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Yin JL, Yang J, Song XJ, Qin X, Chang YJ, Chen X, Liu FH, Li YZ, Xu HL, Wei YF, Cao F, Bai XL, Wu L, Tao T, Du J, Gong TT, Wu QJ. Triglyceride-glucose index and health outcomes: an umbrella review of systematic reviews with meta-analyses of observational studies. Cardiovasc Diabetol 2024; 23:177. [PMID: 38783270 PMCID: PMC11118729 DOI: 10.1186/s12933-024-02241-y] [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: 03/26/2024] [Accepted: 04/20/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Numerous meta-analyses have explored the association between the triglyceride-glucose (TyG) index and diverse health outcomes, yet the comprehensive assessment of the scope, validity, and quality of this evidence remains incomplete. Our aim was to systematically review and synthesise existing meta-analyses of TyG index and health outcomes and to assess the quality of the evidence. METHODS A thorough search of PubMed, EMBASE, and Web of Science databases was conducted from their inception through to 8 April 2024. We assessed the quality of reviews using A Measurement Tool to Assess Systematic Reviews (AMSTAR) and the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. This study was registered with PROSPERO (CRD: 42024518587). RESULTS Overall, a total of 95 associations from 29 meta-analyses were included, investigating associations between TyG index and 30 health outcomes. Of these, 83 (87.4%) associations were statistically significant (P < 0.05) according to the random effects model. Based on the AMSTAR tool, 16 (55.2%) meta-analyses were high quality and none was low quality. The certainty of the evidence, assessed by the GRADE framework, showed that 6 (6.3%) associations were supported by moderate-quality evidence. When compared with the lowest category of the TyG index, the risk of contrast-induced nephropathy (CIN) [relative risk (RR) = 2.25, 95%CI 1.82, 2.77], the risk of stroke in patients with diabetes mellitus (RR = 1.26, 95%CI 1.18, 1.33) or with acute coronary syndrome disease (RR = 1.56, 95%CI 1.06, 2.28), the prognosis of coronary artery disease (CAD)-non-fatal MI (RR = 2.02, 95%CI 1.32, 3.10), and the severity of CAD including coronary artery stenosis (RR = 3.49, 95%CI 1.71, 7.12) and multi-vessel CAD (RR = 2.33, 95%CI 1.59, 3.42) increased with high TyG index. CONCLUSION We found that the TyG index was positively associated with many diseases including the risk of CIN and stroke, the prognosis of CAD, and the severity of CAD which were supported by moderate-quality evidence. TyG index might be useful to identify people at high-risk for developing these diseases.
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Affiliation(s)
- Jia-Li Yin
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Jing Yang
- Department of Endocrinology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Xin-Jian Song
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Xue Qin
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Jiao Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xing Chen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Zi Li
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - He-Li Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Fan Wei
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fan Cao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xue-Li Bai
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Lang Wu
- Cancer Epidemiology Division, Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Tao Tao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Jian Du
- Department of Endocrinology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China.
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China.
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China.
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
- NHC Key Laboratory of Advanced Reproductive Medicine and Fertility, (China Medical University), National Health Commission, Shenyang, 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 Y, Kong Y, Yan Y, Hui P. Explore the value of carotid ultrasound radiomics nomogram in predicting ischemic stroke risk in patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2024; 15:1357580. [PMID: 38706699 PMCID: PMC11066235 DOI: 10.3389/fendo.2024.1357580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/08/2024] [Indexed: 05/07/2024] Open
Abstract
Background and objective Type 2 Diabetes Mellitus (T2DM) with insulin resistance (IR) is prone to damage the vascular endothelial, leading to the formation of vulnerable carotid plaques and increasing ischemic stroke (IS) risk. The purpose of this study is to develop a nomogram model based on carotid ultrasound radiomics for predicting IS risk in T2DM patients. Methods 198 T2DM patients were enrolled and separated into study and control groups based on IS history. After manually delineating carotid plaque region of interest (ROI) from images, radiomics features were identified and selected using the least absolute shrinkage and selection operator (LASSO) regression to calculate the radiomics score (RS). A combinatorial logistic machine learning model and nomograms were created using RS and clinical features like the triglyceride-glucose index. The three models were assessed using area under curve (AUC) and decision curve analysis (DCA). Results Patients were divided into the training set and the testing set by the ratio of 0.7. 4 radiomics features were selected. RS and clinical variables were all statically significant in the training set and were used to create a combination model and a prediction nomogram. The combination model (radiomics + clinical nomogram) had the largest AUC in both the training set and the testing set (0.898 and 0.857), and DCA analysis showed that it had a higher overall net benefit compared to the other models. Conclusions This study created a carotid ultrasound radiomics machine-learning-based IS risk nomogram for T2DM patients with carotid plaques. Its diagnostic performance and clinical prediction capabilities enable accurate, convenient, and customized medical care.
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Affiliation(s)
| | | | | | - Pinjing Hui
- Department of Stroke Center, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 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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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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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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Yang H, Chen Y, Liu C. Triglyceride-glucose index is associated with metabolic syndrome in women with polycystic ovary syndrome. Gynecol Endocrinol 2023; 39:2172154. [PMID: 36708155 DOI: 10.1080/09513590.2023.2172154] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To explore the correlation of triglyceride-glucose index (TyG) index with metabolic syndrome (MetS) and metabolic risk factors, and to assess the predictive value of TyG for MetS in women with PCOS. METHODS This is a retrospective cross-sectional study that included 819 women diagnosed with PCOS and 3122 women without PCOS from January 2018 to December 2021. The definition of MetS adopted in this study was the International Diabetes Federation (IDF) criteria. The TyG index was calculated as the ln (fasting triglyceride level [mg/dL] × fasting glucose level [mg/dL]/2). RESULTS MetS was diagnosed in 266 women (32.5%) among 819 subjects with PCOS, and in 287 women (9.2%) among 3122 subjects without PCOS. Logistic regression analysis showed that women in the highest tertile of TyG index had the highest prevalence of MetS (OR = 3.66, 95%CI: 1.28-10.49) after adjusting for confounding factors. Compared with the lowest tertile, PCOS women in the highest tertile showed the highest odds ratio of hypertension, obesity, central obesity, hyperglycemia and dyslipidemia. Furthermore, TyG index was able to identify MetS in women with PCOS, and the optimal cutoff values were 8.65 (Youden index = 0.65). CONCLUSION TyG index was positively and independently correlated with the prevalence of MetS, which also indicated a good predictive ability in women with PCOS.
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Affiliation(s)
- Haiyan Yang
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
| | - Yufeng Chen
- Gynaecology, The First People's Hospital of Jiashan County, Jiaxing, Zhejiang, PR China
| | - Chang Liu
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
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Zhang F, Li W, Zhang Y, Wang D, Li J, Li C, He L. lncRNA TPRG1-AS1 Screened the Onset of Acute Coronary Syndromes and Predicted Severity and the Occurrence of MACE During Patients' Hospitalization. J Inflamm Res 2023; 16:5385-5391. [PMID: 38026258 PMCID: PMC10661923 DOI: 10.2147/jir.s435945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Acute coronary syndrome (ACS) is a common acute myocardial ischemia syndrome and is one of the death-related causes of cardiovascular diseases. Identifying biomarkers to indicate disease severity and predict the occurrence of major adverse cardiovascular events (MACE) would benefit the clinical prognosis of ACS. This study estimated the expression and significance of lncRNA TPRG1-AS1 in the onset and development of ACS, aiming to explore a novel biomarker for the diagnosis and prognosis of ACS. Patients and Methods A total of 109 ACS patients and 66 patients who received coronary angiography and excluded ACS were enrolled in this study. TPRG1-AS1 in the serum of study subjects was analyzed by PCR. The significance of TPRG1-AS1 in screening ACS was evaluated by ROC analysis. The association of TPRG1-AS1 with the disease severity of ACS was assessed by Pearson correlation analysis with patients' clinicopathological features. The potential of TPRG1-AS1 in predicting the occurrence of MACE was assessed by logistic regression analysis. Results Significant upregulation of TPRG1-AS1 was observed in ACS patients, which served as a risk factor for ACS and distinguish between ACS patients and the normal group. TPRG1-AS1 was positively correlated with Gensini score, cys-C, cTnI, and NT-proBNP levels of ACS patients, which indicate severe development of ACS. Additionally, increasing serum TPRG1-AS1 was associated with the high incidence of MACE during patients' hospitalization and was identified as a risk factor for MACE in ACS patients. Conclusion Upregulated TPRG1-AS1 in ACS served as a diagnostic biomarker and predicted the severe development of patients.
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Affiliation(s)
- Fan Zhang
- Department of Cardiology, Intervention Cardiology Center, Wuhan No.1 Hospital, Wuhan, 430022, People’s Republic of China
| | - Wei Li
- Department of Cardiology, Intervention Cardiology Center, Wuhan No.1 Hospital, Wuhan, 430022, People’s Republic of China
| | - Yingying Zhang
- Department of Cardiology, Intervention Cardiology Center, Wuhan No.1 Hospital, Wuhan, 430022, People’s Republic of China
| | - Dong Wang
- Department of Cardiology, Intervention Cardiology Center, Wuhan No.1 Hospital, Wuhan, 430022, People’s Republic of China
| | - Jing Li
- Department of Cardiology, Intervention Cardiology Center, Wuhan No.1 Hospital, Wuhan, 430022, People’s Republic of China
| | - Chengpeng Li
- Department of Cardiology, Intervention Cardiology Center, Wuhan No.1 Hospital, Wuhan, 430022, People’s Republic of China
| | - Liqun He
- Department of Cardiology, Intervention Cardiology Center, Wuhan No.1 Hospital, Wuhan, 430022, People’s Republic of China
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Ulambayar B, Ghanem AS, Kovács N, Trefán L, Móré M, Nagy AC. Cardiovascular disease and risk factors in adults with diabetes mellitus in Hungary: a population-based study. Front Endocrinol (Lausanne) 2023; 14:1263365. [PMID: 37780630 PMCID: PMC10538629 DOI: 10.3389/fendo.2023.1263365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/01/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Diabetes mellitus (DM) and cardiovascular disease (CVD) such as acute myocardial infarction, stroke, and coronary artery disease are highly prevalent conditions that are responsible for significant morbidity and mortality, particularly in Hungary. The conditions are attributed to identical risk factors, and individuals with DM are primarily susceptible to cardiovascular complications, which are the leading causes of death and disability in patients with DM. The objective of this study was to estimate the prevalence of CVD in individuals with DM and to investigate the association between potential risk factors and the presence of CVD among individuals with DM in a population-based sample. Methods The study was based on data from three waves of the European Health Interview Surveys (EHIS) conducted in Hungary in 2009, 2014, and 2019. Results The prevalence of CVD among patients with DM decreased during the study period and that socioeconomic factors, cardiometabolic risk factors including high blood pressure and high cholesterol, and depression are major contributors to CVD burden in patients with DM in Hungary. Discussion Our findings suggest the importance of regular check-up for hypertension and hypercholesterolemia, better focus on socioeconomic status, as well as ongoing monitoring of mental health among patients with diabetes. Further research is needed to understand the potential causes behind the observed decrease in CVD prevalence.
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Affiliation(s)
- Battamir Ulambayar
- Department of Health Informatics, Institute of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Amr Sayed Ghanem
- Department of Health Informatics, Institute of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Nóra Kovács
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - László Trefán
- Department of Health Informatics, Institute of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Marianna Móré
- Institute of Social and Sociological Sciences, Faculty of Health Sciences, University of Debrecen, Nyíregyháza, Hungary
| | - Attila Csaba Nagy
- Department of Health Informatics, Institute of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
- Coordinating Centre for Epidemiology, University of Debrecen, Debrecen, Hungary
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Zhang Y, Chen S, Tian X, Wang P, Xu Q, Xia X, Zhang X, Li J, Liu F, Wu S, Wang A. Association between cumulative atherogenic index of plasma exposure and risk of myocardial infarction in the general population. Cardiovasc Diabetol 2023; 22:210. [PMID: 37592247 PMCID: PMC10436658 DOI: 10.1186/s12933-023-01936-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/22/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Atherogenic index of plasma (AIP) has been confirmed as a novel marker for myocardial infarction (MI), but few evidence on the long-term AIP and MI risk in general populations. We thus aimed to evaluate the relationships of cumulative exposure to AIP and its accumulation time course with the risk of MI. METHODS A total of 54,440 participants were enrolled in the Kailuan study. Time-weighted cumulative AIP was calculated as the weighted sum of the mean AIP value for each time interval, then normalized by total exposure duration, the exposure duration was from 2006 to 2010. Duration of high AIP exposure was defined as the duration with high AIP and ranged from 0 to 6 years. The time course of AIP accumulation was categorized by the combination of time-weighted cumulative AIP < or ≥ median (- 0.12) and AIP slope. RESULTS After 11.05 years of follow-up, 766 incident MI cases were documented. After adjustment for potential confounders, higher risk of MI was observed in participants with the highest time-weighted cumulative AIP quartile (HR, 1.89; 95% CI 1.47-2.43), the longest exposure duration of high AIP (HR, 1.52; 95% CI 1.18-1.95), and those with high time-weighted cumulative AIP and negative slope (HR, 1.42; 95% CI 1.13-1.79). CONCLUSIONS Long-term cumulative exposure to AIP and the time course of AIP accumulation increased the risk of MI. High AIP earlier resulted in a greater risk increase than later in life with the same time-weighted cumulative AIP, emphasizing the importance of controlling atherogenic dyslipidemia early in life.
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Affiliation(s)
- Yijun Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 S 4th Ring W Rd, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xue Tian
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 S 4th Ring W Rd, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Penglian Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 S 4th Ring W Rd, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qin Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 S 4th Ring W Rd, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China
| | - Xue Xia
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 S 4th Ring W Rd, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China
| | - Xiaoli Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 S 4th Ring W Rd, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China
| | - Jing Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 S 4th Ring W Rd, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China
| | - Fen Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 S 4th Ring W Rd, Fengtai District, Beijing, 100070, China.
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China.
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Yu S, Wei D, Shi N. Comprehensive nursing intervention improves quality of life and reduces hospitalization time and expense in elderly patients with severe heart failure undergoing rh-BNP treatment. Am J Transl Res 2023; 15:5239-5248. [PMID: 37692925 PMCID: PMC10492075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE This study was designed to explore the efficacy of comprehensive nursing intervention in elderly patients with severe heart failure (SHF) treated by recombinant human brain natriuretic peptide (rh-BNP). METHODS A retrospective analysis was made on 131 patients with SHF treated with rh-BNP in Wuhan Asia Cardiology Hospital from May 2019 to May 2022. Of them, 71 patients who received routine nursing care between May 2019 and December 2021 were assigned to the control group, and 60 patients who received comprehensive nursing between January 2022 and May 2022 were assigned to the observation group. The changes in quality of life (QoL) before and after nursing and the occurrence of adverse events after nursing were counted and compared between the two groups. The two groups were compared reagarding changes in anxiety and depression scores before and after nursing, as well as hospitalization expenses and hospitalization time. The left ventricular end-diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) of patients were determined. The nursing satisfaction of the two groups was evaluated. Additionally, logistic regression was carried out to analyze the risk factors for adverse events. RESULTS The control group had lower QoL scores than the observation group after nursing (P < 0.0001). The control group got significantly higher self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores than the observation group (P < 0.0001). The control group showed lower levels of LVEDV and LVEF than the observation group (P < 0.0001). The control group experienced greatly longer hospitalization time than the observation group, and also had a higher hospitalization expense than the observation group (P < 0.001). The observation group expressed much higher nursing satisfaction than the control group (P=0.007). Additionally, according to multivariate logistic regression analysis, age, hypertension, and diabetes mellitus were independent risk factors for adverse events (P < 0.05). CONCLUSION For elderly SHF patients treated by rh-BNP, comprehensive nursing intervention can contribute to higher QoL, shorter hospitalization time, lower hospitalization expense, and milder negative emotions, but did not correlate with short-term adverse cardiovascular events.
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Affiliation(s)
- Sujun Yu
- CCU, Wuhan Asia Cardiology HospitalWuhan, Hubei, China
| | - Dan Wei
- CCU, Wuhan Asia Cardiology HospitalWuhan, Hubei, China
| | - Nian Shi
- PICU, Wuhan Asia Cardiology HospitalWuhan, Hubei, China
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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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Pan L, Zou H, Meng X, Li D, Li W, Chen X, Yang Y, Yu X. Predictive values of metabolic score for insulin resistance on risk of major adverse cardiovascular events and comparison with other insulin resistance indices among Chinese with and without diabetes mellitus: Results from the 4C cohort study. J Diabetes Investig 2023; 14:961-972. [PMID: 37132055 PMCID: PMC10360377 DOI: 10.1111/jdi.14024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/06/2023] [Accepted: 04/14/2023] [Indexed: 05/04/2023] Open
Abstract
AIMS/INTRODUCTION To investigate the relationship between the metabolic score for insulin resistance (METS-IR) index and major adverse cardiac events (MACEs) and to compare its ability to predict MACEs with other IR indices including homeostatic model assessment for IR (HOMA-IR) and triglyceride glucose (TyG) index-related parameters. MATERIALS AND METHODS We conducted a cohort study enrolling 7,291 participants aged ≥40 years. Binary logistic regression and restricted cubic splines were performed to determine the association between METS-IR and MACEs, and the receiver operating curve (ROC) was utilized to compare the predictive abilities of IR indices and to determine the optimal cut-off points. RESULTS There were 348 (4.8%) cases of MACEs during a median follow-up of 3.8 years. Compared with participants with a METS-IR in the lowest quartile, the multivariate-adjusted RRs and 95% CIs for participants with a METS-IR in the highest quartile were 1.47 (1.05-2.77) in all participants, 1.42 (1.18-2.54) for individuals without diabetes, and 1.75 (1.11-6.46) for individuals with diabetes. Significant interactions were found between the METS-IR and the risk of MACEs by sex in all participants and by age and sex in individuals without diabetes (all P values for interaction < 0.05). In the ROC analysis, the METS-IR had a higher AUC value than other indices for predicting MACEs in individuals with diabetes and had a comparable or higher AUC than other indices for individuals without diabetes. CONCLUSIONS The METS-IR can be an effective clinical indicator for identifying MACEs, as it had superior predictive power when compared with other IR indices in individuals with diabetes.
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Affiliation(s)
- Limeng Pan
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Huajie Zou
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Division of Endocrinology, Department of Internal MedicineThe Affiliated Hospital of Qinghai UniversityXiningChina
| | - Xiaoyu Meng
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Danpei Li
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Wenjun Li
- Computer Center, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Xi Chen
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Yan Yang
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Xuefeng Yu
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
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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 Y, Zhu B, Zhou W, Du Y, Qi D, Wang C, Cheng Q, Zhang Y, Wang S, Gao C. Triglyceride-glucose index as a marker of adverse cardiovascular prognosis in patients with coronary heart disease and hypertension. Cardiovasc Diabetol 2023; 22:133. [PMID: 37296406 PMCID: PMC10257289 DOI: 10.1186/s12933-023-01866-9] [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: 04/28/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index has been proposed as a potential predictor of adverse prognosis of cardiovascular diseases (CVDs). However, its prognostic value in patients with coronary heart disease (CHD) and hypertension remains unclear. METHODS A total of 1467 hospitalized patients with CHD and hypertension from January 2021 to December 2021 were included in this prospective and observational clinical 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 endpoint was a compound endpoint, defined as the first occurrence of all-cause mortality or total nonfatal CVDs events within one-year follow up. The secondary endpoint was atherosclerotic CVD (ASCVD) events, including non-fatal stroke/transient ischemic attack (TIA) and recurrent CHD events. We used restricted cubic spline analysis and multivariate adjusted Cox proportional hazard models to investigate the associations of the TyG index with primary endpoint events. RESULTS During the one-year follow-up period, 154 (10.5%) primary endpoint events were recorded, including 129 (8.8%) ASCVD events. After adjusting for confounding variables, for per standard deviation (SD) increase in the TyG index, the risk of incident primary endpoint events increased by 28% [hazard ratio (HR) = 1.28, 95% confidence interval (CI) 1.04-1.59]. Compared with subjects in the lowest tertile (T1), the fully adjusted HR for primary endpoint events was 1.43 (95% CI 0.90-2.26) in the middle (T2) and 1.73 (95% CI 1.06-2.82) in highest tertile (T3) (P for trend = 0.018). Similar results were observed in ASCVD events. Restricted cubic spline analysis also showed that the cumulative risk of primary endpoint events increased as TyG index increased. CONCLUSIONS The elevated TyG index was a potential marker of adverse prognosis in patients with CHD and hypertension.
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Affiliation(s)
- Yahui Liu
- Department of Cardiology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Binbin Zhu
- Department of Cardiology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Weicen Zhou
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Yao Du
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Datun Qi
- Department of Cardiology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Chenxu Wang
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Qianqian Cheng
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - You Zhang
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Shan Wang
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Chuanyu Gao
- Department of Cardiology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China.
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China.
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Wu Y, Yang Y, Zhang J, Liu S, Zhuang W. The change of triglyceride-glucose index may predict incidence of stroke in the general population over 45 years old. Cardiovasc Diabetol 2023; 22:132. [PMID: 37296457 PMCID: PMC10257314 DOI: 10.1186/s12933-023-01870-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Stroke has been found to be highly correlated with the triglyceride-glucose (TyG) index. The relation between the TyG index changes and stroke, however, has seldom been reported, and current researches mentioning the TyG index concentrate on individual values. We aimed to investigate whether the level and the change of TyG index was associated with the incidence of stroke. METHODS Sociodemographic, medical background, anthropometric and laboratory information were retrospectively collected. Classification was conducted using k-means clustering analysis. Logistic regressions were to determine the relationship between different classes with changes in the TyG index and incidence of stroke, taking the class with the smallest change as a reference. Meanwhile, restricted cubic spline regression was applied to examine the links of cumulative TyG index and stroke. RESULTS 369 (7.8%) of 4710 participants had a stroke during 3 years. Compared to class 1 with the best control of the TyG Index, the OR for class 2 with good control was 1.427 (95% CI, 1.051-1.938), the OR for class 3 with moderate control was 1.714 (95% CI, 1.245-2.359), the OR for class 4 with worse control was 1.814 (95% CI, 1.257-2.617), and the OR for class 5 with consistently high levels was 2.161 (95% CI, 1.446-3.228). However, after adjusting for multiple factors, only class 3 still had an association with stroke (OR 1.430, 95%CI, 1.022-2.000). The relation between the cumulative TyG index and stroke was linear in restricted cubic spline regression. In subgroup analysis, similar results were shown in participants without diabetes or dyslipidemia. There is neither additive nor multiplicative interaction between TyG index class and covariates. CONCLUSION A constant higher level with worst control in TyG index indicated a higher risk of stroke.
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Affiliation(s)
- Yaoling Wu
- Shantou University Medical College, Shantou, Guangdong China
- Neurology Department, First Affiliated Hospital of Shantou University Medical College, No.57, ChangPing Road, JinPing District, ShanTou City, 515041 Guangdong Province China
| | - Yongbiao Yang
- Shantou University Medical College, Shantou, Guangdong China
- Neurology Department, First Affiliated Hospital of Shantou University Medical College, No.57, ChangPing Road, JinPing District, ShanTou City, 515041 Guangdong Province China
| | - Jinsheng Zhang
- Shantou University Medical College, Shantou, Guangdong China
- Neurology Department, First Affiliated Hospital of Shantou University Medical College, No.57, ChangPing Road, JinPing District, ShanTou City, 515041 Guangdong Province China
| | - Shuo Liu
- Neurology Department, First Affiliated Hospital of Shantou University Medical College, No.57, ChangPing Road, JinPing District, ShanTou City, 515041 Guangdong Province China
| | - Weiduan Zhuang
- Neurology Department, First Affiliated Hospital of Shantou University Medical College, No.57, ChangPing Road, JinPing District, ShanTou City, 515041 Guangdong Province China
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Wu C, Ren C, Song Y, Gao H, Pang X, Zhang L. Gender-specific effects of oxidative balance score on the prevalence of diabetes in the US population from NHANES. Front Endocrinol (Lausanne) 2023; 14:1148417. [PMID: 37214249 PMCID: PMC10194026 DOI: 10.3389/fendo.2023.1148417] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/28/2023] [Indexed: 05/24/2023] Open
Abstract
Background The relationship between oxidative balance score (OBS) and diabetes remains poorly understood and may be gender-specific. We conducted a cross-sectional study to investigate the complex association between OBS and diabetes among US adults. Methods Overall, 5,233 participants were included in this cross-sectional study. The exposure variable was OBS, composed of scores for 20 dietary and lifestyle factors. Multivariable logistic regression, subgroup analysis, and restricted cubic spline (RCS) regression were applied to examine the relationship between OBS and diabetes. Results Compared to the lowest OBS quartile group (Q1), the multivariable-adjusted odds ratio (OR) (95% confidence interval (CI) for the highest OBS quartile group (Q4) was 0.602 (0.372-0.974) (p for trend = 0.007), and for the highest lifestyle, the OBS quartile group was 0.386 (0.223-0.667) (p for trend < 0.001). Moreover, gender effects were found between OBS and diabetes (p for interaction = 0.044). RCS showed an inverted-U relationship between OBS and diabetes in women (p for non-linear = 6e-04) and a linear relationship between OBS and diabetes in men. Conclusions In summary, high OBS was negatively associated with diabetes risk in a gender-dependent manner.
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Affiliation(s)
- Cuiling Wu
- Department of Biochemistry, Changzhi Medical College, Changzhi, China
| | - Chenxia Ren
- Central Laboratory, Changzhi Medical College, Changzhi, China
| | - Yingda Song
- Department of Thoracic Surgery, Shanxi Provincial People’s Hospital, Taiyuan, China
- Fifth Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Huifang Gao
- Department of Biochemistry, Changzhi Medical College, Changzhi, China
| | - Xin Pang
- Department of Biochemistry, Changzhi Medical College, Changzhi, China
| | - Lianyun Zhang
- Department of Biochemistry, Changzhi Medical College, Changzhi, China
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Muhammad IF, Bao X, Nilsson PM, Zaigham S. Triglyceride-glucose (TyG) index is a predictor of arterial stiffness, incidence of diabetes, cardiovascular disease, and all-cause and cardiovascular mortality: A longitudinal two-cohort analysis. Front Cardiovasc Med 2023; 9:1035105. [PMID: 36684574 PMCID: PMC9846351 DOI: 10.3389/fcvm.2022.1035105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023] Open
Abstract
Background Triglyceride-glucose (TyG) index is a useful low-cost marker of insulin resistance. We aimed to evaluate the association between TyG index and arterial stiffness, incidence of diabetes, adverse cardiovascular outcomes, and all-cause and cardiovascular mortality in two large prospective Swedish cohorts, the Malmö Diet and Cancer Study-Cardiovascular Cohort (MDCS-CV) and the Malmö Preventive Project (MPP). Methods Association between baseline TyG index and arterial stiffness, measured by carotid femoral pulse wave velocity (c-f PWV), was assessed using linear regression and general linear models, adjusting for covariates. Cox proportional hazard regression was used to assess the association between TyG index and incidence of diabetes, coronary events (CE), stroke, atrial fibrillation (AF), heart failure, and all-cause and cardiovascular mortality. Results After multivariable adjustment, baseline TyG index was significantly associated with increased arterial stiffness (β for c-f PWV = 0.61, p = 0.018). Participants in the highest quartile of TyG index vs. lowest quartile had an increased incidence of diabetes (HR: 3.30, 95% CI: 2.47-4.41), CE (HR: 1.53, 95% CI: 1.41-1.68), stroke (HR: 1.30, 95% CI: 1.18-1.44), all-cause mortality (HR: 1.22, 95% CI: 1.16-1.28), and cardiovascular mortality (HR: 1.37, 95% CI: 1.26-1.49) after adjustment for covariates. Per unit increase in TyG index was associated with increased heart failure risk. No significant association was observed for incident AF. Conclusion Elevated TyG index is positively associated with increased arterial stiffness and increased incidence of diabetes, CE, stroke, and all-cause and cardiovascular mortality. The results suggest that TyG index can potentially be useful in the identification of those at increased long-term risk of adverse health outcomes.
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Affiliation(s)
- Iram Faqir Muhammad
- Department of Clinical Sciences, Lund University, Malmö, Sweden,*Correspondence: Iram Faqir Muhammad,
| | - Xue Bao
- Department of Clinical Sciences, Lund University, Malmö, Sweden,Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden,Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Suneela Zaigham
- Department of Clinical Sciences, Lund University, Malmö, Sweden,Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Hao Q, Yuanyuan Z, Lijuan C. The Prognostic Value of the Triglyceride Glucose Index in Patients With Acute Myocardial Infarction. J Cardiovasc Pharmacol Ther 2023; 28:10742484231181846. [PMID: 37335126 DOI: 10.1177/10742484231181846] [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] [Indexed: 06/21/2023]
Abstract
Objective: The triglyceride-glucose (TyG) index is a simple and reliable surrogate for insulin resistance. Recent studies have suggested that the TyG index is an independent predictor of cardiovascular disease. However, the prognostic value of the TyG index in patients with acute myocardial infarction (AMI) remains uncertain. Thus, this study aimed to evaluate the prognostic value of the TyG index in patients with AMI. Methods: AMI patients admitted to Zhongda Hospital from 2018 to 2020 were successively enrolled. After screening the inclusion criteria, 1144 patients were divided into three groups according to the tertiles of the TyG index distribution. Patients were followed up for 1 year as outpatients or contacted via telephone, and the occurrence and timing of all-cause deaths were recorded. Results: The TyG index was significantly correlated with heart failure (HF) in AMI patients. Patients with a high TyG index (group 3) (odds ratio: 9.070, 95% confidence interval [CI] 4.359-18.875, P<.001) had a significantly higher incidence of HF compared with patients with median TyG index (group 2). Similarly, the incidence of all-cause death in group 3 was significantly higher than that in group 2 during the 1-year follow-up (hazard ratio: 2.996, 95% CI 1.058-8.487, P = .039). Conclusion: The TyG index is closely related to HF and may be a valuable indicator to predict the long-term prognosis of patients with AMI.
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Affiliation(s)
- Qian Hao
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Zhao Yuanyuan
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Chen Lijuan
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China
- Department of Cardiology, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China
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Mei K, Ling Q, Yan Z. Correlation analysis of the triglyceride glucose index and heart failure with preserved ejection fraction in essential hypertensive patients. Clin Cardiol 2022; 46:109-110. [PMID: 36403260 PMCID: PMC9849432 DOI: 10.1002/clc.23944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/06/2022] [Accepted: 10/06/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
- Kaibo Mei
- Department of Anesthesiologythe People's Hospital of ShangraoJiangxiChina
| | - Qin Ling
- Endocrine DepartmentThe Second Affiliated Hospital of Nanchang UniversityJiangxiChina
| | - Zhiwei Yan
- Department of Sports Rehabilitation, College of Human KinesiologyShenyang Sport UniversityLiaoningShenyangChina
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21
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Liao LP, Yang Y, Wu Y, Li W. Correlation analysis of the triglyceride glucose index and heart failure with preserved ejection fraction in essential hypertensive patients. Clin Cardiol 2022; 45:936-942. [PMID: 35770315 PMCID: PMC9451667 DOI: 10.1002/clc.23881] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Triglyceride glucose index (TyG index) is a novel marker of insulin resistance. Studies have shown that TyG index is closely associated with the occurrence of hypertension and cardiovascular disease. However, little is known about the correlation between TyG index and the occurrence of heart failure with preserved ejection fraction (HFpEF) in hypertensive patients. HYPOTHESIS Our study assumes that TyG index strongly correlates with occurence of HFpEF in hypertensive patients. METHODS This research enrolled 559 hypertensive patients (273 patients with HFpEF and 286 without HFpEF) admitted to the Department of Cardiology of Jiading Branch of Shanghai General Hospital from 2020 to 2021 as the study subjects. Gender, age, diastolic blood pressure, systolic blood pressure (SBP), and heart rate (HR) were recorded at admission. Medication history and fasting blood samples were harvested after admission to detect laboratory index. Cardiac function and ventricular structure index were measured by echocardiography. Pearson correlation analysis was conducted to identify the correlation of TyG index with cardiac function and ventricular structure. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of TyG index in HFpEF with hypertension. RESULTS HFpEF patients had higher diuretic use frequencies, fasting plasma glucose, NT-proBNP, triglycerides, TyG index, left atrial diameter (LAD), left ventricular mass index (LVMI), the ratio of peak E-velocity of mitral orifice to peak velocity of early diastolic mitral annulus (E/e'), and SBP but lower ratio of peak E of early diastolic maximum blood flow velocity to peak A of late diastolic maximum blood flow velocity of mitral orifice (E/A) and average e' than non-HFpEF patients. Moreover, TyG index was correlated with LAD, left ventricular ejection fraction (LVEF), LVMI, average e', E/e', and NT-proBNP. The multivariate regression analysis suggested that TyG index, E/e', and NT-proBNP were independent risk factors for HFpEF in hypertensive patients. Compared with E/e' and NT-proBNP, the area under the ROC curve (0.778 [95% confidence interval: 0.707-0.849]) was the largest for TyG index. CONCLUSION TyG index is higher in HFpEF patients than in non-HFpEF patients and related to cardiac diastolic function, which strongly correlates with occurrence of HFpEF in hypertensive patients.
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Affiliation(s)
- Li Ping Liao
- Cardiology Department, Jiading Branch of Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yang Yang
- Cardiology DepartmentThe First Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Yilin Wu
- Cardiology Department, Jiading Branch of Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Weizhen Li
- Cardiology Department, Shanghai General HospitalShanghai JiaoTong University School of MedicineShanghaiChina
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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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Shi L, Liu J, Zhu X, Li T, Wen J, Wang X, Qi X. Triglyceride Glucose Index Was a Predictor of 6-Month Readmission Caused by Pulmonary Infection of Heart Failure Patients. Int J Endocrinol 2022; 2022:1131696. [PMID: 36311911 PMCID: PMC9605826 DOI: 10.1155/2022/1131696] [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: 04/17/2022] [Revised: 08/16/2022] [Accepted: 10/01/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Insulin resistance is associated with the prognosis of heart failure (HF) patients. The triglyceride glucose (TyG) index is a simple marker of insulin resistance. However, it remains unclear whether the TyG index is associated with the incidence of readmission in patients with HF. METHODS We enrolled 901 patients with completed records on serum triglyceride and glucose in our study. The TyG index was calculated as log (fasting triglycerides (mg/dL) x fasting glucose (mg/dL)/2). There were 310 cases of readmission and the average TyG index was 7.8 ± 0.7. Restricted cubic spline was fitted to explore the linearity of TyG index associating with 6-month readmission of HF patients. Logistic regression analysis was performed to explore the association between TyG index quartile and the incidence of 6-month readmission. RESULTS Only the 6-month readmission was significantly different among TyG quartiles, and it was the highest (41.9%) in the lowest quartile (ranging 6.17∼7.36). the TyG index was nonlinearly associated with 6-month readmission (p for nonlinearity = 0.009), with the lower level of TyG index increasing the risk of 6-month readmission. Besides, multivariable logistic analysis showed that the lowest TyG quartile was associated with a higher incidence of 6-month readmission in the unadjusted model (odds ratio [OR] 1.74, 95% confidence interval [CI] 1.18-2.57; p=0.005), partially adjusted model (OR 1.82, 95%CI 1.22-2.72; p=0.004), and fully-adjusted model (OR 1.65, 95%CI 1.09-2.45; p=0.024). The association was consistent across gender and diabetes group. CONCLUSION A lower TyG index independently increased the risk of 6-month readmission in HF patients, which could be a prognostic factor in heart failure.
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Affiliation(s)
- Licheng Shi
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Nanjing Medical University, 210029 Nanjing, China
- Department of Respiratory Medicine, Jiangsu Province Official Hospital, 212004 Nanjing, China
| | - Jianan Liu
- Department of Respiratory Medicine, Jiangsu Province Official Hospital, 212004 Nanjing, China
| | - Xuanfeng Zhu
- Department of Respiratory Medicine, Jiangsu Province Official Hospital, 212004 Nanjing, China
| | - Tiantian Li
- Department of Respiratory and Critical Care Medicine, XuZhou Central Hospital, 221009 Xuzhou, China
| | - Jingli Wen
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Nanjing Medical University, 210029 Nanjing, China
| | - Xinyu Wang
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Nanjing Medical University, 210029 Nanjing, China
| | - Xu Qi
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Nanjing Medical University, 210029 Nanjing, China
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Dong J, Yang H, Zhang Y, Chen L, Hu Q. A high triglyceride glucose index is associated with early renal impairment in the hypertensive patients. Front Endocrinol (Lausanne) 2022; 13:1038758. [PMID: 36589813 PMCID: PMC9794992 DOI: 10.3389/fendo.2022.1038758] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Serum β2-microglobulin (β2-MG) and serum cystatin C (CysC) are sensitive and reliable indicators of early renal impairment. Triglyceride glucose index (TyG) is an emerging vital indicator of insulin resistance and is associated with increased risk of hypertension. We aimed to analyze the relationship between TyG and early renal impairment in hypertensive patients. METHODS A retrospective analysis was performed on 881 hypertensive patients treated in Qinghai Provincial People, s Hospital from March 2018 to March 2021, their clinical data and corresponding laboratory index values were recorded, and the TyG index was calculated. According to the TyG index, the patients were divided into a low TyG (L-TyG) group (TyG ≤ 8.50, n=306), medium TyG (M-TyG) group (8.51≤TyG ≤ 8.94, n=281), and high TyG (H-TyG) group (TyG>8.95, n=294) in sequence by using tertiles. Then, according to serum β2-MG and CysC levels, they were divided into a normal renal function group (β2-MG ≤ 2.4 mg/L, n=700 and CysC ≤ 1.25mg/L, n=721) and a renal function injury group (β2-MG>2.4 mg/L, n=181, and CysC>1.25 mg/L, n=160). Multivariate linear regression analysis was used to analyze the influencing factors of serum β2-microglobulin and cystatin C. Multivariate Logistic regression was used to analyze the relationship between the TyG index and early renal impairment in hypertensive patients. The receiver operating characteristic curve (ROC) was used to determine the value of the TyG index in predicting early renal impairment in patients with hypertension. RESULT As the TyG index level increased, serum β2-MG and CysC levels also gradually increased. Multivariate linear regression analysis showed that TyG index was the influencing factor of serum β2-MG (B=0.060, P=0.007) and serum CysC (B=0.096, P<0.001). For every 1 standard deviation increase in the TyG index, the serum β2-MG and CysC increased by 0.06mg/L and 0.096mg/L, respectively. When compared to the normal group, the TyG level (8.91 ± 0.65 vs 8.64 ± 0.60, P<0.001) was higher in the renal impairment group with β2-MG>2.4 mg/L. The results of multivariate logistic regression analysis revealed that for every 1 standard deviation increase in the TyG index, the risk of early renal impairment in hypertensive patients increased 1.53 times (OR=1.53, 95%CI 1.006-2.303).The ROC curves showed that the TyG index was not superior to TG in predicting early renal impairment in hypertensive patients. the AUC values were 0.623 and 0.617, respectively. Then, when CysC>1.25 mg/L was used as the renal damage group, the level of TyG was still higher than that in the normal group (8.94 ± 0.67 and 8.64 ± 0.60, P<0.001). Multivariate Logistic regression analysis showed that for every 1 standard deviation increase in the TyG index, the risk of early renal impairment in hypertensive patients increased 2.82 times (OR=2.82, 95%CI 1.863-4.262). The ROC curves showed that the TyG index was not superior to TG in predicting early renal impairment in hypertensive patients. the AUC values were 0.629 and 0.626, respectively. CONCLUSION TyG index is an influential factor in serum β2-MG and CysC levels. The elevated TyG index levels are closely associated with the occurrence and development of early renal impairment in hypertensive patients, but it should be used cautiously in the prediction of early renal impairment.
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Affiliation(s)
- Jiankai Dong
- Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medical Center, Fujian Institute of Coronary Heart Disease, Fuzhou, China
| | - Huijie Yang
- Department of Cardiology, Qinghai Provincial People’s Hospital, Xining, China
| | - Yaping Zhang
- Department of Cardiology, Qinghai Provincial People’s Hospital, Xining, China
| | - Lianglong Chen
- Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medical Center, Fujian Institute of Coronary Heart Disease, Fuzhou, China
- *Correspondence: Lianglong Chen, ; Quanzhong Hu,
| | - Quanzhong Hu
- Department of Cardiology, Qinghai Provincial People’s Hospital, Xining, China
- *Correspondence: Lianglong Chen, ; Quanzhong Hu,
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