The Cut-off Values of Triglycerides and Glucose Index for Metabolic Syndrome in American and Korean Adolescents

Relationship between insulin resistance surrogate markers with diabetes and dyslipidemia: A Bayesian network analysis of Korean adults

Insulin resistance (IR) can be optimally assessed using the euglycemic clamp, but practical clinical limitations necessitate surrogate markers. This study leveraged the Bayesian network analysis to evaluate three established IR markers: the Homeostatic Model Assessment of IR (HOMA-IR) using insulin level and fasting blood glucose (FBG), TG-Glucose (TyG) index using triglycerides (TG) and FBG, and TG-to-HDL ratio (TG/HDL ratio) using TG and high-density lipoprotein (HDL), based on the Korean National Health and Nutrition Examination Survey data (2019-2021). Our analysis revealed a sequential association pattern (TG/HDL ratio → TyG index → HOMA-IR), positioning the TyG index as a central connecting marker. The HOMA-IR exhibited strong predictive power for diabetes, while the TG/HDL ratio was most effective for assessing dyslipidemia. However, both had limited crossover utility. In contrast, the TyG index bridged this gap, demonstrating robust predictive capability for both conditions. The Markov blanket analysis illuminated the distinctive metabolic signatures of each marker: The TyG index displayed balanced glucose-lipid metabolic contributions, the HOMA-IR predominantly reflected glucose metabolism and obesity characteristics, and the TG/HDL ratio emphasized lipid metabolism. Notably, the TyG index's predictive performance showed significant enhancement when integrated with obesity information, contrasting with the HOMA-IR's minimal response owing to its inherent incorporation of obesity characteristics. These findings position the TyG index as a superior clinical marker, offering both comprehensive predictive capability and enhanced performance through synergistic integration with obesity measures. While each marker demonstrated reliability, the TyG index's unique combination of versatility and scalability establishes it as an effective tool for comprehensive metabolic risk assessment.

Relationship Between Body Composition and Insulin Resistance Evaluated by the TyG Index: A Retrospective Study Among Chinese Population

OBJECTIVE

The triglyceride glucose (TyG) index, a novel and easily obtained marker of insulin resistance (IR), has been shown to predict metabolic diseases. Monitoring body composition is crucial in assessing disease states. This study aimed to investigate the relationship between body composition and IR as assessed by the TyG index.

METHODS

Between January 2018 and December 2021, 12,186 individuals were initially enroled, with 4061 adults were ultimately included. Body composition, including fat mass (FM), fat mass index (FMI), fat-free mass (FFM), fat-free mass index (FFMI), and percent body fat (PBF), was measured using bioelectrical impedance analysis. Spearman analysis assessed correlations between body composition indices and the TyG index. Binary logistic regression identified independent predictors of IR.

RESULTS

Older women (≥ 50 years old) showed significantly higher BMI, PBF, FM, FMI, FFMI, HOMA-IR, and the TyG index, but lower FFM compared to younger women; Older men exhibited significantly lower BMI, FM, FFM, FFMI, HOMA-IR, and the TyG index than the younger men. FM, FMI, FFM, FFMI, and PBF were positively correlated with the TyG index. FFMI and PBF significantly predicted IR in both genders. Combined FFMI and PBF yielded an area under the ROC curves of 0.718 in women and 0.661 in men for IR diagnosis.

CONCLUSION

The TyG index correlates with body composition parameters of FFMI and PBF as well as HOMA-IR potentially making it a convenient marker of metabolic risk.

Triglyceride and Glucose Index as an Optimal Predictor of Metabolic Syndrome in Lebanese Adults

Background: Globally, the prevalence of metabolic syndrome (MetS) is on the rise, especially in Arab countries, which emphasizes the need for reliable ethnic-specific biochemical screening parameters. Methods: Two hundred twenty-one Lebanese adults were enrolled in this cross-sectional study. Biochemical parameters including Homeostasis Model Assessment (HOMA), Triglyceride and Glucose index (TyG), ratio of Triglycerides to High-Density Lipoprotein Cholesterol (TG/HDL-C), Atherogenic Index of Plasma (AIP), and Visceral Adiposity Index (VAI) were assessed for their prediction of MetS. Analysis of covariance, logistic regression, expected-versus-observed case ratio were used to determine model calibration, concordance statistic, area under the receiver operating characteristic curve (AUC) and 95% confidence intervals (CIs), sensitivity, specificity, and negative and positive predictive values (PPV, NPV). Results: The prevalence of MetS was 44.3%. All biochemical parameters were significantly associated with MetS, with a strong model discrimination (c-statistic between 0.77 and 0.94). In both sex categories, TyG best predicted MetS (females: cut-off value, 8.34; males: cut-off value, 8.43) and showed good estimation among females, but overestimation among males. HOMA had the lowest discriminatory power in both sex categories. Conclusions: This study suggests that TyG best predicts MetS, while HOMA has the lowest predictive power. Future larger studies need to focus on harmonizing ethnic specific cut-offs and further validating our results.

Triglyceride-glucose index is associated with all-cause mortality in critically ill patients with alcohol use disorder: a retrospective cohort study

BACKGROUND

The relationship between Triglyceride-glucose (TyG) index and clinical outcomes in patients with alcohol use disorder (AUD) is unclear. The aim of this study was to evaluate the association between TyG index and all-cause mortality in critically ill patients with AUD.

METHODS

We used data from the multi-parameter intelligent monitoring in intensive care IV (MIMIC-IV) database. The patients were equally divided into quartiles. Kaplan-Meier curves were used for survival analysis. The primary endpoint of the study was 28-day mortality, followed by 1-year mortality. We used Cox proportional hazard models to assess the relationship between TyG index and all-cause mortality at different endpoints.

RESULTS

A total of 537 AUD patients were included. Using TyG value as a continuous variable (HR 1.460, 95% CI 1.121-1.903, p = 0.005) and categorical variable (HR 1.447-3.477 from Q2 to Q4, with Q1 as reference), elevated TyG value was significantly associated with increased 28-day mortality. TyG was positively associated with 1-year mortality in AUD patients with an HR of 1.295 (95% CI 1.011-1.659, p = 0.041).

CONCLUSION

TyG index is positively associated with different clinical outcomes of critically ill AUD patients.

The association of triglyceride-glucose index and combined obesity indicators with chest pain and risk of cardiovascular disease in American population with pre-diabetes or diabetes

Aim

To investigate the correlation of the triglyceride-glucose (TyG) index and its combined obesity indicators with chest pain and cardiovascular disease (CVD) in the pre-diabetes and diabetes population.

Methods

This cross-sectional investigation encompassed 6488 participants with diabetes and pre-diabetes who participated in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016. The association of the TyG and combined obesity index with chest pain and CVD was investigated using weighted logistic regression models and restricted cubic spline (RCS) analysis. The receiver operating characteristic (ROC) curve analysis was performed to compare different indicators.

Results

In multivariate logistic regression fully adjusted for confounding variables, our analyses revealed significant associations between TyG, TyG-BMI, TyG-WC, and TyG-WHtR and chest pain, with adjusted ORs (95% CI) of 1.21 (1.05, 1.39), 1.06 (1.01, 1.11), 1.08 (1.04, 1.14), and 1.27 (1.08, 1.48), respectively. For total-CVD, the adjusted ORs (95% CI) were 1.32 (1.08, 1.61), 1.10 (1.03, 1.17), 1.13 (1.06, 1.19), and 1.63 (1.35, 1.97), respectively, among which TyG, TyG-WC, and TyG-WHtR present curvilinear associations in RCS analysis (all P-nonlinear < 0.05). Furthermore, the ROC curve showed that TyG-WC had the most robust predictive efficacy for total-CVD, coronary heart disease (CHD), and myocardial infarction (MI), while TyG-WHtR had the best predictive ability for angina and heart failure.

Conclusion

There are significant associations of TyG and its related indicators with chest pain and total-CVD among the pathoglycemia population. TyG-WC and TyG-WHtR demonstrated superior predictive capability for the incidence of cardiovascular events.

Association between triglyceride glucose index and cognitive decline: A meta-analysis

BACKGROUND

The triglyceride glucose (TyG) index, a novel surrogate indicator for insulin resistance (IR), is believed to be associated with various diseases. However, its connection with cognitive decline remains controversy.

METHODS

The PubMed, EMBASE, Cochrane Library, Web of Science, and Medline databases were systematically searched up to October 2023 to assess the association between the TyG index and the risk of cognitive decline. Effect estimates and 95 % confidence intervals (CIs) were calculated using a random-effects model.

RESULTS

Our review included 3 cohort studies and 9 case-control/cross-sectional studies with a total of 5,603,350 participants. In comparison to a low TyG index, a higher TyG index was connected to an elevated risk of cognitive decline (RR/HR = 1.14, 95 % CI [1.11, 1.17], P < 0.05; OR = 1.75, 95 % CI [1.34, 2.29], P < 0.05). Furthermore, the dose-response analysis from the case-control/cross-sectional studies revealed a 1.42 times higher risk of cognitive decline per 1 mg/dl increment of the TyG index (OR = 1.42, 95 % CI [1.19, 1.69], P < 0.05).

LIMITATIONS

The inclusion of observational studies in the meta-analysis demonstrated a lower hierarchy of evidence compared to randomized controlled trials. Moreover, we incorporated a restricted number of studies and identified significant heterogeneity among them, potentially attributed to the presence of numerous confounding variables.

CONCLUSION

TyG index is related to cognitive decline. In view of some of the limitations of this study, further research will be necessary to confirm this relationship.

Relationship between triglyceride-glucose index and gallstones risk: a population-based study

Background

Globally, gallstones represented a prevalent condition of the digestive system, heavily affected by metabolic dysfunctions such as obesity, dyslipidemia, insulin resistance, and diabetes. The triglyceride-glucose (TyG) index served as an accessible novel indicator for evaluating insulin resistance, offering a precise reflection of metabolic conditions. However, no studies have yet explored their relationship. The link between the TyG and gallstone risk was the primary purpose of this study.

Methods

Utilized data from the public database, the National Health and Nutrition Examination Survey, for the years 2017-2020. The logit model was utilized to elucidate the connection between the TyG and the gallstones risk. The restricted cubic spline (RCS) analysis served to verify any non-linear relationships existing between them. Sensitivity analyses, encompassing both stratified and interaction analyses, were conducted to identify populations of particular interest and assess potential interactions between covariates and the TyG index.

Results

A total of 4544 individuals were included. The risk of gallstones in high group was 1.6 times that of the low group. The potential cut-off value for the TyG index was 6.19. Above this threshold, there was a 40% heightened risk of gallstones with each one-unit increment in the TyG. The RCS analysis revealed the absence of a non-linear association between them. The populations warranting particular focus included those over 60 years, non-White people, individuals with a body mass index ≥25, smokers, drinkers, those with hypertension, and diabetes. Apart from smoking history, alcohol consumption, and history of diabetes, there were no interactions between other variables and the TyG index.

Conclusion

The current study represented the inaugural investigation into the link between TyG index and the risk of gallstones. A positive correlation existed between them, signifying that an increase in TyG paralleled an elevated risk of gallstones. No non-linear relationship has been found between them. Besides, a 40% increase in gallstone risk accompanied each unit rise in TyG. Considering the convenience and accessibility of TyG in clinical settings, it has a promising potential for clinical application.

The association between the size of adipocyte-derived extracellular vesicles and fasting serum triglyceride-glucose index as proxy measures of adipose tissue insulin resistance in a rat model of early-stage obesity

Introduction

Obesity is a complex disease that predisposes individuals to cardiometabolic alterations. It leads to adipose tissue (AT) dysfunction, which triggers insulin resistance (IR). This suggests that people with obesity develop local IR first and systemic IR later. AT secretes extracellular vesicles, which may be physiopathologically associated with the development of IR. Our aim was to evaluate the effect of a high-fat diet on different parameters of adiposity in a rat model of early-stage obesity and to determine if these parameters are associated with markers of systemic IR. In addition, we sought to explore the relationship between fasting blood measures of IR (Triglycerides/High Density Lipoprotein-cholesterol [TAG/HDL-c] and Triglycerides-Glucose Index [TyG Index]) with the size of adipocyte-derived extracellular vesicles (adEV).

Methods

We used a model of diet-induced obesity for ten weeks in Wistar rats exposed to a high-fat diet. Final weight gain was analyzed by Dual X-ray absorptiometry. Visceral obesity was measured as epididymal AT weight. IR was evaluated with fasting TyG Index & TAG/HDL-c, and adEV were isolated from mature adipocytes on ceiling culture.

Results

In the high-fat diet group, glucose and triglyceride blood concentrations were higher in comparison to the control group (Log2FC, 0.5 and 1.5 times higher, respectively). The values for TyG Index and adEV size were different between the control animals and the high-fat diet group. Multiple linear regression analyses showed that adEV size can be significantly associated with the TyG Index value, when controlling for epididymal AT weight.

Conclusion

Our results show that lipid and glucose metabolism, as well as the size and zeta potential of adEV are already altered in early-stage obesity and that adEV size can be significantly associated with liver and systemic IR, estimated by TyG Index.

Fetal femur length and risk of diabetes in adolescence: a prospective cohort study

BACKGROUND

Diabetes is more apparent in adulthood but may be dormant in childhood and originates during early fetal development. In fetal biometry, femur length (FL) is crucial for assessing fetal growth and development. This study aimed to assess potential associations between fetal femur growth and prediabetic biomarkers in Bangladeshi children.

METHODS

A cohort study embedded in a population-based maternal food and micronutrient supplementation (MINIMat) trial was conducted in Matlab, Bangladesh. The children in the cohort were followed up until 15 years of age. In the original trial, pregnancy was confirmed by ultrasound before 13 gestational weeks (GWs). Afterward, ultrasound assessments were performed at 14, 19, and 30 GWs. FL was measured from one end to the other, capturing a complete femoral image. The FL was standardized by GW, and a z-score was calculated. FBG and HbA1c levels were determined in plasma and whole blood, and the triglyceride-glucose index, a biomarker of insulin resistance, was calculated as Ln [fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. Multivariable linear regression analysis using a generalized linear model was performed to estimate the effects of FL at 14, 19 and 30 GWs on prediabetic biomarkers at 9 and 15 years of age. Maternal micronutrient and food supplementation group, parity, child sex, and BMI at 9 years or 15 years were included as covariates.

RESULTS

A total of 1.2% (6/515) of the participants had impaired fasting glucose during preadolescence, which increased to 3.5% (15/433) during adolescence. At 9 years, 6.3% (32/508) of the participants had elevated HbA1c%, which increased to 28% (120/431) at 15 years. Additionally, the TyG index increased from 9.5% (49/515) (during preadolescence) to 13% (56/433) (during adolescence). A one standard deviation decrease in FL at 14 and 19 GWs was associated with increased FBG (β = - 0.44 [- 0.88, - 0.004], P = 0.048; β = - 0.59 [- 1.12, - 0.05], P = 0.031) and HbA1c (β = - 0.01; [- 0.03, -0.005], P = 0.007; β = - 0.01 [- 0.03, - 0.003], P = 0.018) levels at 15 years. FL was not associated with diabetic biomarkers at 9 years.

CONCLUSION

Mid-trimester impaired femur growth may be associated with elevated prediabetic biomarkers in Bangladeshi adolescents.

Validity of the Triglyceride-Glucose Indices for Predicting the Severity of Coronary Artery Disease in Patients With Nondiabetic Chronic Coronary Syndrome

BACKGROUND

The triglyceride-glucose (TyG) index was shown to be an independent predictor of coronary artery disease (CAD) progression and prognosis. However, whether the TyG index can predict the severity of CAD in nondiabetic patients with chronic coronary syndrome remains unclear.

METHODS

A total of 118 individuals who underwent elective coronary angiography were classified into group A (59 with coronary lesions) and group B (59 with normal coronary arteries; as a control group) after coronary angiography and laboratory tests for fasting and the postprandial (PP) TyG index. The complexity of CAD was determined by the Synergy Between Percutaneous Coronary Intervention (SYNTAX) score (SYNTAX score >22 indicated moderate-high risk), and patients diagnosed with diabetes or prediabetes were excluded.

RESULTS

The TyG index was not related to the SYNTAX score in groups A and B; however, in the CAD group with an low-density lipoprotein (LDL) concentration <70 mg/dL (group A1), a fasting TyG index ≥8.25 and a PP TyG index ≥11 could predict moderate-high SYNTAX risk score; in addition, the odds ratio (OR) was 4.3× higher and the relative risk (RR) was 1.8× greater (OR = 4.3, RR = 1.8, 95% confidence interval = 1.4-13.5, P < 0.05) for individuals with a higher fasting TyG index ≥8.25 to have a moderate-high SYNTAX risk score. Individuals with a higher PP TyG index ≥11 had OR of 2.6× higher and a RR of 1.4× greater to have moderate-high SYNTAX risk score.

CONCLUSIONS

Both fasting and PP TyG levels were associated with greater coronary anatomical complexity (SYNTAX score >22) in nondiabetic chronic coronary patients with LDL <70 mg/dL. Fasting and the PP TyG indices can serve as noninvasive predictors of CAD complexity in nondiabetic patients with LDL <70 mg/dL and could change the management and therapeutic approaches.

The impacts of COVID-19 on childhood obesity: prevalence, contributing factors, and implications for management

PURPOSE

This study aimed to identify changes in the prevalence of obesity and related diseases among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

This study was conducted using data from the 2016-2021 Korean National Health and Nutrition Examination Survey and included 3,861 children and adolescents aged 10-18 years. The prevalence of obesity and related diseases was adjusted for age, sex, and income. We also analyzed the socioeconomic, nutritional, and physical activity items in the survey.

RESULTS

During the COVID-19 pandemic, there was a significant increase in the prevalence of obesity (p=0.02), central obesity (p=0.001), mean body mass index (BMI, p=0.03), and hemoglobin A1c (p=0.005) among children and adolescents aged 10-18 years. The intake of food and calories was significantly reduced in the normal-weight group (p=0.001 and <0.001) but not in the obese group. Incidences of skipping breakfast increased and eating out decreased, regardless of obesity status. However, the changes in health behaviors were not significant. The prevalence of central obesity and increased BMI showed a significant linear association between children and their parents, especially in the 10-12-year-old age group. A clear increase in the proportion of metabolically unhealthy children and adolescents was observed in the obese group, and the frequency of central obesity in parents also increased.

CONCLUSION

The number of metabolically unhealthy, obese children and adolescents increased during the COVID-19 pandemic. Age-specific strategies that consider growth, development, and genetic and social factors are required. Health strategies targeting the entire family are required to develop healthier habits.

The association of triglyceride-glucose index and related parameters with hypertension and cardiovascular risk: a cross-sectional study

The objective of this study was to investigate the association between triglyceride-glucose index (TyG) and related parameters (TyG-BMI, TyG-WC, TyG-WHR, and TyG-WHtR) with hypertension and cardiovascular risk. Additionally, the study aimed to compare the performance of these parameters in identifying patients with hypertension and high cardiovascular risk and determine appropriate indicators for the prediction of cardiovascular risk. Residents from a community in Beijing, China, who underwent health examinations at a regional hospital between December 2011 and August 2012, were recruited. Logistic regression analysis was used to explore the association between each parameter with hypertension and cardiovascular disease (CVD). The receiver operating characteristic curve was used to compare the predictive ability of each parameter in identifying people with hypertension or high cardiovascular risk. A total of 16,834 participants were included. After adjusting for confounders, the highest quartile groups of TyG and related parameters showed a significantly increased risk of hypertension compared to the lowest quartile groups. Among the parameters, TyG-WC exhibited the highest diagnostic efficacy for hypertension [area under the curve (AUC): 0.665, 95% CI: 0.656-0.673] followed by TyG-WHtR, TyG-BMI, TyG-WHR, and TyG index. Similarly, the highest quartile groups of each parameter demonstrated significantly increased risks of high cardiovascular risk compared to the lowest quartile groups. TyG-WHR performed best in distinguishing participants with high cardiovascular risk (AUC: 0.718, 95% CI: 0.710-0.726) followed by TyG-WC, TyG-WHtR, TyG-BMI, and TyG index. In conclusion, TyG-related parameters had independent associations with hypertension and cardiovascular risk. TyG-WHR exhibited the highest efficacy in distinguishing participants with high cardiovascular risk, which might contribute to the primary prevention of CVD.

Predictive cut-off values for the triglyceride-to-high-density lipoprotein cholesterol ratio to predict metabolic syndrome in the middle-aged Korean population

BACKGROUND AND AIMS

The triglyceride-to-high density lipoprotein cholesterol (TG/HDL) ratio is associated with insulin resistance related diseases, including metabolic syndrome (MetS). However, specific TG/HDL values that can predict MetS have not been well identified. In this study, we analyzed both cross-sectional and longitudinal data from two national Korean datasets to obtain TG/HDL cut-off values that can identify MetS and predict its occurrence.

METHODS AND RESULTS

To distinguish the presence and occurrence of MetS, the cut-off values were determined using the maximum F-score calculated through a logistic regression analysis. To predict new-onset MetS within 10 years, Cox proportional hazard models were used to consider the time of occurrence. The TG/HDL cut-off values of 3.97, 3.24, and 3.24 were optimal for identifying current MetS and predicting new-onset MetS within 10 years and five years, respectively, in Korean men. In Korean women, the optimal values for each task were 3.18, 2.38, and 2.26, respectively.

CONCLUSIONS

We suggest the TG/HDL ratio as a potential candidate predictor for MetS. Therefore, we anticipate that future studies will apply individual lipid levels as well as their combinatory values to establish models that predict the prevalence and occurrence of MetS, diabetes, and cardiovascular disease.

Weight Gain from Birth to Adolescence and TyG Index at Age 18 Years: A Cohort Study in Northeast Brazil

BACKGROUND

Developmental models suggest that the phenotypes may arise from an immediate or mediated adaptive metabolic response of the perinatal growth. Evidence on the cumulative effects of growth and factors associated with risk of insulin resistance in adolescents is lacking.

OBJECTIVE

To investigate the association between birthweight, weight gain during infancy, childhood and adolescence and the triglyceride-glucose index in adolescents.

METHODS

This is a cohort of 217 children born at term, followed for the first six months, and reassessed at 8 and 18 years of age. The variables of interest were birthweight, postnatal growth defined as rapid postnatal growth when the weight gain from birth to six months of age was greater than 0.67 z-score, and the same criterion was used for high BMI gain from ages 6 months to 8 years, and from 8 to 18 years. Socioeconomic condition, nutritional status, practice of physical exercises and consumption of ultra-processed foods were verified. Multivariate linear regression analysis was used to verify the effect of the variables on the triglyceride-glucose index.

RESULTS

Birthweight was not associated with triglyceride-glucose index in adolescence. Rapid postnatal growth during the first 6 months, higher BMI gain from 8 to 18 years and higher waist circumference contributed significantly to explain higher triglyceride-glucose index.

CONCLUSION FOR PRACTICE

Our findings suggest that rapid postnatal growth may be one of the first signs of a higher triglyceride-glucose index in adolescence and that attention should be paid to the greater gain in body mass between childhood and adolescence for the risk of a higher triglyceride-glucose index.

Triglyceride-glucose index demonstrates reasonable performance as a screening tool but exhibits limited diagnostic utility for insulin resistance: Data from the ELSA-Brasil cohort

Insulin resistance (IR) is a key risk factor for chronic metabolic diseases, but its laboratory diagnosis is still costly; thus, the triglyceride-glucose (TyG) index has been proposed as a surrogate method. Our aim was to provide a detailed analysis of cutoffs and test the hypothesis that the TyG index would present reasonable performance parameters for IR screening. This is a cross-sectional study with baseline data from 12,367 eligible participants of both sexes (aged 35-74 years) from the Brazilian Longitudinal Study of Adult Health. TyG correlation and agreement with the Homeostasis Model Assessment for Insulin Resistance were analyzed. Positive and negative predictive values (PV+, PV-) and likelihood ratio (LR+, LR-) were calculated. A moderate positive correlation between TyG and Homeostasis Model Assessment for Insulin Resistance was observed (Pearson r = 0.419). The area under the receiver operating characteristic curve of TyG for IR diagnosis was 0.742 and the optimal cutoff was 4.665, reaching a kappa agreement value of 0.354. For this cutoff, a PV+ of 59.3% and PV- of 76.0%, as well as an LR+ of 2.07 and LR- of 0.45 were obtained. Alternatively, because high sensitivity is desired for screening tests, selecting a lower cutoff, such as 4.505, increases the PV- to 82.1%, despite decreasing the PV+ to 50.8%. We conclude that TyG has important performance limitations for detecting IR, but that it may still be reasonably useful to help screening for IR in adults because it can be calculated from low-cost routine blood tests.

The triglycerides and glucose index is more strongly associated with metabolically healthy obesity phenotype than the lipid and obesity indices

PURPOSE

The triglycerides and glucose (TyG) index is a reliable biomarker for estimating insulin resistance; however, evidence regarding the use of the TyG index in individuals with metabolically healthy obesity (MHO) is scarce. Thus, we examined the association between the TyG index and the MHO phenotype.

METHODS

Apparently healthy men and women aged 18 years or more with obesity (body mass index [BMI] ≥ 30 kg/m2) were allocated into the following groups: MHO and metabolically unhealthy obesity (MUO). The MHO phenotype was defined by obesity and the absence of the following metabolic disorders: elevated triglyceride concentrations, elevated glucose levels, elevated blood pressure, and low HDL-C. The MUO was defined by individuals with obesity and at least one of the aforementioned cardiovascular risk factors.

RESULTS

A total 827 individuals, 605 (73.1%) women and 222 (26.9%) men were enrolled and allocated into the MHO (n = 104) and MUO (n = 723) groups. The adjusted regression analysis by age, sex, BMI, and waist circumference showed that fasting glucose (OR = 0.90; 95% CI: 0.88-0.93), and triglycerides (OR = 0.97; 95% CI: 0.96-0.98), as well as the triglycerides/HDL-C (OR = 0.18; 95% CI: 0.13-0.26), lipid accumulation product (OR = 0.95; 95% CI: 0.93-0.96), visceral adipose index (OR = 0.38; 95% CI: 0.31-0.46), and TyG index (OR = 0.001; 95% CI: 0.000-0.004) are inversely associated with the MHO, while the HDL-C (OR = 1.10; 95% CI: 1.07-1.12) had a direct association.

CONCLUSIONS

Our results show that the TyG index is more strongly associated with the MHO phenotype than the lipid and obesity indices.

Non-alcoholic fatty liver disease in Tanzania: prevalence, determinants, and diagnostic performance of triglycerides-glucose index and triglycerides-glucose index -body mass index compared to the hepatic ultrasound in overweight and obese individuals

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD), which is closely associated with metabolic syndrome (MetS), is rarely reported in Tanzania, where MetS is prevalent. The purpose of this study was to determine the prevalence and associated factors of this condition in overweight and obese individuals and to correlate standard ultrasound diagnosis with triglyceride-glucose index (TyG) and TyG-body mass index (TyG-BMI).

METHODS

A cross-sectional analysis was performed in 181 adult outpatients attending a general medical clinic. The presence of fatty liver was detected by ultrasound. Demographic, clinical, and laboratory data were collected and analyzed using STATA 15. To compare categorical variables, a chi-square test was employed, while a Student's t-test was used to compare continuous variables. Additionally, a multivariate regression analysis was conducted to identify the determinants of NAFLD. A significance level was set at p < 0.05. The discriminatory power of TyG and TyG-BMI for diagnosing NAFLD was evaluated using Receiver Operating Characteristic (ROC) Curve analysis and the Area Under the ROC Curve (AUC) was reported.

RESULTS

The overall prevalence of NAFLD was 30.4% (55/181). The prevalence's of NAFLD in patients with class III obesity, class II obesity, class I obesity and overweight were 50.0% (12/24),, 38% (19/50), 23.7% (18/76), and 19.5% (6/31),respectively. NAFLD was strongly predicted by hyperuricemia (≥ 360 μmol/L) (p = 0.04) and TyG ≥ 8.99 (p = 0.003). The best cut-off values of TyG and TyG-BMI to predict NAFLD were 8.99 [AUC 0.735; sensitivity 70.9%, specificity 79.3%] and 312 [AUC 0.711; sensitivity 60% and specificity 75.4%] respectively.

CONCLUSIONS

The prevalence of NAFLD is high among people with overweight and obesity in Tanzania. We did not find sufficient evidence to recommend the use of TyG and TyG-BMI as surrogates for hepatic ultrasound in detecting NAFLD, and further evaluation is recommended.

Double diabetes-when type 1 diabetes meets type 2 diabetes: definition, pathogenesis and recognition

Currently, the differentiation between type 1 diabetes (T1D) and type 2 diabetes (T2D) is not straightforward, and the features of both types of diabetes coexist in one subject. This situation triggered the need to discriminate so-called double diabetes (DD), hybrid diabetes or type 1.5 diabetes, which is generally described as the presence of the insulin resistance characteristic of metabolic syndrome in individuals diagnosed with T1D. DD not only raises the question of proper classification of diabetes but is also associated with a significantly greater risk of developing micro- and macroangiopathic complications, which was independent of glycaemic control. When considering the global obesity pandemic and increasing incidence of T1D, the prevalence of DD may also presumably increase. Therefore, it is of the highest priority to discover the mechanisms underlying the development of DD and to identify appropriate methods to prevent or treat DD. In this article, we describe how the definition of double diabetes has changed over the years and how it is currently defined. We discuss the accuracy of including metabolic syndrome in the DD definition. We also present possible hypotheses connecting insulin resistance with T1D and propose possible methods to identify individuals with double diabetes based on indirect insulin resistance markers, which are easily assessed in everyday clinical practice. Moreover, we discuss adjuvant therapy which may be considered in double diabetic patients.

Interaction between triglyceride-glucose index and thyroid hormones on coronary artery disease risk in patient with euthyroid

Background

Triglyceride-glucose (TyG) index is an effective indicator in indentifying in pre-diabetes, diabetes, and coronary artery disease (CAD). However, the value of TyG index combined with thyroid hormones (THs) to affect CAD has not been fully evaluated. Here, we investigated the association between TyG index and THs and further studied the impacts of TyG index and THs on CAD in euthyroid.

Methods

Subjects (1,297) with euthyroid who underwent selective coronary angiography (CAG) were enrolled in the present study, including 893 patients with CAD and 404 controls. The association between TyG index and THs were analyzed by linear regression models. Multivariate logistic regression analysis was used to evaluate the interaction of TyG and THs with the risk of CAD. According to the cutoff value of free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and TyG index, the patients were respectively separated into four groups: low TyG/FT3 (low or high), high TyG/FT3 (low or high), low TyG/FT4 (low or high), high TyG/FT4 (low or high), low TyG/TSH (low or high), high TyG/TSH (low or high).

Results

The baseline analysis showed that FT4 level differs among the three groups according to the tertile of the TyG index. Multiple linear regression analysis revealed decreased serum FT3 level and serum FT4 level as an independent risk factor for elevated TyG index. After adjusting for confounding variables, multiple logistic regression analysis showed that patients with lower TyG index and higher FT3 level had an important protective effect on CAD when considering patients with lower TyG index and FT3 level as reference(OR = 0.536, 95% CI: 0.369-0.778, P = 0.001). Patients with higher TyG index and FT4 level (lower or higher) had a significantly increased risk of CAD (OR 1.656, 95% CI: 1.117-2.455; OR = 1.920, 95% CI: 1.279-2.848, respectively). The area under the curve for the combined diagnosis of CAD by TyG index and FT3 level is 0.615.

Conclusions

These findings suggest that TyG is independently negatively correlated with FT3 or FT4 in euthyroid. In addition, there was a significant interaction between TyG index and THs on the risk of CAD.

Association of the Triglyceride-Glucose Index With Risk of Alzheimer's Disease: A Prospective Cohort Study

INTRODUCTION

Triglyceride-glucose index (TyG) is a reliable surrogate marker of insulin resistance, and insulin resistance has been implicated in Alzheimer's disease pathophysiology. However, the relationship between the TyG index and Alzheimer's disease remains unclear. This study aimed to evaluate the association of the TyG index with the risk of Alzheimer's disease.

METHODS

This prospective study included 2,170 participants free of Alzheimer's disease from the Framingham Heart Study Offspring Cohort Exam 7 (1998-2001), whose follow-up data were collected until 2018. The TyG index was calculated as Ln(fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The association of the TyG index with Alzheimer's disease was evaluated by competing risk regression model. Statistical analyses were performed in 2023.

RESULTS

During a median follow-up of 13.8 years, 163 (7.5%) participants developed Alzheimer's disease. When compared with the reference (TyG index ≤8.28), a significantly elevated risk of Alzheimer's disease was seen in the group with a triglyceride-glucose index of 8.68-9.09 (adjusted hazard ratio=1.69, 95% CI=1.02, 2.81). When the TyG index was considered as a continuous variable, each unit increment in the TyG index was not significantly associated with the risk of Alzheimer's disease (adjusted hazard ratio=1.32, 95% CI=0.98, 1.77).

CONCLUSIONS

This study showed that moderately elevated TyG index was independently associated with a higher incidence of Alzheimer's disease. TheTyG index might be used to define a high-risk population of Alzheimer's disease.

The Triglyceride-Glucose Index Might Be a Better Indicator for Predicting Poor Cardiovascular Outcomes in Chronic Coronary Syndrome

This study aimed to explore the potential association between the triglyceride-glucose index (TyG) and the atherogenic index of plasma (AIP)-both considered surrogate markers for atherosclerosis-and major adverse cardiovascular events (MACEs) in patients diagnosed with chronic coronary syndrome (CCS). We conducted a retrospective analysis, encompassing 715 consecutive patients with intermediate CCS risk, who presented at the outpatient clinic between June 2020 and August 2022. MACEs included non-fatal myocardial infarction, hospitalization for heart failure, cerebrovascular events, non-cardiac mortality, and cardiac mortality. The primary outcome was the composite occurrence of MACEs during the follow-up period. For time-to-event analysis of the primary outcome, we employed Kaplan-Meier plots and Cox proportional hazard models. The median age of the overall study population was 55 years, with a median follow-up duration of 17 months. Multivariate Cox regression analysis identified age, hypertension, Coronary Artery Disease-Reporting and Data System score, and TyG index as independent predictors of the primary outcome. Notably, individuals with high TyG levels exhibited a significantly higher primary outcome rate compared to those with low TyG levels (18.7% vs. 3.8%, p < 0.001). Similarly, patients with elevated TyG values demonstrated statistically higher rates of cerebrovascular events, hospitalizations for heart failure, non-fatal myocardial infarctions, non-cardiac mortality, and cardiac mortality. These findings suggest that TyG may serve as a predictive marker for adverse cardiovascular outcomes in patients with CCS.

Periodontitis is associated with insulin resistance in adults living with diabetes mellitus in Uganda: a cross- sectional study

INTRODUCTION

Evidence suggests that majority of patients with diabetes mellitus in Uganda have poor glycaemic control as well as periodontal disease. This study set out to determine the association between periodontitis and insulin resistance in adult patients with diabetes mellitus in Uganda using the triglyceride glucose index.

METHODS

Two hundred and twenty-three adult study participants with confirmed diabetes mellitus were enrolled in a cross-sectional study. Oral examination was carried with the aid of a periodontal probe to determine the periodontal status and findings recorded using the WHO Oral Health Assessment Tool for Adults, 2013. We recorded clinical details for body mass index (BMI in kg/m2) and laboratory parameters including fasting blood sugar (mmol/L), glycated hemoglobin levels (HbA1c, %) and serum triglycerides (mmol/L) using a study questionnaire. Data were analyzed using R version 4.10. The glucose triglyceride index was used as a measure of insulin resistance. Logistic regression analysis carried out to determine the factors associated insulin resistance.

RESULTS

The majority of the study participants was female (70%) with an average age of 48.5 years (SD+/- 11.1). The mean body mass index was 29.6 kg/m2 (SD+/- 5.82). The mean serum triglyceride index was 9.48 (SD+/- 0.675). Eighty-six-point 1% of the participants had periodontal disease. Bivariate analysis revealed high odds for male sex (OR = 1.31, 95% C.I = 0.44-4.84, p = 0.65) and periodontitis (OR = 3.65, 95% C.I = 0.79-26.15, p = 0.13) but low odds for a high BMI (OR = 0.45. 95% C.I = 0.07-1.67, p = 0.30). Multivariate regression revealed a significant association between insulin resistance and periodontitis. (AOR = 3.52, 95% C.I = 1.19-1.83, p = 0.03).

CONCLUSION

Insulin resistance is highly prevalent in patients with diabetes mellitus in Uganda and is associated with periodontitis and low body weight.

Association between triglyceride-glucose index and chronic kidney disease: A cohort study and meta-analysis

BACKGROUND AND AIMS

Nowadays, the relationship between triglyceride-glucose (TyG) index and chronic kidney disease (CKD) is still controversial. We aimed to prospectively investigate the relationship between TyG index and CKD in a cohort and meta-analysis.

METHODS AND RESULTS

A total of 10498 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included. Participants were divided into four groups based on the quartiles of the TyG index. CKD was based on self-reported physicians' diagnosis or personal eGFR level. A cox regression model was established to analyze the correlation between TyG index and CKD. A meta-analysis was conducted to incorporate the results of the current study and previous studies on the association of TyG index with CKD. In multivariable-adjusted analyses, the adjusted hazard ratio (95% confidence interval) for the highest versus lowest quartile of TyG index was 1.30 (1.08-1.57). Each 1-SD higher TyG index was associated with an increased risk of 11% (HR 1.11, 95% CI 1.03-1.19). The meta-analysis further confirmed the significant associations between TyG and CKD and pooled relative risk for highest vs lowest TyG index quartile was 1.47 (1.32-1.63).

CONCLUSIONS

Higher TyG index was associated with increased risk of CKD, independently of established risk factors. The TyG index may be a predictor of incident CKD.

The triglyceride-glucose index as an indicator of insulin resistance and cardiometabolic risk in Brazilian adolescents

Objective

To set cutoff points for the triglyceride and glucose index (TyG) as a marker of insulin resistance (IR) for the pediatric population.

Subjects and methods

This was a cross-sectional study with schoolchildren population-based data using data of 377 schoolchildren age 10 to 17 years of both sexes. We studied metabolic variables associated with IR indicators, such as fasting insulin and blood glucose, to calculate the homeostatic model assessment (HOMA-IR), and we studied triglycerides (TG) to determine the TyG index. We obtained TyG cutoff values for IR using the receiver operation characteristic (ROC), with definitions of sensitivity (Sen), specificity (Spe), and area under the ROC curve (AUC), with the HOMA-IR as reference.

Results

The cutoff points of the TyG index for IR in adolescents are 7.94 for both sexes, 7.91 for boys, and 7.94 for girls, indicating moderate discriminatory power. When we also considered anthropometric variables of excess weight [TyG-BMI (body mass index)] and visceral fat [TyG-WC (waist circumference)], these indexes reached AUC values higher than 0.72, enhancing their potential use for a good diagnosis.

Conclusion

TyG has proven to be a useful instrument for identifying IR in adolescent health screening, with high discrimination capacity when added to anthropometric variables, making it a feasible and inexpensive option.

Comparison of the ability of HOMA-IR, VAI, and TyG indexes to predict metabolic syndrome in children with obesity: a cross-sectional study

BACKGROUND

The increasing trend in childhood obesity needs to be closely monitored and intervened due to long-term health issues such as metabolic syndrome, cardiovascular diseases, hypertension, and type 2 diabetes. We aimed to determine and compare the cut-off values for the visceral adiposity index (VAI), triglyceride-glucose index (TyG), and HOMA-IR for predicting metabolic syndrome (MetS).

METHODS

This population-based cross-sectional study was conducted in May 2019 in Samsun, Turkey. The study included 169 children with obesity aged 9 and 10 years. After anthropometric and clinical evaluation, fasting blood samples were collected from the children. The areas under the curve of the visceral adiposity index, triglyceride-glucose index, and HOMA-IR were compared by receiver-operating-characteristic (ROC) analysis in predicting the MetS.

RESULTS

The total prevalence of MetS was 21.3% in children with obesity, and it was two times higher in girls than in boys. The mean values of TyG and VAI were significantly different in those who have and have not MetS in both genders. However, the HOMA-IR index was higher only in girls with MetS and did not differ in boys by having MetS. The VAI and the TyG index both had statistically significant cut-off values in both sexes and a larger ROC area than the HOMA-IR index in predicting MetS.

CONCLUSIONS

The VAI and TyG index are effective indicators in assessing the MetS risk in children with obesity. Both indexes can be considered useful tools in pediatric research and the evaluation of interventions. However, the HOMA-IR index formula needs to be developed taking into account age, gender, and ethnicity.

Triglyceride glucose index and poor sleep patterns in non-diabetic adults: Evidence from NHANES 2005-2016

Introduction

Sleep disorders are commonly encountered in modern populations. This cross-sectional study aimed to investigate the associations between triglyceride glucose (TyG) index and poor sleep patterns in non-diabetic adults.

Methods

Data of non-diabetic adults aged 20-70 years were extracted from the US National Health and Nutrition Examination Survey database 2005-2016. Pregnant women, individuals with diabetes and cancer history, and individuals lacking complete data on sleep patterns or parameters for calculating TyG index were excluded. Poor sleep pattern was defined as having two or more following conditions: (1) abnormal sleep duration, defined as less than 7 h or longer than 9 h; (2) self-reported trouble sleeping; and (3) physician-confirmed sleep disorders. Associations between poor sleep patterns, TyG index, and an additional index incorporating body mass index (BMI), TyGBMI, and other study variables were determined by univariable and multivariable logistic regression analysis.

Results

Among 9,390 included participants, 1,422 had poor sleep patterns and 7,968 did not. The individuals with poor sleep patterns had a higher mean TyG index, were older, had higher BMI, and had higher proportions of hypertension and history of CVD than those without poor sleep pattern (all p < 0.001). Multivariable analysis showed no significant association between poor sleep pattern and TyG index. However, among the components of poor sleep pattern, TyG index in the highest quartile (Q4) was significantly associated with trouble sleeping [adjusted OR (aOR): 1.46, 95%CI: 1.04-2.03) as compared with the lowest TyG quartile (Q1). In addition, TyG-BMI in Q4 was indepently associated with increased likelihood for poor sleep patterns (aOR: 2.18, 95%CI: 1.61-2.95), trouble sleeping (aOR: 1.76, 95%CI: 1.30-2.39), abnormal sleep duration (aOR: 1.41, 95%CI: 1.12-1.78), and sleep disorders (aOR: 3.11, 95%CI: 2.08-4.64) as compared to Q1.

Discussion

Among US adults without diabetes, elevated TyG index is correlated with self-reported trouble sleeping, independent of BMI. Future studies should build upon this preliminary work and examine these associations longitudinally and through treatment trials.

Association between the Triglyceride-Glucose Index and Vitamin D Status in Type 2 Diabetes Mellitus

BACKGROUND

Vitamin D deficiency (VDD) increases the risk for type 2 diabetes mellitus (T2DM), which might be related to insulin resistance (IR). We aimed to explore the association between the triglyceride-glucose (TyG) index, a reliable indicator of IR, and VDD in patients with T2DM.

METHODS

There were 1034 participants with T2DM enrolled in the Second Xiangya Hospital of Central South University. The TyG index was calculated as ln (fasting triglyceride (TG, mg/dL) × fasting blood glucose (mg/dL)/2). VDD was defined as 25-hydroxyvitamin D [25(OH)D] level <50 nmol/L.

RESULTS

Correlation analysis showed a negative association between the TyG index and 25(OH)D level. After adjustments for clinical and laboratory parameters, it was revealed that when taking the Q1 quartile of TyG index as a reference, an increasing trend of VDD prevalence was presented in the other three groups divided by TyG index quartiles, where the OR (95% CI) was 1.708 (1.132-2.576) for Q2, 2.041 (1.315-3.169) for Q3, and 2.543 (1.520-4.253) for Q4 (all p < 0.05).

CONCLUSIONS

Patients with higher TyG index were more likely to have an increased risk of VDD in T2DM population, which may be related to IR.

Triglyceride-Glucose Index as a Potential Indicator of Sarcopenic Obesity in Older People

PURPOSE

This population-based cross-sectional study aimed to determine whether the triglyceride-glucose index (TyG index) is associated with sarcopenic obesity (SO) and whether it would be a helpful indicator of SO.

METHODS

A total of 3821 participants aged ≥ 60 years were selected for the study group, and 4919 participants aged 20-39 years were included as a reference group. The participants were allocated to sarcopenia, obesity, and SO groups depending on if their body mass index (BMI) was ≥25 kg/m² and their sarcopenia index was ≤1 standard deviation (SD) lower than the mean of the reference group. The sex-specific differences and trends among the participants were analyzed by using the TyG index tertiles, and appropriate cut-off values of the TyG index for SO were calculated.

RESULTS

As the TyG index increased, BMI increased, but the sarcopenia index decreased in both sexes. Males and females in the middle and highest tertiles of the TyG index were 1.775 and 3.369, and they were 1.993 and 3.157 times more likely to have SO, respectively. The cut-off values of the TyG index for SO in males and females were ≥8.72 and 8.67, respectively.

CONCLUSION

A high TyG index is positively associated with SO, and the TyG index may be considered a potential indicator of SO.

Metabolic syndrome screening in adolescents: New scores AI_METS based on artificial intelligence techniques

BACKGROUND AND AIMS

Metabolic syndrome (MetS) definitions in adolescents based on the percentiles of its components are rather complicated to use in clinical practice. The aim of this study was to test the validity of artificial intelligence (AI)-based scores (AI_METS) that do not use these percentiles for MetS screening for adolescents.

METHODS AND RESULTS

This study included 1086 adolescents aged 12 to 18. The cohort underwent anthropometric measurements and blood tests. Mean blood pressure (MBP), and triglyceride glucose index (TyG) were calculated. Explainable AI methods are used to extract the learned function. Gini importance techniques were tested and used to build new scores for the screening of MetS. IDF, Cook, De Ferranti, Viner, and Weiss definitions of MetS were used to test the validity of these scores. MetS prevalence was 0.4%-4.7% according to these definitions. AI_METS used age, waist circumference, MBP, and TyG index. They offer area under the curves (AUCs) 0.91, 0.93, 0.89, 0.93, and 0.98; specificity 81%, 75%, 72%, 80%, and 97%; and sensitivity 90%, 100%, 90%, 100%, and 100%, respectively, for the detection of MetS according to these definitions. Considering only MBP offers a better specificity and sensitivity to detect MetS than considering only TyG index. MBP offers slightly lower performance than AI_METS.

CONCLUSION

AI techniques have proven their ability to extract knowledge from data. They allowed us to generate new scores for MetS detection in adolescents without using specific percentiles for each component. Although these scores are less intuitive than the percentile-based definition, their accuracy is rather effective for the detection of MetS.

Association between triglyceride glucose index and risk of cerebrovascular disease: systematic review and meta-analysis

BACKGROUND

The triglyceride glucose (TyG) index, which is a new surrogate indicator of insulin resistance (IR), is thought to be associated with many diseases, such as cardiovascular disease, but its relationship with cerebrovascular disease is still controversial.

METHODS

The PubMed, EMBASE, Cochrane Library, Web of Science and Medline databases were searched until March 2022 to evaluate the association between the TyG index and cerebrovascular disease risk. A random‒effects model was used to calculate the effect estimates and 95% confidence intervals (CIs).

RESULTS

A total of 19 cohort studies and 10 case‒control/cross‒sectional studies were included in our study, which included 11,944,688 participants. Compared with a low TyG index, a higher TyG index increased the risk of cerebrovascular disease (RR/HR = 1.22, 95% CI [1.14, 1.30], P&lt;  0.001; OR = 1.15, 95% CI [1.07, 1.23], P&lt;  0.001). Furthermore, the results of the dose-response analysis of the cohort study demonstrated that the risk of cerebrovascular disease increased by 1.19 times per 1 mg/dl increment of the TyG index (relative risk = 1.19, 95% CI [1.13,1.25], P&lt;  0.001).

CONCLUSION

TyG index is related to cerebrovascular disease. More data and basic research are needed to confirm the association.

Insulin Resistance Markers to Detect Nonalcoholic Fatty Liver Disease in a Male Hispanic Population

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease and is closely associated with cardiometabolic disorders, being insulin resistance (IR) the common pathogenic mechanism. The triglycerides/glucose (TyG) index and triglycerides/HDL-c (TG/HDL) ratio are markers correlated with IR. We compared the capacity of these two indexes, alongside IR, to detect NAFLD.

METHODS

In a cross-sectional cohort study, we examined 263 active military personnel from the Colombian Air Force, aged between 29 and 54 years. Anthropometric measurements and biochemical determinations (glycemia, lipid profile, and insulin) were obtained, and ultrasound studies were performed to evaluate the presence of NAFLD. HOMA-IR index was calculated as (fasting insulin (µIU/mL) × fasting glucose (mmol/L)/22.5), the TyG index as Ln (triglycerides (mg/dL) × fasting glucose (mg/dL)/2), and the TG/HDL ratio as (triglycerides (mg/dL)/HDL-c (mg/dL)).

RESULTS

NAFLD ultrasound criteria were met in 70 individuals (26.6%). Subjects with NAFLD had significantly higher values of HOMA-IR (2.55 ± 1.36 vs. 1.51 ± 0.91), TyG (9.17 ± 0.53 vs. 8.7 ± 0.51), and TG/HDL (6.6 ± 4.54 vs. 3.52 ± 2.32) compared to those without NAFLD (p < 0.001). A TyG cutoff point of 8.92 showed an AUC of 0.731, while cutoff points of 3.83 for TG/HDL and 1.68 for HOMA-IR showed an AUC of 0.766 and 0.781, respectively.

CONCLUSION

Our study shows that novel and lower-cost markers of IR are useful for detecting NALFD, with a performance comparable to the HOMA-IR index. These markers should be used as the first step when screening patients for NAFLD.

The correlation between pseudoexfoliation syndrome and the Triglyceride-Glucose index

PURPOSE

Pseudoexfoliation (PEX) syndrome is an age-related disease characterized by the accumulation of extracellular material in many ocular structures, skin and internal organs. Recent studies have shown that the Triglyceride-Glucose (TyG) index has clinical importance for the evaluation of vascular damage. The purpose of this study was to determine the relationship between PEX syndrome and TyG index, and to detect the risk in terms of vascular diseases.

METHODS

In the present study, 50 patients with PEX syndrome who were admitted to the ophthalmology outpatient clinic were evaluated along with 50 others who made up the control group. The Triglyceride-Glucose index was calculated with fasting plasma glucose and triglyceride values.

RESULTS

The mean age was 68.2 ± 1.2 years and 61.0% of the patients were male. There was no statistically significant difference between the two groups in terms of blood sugar and lipid profile (except triglyceride) (p > 0.05). The TyG index value was 8.9 ± 0.5 in the PEX group and 8.6 ± 0.6 in the control group. This difference was statistically significant (p = 0.003). In univariate regression analysis, TyG index (OR = 2.81; CI: 1.37-5.75; p = 0.005) was found to be correlated with PEX. In multivariate logistic regression analysis, this correlation remained statistically significant when adjusted for age and sex (OR = 2.89; CI: 1.35-6.18; p = 0.006).

CONCLUSION

Results showed that the TyG index was high in patients diagnosed with PEX. The risk of vascular diseases can be determined by examining the TyG index in patients with PEX, and this predetermination would have significant consequences for public health.

Triglyceride glucose index is superior biomarker for predicting type 2 diabetes mellitus in children and adolescents

The triglyceride-glucose (TyG) index is associated with predicting type 2 diabetes mellitus (T2DM), but its relationship with homeostatic model assessment of insulin resistance (HOMA-IR) in T2DM is not established. We aimed to investigate the role of TyG index for detection of T2DM in children and adolescents and compare it with HOMA-IR. A cross sectional study was performed in 176 overweight or obese children and adolescents with mean age of 11.34 ± 3.24 years. TyG index was calculated as ln (fasting triglyceride (TG) [mg/dL] × fasting glucose [mg/dL]/2). Of a total of 176 subjects, 57 (32%) were diagnosed with T2DM. Significant differences were observed in the TyG index between T2DM and non-T2DM (p < 0.001). The TyG index had a positive correlation with fasting glucose (r = 0.519, p < 0.001), HOMA-IR (r = 0.189, p < 0.017), HbA1c (r = 0.429, p < 0.001), total cholesterol (TC) (r = 0.257, p = 0.001), TG (r = 0.759, p < 0.001), and low-density lipoprotein cholesterol (LDL-C)(r = 0.152, p < 0.001), and a negative correlation with high-density lipoprotein cholesterol (HDL-C)(r = -0.107, p < 0.001) after controlling for sex, age and BMI standard deviation scores (SDS). In multiple regression analyses, 91.8% of the variance in TyG index was explained by age, glucose, HOMA-IR, TG, LDL-C, and HDL-C (p < 0.001). In the receiver operating characteristic (ROC) analysis, the TyG index [area under the curve (AUC) 0.839)] showed a better performance compared to HOMA-IR (AUC 0.645) in identifying patients with T2DM (p < 0.001). In conclusion, the TyG index had significant association with insulin resistance in T2DM and was superior to HOMA-IR in predicting T2DM in children and adolescents.

Triglyceride-glucose index as a marker in cardiovascular diseases: landscape and limitations

The triglyceride-glucose (TyG) index has been identified as a reliable alternative biomarker of insulin resistance (IR). Recently, a considerable number of studies have provided robust statistical evidence suggesting that the TyG index is associated with the development and prognosis of cardiovascular disease (CVD). Nevertheless, the application of the TyG index as a marker of CVD has not systemically been evaluated, and even less information exists regarding the underlying mechanisms associated with CVD. To this end, in this review, we summarize the history of the use of the TyG index as a surrogate marker for IR. We aimed to highlight the application value of the TyG index for a variety of CVD types and to explore the potential limitations of using this index as a predictor for cardiovascular events to improve its application value for CVD and provide more extensive and precise supporting evidence.

Fasting and Non-Fasting Triglycerides in Patients With Acute Ischemic Stroke

BACKGROUND

Clinical implications of elevated fasting triglycerides (FTGs) and non-fasting triglycerides (NFTGs) in acute ischemic stroke (AIS) remain unknown. We aimed to elucidate the correlation and clinical significance of FTG and NFTG levels in AIS patients.

METHODS

Using a multicenter prospective stroke registry, we identified AIS patients hospitalized within 24 hours of onset with available NFTG results. The primary outcome was a composite of stroke recurrence, myocardial infarction, and all-cause mortality up to one year.

RESULTS

This study analyzed 2,176 patients. The prevalence of fasting and non-fasting hypertriglyceridemia was 11.5% and 24.6%, respectively. Multivariate analysis revealed that younger age, diabetes, higher body mass index and initial systolic blood pressure were independently associated with both fasting and non-fasting hypertriglyceridemia (all P < 0.05). Patients with higher quartiles of NFTG were more likely to be male, younger, ever-smokers, diabetic, and have family histories of premature coronary heart disease and stroke (all P < 0.05). Similar tendencies were observed for FTG. The composite outcome was not associated with FTG or NFTG quartiles.

CONCLUSION

The fasting and non-fasting hypertriglyceridemia were prevalent in AIS patients and showed similar clinical characteristics and outcomes. High FTG and NFTG levels were not associated with occurrence of subsequent clinical events up to one year.

Association of Lipid Accumulation Product and Triglyceride-Glucose Index with Metabolic Syndrome in Young Adults: A Cross-sectional Study

BACKGROUND

Metabolic syndrome is a cluster of elements linked with type 2 diabetes mellitus and cardiovascular disease (CVD). The early detection of individuals at the risk of developing metabolic syndrome can prevent the development of type 2 diabetes mellitus and CVD.

OBJECTIVES

This study aimed to evaluate the association of the lipid accumulation product (LAP) and triglyceride-glucose (TyG) index with metabolic syndrome among young adults.

METHODS

This cross-sectional study included 300 young adults within the age range of 20 - 40 years. Metabolic syndrome was defined according to modified National Cholesterol Education Program Adult Treatment Panel III guidelines. The LAP and TyG index were calculated. Multivariate logistic regression and receiver operating characteristic curve analyses were performed to assess the association of the LAP and TyG index with metabolic syndrome.

RESULTS

The LAP and TyG index were significantly associated with metabolic syndrome (P < 0.05). The LAP showed the highest area under the curve (0.882 and 0.905 in male and female subjects, respectively), followed by the TyG index (0.875 and 0.886 in male and female subjects, respectively, at P < 0.0001. The cut-off values for the LAP were 45.65 in males with a sensitivity and specificity of 80% and 46.91 in females with a sensitivity and specificity of 88%. The cut-off points for the TyG index were 8.63 in males with 80% sensitivity and 78.9% specificity and 8.54 in females with 83.3% sensitivity and 79.6% specificity.

CONCLUSIONS

The LAP and TyG index are significantly associated with metabolic syndrome in young adults. As simple and inexpensive markers, they can be used to identify individuals with metabolic syndrome with high sensitivity and specificity.

Comparison of the Triglyceride Glucose Index and Modified Triglyceride Glucose Indices to Predict Nonalcoholic Fatty Liver Disease in Youths

OBJECTIVE

To assess the associations between the triglyceride glucose (TyG) index and modified TyG indices with nonalcoholic fatty liver disease (NAFLD) and evaluate their ability as predictors of NAFLD in youths.

STUDY DESIGN

We analyzed the cross-sectional data of 3728 individuals aged 10-19 years using the Korea National Health and Nutrition Examination Survey, a nationally representative survey. Logistic regression analysis was performed, and ORs and 95% CIs of tertiles 2 and 3 for each variable for predicting NAFLD were calculated and compared with those of tertile 1 as the reference. Receiver operating characteristic (ROC) curves were plotted to evaluate the ability of each variable for NAFLD prediction.

RESULTS

All TyG and modified TyG indices exhibited progressively increased ORs and 95% CIs for NAFLD across all tertiles (all P < .001). In addition, all TyG and modified TyG indices significantly predicted NAFLD through ROC curves. All modified TyG indices were superior to the TyG index for predicting NAFLD in all subjects and in males. Among females, the TyG-waist-to-height ratio was superior to the TyG index, TyG-body mass index (BMI), and TyG-waist circumference (WC), and the TyG-BMI SDS and TyG-WC were superior to the TyG index.

CONCLUSIONS

The TyG and modified TyG indices are markers for NAFLD prediction in youths, and the modified TyG indices are superior to the TyG index. Modified TyG indices have the potential to be simple and cost-effective markers in screening for NAFLD in youths.

Triglyceride-Glucose Index and Intravenous Thrombolysis Outcomes for Acute Ischemic Stroke: A Multicenter Prospective–Cohort Study

Background

The triglyceride-glucose (TyG) index has recently been proposed as a reliable marker of insulin resistance. There is insufficient evidence to verify that the TyG index is correlated with functional outcomes and hemorrhagic transformation and in patients with stroke treated with intravenous thrombolysis (IVT).

Methods

We designed a multicenter cohort study, which enrolled patients with acute ischemic stroke treated with IVT between December 2004 and December 2016. The TyG index was divided into tertiles and calculated on a continuous scale. Unfavorable functional outcomes were defined by the modified Rankin Scale of 3–6 at 90 days and the incident rates of symptomatic intracranial hemorrhage (SICH) within 36 h of IVT onset were surveyed. Stroke severity was defined as mild (4–8), moderate (9–15), or high (≥16) based on the National Institutes of Health Stroke Scale (NIHSS) scores.

Results

Among 914 enrolled patients, the tertiles of the TyG index were 8.48 for T1, 8.48–9.04 for T2, and 9.04 for T3. T3 showed an increased risk of unfavorable functional outcomes at 90 days [odds ratio (OR): 1.76; P = 0.0132]. The TyG index was significantly associated with unfavorable functional outcomes at 90 days (OR: 1.32; P = 0.0431 per unit increase). No association was found between the TyG index and SICH. These findings were applicable for T3 with stroke of moderate (OR, 2.35; P = 0.0465) and high severity (OR: 2.57, P = 0.0440) patients with stroke.

Conclusion

This study supports the strong association between the increased TyG index and increased unfavorable functional outcomes at 90 days in patients with acute ischemic stroke treated with IVT. These findings were found to be robust in patients with moderate and high stroke severity.

Comparison of Lipid-Derived Markers for Metabolic Syndrome in Youth: Triglyceride/HDL Cholesterol Ratio, Triglyceride-Glucose Index, and non-HDL Cholesterol

Triglyceride/high-density lipoprotein (HDL) cholesterol ratio (TG/HDL-C), triglyceride-glucose index (TyG), and non-HDL cholesterol level (non-HDL-C) have been proposed as surrogate markers for predicting metabolic syndrome (MetS). This study investigated whether these lipid-derived surrogate markers can predict MetS in Korean children and adolescents. Data from 1,814 participants were analyzed from the 2013-2016 Korean National Health and Nutrition Examination Survey. MetS was defined using three sets of criteria: Cook et al. (MetS1), de Ferranti et al. (MetS2), and the International Diabetes Federation (MetS3). The prevalence of MetS1, MetS2, and MetS3 was 4.6%, 11.3%, and 2.7%, respectively. In receiver operating characteristic curve analysis of MetS and lipid-derived surrogate markers, TG/HDL-C (0.937 for MetS1, 0.894 for MetS2, and 0.897 for MetS3) had the largest area under the curve (AUC), followed by TyG (0.906 for MetS1, 0.864 for MetS2, and 0.887 for MetS3), and non-HDL-C (0.752 for MetS1, 0.708 for MetS2, and 0.703 for MetS3) (all P < 0.001). The cutoff values for detecting MetS with TG/HDL-C, TyG, and non-HDL-C were 2.64, 8.52, and 111.6 for MetS1; 2.23, 8.47, and 110.7 for MetS2; and 2.64, 8.74, and 110.8 for MetS3, respectively. In conclusion, TG/HDL-C and TyG were similarly predictive of MetS. We propose using TG/HDL-C and TyG as surrogate markers for assessing MetS in Korean children and adolescents.

Relationship of the Triglyceride-Glucose Index with Subclinical White Matter Hypersensitivities of Presumed Vascular Origin Among Community-Dwelling Koreans

Purpose

The triglyceride-glucose (TyG) index, a widely accessible measure, has been a surrogate indicator of peripheral insulin resistance, and its clinical importance continues to grow in East Asia. We hypothesized that the TyG index is relevant to subclinical white matter hypersensitivities (WMHs) of presumed vascular origin among community-dwelling Koreans.

Methods

We investigated the relationship between the TyG index and WMHs on brain magnetic resonance imaging scans in 2417 Koreans over 45 years of age without a history of cancer, stroke, or ischemic heart disease. The study population was divided into four groups according to the TyG index quartiles. Using multiple logistic regression analysis, we assessed the odds ratios (ORs) and 95% confidence intervals (95% CIs) for WMHs across the TyG index quartiles.

Results

The prevalence of WMHs was significantly higher in the fourth TyG index quartile, with an overall rate of 9.3%. After adjusting for potential confounding variables, the ORs of WMHs for the TyG index quartiles were 1.00, 1.47 (95% CI, 0.91–2.40), 1.76 (95% CI, 1.05–2.97), and 6.79 (95% CI, 3.85–1.54), respectively.

Conclusion

We found that higher TyG index values were associated with the brain’s WMHs of presumed vascular origin. Our findings suggest that the serum TyG index could be an additional valuable biomarker for assessing the risk of cerebral small vessel disease in the preclinical stage.

A population-based study of TyG index distribution and its relationship to cardiometabolic risk factors in children and adolescents

The purpose of this study was to present age- and sex-specific distributions of the triglyceride-glucose (TyG) index and to evaluate their relationship with cardiometabolic risk factors in children and adolescents. A total of 7404 participants aged 10-18 years from the Korean National Health and Nutrition Survey were included as the reference population. The TyG index was calculated as ln(fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The percentile of the TyG index exhibited a steady linear relationship with age for both sexes. TyG index significantly correlated with waist circumference (WC) standard deviation score (SDS; r = 0.110, p < 0.001), systolic blood pressure (SBP; r = 0.104, p < 0.001), diastolic blood pressure (DBP; r = 0.083, p < 0.001), glucose (r = 0.220, p < 0.001), high-density lipoprotein cholesterol (HDL-C; r = - 0.325, p < 0.001), and triglycerides (TG; r = 0.926, p < 0.001). Multiple linear regression analysis revealed that the TyG index was significantly associated with WC SDS (β = 0.116, p < 0.001), SBP (β = 2.009, p < 0.001), DBP (β = 1.464, p < 0.001), glucose (β = 3.376, p < 0.001), HDL-C (β =  - 6.431, p < 0.001), and TG (β = 85.518, p < 0.001). Our results suggest that the TyG index has a steady linear distribution for sex and age in children and adolescents and constitutes an indicator for predicting metabolic disorders that could lead to cardiovascular disease later in life.

Endocrine comorbidities of pediatric obesity

Pediatric obesity has become a serious public health issue. The prevalence of obesity in children and adolescents has increased worldwide and in Korea over several decades. Obese children are more likely to be obese adults with an increased cardiovascular risk. Therefore, maintaining a healthy weight and preventing obesity during childhood are of critical importance. Moreover, obese children and adolescents often have endocrine comorbidities such as prediabetes, type 2 diabetes, dyslipidemia, metabolic syndrome, polycystic ovary syndrome, and central precocious puberty. Hence, the early implementation of obesity management using a multidisciplinary team approach and screening for these comorbidities in obese children and adolescents are required with the appropriate management of each comorbidity and/or specialist referral.

Triglyceride glycemic index as a biomarker for gestational diabetes mellitus: a systemic review and meta-analysis

BACKGROUND

Triglyceride glycemic (TyG) index is a novel tool for assessing insulin resistance (IR). Recently, TyG index as a potential biomarker for gestational diabetes mellitus (GDM) has been studied, but its performance is yet inconclusive. Thus, we performed this systemic review and meta-analysis to evaluate the performance of TyG index in predicting GDM.

METHODS

Studies published before March 1, 2021, with comparison of TyG index between GDM patients and healthy controls were retrieved from multiple databases (PubMed, Web of Science, The Cochrane Library, and Embase). The mean difference (MD) of TyG index in GDM patients and healthy controls was pooled using random-effect models.

RESULTS

Differentiation of TyG index between patients with GDM and controls showed significant results. Overall, there is a four-fold increase in TyG index in GDM patients compared with controls (MD: 0.22, 95% CI: 0.07-0.36, P = 0.003; I2 = 71%, P = 0.009). In subgroup analyses according to gestational time, TyG index in the second trimester predicted GDM with low heterogeneity (MD: 0.26, 95% CI: 0.15-0.37, P < 0.001; I2 = 0%, P = 0.54), while no such correlation was found in the first trimester.

CONCLUSION

TyG index, especially in the second trimester, could be a promising biomarker for predicting GDM.

The association between triglyceride-glucose index, cardio-cerebrovascular diseases, and death in Korean adults: A retrospective study based on the NHIS-HEALS cohort

BACKGROUND

The triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance. We aimed to investigate the TyG index in relation to cardio-cerebrovascular diseases (CCVDs and mortality.

METHODS

This retrospective study included 114,603 subjects. The TyG index was categorized into four quartiles by sex: Q1, <8.249 and <8.063; Q2, 8.249‒<8.614 and 8.063‒<8.403; Q3, 8.614‒< 8.998 and 8.403‒<8.752; and Q4, ≥8.998 and ≥8.752, in men and women, respectively. To calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the primary outcomes (CCVDs and all-cause mortality) and secondary outcomes (cardiovascular diseases [CVDs], cerebrovascular diseases [CbVDs], CCVD-related deaths, or all-cause deaths), Cox proportional hazards regression models were adopted.

RESULTS

Compared to Q1, the HRs (95% CIs) for the primary outcomes of Q2, Q3, and Q4 were 1.062 (0.981‒1.150), 1.110 (1.024-1.204), and 1.151 (1.058-1.252) in men and 1.099 (0.986-1.226), 1.046 (0.938-1.166), and 1.063 (0.954-1.184) in women, respectively, after adjusted for age, smoking status, drinking status, physical activity, body mass index, systolic blood pressure, low-density lipoprotein cholesterol, economic status, and anti-hypertensive medications. Fully adjusted HRs (95% CIs) for CVDs of Q2, Q3, and Q4 were 1.114 (0.969-1.282), 1.185 (1.031-1.363), and 1.232 (1.068-1.422) in men and 1.238 (1.017-1.508), 1.183 (0.971-1.440), and 1.238 (1.018-1.505) in women, respectively. The adjusted HRs (95% CIs) for ischemic CbVDs of Q2, Q3, and Q4 were 1.005 (0.850-1.187), 1.225 (1.041-1.441), and 1.232 (1.039-1.460) in men and 1.040 (0.821-1.316), 1.226 (0.981-1.532), and 1.312 (1.054-1.634) in women, respectively, while the TyG index was negatively associated with hemorrhagic CbVDs in women but not in men. The TyG index was not significantly associated with CCVD-related death or all-cause death in either sex.

CONCLUSIONS

Elevated TyG index was positively associated with the primary outcomes (CCVDs and all-cause mortality) in men and predicted higher risk of CVDs and ischemic CbVDs in both sexes.

Assessment of Different Atherogenic Indices as Predictors of Metabolic Syndrome in Spanish Adolescents

Background: Inconsistent results due to age, ethnic, and geographic differences have been found on the predictive capacity of atherogenic indices in previous studies. The aim of this study was to assess the predictive value of 6 atherogenic indices for MetS in a Spanish adolescent population. Methods: A cross-sectional study was performed on 981 adolescents (13.2 ± 1.2y) that were randomly recruited from schools in Southeastern Spain. Anthropometric and biochemical parameters were evaluated to identify the presence of MetS. The following atherogenic indices were calculated: triglyceride-glucose (TyG) index, atherogenic index of plasma (AIP), non-HDL cholesterol, triglycerides to HDL-cholesterol ratio (TG/HDL-c), LDL-cholesterol to HDL-cholesterol ratio (LDL-c/HDL-c), and total cholesterol to HDL-cholesterol ratio (TC/HDL-c). Results: The area under the curve (AUC) of receiver operating characteristic curves was used for discrimination purposes. AIP was the atherogenic index most strongly associated with MetS with an unadjusted odds ratio (OR) of 37.98 in boys and of 28.75 in girls. A high OR was maintained after adjustment by different factors. AUC values for all atherogenic indices were above 0.83 and 0.88 in boys and in girls, respectively. Conclusions: Among the 6 atherogenic indices studied, AIP was the one most strongly associated with MetS in Spanish adolescents. The AUC values obtained from ROC analyses suggest that all atherogenic indices have the ability to predict MetS. These atherogenic indices are interesting and useful predictive indicators for MetS. However, more studies are needed to explore in-depth this predictive capacity.

The triglyceride/glucose index as an insulin resistance marker in the pediatric population and its relation to eating habits and physical activity

INTRODUCTION

To examine the triglyceride/glucose index (TyG) as an insulin resistance marker in obese children and adolescents and its relation to clinical and biochemical parameters, body composition and lifestyle.

PATIENTS AND METHOD

Sixty patients aged 7-16 years of age were enrolled. Anthropometric variables were recorded, together with pubertal stage, blood pressure and body composition assessed by bioimpedance. The TyG index was calculated as ln (fasting glucose (mg/dL) × triglycerides (mg/dL))/2 and the HOMA (homeostatic model assessment) index as fasting insulin (μU/mL) × fasting glucose (mmol/L)/22.5. Feeding habits were documented by adherence to the Mediterranean dietary pattern questionnaire, while physical activity was assessed using the International Sedentary Assessment Tool (ISAT), as well as accelerometry (Actigraph wGT3X+).

RESULTS

The mean TyG index was 4.45 ± 0.18, and proved higher in the pubertal group. We found a positive correlation with the HOMA index (r = 0.39; P = 0.03) and TG/HDL-c index (r = 0.53; P < 0.001). The best cut-off point of the TyG index for predicting insulin resistance was 4.21 in prepubertal children (sensitivity 84%, specificity 100%; AUC: 0.84) and 4.33 in pubertal children (sensitivity 89%, specificity 69%; AUC: 0.61). A positive correlation was found with screen time (r = 0.39; P = 0.01), as well as a negative correlation with caloric expenditure (Kcal/day) in the prepubertal group (r = -0.81; P = 0.005).

CONCLUSIONS

The TyG index could be a useful insulin resistance marker in the pediatric population. Moderate to vigorous physical activity should be encouraged, as well as restricting screen time for leisure purposes, mainly in the prepubertal group.

Association and diagnostic value of a novel uric acid index to cardiovascular risk

OBJECTIVES

Cardiovascular diseases (CVD) are the leading cause of death and disability worldwide. The aim of this study was to assess the association and diagnostic value of a novel uric acid index (UA index) to cardiovascular risk (CVR).

DESIGN

and Methods: An analytical cross-sectional study was performed. We analyzed data from the Plan for Prevention and Surveillance of Communicable and Non-Communicable Diseases at the Hospital de Huaycan, Peru. The QRISK model was used to measure the CVR. Stepwise regression models were performed to determine significant factors to predict CVR and formulate the UA index, then the association of UA index and high CVR was evaluated by Poisson regression models, and the diagnostic accuracy was verified through ROC curves.

RESULTS

In total 291 participants (206 women and 85 men) were analyzed. The correlation between UA index to CVR was stronger (R 2 :0.31, p < 0.001) than uric acid (UA) alone (R 2 :0.19, p < 0.001), and the contribution of UA was stronger than triglycerides or glucose in the stepwise regression model. In the Poisson models, the UA index adjusted model (PRa: 1.58, CI95% 1.11-2.24) presented significant independent association to CVR. The diagnostic accuracy was similar in men (cut-off: 10.8, AUC:0.81; 0.75-0.87) and women (cut-off: 10.0; AUC: 0.77, 0.71-0.84).

CONCLUSION

UA index presented a good diagnostic accuracy and independent significant association to high CVR in adults from Peru. This marker can be used to assess CVR and follow therapeutic progress in primary health care.

A novel prognostic risk factor for patients undergoing radical prostatectomy: Triglyseride-glucose index

BACKGROUND

Obesity and metabolic syndrome are growing health problems in western countries. Recently reported triglyseride-glucose (TyG) index is a reliable and accessible indicator of metabolic syndrome. TyG index could be used as a indicator of a prognostic risk factor for metabolic syndrome-related cancers.

OBJECTIVES

To investigate the prognostic role of TyG index on oncological outcomes in patients undergoing radical prostatectomy.

DESIGN, SETTING AND PARTICIPANTS

Data from 200 men who underwent radical prostatectomy were used.

OUTCOME MEASUREMENTS AND STATSITICAL ANALYSE

TyG was calculated based on TyG index = Ln [TG (mg/dL) FPG (mg/dL)/2] formula. Patients were divided into two groups according to the 8.55 level as cut-off value for TyG index. Laboratory results, oncological outcomes and survivals were comparised statistically between groups.

RESULTS

Mean ages of patients were 64.32 ± 6.1 years and median follow-up time was 61.6 ± 35 (range 4-140) month. Biochemical recurrens was observed in 42 (21%) patients. Positive correlation between TyG index, body mass index, waist circumference, prostate biopsy gleason score, clinical T stage, positive surgical margin, pathological T stage and biochemical recurrence were observed. There was no statistical significance in terms of survival between groups.

CONCLUSION

Association between TyG index and prostate cancer may facilitate to predict unfavorable prognostic factors of radical prostatectomy. Increased TyG index may use as a predictive marker of positive surgical margin status before radical prostatectomy, BCR, advanced cT and pT stages after radical prostatectomy or worse biopsy gleason score in clinical practice.

Prediction of Insulin Resistance by Modified Triglyceride Glucose Indices in Youth

The triglyceride glucose (TyG) index, derived from a combination of fasting glucose and triglycerides, has been suggested as a useful marker for insulin resistance (IR), in addition to modified TyG indices that combine obesity parameters. This study investigated the association and utility of TyG and modified TyG indices for IR prediction in youth. Based on the Korea National Health and Nutritional Examination Survey, the data of 3728 youth aged 10–19 years were analyzed. Odds ratios (ORs) and 95% confidence intervals (CIs) of tertiles 2 and 3 for each parameter were calculated and compared with tertile 1 as a reference. To compare the parameters for identifying IR, receiver operating characteristic curves were plotted and the area under the curve (AUC) was calculated. The ORs and 95% CIs for insulin resistance (IR) progressively increased across tertiles of each parameter. Overall, all modified TyG indices presented higher ORs and AUC than the TyG index. The TyG-body mass index standard deviation score showed the largest AUC for IR detection in all subjects. In conclusion, TyG and modified TyG indices could be used as valuable markers for the prediction of IR in youth. Moreover, modified TyG indices had better diagnostic accuracy than the TyG index.