sijing Cheng
- Cardiac Arrhythmia Center, Department of Cardiology, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Deng
- Cardiac Arrhythmia Center, Department of Cardiology, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Gu
- Cardiac Arrhythmia Center, Department of Cardiology, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chi Cai
- Cardiac Arrhythmia Center, Department of Cardiology, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohui Ning
- Cardiac Arrhythmia Center, Department of Cardiology, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuhua Chen
- Cardiac Arrhythmia Center, Department of Cardiology, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongxia Niu
- Cardiac Arrhythmia Center, Department of Cardiology, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Hua
- Cardiac Arrhythmia Center, Department of Cardiology, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Liu X, Abudukeremu A, Jiang Y, Cao Z, Wu M, Ma J, Sun R, He W, Chen Z, Chen Y, Yu P, Zhu W, Zhang Y, Wang J. U-shaped association between the triglyceride-glucose index and atrial fibrillation incidence in a general population without known cardiovascular disease. Cardiovasc Diabetol 2023; 22:118. [PMID: 37208737 DOI: 10.1186/s12933-023-01777-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/20/2023] [Indexed: 05/21/2023] Open
Abstract
OBJECTIVE The triglyceride-glucose (TyG) index has been shown to be a new alternative measure for insulin resistance. However, no study has attempted to investigate the association of the TyG index with incident atrial fibrillation (AF) in the general population without known cardiovascular diseases. METHODS Individuals without known cardiovascular diseases (heart failure, coronary heart disease, or stroke) from the Atherosclerosis Risk in Communities (ARIC) cohort were recruited. The baseline TyG index was calculated as the Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. The association between the baseline TyG index and incident AF was examined using Cox regression. RESULTS Of 11,851 participants, the mean age was 54.0 years; 6586 (55.6%) were female. During a median follow-up of 24.26 years, 1925 incidents of AF cases (0.78/per 100 person-years) occurred. An increased AF incidence with a graded TyG index was found by Kaplan‒Meier curves (P < 0.001). In multivariable-adjusted analysis, both < 8.80 (adjusted hazard ratio [aHR] = 1.15, 95% confidence interval [CI] 1.02, 1.29) and > 9.20 levels (aHR 1.18, 95% CI 1.03, 1.37) of the TyG index were associated with an increased risk of AF compared with the middle TyG index category (8.80-9.20). The exposure-effect analysis confirmed the U-shaped association between the TyG index and AF incidence (P = 0.041). Further sex-specific analysis showed that a U-shaped association between the TyG index and incident AF still existed in females but not in males. CONCLUSIONS A U-shaped association between the TyG index and AF incidence is observed in Americans without known cardiovascular diseases. Female sex may be a modifier in the association between the TyG index and AF incidence.
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Affiliation(s)
- Xiao Liu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, The Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Ayiguli Abudukeremu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yuan Jiang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Zhengyu Cao
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Maoxiong Wu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Jianyong Ma
- Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, USA
| | - Runlu Sun
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Wanbing He
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Zhiteng Chen
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Yangxin Chen
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Peng Yu
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, The Second Affiliated Hospital of Nanchang University, Jiangxi, China.
- Department of Endocrine, The Second Affiliated Hospital of Nanchang University, Jiangxi, China.
| | - Wengen Zhu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
| | - Yuling Zhang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China.
| | - Jingfeng Wang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China.
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Zhang W, Liu L, Chen H, Li S, Wan M, Mohammed AQ, Xu B, Yin G, Lv X, Shi T, Galip J, Mohammed AA, Mareai RM, Xu Y, Abdu FA, Che W. Association between the triglyceride-glucose index and the presence and prognosis of coronary microvascular dysfunction in patients with chronic coronary syndrome. Cardiovasc Diabetol 2023; 22:113. [PMID: 37179333 PMCID: PMC10183136 DOI: 10.1186/s12933-023-01846-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Coronary microvascular dysfunction (CMD) is a strong determinant of prognosis in patients with chronic coronary syndrome (CCS). The triglyceride-glucose index (TyG index), an alternative method to evaluate insulin resistance, is positively correlated with the incidence and adverse outcomes of cardiovascular diseases. However, the relationship between the TyG index and the presence and prognosis of CMD in CCS patients has not been investigated. Therefore, we aimed to evaluate the association between the TyG index and the presence and clinical outcomes of CMD among CCS patients. METHODS CCS patients who underwent coronary angiography between June 2015 to June 2019 were included. The TyG index was calculated as Ln[fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Coronary angiography‑derived index of microvascular resistance (caIMR) was used to measure microvascular function, and CMD was defined as caIMR ≥ 25U. Patients with CMD were divided into three groups (T1, T2, and T3 groups) according to TyG tertiles. The primary endpoint was major adverse cardiac event (MACE). RESULTS Of 430 CCS patients, 221 patients had CMD. CMD patients had significantly higher TyG index than those without CMD. Sixty-three MACE was recorded during the follow-up duration among CMD patients, and the incidence rate of MACE was higher in the T3 group compared to T1/T2 groups (39.2% vs. 20.5% vs. 25.7%; P = 0.035). Multivariable logistic regression analysis showed that the TyG index was an independent predictor of CMD (OR, 1.436; 95% CI, 1.014-2.034; P = 0.042). Compared to the T1 group, the T3 group strongly correlated with the risk of MACE in CMD patients even after adjusting for additional confounding risk factors (HR, 2.132; 95%CI, 1.066-4.261; P = 0.032). CONCLUSION TyG index is significantly associated with the risk of CMD, and it is an independent predictor of MACE among CMD patients with CCS. This study suggests that the TyG index has important clinical significance for the early prevention and risk stratification of CMD.
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Affiliation(s)
- Wen Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Lu Liu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Huiying Chen
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Siqi Li
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Minying Wan
- Department of Cardiology, Shanghai Tenth People's Hospital Chongming Branch, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Abdul-Quddus Mohammed
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Bin Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Guoqing Yin
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Xian Lv
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Tingting Shi
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Jassur Galip
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Ayman A Mohammed
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Redhwan M Mareai
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Fuad A Abdu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China.
| | - Wenliang Che
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China.
- Department of Cardiology, Shanghai Tenth People's Hospital Chongming Branch, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China.
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Yan S, Wang D, Jia Y. Comparison of insulin resistance-associated parameters in US adults: a cross-sectional study. Hormones (Athens) 2023; 22:331-341. [PMID: 36972006 DOI: 10.1007/s42000-023-00448-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/15/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Triglyceride-glucose (TyG) is correlated with cardiovascular events caused by insulin resistance (IR). The aim of this study was to analyze the relationship between TyG and its related indicators and IR among US adults from 2007 to 2018 in the National Health and Nutrition Examination Survey (NHANES) database so as to identify more accurate and reliable predictors of IR. METHODS This is a cross-sectional study including 9884 participants (2255 with IR and 7629 without IR). TyG, TyG-body mass index (TyG-BMI), TyG waist circumference (TyG-WC), and TyG waist-to-height ratio (TyG-WtHR) were measured using standard formulas. RESULTS TyG, TyG-BMI, TyG-WC, and TyG-WtHR were significantly correlated with IR in the general population, with TyG-WC being the most strongly correlated, with an odds ratio of 8.00 (95% confidence interval 5.05-12.67) for the fourth quartile of TyG-WC compared with the first quartile in the adjusted model. Receiver operating characteristic (ROC) analysis of the participants showed that the maximum area under the TyG-WC curve was 0.8491, which was significantly higher than that of the other three indicators. Moreover, this trend was stable both among people of both genders and among patients with coronary heart disease (CHD), hypertension, and diabetes. CONCLUSIONS The present study confirms that the TyG-WC index is more successful than TyG alone in identifying IR. In addition, our findings demonstrate that TyG-WC is a simple and effective marker for screening the general US adult population and those with CHD, hypertension, and diabetes and can be effectively used in clinical practice.
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Affiliation(s)
- Shaoyi Yan
- Department of Cardiovascular Medicine, First Hospital of Shanxi Medical University, Taiyuan, China.
| | - Di Wang
- Department of Cardiovascular Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yongping Jia
- Department of Cardiovascular Medicine, First Hospital of Shanxi Medical University, Taiyuan, China.
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Funck KL, Bjerg L, Isaksen AA, Sandbæk A, Grove EL. Gender disparities in time-to-initiation of cardioprotective glucose-lowering drugs in patients with type 2 diabetes and cardiovascular disease: a Danish nationwide cohort study. Cardiovasc Diabetol 2022; 21:279. [PMID: 36496402 PMCID: PMC9737743 DOI: 10.1186/s12933-022-01713-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND We aimed to examine the impact of gender and specific type of cardiovascular disease (CVD) diagnosis (ischemic heart disease [IHD], heart failure, peripheral artery disease [PAD] or stroke) on time-to-initiation of either a sodium glucose cotransporter 2 inhibitor or glucagon-like peptide 1 analogue (collectively termed cardioprotective GLD) after a dual diagnosis of type 2 diabetes (T2DM) and CVD. METHODS In a nationwide cohort study, we identified patients with a new dual diagnosis of T2DM and CVD (January 1, 2012 and December 31, 2018). Cumulative user proportion (CUP) were assessed. Poisson models were used to estimate the initiation rate of cardioprotective GLDs. The final analyses were adjusted for potential confounders. RESULTS In total, we included 70,538 patients with new-onset T2DM and CVD (38% female, mean age 70 ± 12 years at inclusion). During 183,256 person-years, 6,276 patients redeemed a prescription of a cardioprotective GLD. One-year CUPs of cardioprotective GLDs were lower in women than men. Initiation rates of GLDs were lower in women (female-to-male initiation-rate-ratio crude: 0.76, 95% CI 0.72-0.81); adjusted 0.92, 95% CI 0.87-0.97). In CVD-stratified analysis, the adjusted initiation rate ratio was lower in female patients with IHD and heart failure (IHD: 0.91 [95% CI 0.85-0.98], heart failure: 0.85 [95% CI 0.73-1.00], PAD: 0.92 [95% CI 0.78-1.09], and stroke: 1.06 [95% CI 0.93-1.20]). CONCLUSIONS Among patients with a new dual diagnosis of T2DM and CVD, female gender is associated with lower initiation rates of cardioprotective GLDs, especially if the patient has IHD or heart failure.
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Affiliation(s)
- Kristian Løkke Funck
- grid.154185.c0000 0004 0512 597XSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Lasse Bjerg
- grid.154185.c0000 0004 0512 597XSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Anders Aasted Isaksen
- grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Annelli Sandbæk
- grid.154185.c0000 0004 0512 597XSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Erik Lerkevang Grove
- grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark ,grid.154185.c0000 0004 0512 597XDepartment of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
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Wang Y, Qiu L, Wang Y, He Z, Lan X, Cui L, Wang Y. Genetic variation within the pri-let-7f-2 in the X chromosome predicting stroke risk in a Chinese Han population from Liaoning, China: From a case-control study to a new predictive nomogram. Front Med (Lausanne) 2022; 9:936249. [DOI: 10.3389/fmed.2022.936249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 11/15/2022] [Indexed: 12/05/2022] Open
Abstract
Background and objectivesStroke is the most common cause of disability and the second cause of death worldwide. Therefore, there is a need to identify patients at risk of developing stroke. This case-control study aimed to create and verify a gender-specific genetic signature-based nomogram to facilitate the prediction of ischemic stroke (IS) risk using only easily available clinical variables.Materials and methodsA total of 1,803 IS patients and 1,456 healthy controls from the Liaoning province in China (Han population) were included which randomly divided into training cohort (70%) and validation cohort (30%) using the sample function in R software. The distribution of the pri-let-7f-2 rs17276588 variant genotype was analyzed. Following genotyping analysis, statistical analysis was used to identify relevant features. The features identified from the multivariate logistic regression, the least absolute shrinkage and selection operator (LASSO) regression, and univariate regression were used to create a multivariate prediction nomogram model. A calibration curve was used to determine the discrimination accuracy of the model in the training and validation cohorts. External validity was also performed.ResultsThe genotyping analysis identified the A allele as a potential risk factor for IS in both men and women. The nomogram identified the rs17276588 variant genotype and several clinical parameters, including age, diabetes mellitus, body mass index (BMI), hypertension, history of alcohol use, history of smoking, and hyperlipidemia as risk factors for developing IS. The calibration curves for the male and female models showed good consistency and applicability.ConclusionThe pri-let-7f-2 rs17276588 variant genotype is highly linked to the incidence of IS in the northern Chinese Han population. The nomogram we devised, which combines genetic fingerprints and clinical data, has a lot of promise for predicting the risk of IS within the Chinese Han population.
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Mahdavi-Roshan M, Mozafarihashjin M, Shoaibinobarian N, Ghorbani Z, Salari A, Savarrakhsh A, Hekmatdoost A. Evaluating the use of novel atherogenicity indices and insulin resistance surrogate markers in predicting the risk of coronary artery disease: a case‒control investigation with comparison to traditional biomarkers. Lipids Health Dis 2022; 21:126. [DOI: 10.1186/s12944-022-01732-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/03/2022] [Indexed: 11/28/2022] Open
Abstract
Abstract
Background
Due to the contribution of coronary artery disease (CAD) to serious cardiovascular events, determining biomarkers that could robustly predict its risk would be of utmost importance. Thus, this research was designed to assess the value of traditional cardio-metabolic indices, and more novel atherogenicity indices and insulin resistance surrogate markers in the identification of individuals at risk of CAD.
Methods
A case‒control survey was conducted, in which 3085 individuals were enrolled. Their clinical and biochemical data were gathered at baseline. The investigated indices included the atherogenic index of plasma (AIP), triglyceride-glucose (TyG) index, TyG-body mass index (TyG-BMI), lipoprotein combine index (LCI), cholesterol index (CHOLINDEX), Castelli’s risk indices-I, II (CRI-I, CRI-II), and metabolic score for insulin resistance (METS − IR). To examine the relationship between these variables and CAD risk, multiple regression analyses adjusted for potential confounders were conducted.
Results
Overall, 774 angiographically confirmed CAD patients (mean age = 54 years) were compared with 3085 controls (mean age = 51 years). Higher triglyceride, total cholesterol and fasting blood sugar levels and lower HDL-C levels were related to an elevated risk of CAD (P-for-trend < 0.001), while the direct association between increased serum LDL-C concentrations and a greater risk of CAD only became apparent when excluding those with diabetes, and statin users. Among novel indices, greater values of the majority of these markers, including AIP, CRI-I, and -II, CHOLINDEX, LCI, and TyG-index, in comparison to the lower values, significantly elevated CAD risk (P-for-trend < 0.001).
Conclusion
According to the current findings, novel atherogenicity indices and insulin resistance surrogate markers, in particular, AIP, CRI-I and II, CHOLINDEX, LCI, and TyG-index, may be useful in predicting CAD risk.
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Ramezankhani A, Azizi F, Hadaegh F. Gender differences in changes in metabolic syndrome status and its components and risk of cardiovascular disease: a longitudinal cohort study. Cardiovasc Diabetol 2022; 21:227. [PMID: 36324143 PMCID: PMC9632145 DOI: 10.1186/s12933-022-01665-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Background We aimed to investigate the gender difference in the association between changes in metabolic syndrome (MetS) and its components with the risk of cardiovascular disease (CVD) and coronary heart disease (CHD) among adult participants in the Tehran lipid and glucose study cohort. Methods A total of 4624 adults (aged ≥ 30 years) who participated in two Phases 2 (2002–2005) and 3 (2005–2008) were included and followed up until 2018. Based on the status of MetS and its components in two phases, we divided participants into four groups: MetS-free, MetS-developed, MetS-recovery and MetS-stable groups, and similar categories were defined for MetS components. Multiple Cox regression models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs), and women-to-men ratios of HRs (RHRs). Results During a median follow-up of 11.6 years, 619 CVD events (292 women) and 512 CHD events (230 women) occurred. In both genders, the MetS-stable group had the highest risk of CVD and CHD, compared with the MetS-free group, but the associations were stronger in women than men: the HR (95% CI) were (2.76, 2.00-3.82) and (3.08, 2.15–4.40) for CVD and CHD, respectively, in women, and (1.60, 1.23–2.09) and (1.74, 1.30–2.31) for men. The multivariate adjusted women-to-men RHRs were (1.72, 1.16–2.56) for CVD and (1.77, 1.14–2.73) for CHD. Only among women, the risks for CVD in MetS-recovery group (1.67, 1.06–2.63) and MetS-developed group (1.89, 1.16–3.06|) were higher than MetS-free group. For CHD, women in MetS-developed group (1.86, 1.07–3.22) had higher risk than MetS-free group. However, no evidence of gender difference was observed in these associations. Among MetS components, persistent high blood pressure (BP) conferred greater risk for CVD and CHD in women than men; the women-to-men RHRs of CVD and CHD for high BP-stable groups were 1.54 (1.05–2.26) and 1.62 (1.07–2.47), respectively. For CHD events, persistent high fasting plasma glucose was associated with greater risk in women than men with women-to-men RHRs of 1.62 (1.09–2.40). Conclusion Change in MetS and its key components were associated with different risks for CVD events in both genders, with generally stronger associations in women than men. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01665-8.
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Affiliation(s)
- Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Pathophysiological and clinical aspects of the circadian rhythm of arterial stiffness in diabetes mellitus: A minireview. Endocr Regul 2022; 56:284-294. [DOI: 10.2478/enr-2022-0031] [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: 12/23/2022] Open
Abstract
Abstract
Several cross-sectional trials have revealed increased arterial stiffness connected with the cardiac autonomic neuropathy in types 2 and 1 diabetic patients. The pathophysiological relationship between arterial stiffness and autonomic dysfunction in diabetes mellitus is still underinvestigated and the question whether the presence of cardiac autonomic neuropathy leads to arterial stiffening or increased arterial stiffness induced autonomic nervous system impairment is still open. Both arterial stiffness and dysfunction of the autonomic nervous system have common pathogenetic pathways, counting state of the chronic hyperinsulinemia and hyperglycemia, increased formation of advanced glycation end products, activation of protein kinase C, development of endothelial dysfunction, and chronic low-grade inflammation. Baroreceptor dysfunction is thought to be one of the possible reasons for the arterial wall stiffening development and progression. On the contrary, violated autonomic nervous system function can affect the vascular tone and by this way alter the large arteries walls elastic properties. Another possible mechanism of attachment and/or development of arterial stiffness is the increased heart rate and autonomic dysfunction corresponding progression. This minireview analyzes the current state of the relationship between the diabetes mellitus and the arterial stiffness. Particular attention is paid to the analysis, interpretation, and application of the results obtained in patients with type 2 diabetes mellitus and diabetic cardiac autonomic neuropathy.
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Caimi G, Urso C, Brucculeri S, Amato C, Lo Presti R, Carlisi M. Leukocyte subtypes, gelatinases, and their tissue inhibitors in a group of subjects with asymptomatic carotid atherosclerosis. Clin Hemorheol Microcirc 2022; 82:37-51. [PMID: 35599473 PMCID: PMC9741743 DOI: 10.3233/ch-221380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In a cohort of subjects with asymptomatic carotid atherosclerosis (ACA), we have evaluated the neutrophil and lymphocyte count and their ratio (NLR), the gelatinases (MMP-2 and MMP-9) and their tissue inhibitors (TIMP-1 and TIMP-2). At baseline, no difference was observed between ACA subjects and subject control group regarding neutrophil and lymphocyte count while was evident in ACA subjects a significant increase in MMP-2, MMP-9 and TIMP-2 associated to a significant decrease in TIMP-1. Dividing the ACA according to the number of cardiovascular risk factors (CRFs) we have observed an increase in lymphocyte count in the subgroup with 3-5 CRFs. Evaluating the leukocyte subtypes according to all the surrogate markers of insulin resistance has been noted, in the subgroups that exceed the medians of these markers, a significant increase in neutrophil and lymphocyte count without any variation of the NLR. Effecting the same evaluation for the MMP/TIMP pattern we observed, instead, that the same subgroups tend to show a decrease in MMP-2 and an increase in MMP-9. No difference instead for TIMP-1 and TIMP-2. The abnormality of the MMP/TIMP pattern, bearing in mind the cardiometabolic clustering present in this cohort of ACA subjects, would induce to use drugs able not only to cure the cardiometabolic risk factors but also to influence the MMP/TIMP profile.
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Affiliation(s)
- Gregorio Caimi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy,Corresponding author: Gregorio Caimi, Via Leonardo Da Vinci, 52, 90145, Palermo, Italy. E-mails: ;
| | - C. Urso
- Fondazione Istituto “G. Giglio” Cefalù, Palermo, Italy
| | - S. Brucculeri
- Fondazione Istituto “G. Giglio” Cefalù, Palermo, Italy
| | - C. Amato
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy
| | - R. Lo Presti
- Department of Psychology, Educational Science and Human Movement, Università degli Studi di Palermo, Palermo, Italy
| | - M. Carlisi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy
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Relationship between the triglyceride-glucose index and risk of cardiovascular diseases and mortality in the general population: a systematic review and meta-analysis. Cardiovasc Diabetol 2022; 21:124. [PMID: 35778731 PMCID: PMC9250255 DOI: 10.1186/s12933-022-01546-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 05/09/2022] [Indexed: 12/23/2022] Open
Abstract
Background The triglyceride-glucose (TyG) index is a new alternative measure for insulin resistance. This meta-analysis was conducted to assess the associations of the TyG index with the risks of cardiovascular diseases and mortality in the general population. Methods The PubMed, Cochrane Library and Embase databases were searched for randomized controlled trials or observational cohort studies reporting associations of the TyG index with cardiovascular diseases and mortality from inception to April 16, 2022. Effect sizes were pooled using random-effects models. Robust error meta-regression methods were applied to fit nonlinear dose–response associations. Evidence quality levels and recommendations were assessed using the Grading of Recommendations Assessment, Development and Evaluation system (GRADE). Results Twelve cohort studies (6 prospective and 6 retrospective cohorts) involving 6,354,990 participants were included in this meta-analysis. Compared with the lowest TyG index category, the highest TyG index was related to a higher incidence of coronary artery disease (CAD) (3 studies; hazard ratio [HR] = 2.01; 95% confidence interval [CI] 1.68–2.40; I2 = 0%), myocardial infarction (MI) (2 studies; HR = 1.36; 95% CI 1.18–1.56; I2 = 35%), and composite cardiovascular disease (CVD) (5 studies; HR = 1.46; 95% CI 1.23–1.74; I2 = 82%). However, there was no association between the TyG index and mortality (cardiovascular mortality [3 studies; HR = 1.10; 95% CI 0.82–1.47; I2 = 76%] or all-cause mortality [4 studies; HR = 1.08; 95% CI 0.92–1.27; I2 = 87%]). In the dose–response analysis, there was a linear association of the TyG index with the risk of CAD (Pnonlinear = 0.3807) or CVD (Pnonlinear = 0.0612). GRADE assessment indicated very low certainty for CVD, MI, cardiovascular mortality and all-cause mortality, and moderate certainty for CAD. Conclusions Based on our current evidence, a higher TyG index may be associated with an increased incidence of CAD (moderate certainty), MI (very low certainty) and CVD (very low certainty) in the general population. There is a potential linear association of the TyG index with CAD and the composite CVD incidence. Further prospective studies (especially in non-Asians) are needed to confirm our findings. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01546-0.
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Yang X, Gao Z, Huang X, Zhang M, Chen Z. The correlation of atherosclerosis and triglyceride glucose index: a secondary analysis of a national cross-sectional study of Japanese. BMC Cardiovasc Disord 2022; 22:250. [PMID: 35659558 PMCID: PMC9164853 DOI: 10.1186/s12872-022-02685-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/20/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Few studies examined the relationship between triglyceride/glucose index (TyG index) and atherosclerosis in Japanese adults. Therefore, this study evaluated their relationship, as measured based on the brachial-ankle pulse wave velocity (baPWV) in Japanese adults. METHODS A total of 912 participants was selected from the NAGALA (NAFLD in Gifu Area, Longitudinal Analysis) study conducted from 2004 to 2012. The relationship between the TyG index and baPWV was estimated through a logistic model. Subgroup analyses by sex, age, body mass index (BMI), total cholesterol, low-density lipoprotein cholesterol, estimated glomerular filtration rate (eGFR), and fatty liver was performed. The formula for TyG index was ln (½fasting triglyceride level [mg/dL] × fasting plasma glucose level [mg/dL]). RESULTS A linear relationship between TyG and baPWV was discovered after adjusting for underlying confounders. An increased risk of baPWV was observed after adjusting for sex, age, BMI, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, fatty liver, eGFR, and TyG as a continuous variable (adjusted odds ratio [adj OR], 1.57; 95% confidence interval [95% CI], 1.14-2.18). Compared with the TyG index in the first tertile, the probabilities of subjects in the third tertile that developed to baPWV were 1.78-fold higher (adj OR 1.78, 95% CI 1.08-2.95: P for trend 0.024). Moreover, stable associations were observed between the TyG index and baPWV in different variables through subgroup analyses. CONCLUSIONS The highest tertile (above 8.57) of the TyG index was positively and linearly related to subclinical atherosclerosis in Japanese adults and may be valuable as a predicted marker.
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Affiliation(s)
- Xingping Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jinan University, No. 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510105, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Zhao Gao
- Office of Academic Research, Er Sha Sports Training Center of Guangdong Province, Guangzhou, 510105, China
| | - Xuming Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Mingxing Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Zhuoming Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jinan University, No. 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510105, China.
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Huang R, Wang Z, Chen J, Bao X, Xu N, Guo S, Gu R, Wang W, Wei Z, Wang L. Prognostic value of triglyceride glucose (TyG) index in patients with acute decompensated heart failure. Cardiovasc Diabetol 2022; 21:88. [PMID: 35641978 PMCID: PMC9158138 DOI: 10.1186/s12933-022-01507-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/20/2022] [Indexed: 12/14/2022] Open
Abstract
Background The triglyceride glucose (TyG) index has been proposed as a reliable marker of insulin resistance (IR) and an independent predictor of cardiovascular disease risk. However, its prognostic value in patients with acute decompensated heart failure (ADHF) remains unclear. Methods A total of 932 hospitalized patients with ADHF from January 1st, 2018 to February 1st, 2021 were included in this retrospective study. The TyG index was calculated as ln [fasting triglyceride level (mg/dL) × fasting plasma glucose level (mg/dL)/2]. Patients were divided into tertiles according to TyG index values. The primary endpoints were all-cause death, cardiovascular (CV) death and major adverse cardiac and cerebral events (MACCEs) during follow-up. We used multivariate adjusted Cox proportional hazard models and restricted cubic spline analysis to investigate the associations of the TyG index with primary endpoints. Results During a median follow-up time of 478 days, all-cause death, CV death and MACCEs occurred in 140 (15.0%), 103 (11.1%) and 443 (47.9%) cases, respectively. In multivariate Cox proportional hazard models, the risk of incident primary endpoints was associated with the highest TyG tertile. After adjustment for confounding factors, hazard ratios (HRs) for the highest tertile (TyG index ≥ 9.32) versus the lowest tertile (TyG index < 8.83) were 2.09 (95% confidence interval [CI], 1.23–3.55; p = 0.006) for all-cause death, 2.31 (95% CI, 1.26–4.24; p = 0.007) for CV death and 1.83 (95% CI, 1.18–3.01; p = 0.006) for MACCEs. Restricted cubic spline analysis also showed that the cumulative risk of primary endpoints increased as TyG index increased. When the TyG index was used as a continuous variable, the hazard ratios of the three primary endpoints rapidly increased within the higher range of the TyG index (all cause death, TyG > 9.08; CV death, TyG > 9.46; MACCEs, TyG > 9.87). Conclusions The elevated TyG index was independently associated with poor prognosis, and thus would be useful in the risk stratification in patients with ADHF.
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Affiliation(s)
- Rong Huang
- Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China
| | - Ziyan Wang
- Department of Cardiology, Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, 210008, Jiangsu, China
| | - Jianzhou Chen
- Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China
| | - Xue Bao
- Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China
| | - Nanjiao Xu
- Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China
| | - Simin Guo
- Department of Endocrinology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China
| | - Rong Gu
- Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China
| | - Weimin Wang
- Department of Endocrinology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China.
| | - Zhonghai Wei
- Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China.
| | - Lian Wang
- Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China. .,Department of Cardiology, Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, 210008, Jiangsu, China.
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Miao M, Zhou G, Bao A, Sun Y, Du H, Song L, Cao Y, You S, Zhong C. Triglyceride-glucose index and common carotid artery intima-media thickness in patients with ischemic stroke. Cardiovasc Diabetol 2022; 21:43. [PMID: 35303881 PMCID: PMC8933990 DOI: 10.1186/s12933-022-01472-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Triglyceride glucose (TyG) index was recently reported to be associated with an increased risk of the development and recurrence of cardiovascular events, and atherosclerosis is a main speculative mechanism. However, data on the relationship between TyG index and atherosclerosis, especially in the setting of ischemic stroke, is rare. We aimed to explore the association between TyG index and carotid atherosclerosis in patients with ischemic stroke. METHODS A total of 1523 ischemic stroke patients with TyG index and carotid artery imaging data were enrolled in this analysis. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Carotid atherosclerosis was measured by common carotid artery intima-media thickness (cIMT), and abnormal cIMT was defined as a mean cIMT and maximum cIMT value ≥ 1 mm. Multivariable logistic regression models and restricted cubic spline models were used to assess the relationships between TyG index and abnormal cIMT. Risk reclassification and calibration of models with TyG index were analyzed. RESULTS The multivariable-adjusted odds ratios (95% CIs) in quartile 4 versus quartile 1 of TyG index were 1.56 (1.06-2.28) for abnormal mean cIMT and 1.46 (1.02-2.08) for abnormal maximum cIMT, respectively. There were linear relationships between TyG index and abnormal mean cIMT (P for linearity = 0.005) and abnormal maximum cIMT (P for linearity = 0.027). In addition, the TyG index provided incremental predictive capacity beyond established risk factors, shown by an increase in net reclassification improvement and integrated discrimination improvement (all P < 0.05). CONCLUSIONS A higher TyG index was associated with carotid atherosclerosis measured by cIMT in patients with ischemic stroke, suggesting that TyG could be a promising atherosclerotic marker.
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Affiliation(s)
- Mengyuan Miao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu, China.,Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Guo Zhou
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.,Department of Cardiology, Nantong Third People's Hospital, Nantong University, Nantong, 226006, China
| | - Anran Bao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu, China
| | - Yaming Sun
- Department of Neurology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215600, China
| | - Huaping Du
- Department of Neurology, The Affiliated Wujiang Hospital of Nantong University, Suzhou, 215200, China
| | - Liyan Song
- Department of Neurology, The First People's Hospital of Taicang, Suzhou, 215400, China
| | - Yongjun Cao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Shoujiang You
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu, China.
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Li Z, He Y, Wang S, Li L, Yang R, Liu Y, Cheng Q, Yu L, Zheng Y, Zheng H, Gao S, Yu C. Association between triglyceride glucose index and carotid artery plaque in different glucose metabolic states in patients with coronary heart disease: a RCSCD-TCM study in China. Cardiovasc Diabetol 2022; 21:38. [PMID: 35277186 PMCID: PMC8917731 DOI: 10.1186/s12933-022-01470-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/28/2022] [Indexed: 01/14/2023] Open
Abstract
Background The triglyceride glucose (TyG) index serves as a surrogate indicator of insulin resistance. However, there is limited evidence on the association between the TyG index and carotid artery plaque (CAP) in patients with coronary heart disease (CHD). Methods The 10,535 CHD patients were divided according to TyG index quartiles (Q1: TyG index < 8.52; Q2: 8.52 ≤ TyG index < 8.93; Q3: 8.93 ≤ TyG index ≤ 9.40; Q4: TyG index > 9.40). The presence or absence of CAP was determined by carotid ultrasonography. Logistic regression was used to analyze the relationship between the TyG index and CAP in CHD patients. The relationship between the TyG index and CAP in according to sex, age groups, and glucose metabolism states were also assessed. Results The baseline analysis showed that there were significant differences in related parameters among CHD patients divided into four groups according to the quartile of the TyG index. In the multi-adjusted modles, compared to Q1 of the TyG index, the odds ratios (OR) for Q4 of the TyG index for CAP were 1.37 (95% confidence interval [CI] 1.28–1.47) in CHD patients. The association between the TyG index and CAP in female (OR: 1.35; 95% CI 1.29–1.43) was higher than that in male (OR: 1.20; 95% CI 1.13–1.27). The OR value of middle-aged (≤ 60 years old) patients (OR: 1.34; 95% CI 1.26–1.42) was higher than that in elderly (> 60 years old) patients (OR: 1.16; 95% CI 1.11–1.22). In different glucose metabolism states, the TyG index of CHD patients was significantly related to the risk of CAP, with the highest OR value observed for diabetes (OR: 1.36; 95% CI 1.26–1.46). Conclusions The TyG index and CAP showed a significant association in CHD patients. This association between TyG index and CAP in CHD patients is higher in female than in male, and the association in middle-aged and elderly patients is higher than that in elderly patients. In the condition of DM, the association between TyG index and carotid artery plaque in CHD patients is higher. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01470-3.
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Quiroga B, Ramos PM, Horrillo AS, Ortiz A, Valdivieso JM, Carrero JJ. Triglycerides-glucose index and the risk of cardiovascular events in persons with non-diabetic chronic kidney disease. Clin Kidney J 2022; 15:1705-1712. [PMID: 36003671 PMCID: PMC9394724 DOI: 10.1093/ckj/sfac073] [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: 12/20/2021] [Indexed: 11/12/2022] Open
Abstract
Background Chronic kidney disease (CKD) is associated with high rates of cardiovascular events. We
here explored whether the recently described triglycerides–glucose index (TyG) predicted
the incidence of major adverse cardiovascular events (MACE) in these patients. Methods This observationa study was undertaken of 1142 persons with CKD and free from diabetes
and 460 controls from the prospective NEFRONA study. The study exposure was the TyG
index at cohort inclusion. The study outcome was MACE (cardiovascular death, nonfatal
myocardial infarction, nonfatal stroke and hospitalization for unstable angina).
Covariates included demographics, comorbidities, lipid profile, renal function and
glycaemic control. Cox regression models evaluated the association between TyG index and
4-point MACE in patients with CKD. Results TyG was higher [median 8.63 (interquartile range 8.32–8.95)] in patients with CKD
compared with controls (P < 0.001). TyG increased across albuminuria categories but
was similar for glomerular filtration rate categories among patients with CKD stages
3–5. During 46 ± 13 months of follow-up, 49 (4.3%) MACE were registered. TyG predicted
the occurrence of MACE {hazard ratio (HR) 1.95 [95% confidence interval (CI) 1.11–3.40]
per TyG unit increase; and HR 2.29 (95% CI 1.24–4.20] for TyG values above the median of
8.63 units}. Sensitivity analysis for subgroups of participants according to age, kidney
function, body mass index and imaging evidence of atherosclerosis yielded similar
results, as did adjusted analysis. Neither triglycerides nor glucose alone was
associated with MACE. Conclusions The TyG index is associated with the occurrence of major cardiovascular events in
persons free from diabetes with non-dialysis dependent CKD.
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Affiliation(s)
- Borja Quiroga
- IIS-La Princesa. Nephrology Department, Hospital Universitario de la Princesa, Madrid, Spain
| | | | - Ana Sánchez Horrillo
- IIS-La Princesa. Nephrology Department, Hospital Universitario de la Princesa, Madrid, Spain
| | - Alberto Ortiz
- IIS-Fundación Jimenez Diaz, School of Medicine, Universidad Autónoma de Madrid, Fundación Renal Iñigo Alvarez de Toledo-IRSIN, REDinREN, Instituto de Investigación Carlos III, Madrid, Spain
| | - José Manuel Valdivieso
- Vascular and Renal Translational Research Group, UDETMA, REDinREN del ISCIII, IRBLleida, Lleida, Spain
| | - Juan Jesús Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Mone P, Gambardella J, Lombardi A, Pansini A, De Gennaro S, Leo AL, Famiglietti M, Marro A, Morgante M, Frullone S, De Luca A, Santulli G. Correlation of physical and cognitive impairment in diabetic and hypertensive frail older adults. Cardiovasc Diabetol 2022; 21:10. [PMID: 35045834 PMCID: PMC8772197 DOI: 10.1186/s12933-021-01442-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/30/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Diabetes and hypertension are common in older adults and represent established risk factors for frailty. Frailty is a multidimensional condition due to reserve loss and susceptibility to stressors with a high risk of death, hospitalizations, functional and cognitive impairment. Comorbidities such as diabetes and hypertension play a key role in increasing the risk of mortality, hospitalization, and disability. Moreover, frail patients with diabetes and hypertension are known to have an increased risk of cognitive and physical impairment. Nevertheless, no study assessed the correlation between physical and cognitive impairment in frail older adults with diabetes and hypertension. METHODS We evaluated consecutive frail older patients with diabetes and hypertension who presented at ASL (local health unit of the Italian Ministry of Health) Avellino, Italy, from March 2021 to October 2021. The inclusion criteria were: a previous diagnosis of diabetes and hypertension with no evidence of secondary causes; age > 65 years; a frailty status; Montreal Cognitive Assessment (MoCA) score < 26. RESULTS 179 patients successfully completed the study. We found a strong and significant correlation between MoCA score and 5-m gait speed test (r: 0.877; p < 0.001). To further verify our results, we performed a linear multivariate analysis adjusting for potential confounding factors, with MoCA score as dependent variable, which confirmed the significant association with glycemia (p < 0.001). CONCLUSIONS This is the first study showing a significant correlation between 5-m gait speed test and MoCA score in frail diabetic and hypertensive older adults.
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Affiliation(s)
- Pasquale Mone
- grid.251993.50000000121791997Department of Medicine, Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), The Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine, New York, NY USA ,grid.9841.40000 0001 2200 8888Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy ,Division of Internal Medicine, Sant’Angelo Dei Lombardi Hospital, ASL (Local Health Unit), Avellino, Italy
| | - Jessica Gambardella
- grid.251993.50000000121791997Department of Medicine, Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), The Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine, New York, NY USA ,grid.4691.a0000 0001 0790 385XInternational Translational Research and Medical Education (ITME) Consortium, Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy
| | - Angela Lombardi
- grid.251993.50000000121791997Department of Medicine, Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), The Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine, New York, NY USA
| | - Antonella Pansini
- Elderly Assistance and Home Care, ASL (Local Health Unit), Avellino, Italy
| | - Stefano De Gennaro
- Division of Internal Medicine, Sant’Angelo Dei Lombardi Hospital, ASL (Local Health Unit), Avellino, Italy
| | - Anna Luisa Leo
- Division of Internal Medicine, Sant’Angelo Dei Lombardi Hospital, ASL (Local Health Unit), Avellino, Italy
| | - Michele Famiglietti
- Division of Internal Medicine, Sant’Angelo Dei Lombardi Hospital, ASL (Local Health Unit), Avellino, Italy
| | - Anna Marro
- Elderly Assistance and Home Care, ASL (Local Health Unit), Avellino, Italy
| | - Maria Morgante
- Elderly Assistance and Home Care, ASL (Local Health Unit), Avellino, Italy
| | - Salvatore Frullone
- Division of Internal Medicine, Sant’Angelo Dei Lombardi Hospital, ASL (Local Health Unit), Avellino, Italy
| | - Antonio De Luca
- grid.9841.40000 0001 2200 8888Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Gaetano Santulli
- grid.251993.50000000121791997Department of Medicine, Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), The Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine, New York, NY USA ,grid.4691.a0000 0001 0790 385XInternational Translational Research and Medical Education (ITME) Consortium, Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy ,grid.251993.50000000121791997Department of Molecular Pharmacology, Institute for Neuroimmunology and Inflammation (INI), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York, NY USA
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Jiang M, Li X, Wu H, Su F, Cao L, Ren X, Hu J, Tatenda G, Cheng M, Wen Y. Triglyceride-Glucose Index for the Diagnosis of Metabolic Syndrome: A Cross-Sectional Study of 298,652 Individuals Receiving a Health Check-Up in China. Int J Endocrinol 2022; 2022:3583603. [PMID: 35814916 PMCID: PMC9259285 DOI: 10.1155/2022/3583603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/13/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE We herein aim to explore the relationship between the triglyceride-glucose (TyG) index and metabolic syndrome (MS). METHODS We enrolled 298,652 individuals with an average age of 47.08 ± 12.94 years and who underwent health check-ups at the First Affiliated Hospital of Wuhu Wannan Medical College in this cross-sectional study from 2014 to 2016. We enlisted 125,025 women (41.86%) and 173,627 men (58.14%). The survey information included a questionnaire survey, a physical examination, and a laboratory examination. RESULTS The prevalence of MS increased gradually in the TyG-index subgroups (Q1, TyG <8.30; Q2, 8.30≤ TyG <8.83; and Q3, TyG ≥8.83). We noted significant differences in hypertension, hyperlipidemia, hyperglycemia, sex, age, body mass index (BMI), smoking and drinking habits, and estimated glomerular filtration rate between the TyG-index subgroups. Multiclass logistic regression analysis showed that the group with TyG <8.30 was the reference group, and the 8.30≤ TyG <8.83 and the TyG ≥8.83 groups exhibited a higher TyG index with MS, and a lower TyG index without MS disease. In the linear curve analysis of the TyG index and MS components, BMI, systolic blood pressure, and diastolic blood pressure showed upward trends, while high-density lipoprotein cholesterol showed no obvious trend in the TyG index at a range of 7.8-11.0. Receiver operating characteristic analysis was used to evaluate the predictive value of the TyG index, triglycerides, and fasting blood glucose for MS, and we found that the area under the TyG index curve was the largest (AUC = 0.89). CONCLUSION There were associations between the TyG index and MS and its components, and the TyG index is therefore of great value in the early diagnosis of MS.
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Affiliation(s)
- Mingfei Jiang
- Department of Diagnostics, School of Clinical Medicine, Wannan Medical College, Wuhu 214002, Anhui, China
| | - Xiaoran Li
- Department of Radiology, Nanjing Gaochun People's Hospital, Nanjing 211300, Jiangsu, China
| | - Huan Wu
- Department of Health and Quarantine, School of Laboratory Medicine, Wannan Medical College, Wuhu 214002, AnHui, China
| | - Fan Su
- Department of Prevention Medical, School of Public Health, Wannan Medical College, Wuhu 214002, AnHui, China
| | - Lei Cao
- Department of Prevention Medical, School of Public Health, Wannan Medical College, Wuhu 214002, AnHui, China
| | - Xia Ren
- Department of Prevention Medical, School of Public Health, Wannan Medical College, Wuhu 214002, AnHui, China
| | - Jian Hu
- Department of Prevention Medical, School of Public Health, Wannan Medical College, Wuhu 214002, AnHui, China
| | - Grace Tatenda
- Department of Prevention Medical, School of Public Health, Wannan Medical College, Wuhu 214002, AnHui, China
| | - Mingjia Cheng
- Department of Diagnostics, School of Clinical Medicine, Wannan Medical College, Wuhu 214002, Anhui, China
| | - Yufeng Wen
- Department of Prevention Medical, School of Public Health, Wannan Medical College, Wuhu 214002, AnHui, China
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Jiang M, Wu H, Zhang H, Su F, Cao L, Ren X, Tatenda G, Hu J, Cheng M, Wen Y. Association between the Triglyceride-Glucose Index and the Risk of Large Artery Atherosclerotic Stroke. Int J Clin Pract 2022; 2022:5191581. [PMID: 36304978 PMCID: PMC9578805 DOI: 10.1155/2022/5191581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/18/2022] [Accepted: 08/09/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this study is to evaluate the value of the triglyceride-glucose (TyG) index and the risk of large artery atherosclerotic (LAA) stroke. Information on general demographic and clinical characteristics, magnetic resonance angiography (MRA) examination, and blood biochemical index determination were obtained. Based on age stratification, three models to evaluate the odds ratio (OR) and the 95% confidence interval (95% CI) were employed to determine the correlation between the TyG index and the risk of LAA stroke. The most effective TyG index threshold in predicting a high risk of LAA stroke was identified using receiver operating characteristic (ROC) curve analysis. Logistic regression verified the association between the risk of LAA stroke and the TyG index. Both with and without age stratification, logistic regression analysis showed that the TyG index was a significant predictor of the occurrence of LAA stroke (P < 0.05). The maximum Youden index for determining a high risk of LAA stroke was found at a TyG index of 4.60. The area under the ROC curve was 0.69 (95% CI: 0.646-0.742, P < 0.05), sensitivity was 78.0%, and specificity was 63.4%. An elevated TyG index was remarkably associated with a high risk of LAA stroke.
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Affiliation(s)
- Mingfei Jiang
- Department of Diagnostics, Clinical School of Medicine, Wannan Medical College, Anhui, Wuhu 214002, China
| | - Huan Wu
- Department of Prevention Medical, School of Laboratory Medicine, Wannan Medical College, Anhui, Wuhu 214002, China
| | - Huiping Zhang
- Stroke Research Center, Department of Ultrasound, Ma'anshan People's Hospital, Anhui, Ma'anshan 243000, China
| | - Fan Su
- Department of Prevention Medical, School of Public Health, Wannan Medical College, Anhui, Wuhu 214002, China
| | - Lei Cao
- Department of Prevention Medical, School of Public Health, Wannan Medical College, Anhui, Wuhu 214002, China
| | - Xia Ren
- Department of Prevention Medical, School of Public Health, Wannan Medical College, Anhui, Wuhu 214002, China
| | - Grace Tatenda
- Department of Prevention Medical, School of Public Health, Wannan Medical College, Anhui, Wuhu 214002, China
| | - Jian Hu
- Department of Prevention Medical, School of Public Health, Wannan Medical College, Anhui, Wuhu 214002, China
| | - Mingjia Cheng
- Department of Diagnostics, Clinical School of Medicine, Wannan Medical College, Anhui, Wuhu 214002, China
| | - Yufeng Wen
- Department of Prevention Medical, School of Public Health, Wannan Medical College, Anhui, Wuhu 214002, China
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Chen S, Mei Q, Guo L, Yang X, Luo W, Qu X, Li X, Zhou B, Chen K, Zeng C. Association between triglyceride-glucose index and atrial fibrillation: A retrospective observational study. Front Endocrinol (Lausanne) 2022; 13:1047927. [PMID: 36568072 PMCID: PMC9773201 DOI: 10.3389/fendo.2022.1047927] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/11/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Insulin resistance is associated with atrial remodeling as well as atrial fibrillation (AF). However, there was limited evidence on the relationship of triglyceride-glucose index (TyG) index, a simple, valuable marker of insulin resistance, with AF. Thus, we aimed to investigate the association between TyG index and AF among hospitalized patients. METHODS A retrospective observational study was conducted in Daping Hospital, which included 356 hospitalized patients from the Department of Cardiology. Clinical and biochemical parameters were collected from electronic medical records and AF was diagnosed from electrocardiogram (ECG) findings. RESULTS We found that the TyG index was significantly higher in the AF group than in the group without AF. Multivariate logistic regression revealed that hypertension (OR = 1.756, 95%CI 1.135-2.717, P = 0.011) and TyG index (OR = 2.092, 95%CI 1.412-3.100, P<0.001) were positively associated with AF. The analysis of the area under the ROC curve was performed and revealed that area under curve (AUC) of TyG index was 0.600 (95%CI, 0.542-0.659, P = 0.001), the optimal critical value was 8.35, the sensitivity was 65.4%, and the specificity was 52.0%. Additional subgroup analyses of diabetic and non-diabetic subjects were also performed and found the TyG index was increased in non-diabetic subjects with AF. Furthermore, a logistic regression analysis showed TyG index was associated with AF (OR = 3.065, 95% CI, 1.819-5.166, P<0.001) in non-diabetic subjects. However, TyG index was not associated with AF in diabetic subjects. CONCLUSION Elevated TyG index is an independent risk factor for AF among non-diabetic hospitalized patients.
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Affiliation(s)
- Shengnan Chen
- ChongQing Medical University, Chongqing, China
- Department of Cardiology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing, China
- Cardiovascular Research Center of Chongqing College, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Chongqing, China
| | - Qiao Mei
- ChongQing Medical University, Chongqing, China
- Department of Cardiology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing, China
- Cardiovascular Research Center of Chongqing College, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Chongqing, China
| | - Li Guo
- Department of Endocrinology, Southwest Hospital, The Third Military Medical University (Army Medical University), Chongqing, China
| | - Xiaoli Yang
- Department of Cardiology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center Chongqing Institute of Cardiology, Chongqing, China
| | - Wenbin Luo
- Department of Cardiology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center Chongqing Institute of Cardiology, Chongqing, China
| | - Xuemei Qu
- Department of Cardiology, The Fifth People’s Hospital of Chongqing, Chongqing, China
| | - Xiaoping Li
- Department of Cardiology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center Chongqing Institute of Cardiology, Chongqing, China
| | - Bingqing Zhou
- Department of Cardiology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center Chongqing Institute of Cardiology, Chongqing, China
| | - Ken Chen
- Cardiovascular Research Center of Chongqing College, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Chongqing, China
- Department of Cardiology, The Fifth People’s Hospital of Chongqing, Chongqing, China
- *Correspondence: Chunyu Zeng, ; Ken Chen,
| | - Chunyu Zeng
- ChongQing Medical University, Chongqing, China
- Department of Cardiology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing, China
- Cardiovascular Research Center of Chongqing College, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center Chongqing Institute of Cardiology, Chongqing, China
- *Correspondence: Chunyu Zeng, ; Ken Chen,
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