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Wu Z, Cui H, Li W, Zhang Y, Liu L, Liu Z, Zhang W, Zheng T, Yang J. Comparison of three non-insulin-based insulin resistance indexes in predicting the presence and severity of coronary artery disease. Front Cardiovasc Med 2022; 9:918359. [PMID: 35966520 PMCID: PMC9374164 DOI: 10.3389/fcvm.2022.918359] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/06/2022] [Indexed: 12/12/2022] Open
Abstract
Background Insulin resistance (IR) has emerged as a risk factor for coronary heart disease (CAD), but there is currently insufficient data on the association of non-insulin-based IR indexes [triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio, triglyceride and glucose (TyG) index, and metabolic score for IR (METS-IR)] with the presence and severity of CAD. Thus, the present study aimed to examine the relationship between these three non-insulin-based IR indexes and CAD, as well as to further compare the predictive values of each index. Materials and methods In total, 802 consecutive patients who underwent coronary angiography for suspected CAD from January 2016 to April 2017 were included in this study and were divided into the control group (n = 149) and CAD group (n = 653) according to the angiography results. The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, triglyceride and glucose index (TyG index), and METS-IR were calculated according to the corresponding formulas. The severity of CAD was evaluated using the Gensini score (GS). The relationship of the TG/HDL-C ratio, TyG index, and METS-IR with CAD was analyzed, and the predictive values of the indexes were compared. Results The TG/HDL-C ratio, TyG index, and METS-IR in the CAD group were significantly higher than those in the control group. The TG/HDL-C ratio and METS-IR in the high GS group were significantly higher than those in the non-high GS group. Multivariate logistic regression analysis showed that the TG/HDL-C ratio and METS-IR were independent predictors for the presence of CAD {adjusted odds ratio (OR) [95% confidence interval (CI)]: 1.32 (1.02-1.70) and 1.65 (1.32-2.05), respectively}, whereas only the METS-IR was an independent predictor of the severity of CAD [adjusted OR (95% CI): 1.22 (1.02-1.47)]. Further subgroup analysis indicated that statistical significance was observed only among men, younger patients (≤ 60), and patients with prediabetes mellitus (PDM). Receiver operator characteristic (ROC) analysis showed that the METS-IR had the highest predictive value for the prediction of both the presence and severity of CAD. Conclusion The TG/HDL-C ratio, TyG index, and METS-IR are valuable predictors of the presence and severity of CAD, and the METS-IR has the highest predictive value among the three non-insulin-based IR indexes.
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Affiliation(s)
- Zhenguo Wu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Huiliang Cui
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wei Li
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yerui Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Li Liu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zaibao Liu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Cardiology, People's Hospital of Qihe County, Dezhou, China
| | - Wencheng Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tengfei Zheng
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jianmin Yang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China
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Yang K, Liu W. Triglyceride and Glucose Index and Sex Differences in Relation to Major Adverse Cardiovascular Events in Hypertensive Patients Without Diabetes. Front Endocrinol (Lausanne) 2021; 12:761397. [PMID: 34803922 PMCID: PMC8602846 DOI: 10.3389/fendo.2021.761397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Studies from recent decades have suggested that women have a lower risk of cardiovascular disease than men due to their characteristics, but hyperglycemia and hyperinsulinemia caused by IR (insulin resistance) might reverse this gender-protective effect. This study examined whether there were sex differences in the relationship between IR [evaluated by triglyceride and glucose index (TyG index)] and major adverse cardiovascular events (MACEs) in hypertensive patients without diabetes. METHODS This was a post-hoc analysis of the Systolic Blood Pressure Intervention Trial (SPRINT). We explored the relationship between TyG index and MACEs by multivariate Cox proportional hazard regressions and two-piecewise linear regression models. The primary endpoint was MACEs, same as SPRINT, defined as a composite of myocardial infarction, stroke, heart failure, and/or death from cardiovascular causes. We used multiple adjustment models for all regressions. RESULTS A total of 9,323 patients from the SPRINT were included in our analysis. TyG index was significantly related to the risk of MACEs in every adjusted model. Each 1 unit increase in TyG index increased the risk of MACEs in total participants (HR, 1.40; 95% CI, 1.20-1.64; P<0.01) and men (HR, 1.42; 95% CI, 1.18-1.71; P=0.02). However, TyG index was not associated with MACEs among female hypertensive patients (HR, 1.33; 95% CI, 0.97-1.82; P=0.0776). There was no interaction between the sex and TyG index (P for interaction= 0.73). We also used the two-stage linear regression model and did not find any threshold effect. There was no significant interaction in other confounders. CONCLUSION We found the TyG index was associated with MACEs in the hypertensive patients, and there was no gender difference between the TyG index and MACEs.
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