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Yu X, Wang L, Zhang W, Ming J, Jia A, Xu S, Li Q, Ji Q. Fasting triglycerides and glucose index is more suitable for the identification of metabolically unhealthy individuals in the Chinese adult population: A nationwide study. J Diabetes Investig 2019; 10:1050-1058. [PMID: 30417578 PMCID: PMC6626942 DOI: 10.1111/jdi.12975] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/29/2018] [Accepted: 11/04/2018] [Indexed: 01/07/2023] Open
Abstract
AIMS/INTRODUCTION Metabolic unhealth can be defined by the components of metabolic syndrome, which is closely connected to insulin resistance. We aimed to determine a simple index to identify metabolic unhealth in the Chinese adult population. MATERIALS AND METHODS A total of 30,291 individuals were screened from the China National Diabetes and Metabolic Disorders Study carried out from June 2007 to May 2008. Metabolic unhealth was defined using components of metabolic syndrome, except waist circumference. We compared the three surrogate indices of insulin resistance: the product of fasting triglycerides and glucose (TyG), triglycerides divided by high-density lipoprotein cholesterol and the metabolic score for insulin resistance for the evaluation of metabolic status. RESULTS All indices had high sensitivity and specificity for the identification of metabolic unhealth, especially the TyG index with an area under the curve of 0.863 for men and 0.867 for women. Participants were divided into subgroups for further analysis. The TyG index also showed high diagnostic values, especially for younger individuals and men with normal waist circumference. Sex-specific cut-offs for three indices were also used to define metabolic unhealth. The TyG index showed the highest agreement with κ values of 0.603 and 0.605 for men and women between the components of metabolic syndrome and three indices. CONCLUSIONS We propose that the TyG index, just read in one blood laboratory test report, is simpler and more suitable for the identification of metabolically unhealthy individuals as well as who have high risk of cardiometabolic diseases of the Chinese adult population.
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Affiliation(s)
- Xinwen Yu
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
| | - Li Wang
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
| | - Wencheng Zhang
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
| | - Jie Ming
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
| | - Aihua Jia
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
- Department of EndocrinologyThe First Hospital of YulinYulinChina
| | - Shaoyong Xu
- Department of EndocrinologyXiangyang Central Hospital of Hubei University of Arts and ScienceXiangyangChina
- Department of Health StatisticsFaculty of Preventive MedicineThe Fourth Military Medical UniversityXi'anChina
| | - Qiaoyue Li
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
| | - Qiuhe Ji
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
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Won KB, Park GM, Lee SE, Cho IJ, Kim HC, Lee BK, Chang HJ. Relationship of insulin resistance estimated by triglyceride glucose index to arterial stiffness. Lipids Health Dis 2018; 17:268. [PMID: 30474549 PMCID: PMC6260653 DOI: 10.1186/s12944-018-0914-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 11/15/2018] [Indexed: 01/31/2023] Open
Abstract
Background Insulin resistance (IR) is an important risk factor for subclinical atherosclerosis. This study evaluated the relationship between the triglyceride glucose (TyG) index, which is a simple and reliable surrogate marker for IR, and arterial stiffness. Methods This study included 2560 Korean subjects without a previous history of coronary artery disease, stroke, and malignancies who participated in a community-based cohort study. Arterial stiffness was measured using the brachial-ankle pulse wave velocity (baPWV). Results All participants were stratified into four groups based on the quartile of the TyG index. The prevalence of metabolic syndrome and diabetes significantly increased with increasing TyG index quartile. The mean baPWV was significantly different among all groups (group I [lowest]: 1421 ± 242 vs. group II: 1480 ± 244 vs. group III: 1534 ± 260 vs. group IV [highest]: 1575 ± 279 cm/s; p < 0.001). The TyG index values were correlated with baPWV (r = 0.224, p < 0.001). Multiple regression analysis showed that age (β = 0.410), male gender (β = 0.051), increased blood pressure (β = 0.266), and TyG index (β = 0.158) were associated with baPWV (p < 0.05, respectively). TyG index was independently related to baPWV in both non-diabetics and diabetics. Conclusions The TyG index is independently associated with arterial stiffness in a relatively healthy Korean population.
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Affiliation(s)
- Ki-Bum Won
- Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea.
| | - Gyung-Min Park
- Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea
| | - Sang-Eun Lee
- Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - In-Jeong Cho
- Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Hyeon Chang Kim
- Division of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Kwon Lee
- Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyuk-Jae Chang
- Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
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Jin JL, Cao YX, Wu LG, You XD, Guo YL, Wu NQ, Zhu CG, Gao Y, Dong QT, Zhang HW, Sun D, Liu G, Dong Q, Li JJ. Triglyceride glucose index for predicting cardiovascular outcomes in patients with coronary artery disease. J Thorac Dis 2018; 10:6137-6146. [PMID: 30622785 DOI: 10.21037/jtd.2018.10.79] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Triglyceride glucose (TyG) index is a novel marker for metabolic disorders and recently it has been reported to be associated with cardiovascular disease (CVD) risk in apparently healthy individuals. However, the prognostic value of TyG index in patients with stable coronary artery disease (CAD) is not determined. Methods We conducted a nested case-control study among 3,745 patients with stable CAD. Patients were followed up for 11,235 person-years. The cardiovascular events (CVEs) were defined as all-cause death, non-fatal myocardial infarction (MI), stroke and post-discharge revascularization [percutaneous coronary intervention (PCI) coronary artery bypass grafting (CABG)]. In total, 290 (7.7%) patients with CVEs and 1,450 controls were matched according to age, gender, previous history of PCI or CABG and the duration of follow-up. TyG index was calculated as formula: ln[fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. Results Multivariable Cox proportional hazards models revealed that TyG index was positively associated with CVEs risk (hazard ratio: 1.364, 95% confidence interval: 1.100-1.691, P=0.005). The Kaplan-Meier analysis indicated that patients within the highest quartile of TyG index presented the lowest event-free survival (P=0.029). Moreover, a 1-standard deviation (SD) increment in TyG index was associated with 23.2% [hazard ratio (HR): 1.232, 95% confidence interval (95% CI): 1.084-1.401] higher risk of CVEs, which was superior to other triglyceride or glycemic related markers. Conclusions The present study, firstly, showed that TyG index was positively associated with future CVEs, suggesting that TyG may be a useful marker for predicting clinical outcomes in patients with CAD.
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Affiliation(s)
- Jing-Lu Jin
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Ye-Xuan Cao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Li-Guo Wu
- Department of Cardiology, TangXian People's Hospital, Baoding 072350, China
| | - Xiang-Dong You
- Department of Cardiology, TangXian People's Hospital, Baoding 072350, China
| | - Yuan-Lin Guo
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Na-Qiong Wu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Cheng-Gang Zhu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Ying Gao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Qiu-Ting Dong
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Hui-Wen Zhang
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Di Sun
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Geng Liu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Qian Dong
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Jian-Jun Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
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Tohidi M, Baghbani-Oskouei A, Ahanchi NS, Azizi F, Hadaegh F. Fasting plasma glucose is a stronger predictor of diabetes than triglyceride-glucose index, triglycerides/high-density lipoprotein cholesterol, and homeostasis model assessment of insulin resistance: Tehran Lipid and Glucose Study. Acta Diabetol 2018; 55:1067-1074. [PMID: 30066042 DOI: 10.1007/s00592-018-1195-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 07/17/2018] [Indexed: 12/20/2022]
Abstract
AIMS To compare the impact of triglyceride-glucose index (TyG-index), the product of fasting plasma glucose (FPG) and triglycerides (TG) with FPG, 2 h post-challenge plasma glucose (2 h-PCPG), TG/high-density lipoprotein cholesterol (TG/HDL-C), and homeostasis model assessment of insulin resistance (HOMA-IR) indices for prediction of type 2 diabetes (T2D) in Iranian adults during a median follow-up of 12 years. METHODS Study population included 4419 (1858 men) subjects with mean age of 40.6 ± 13.2 years. Multivariable Cox proportional hazard models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for each 1-standard deviation increase in each predictor. Areas under the receiver operating characteristics curves (AUC) and 95% CIs were calculated. RESULTS During follow-up, 215 men and 288 women developed T2D. The multivariable HRs for FPG, 2 h-PCPG, TyG-index, HOMA-IR, HOMA2-IR, and TG/HDL-C were 2.20, 1.97, 1.71, 1.33, 1.30, and 1.35 in men and 2.13, 2.11, 1.44, 1.37, 1.32, and 1.36 in women (all P < 0.001). Among the total population, the AUC for FPG [0.752 (0.727-0.776)] was similar to 2 h-PCPG but higher than TyG-index [0.697 (0.673-0.720)], TG/HDL-C [0.644 (0.620-0.669)], HOMA-IR [0.684 (0.659-0.710)], and HOMA2-IR [0.656 (0.630-0.682)]. In men, AUC of TyG-index was higher than TG/HDL-C but did not differ with HOMA-IR indices. In women, the AUC of TyG-index was higher than HOMA2-IR and TG/HDL-C, but was similar to that of HOMA-IR. CONCLUSIONS FPG is a stronger predictor of T2D than the TyG-index, TG/HDL-C, and HOMA-IR indices. Although TyG-index was better than TG/HDL-C in both genders, it did not rank above HOMA-IR.
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Affiliation(s)
- Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, Aarabi St. Velenjak area, Tehran, Iran
| | - Aidin Baghbani-Oskouei
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, Aarabi St. Velenjak area, Tehran, Iran
| | - Noushin Sadat Ahanchi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, Aarabi St. Velenjak area, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Aarabi St. Velenjak area, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, Aarabi St. Velenjak area, Tehran, Iran.
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Low S, Khoo KCJ, Irwan B, Sum CF, Subramaniam T, Lim SC, Wong TKM. The role of triglyceride glucose index in development of Type 2 diabetes mellitus. Diabetes Res Clin Pract 2018; 143:43-49. [PMID: 29936253 DOI: 10.1016/j.diabres.2018.06.006] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/16/2018] [Accepted: 06/13/2018] [Indexed: 02/08/2023]
Abstract
AIMS Triglyceride-Glucose (TyG) is an emerging surrogate indicator of insulin resistance. We explored the role of TyG in development of Type 2 Diabetes Mellitus (T2DM) and elucidated the mechanism for the relationship. METHODS 4109 subjects without baseline T2DM participated in a community screening programme in 2013-2016. TyG was calculated as Ln[fasting triglyceride level (mg/dl) × fasting plasma glucose (FPG) (mg/dl)/2]. Outcome was T2DM defined as FPG ≥ 7.0 mmol/l; current treatment with anti-diabetes medication; and/or self-reported diabetes on follow-up screening. We used Cox proportion-hazard model to assess risk of T2DM by TyG quartiles at baseline. Binary mediation analysis was performed to examine extent of mediation by TyG between Body Mass Index (BMI) and T2DM development. RESULTS After 5734.23 person-years of follow-up, T2DM developed in 117 subjects with an incidence of 20.40/1000 person-years. Risk of T2DM incidence was increased with quartiles 2, 3 and 4 versus quartile 1 of TyG (adjusted HR 1.79(95%CI 0.80-3.99), 2.54 (1.18-5.49) and 4.68(2.19-10.01), Ptrend < 0.001) across TyG quartiles. TyG accounted for 35.1% of association between BMI and T2DM development, having adjusted for potential cofounders (p < 0.001). CONCLUSIONS TyG is potentially useful for predicting T2DM in clinical practice. It is a potential mediator of association between BMI and T2DM development.
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Affiliation(s)
- Serena Low
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | | | - Bastari Irwan
- Transformation Office, Hospital Administration, Khoo Teck Puat Hospital, Singapore
| | - Chee Fang Sum
- Diabetes Centre, Admiralty Medical Centre, Singapore
| | | | - Su Chi Lim
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore; Diabetes Centre, Admiralty Medical Centre, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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Franch-Nadal J, Caballeria L, Mata-Cases M, Mauricio D, Giraldez-García C, Mancera J, Goday A, Mundet-Tudurí X, Regidor E. Fatty liver index is a predictor of incident diabetes in patients with prediabetes: The PREDAPS study. PLoS One 2018; 13:e0198327. [PMID: 29856820 PMCID: PMC5983533 DOI: 10.1371/journal.pone.0198327] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 05/17/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES We evaluated the ability of the Fatty Liver Index (FLI), a surrogate marker of hepatic steatosis, to predict the development of type 2 diabetes (T2D) at 3 years follow-up in a Spanish cohort with prediabetes from a prospective observational study in primary care (PREDAPS). METHODS FLI was calculated at baseline for 1,142 adult subjects with prediabetes attending primary care centers, and classified into three categories: FLI <30 (no steatosis), FLI 30-60 (intermediate) and FLI ≥60 (hepatic steatosis). We estimated the incidence rate of T2D in each FLI category at 3 years of follow-up. The association between FLI and incident T2D was calculated using Cox regression models adjusted for age, sex, educational level, family history of diabetes, lifestyles, hypertension, lipid profile and transaminases. RESULTS The proportion of subjects with prediabetes and hepatic steatosis (FLI ≥60) at baseline was 55.7%. The incidence rate of T2D at 3 years follow-up was 1.3, 2.9 and 6.0 per 100 person-years for FLI<30, FLI 30->60 and FLI ≥60, respectively. The most significant variables increasing the risk of developing T2D were metabolic syndrome (hazard ratio [HR] = 3.02; 95% confidence interval [CI] = 2.14-4.26) and FLI ≥60 (HR = 4.52; 95%CI = 2.10-9.72). Moreover, FLI ≥60 was independently associated with T2D incidence: the HR was 4.97 (95% CI: 2.28-10.80) in the base regression model adjusted by sex, age and educational level, and 3.21 (95%CI: 1.45-7.09) in the fully adjusted model. CONCLUSIONS FLI may be considered an easy and valuable early indicator of high risk of incident T2D in patients with prediabetes attended in primary care, which could allow the adoption of effective measures needed to prevent and reduce the progression of the disease.
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Affiliation(s)
- Josep Franch-Nadal
- redGDPS Foundation, Madrid, Spain
- Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Diabetes and Associated Metabolic Diseases Networking Biomedical Research Centre (CIBERDEM), Madrid, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Llorenç Caballeria
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Liver and Digestive Diseases Networking Biomedical Research Centre (CIBEREHD), Madrid, Spain
- Unitat de Suport a la Recerca Barcelonès Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Manel Mata-Cases
- redGDPS Foundation, Madrid, Spain
- Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Diabetes and Associated Metabolic Diseases Networking Biomedical Research Centre (CIBERDEM), Madrid, Spain
| | - Didac Mauricio
- redGDPS Foundation, Madrid, Spain
- Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Diabetes and Associated Metabolic Diseases Networking Biomedical Research Centre (CIBERDEM), Madrid, Spain
- Department of Endocrinology and Nutrition, Health Sciences Research Institute & University Hospital Germans Trias i Pujol, Badalona, Spain
| | - Carolina Giraldez-García
- redGDPS Foundation, Madrid, Spain
- Preventive Medicine Service, University Hospital Infanta Elena, Madrid, Spain
- Preventive Medicine, Public Health and History of Science Department, Complutense University of Madrid, Madrid, Spain
| | - José Mancera
- redGDPS Foundation, Madrid, Spain
- Health Center Ciudad Jardín, Málaga, Spain
| | - Albert Goday
- redGDPS Foundation, Madrid, Spain
- Endocrinology Service, Hospital del Mar, Barcelona, Spain
| | - Xavier Mundet-Tudurí
- redGDPS Foundation, Madrid, Spain
- Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Autonomous University of Barcelona, Bellaterra, Spain
| | - Enrique Regidor
- redGDPS Foundation, Madrid, Spain
- Preventive Medicine, Public Health and History of Science Department, Complutense University of Madrid, Madrid, Spain
- Epidemiology and Public Health Networking Biomedical Research Centre (CIBERESP), Madrid, Spain
- Health Research Institute, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Lee JW, Lim NK, Park HY. The product of fasting plasma glucose and triglycerides improves risk prediction of type 2 diabetes in middle-aged Koreans. BMC Endocr Disord 2018; 18:33. [PMID: 29843706 PMCID: PMC5975474 DOI: 10.1186/s12902-018-0259-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 05/16/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Screening for risk of type 2 diabetes mellitus (T2DM) is an important public health issue. Previous studies report that fasting plasma glucose (FPG) and triglyceride (TG)-related indices, such as lipid accumulation product (LAP) and the product of fasting glucose and triglyceride (TyG index), are associated with incident T2DM. We aimed to evaluate whether FPG or TG-related indices can improve the predictive ability of a diabetes risk model for middle-aged Koreans. METHODS 7708 Koreans aged 40-69 years without diabetes at baseline were eligible from the Korean Genome and Epidemiology Study. The overall cumulative incidence of T2DM was 21.1% (766 cases) in men and 19.6% (797 cases) in women. Therefore, the overall cumulative incidence of T2DM was 20.3% (1563 cases). Multiple logistic regression analysis was conducted to compare the odds ratios (ORs) for incident T2DM for each index. The area under the receiver operating characteristic curve (AROC), continuous net reclassification improvement (cNRI), and integrated discrimination improvement (IDI) were calculated when each measure was added to the basic risk model for diabetes. RESULTS All the TG-related indices and FPG were more strongly associated with incident T2DM than WC in our study population. The adjusted ORs for the highest quartiles of WC, TG, FPG, LAP, and TyG index compared to the lowest, were 1.64 (95% CI, 1.13-2.38), 2.03 (1.59-2.61), 3.85 (2.99-4.97), 2.47 (1.82-3.34), and 2.79 (2.16-3.60) in men, and 1.17 (0.83-1.65), 2.42 (1.90-3.08), 2.15 (1.71-2.71), 2.44 (1.82-3.26), and 2.85 (2.22-3.66) in women, respectively. The addition of TG-related parameters or FPG, but not WC, to the basic risk model for T2DM (including age, body mass index, family history of diabetes, hypertension, current smoking, current drinking, and regular exercise) significantly increased cNRI, IDI, and AROC in both sexes. CONCLUSIONS Adding either TyG index or FPG into the basic risk model for T2DM increases its prediction and reclassification ability. Compared to FPG, TyG index was a more robust T2DM predictor in the stratified sex and fasting glucose level. Therefore, TyG index should be considered as a screening tool for identification of people at high risk for T2DM in practice.
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Affiliation(s)
- Joung-Won Lee
- Division of Cardiovascular Diseases, Center for Biomedical Sciences, Korea National Institute of Health, 187 Osongsaengmyeng 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 361-951 South Korea
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, South Korea
| | - Nam-Kyoo Lim
- Division of Cardiovascular Diseases, Center for Biomedical Sciences, Korea National Institute of Health, 187 Osongsaengmyeng 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 361-951 South Korea
| | - Hyun-Young Park
- Division of Cardiovascular Diseases, Center for Biomedical Sciences, Korea National Institute of Health, 187 Osongsaengmyeng 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 361-951 South Korea
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Won KB, Kim YS, Lee BK, Heo R, Han D, Lee JH, Lee SE, Sung JM, Cho I, Park HB, Cho IJ, Chang HJ. The relationship of insulin resistance estimated by triglyceride glucose index and coronary plaque characteristics. Medicine (Baltimore) 2018; 97:e10726. [PMID: 29794749 PMCID: PMC6392709 DOI: 10.1097/md.0000000000010726] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The triglyceride glucose (TyG) index is a useful surrogate marker for insulin resistance, which is an important risk factor for coronary artery disease (CAD). However, data on the relationship of the TyG index and coronary plaque characteristics are limited.This study included 2840 participants with near-normal renal function who underwent coronary computed tomography angiography. CAD was defined as the presence of any plaques, and obstructive CAD was defined as the presence of plaques with ≥50% stenosis. The relationship between the TyG index and noncalcified plaque (NCP), calcified or mixed plaque (CMP), and coronary artery calcium score (CACS) was evaluated.All participants were stratified into 4 groups based on the quartiles of the TyG index. The prevalence of CAD and obstructive CAD significantly increased with increasing quartiles. The risk for NCP and obstructive NCP was not different among all groups. However, compared with group I (lowest quartile), the risk for CMP was higher in groups III (odds ratio [OR]: 1.438) and IV (highest quartile) (OR: 1.895) (P < .05), and that for obstructive CMP was higher in groups II (OR: 1.469), III (OR: 1.595), and IV (OR: 2.168) (P < .05). Multivariate regression analysis showed that the TyG index was associated with an increased risk for CAD (OR: 1.700), obstructive CAD (OR: 1.692), and CACS >400 (OR: 1.448) (P < .05).The TyG index was independently associated with the presence and severity of CAD due to an increased risk for CMP.
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Affiliation(s)
- Ki-Bum Won
- Division of Cardiology, Ulsan University Hospital
| | - Yun Seok Kim
- Division of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
| | - Byoung Kwon Lee
- Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Ran Heo
- Division of Cardiology, Hanyang University Seoul Hospital, Hanyang University College of Medicine
| | - Donghee Han
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System
| | - Ji Hyun Lee
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System
| | - Sang-Eun Lee
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System
| | - Ji Min Sung
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System
| | - Iksung Cho
- Division of Cardiology, Chung-Ang University Hospital
| | - Hyung-Bok Park
- Division of Cardiology, Catholic Kwandong University International St. Mary's Hospital, Incheon, South Korea
| | - In-Jeong Cho
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System
| | - Hyuk-Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System
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Ding C, Chan Z, Chooi YC, Choo J, Sadananthan SA, Chang A, Sasikala S, Michael N, Velan SS, Magkos F. Regulation of glucose metabolism in nondiabetic, metabolically obese normal-weight Asians. Am J Physiol Endocrinol Metab 2018; 314:E494-E502. [PMID: 29351481 DOI: 10.1152/ajpendo.00382.2017] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Type 2 diabetes in Asia occurs largely in the absence of obesity. The metabolically obese normal-weight (MONW) phenotype refers to lean subjects with metabolic dysfunction that is typically observed in people with obesity and is associated with increased risk for diabetes. Previous studies evaluated MONW subjects who had greater body mass index (BMI) or total body fat than respective control groups, making interpretation of the results difficult. We evaluated insulin sensitivity (hyperinsulinemic-euglycemic clamp); insulin secretion (mixed meal with oral minimal modeling); intra-abdominal, muscle, and liver fat contents (magnetic resonance); and fasting and postprandial glucose and insulin concentrations in 18 MONW subjects and 18 metabolically healthy controls matched for age (43 ± 3 and 40 ± 3 yr; P = 0.52), BMI (both 22 ± 1 kg/m2; P = 0.69), total body fat (17 ± 1 and 16 ± 1 kg; P = 0.33), and sex (9 men and 9 women in each group). Compared with controls, MONW subjects had an approximately twofold greater visceral adipose tissue volume and an approximately fourfold greater intrahepatic fat content (but similar muscle fat), 20-30% lower glucose disposal rates and insulin sensitivity, and 30-40% greater insulin secretion rates (all P < 0.05). The disposition index, fasting glucose, and HbA1c concentrations were not different between groups, whereas postprandial glucose and insulin concentrations were ~15% and ~65% greater, respectively, in MONW than control subjects (both P < 0.05). We conclude that the MONW phenotype is associated with accumulation of fat in the intra-abdominal area and the liver, profound insulin resistance, but also a robust β-cell insulin secretion response that compensates for insulin resistance and helps maintain glucose homeostasis.
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Affiliation(s)
- Cherlyn Ding
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
| | - Zhiling Chan
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
| | - Yu Chung Chooi
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
| | - John Choo
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore
| | - Amanda Chang
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
| | - S Sasikala
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore
- Laboratory of Molecular Imaging, Singapore Bioimaging Consortium, Agency for Science Technology, and Research, Singapore
| | - Faidon Magkos
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore , Singapore
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60
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Rhee EJ. Being Metabolically Healthy, the Most Responsible Factor for Vascular Health. Diabetes Metab J 2018; 42:19-25. [PMID: 29504303 PMCID: PMC5842296 DOI: 10.4093/dmj.2018.42.1.19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 12/28/2017] [Indexed: 12/18/2022] Open
Abstract
The prevalence of obesity is rapidly increasing worldwide. One-thirds of world population is suffering from the deleterious effects of excessive fat and adipose tissue in their body. At the same time, the average life expectancy is becoming higher and higher every decade. Therefore, living healthy and longer is the dream for everyone. Simply being obese is not the primary cause for the consequence of obesity; rather, the depot where the fat is accumulated, is the primary key for the deleterious effects of obesity. Results from historical research suggest that visceral fat increases the risk for cardiovascular and metabolic diseases, such as diabetes, myocardial infarction and ischemic stroke, not subcutaneous fat. Therefore, body mass index (BMI), which reflects body weight relative to height might not reflect the appropriate size of metabolic burden of fat in our body. In contrast, waist circumference, which reflects abdominal obesity, would mirror the metabolic burden of fat better than BMI. Visceral fat is the marker of ectopic fat accumulation. In this review, I will introduce my researches mainly involved in uncovering the clues to the link between metabolic health and cardiovascular disease.
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Affiliation(s)
- Eun Jung Rhee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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61
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Salazar J, Bermúdez V, Calvo M, Olivar LC, Luzardo E, Navarro C, Mencia H, Martínez M, Rivas-Ríos J, Wilches-Durán S, Cerda M, Graterol M, Graterol R, Garicano C, Hernández J, Rojas J. Optimal cutoff for the evaluation of insulin resistance through triglyceride-glucose index: A cross-sectional study in a Venezuelan population. F1000Res 2017; 6:1337. [PMID: 29375810 PMCID: PMC5760971 DOI: 10.12688/f1000research.12170.3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2018] [Indexed: 02/02/2023] Open
Abstract
Background: Insulin resistance (IR) evaluation is a fundamental goal in clinical and epidemiological research. However, the most widely used methods are difficult to apply to populations with low incomes. The triglyceride-glucose index (TGI) emerges as an alternative to use in daily clinical practice. Therefore the objective of this study was to determine an optimal cutoff point for the TGI in an adult population from Maracaibo, Venezuela. Methods: This is a sub-study of Maracaibo City Metabolic Syndrome Prevalence Study, a descriptive, cross-sectional study with random and multi-stage sampling. For this analysis, 2004 individuals of both genders ≥18 years old with basal insulin determination and triglycerides < 500 mg/dl were evaluated.. A reference population was selected according to clinical and metabolic criteria to plot ROC Curves specific for gender and age groups to determine the optimal cutoff point according to sensitivity and specificity.The TGI was calculated according to the equation: ln [Fasting triglyceride (mg / dl) x Fasting glucose (mg / dl)] / 2. Results: The TGI in the general population was 4.6±0.3 (male: 4.66±0.34 vs. female: 4.56±0.33, p=8.93x10
-10). The optimal cutoff point was 4.49, with a sensitivity of 82.6% and specificity of 82.1% (AUC=0.889, 95% CI: 0.854-0.924). There were no significant differences in the predictive capacity of the index when evaluated according to gender and age groups. Those individuals with TGI≥4.5 had higher HOMA2-IR averages than those with TGI <4.5 (2.48 vs 1.74, respectively, p<0.001). Conclusions: The TGI is a measure of interest to identify IR in the general population. We propose a single cutoff point of 4.5 to classify individuals with IR. Future studies should evaluate the predictive capacity of this index to determine atypical metabolic phenotypes, type 2 diabetes mellitus and even cardiovascular risk in our population.
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Affiliation(s)
- Juan Salazar
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Valmore Bermúdez
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela.,Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - María Calvo
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Luis Carlos Olivar
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Eliana Luzardo
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Carla Navarro
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Heysa Mencia
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - María Martínez
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - José Rivas-Ríos
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Sandra Wilches-Durán
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Marcos Cerda
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Modesto Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Rosemily Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Carlos Garicano
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Juan Hernández
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Joselyn Rojas
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela.,Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
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62
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Salazar J, Bermúdez V, Calvo M, Olivar LC, Luzardo E, Navarro C, Mencia H, Martínez M, Rivas-Ríos J, Wilches-Durán S, Cerda M, Graterol M, Graterol R, Garicano C, Hernández J, Rojas J. Optimal cutoff for the evaluation of insulin resistance through triglyceride-glucose index: A cross-sectional study in a Venezuelan population. F1000Res 2017; 6:1337. [PMID: 29375810 PMCID: PMC5760971 DOI: 10.12688/f1000research.12170.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2018] [Indexed: 09/29/2023] Open
Abstract
Background: Insulin resistance (IR) evaluation is a fundamental goal in clinical and epidemiological research. However, the most widely used methods are difficult to apply to populations with low incomes. The triglyceride-glucose index (TGI) emerges as an alternative to use in daily clinical practice. Therefore the objective of this study was to determine an optimal cutoff point for the TGI in an adult population from Maracaibo, Venezuela. Methods: This is a sub-study of Maracaibo City Metabolic Syndrome Prevalence Study, a descriptive, cross-sectional study with random and multi-stage sampling. For this analysis, 2004 individuals of both genders ≥18 years old with basal insulin determination and triglycerides < 500 mg/dl were evaluated.. A reference population was selected according to clinical and metabolic criteria to plot ROC Curves specific for gender and age groups to determine the optimal cutoff point according to sensitivity and specificity.The TGI was calculated according to the equation: ln [Fasting triglyceride (mg / dl) x Fasting glucose (mg / dl)] / 2. Results: The TGI in the general population was 4.6±0.3 (male: 4.66±0.34 vs. female: 4.56±0.33, p=8.93x10 -10). The optimal cutoff point was 4.49, with a sensitivity of 82.6% and specificity of 82.1% (AUC=0.889, 95% CI: 0.854-0.924). There were no significant differences in the predictive capacity of the index when evaluated according to gender and age groups. Those individuals with TGI≥4.5 had higher HOMA2-IR averages than those with TGI <4.5 (2.48 vs 1.74, respectively, p<0.001). Conclusions: The TGI is a measure of interest to identify IR in the general population. We propose a single cutoff point of 4.5 to classify individuals with IR. Future studies should evaluate the predictive capacity of this index to determine atypical metabolic phenotypes, type 2 diabetes mellitus and even cardiovascular risk in our population.
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Affiliation(s)
- Juan Salazar
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Valmore Bermúdez
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - María Calvo
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Luis Carlos Olivar
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Eliana Luzardo
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Carla Navarro
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Heysa Mencia
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - María Martínez
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - José Rivas-Ríos
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Sandra Wilches-Durán
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Marcos Cerda
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Modesto Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Rosemily Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Carlos Garicano
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Juan Hernández
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Joselyn Rojas
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, 02115, USA
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63
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Salazar J, Bermúdez V, Calvo M, Olivar LC, Luzardo E, Navarro C, Mencia H, Martínez M, Rivas-Ríos J, Wilches-Durán S, Cerda M, Graterol M, Graterol R, Garicano C, Hernández J, Rojas J. Optimal cutoff for the evaluation of insulin resistance through triglyceride-glucose index: A cross-sectional study in a Venezuelan population. F1000Res 2017; 6:1337. [PMID: 29375810 PMCID: PMC5760971 DOI: 10.12688/f1000research.12170.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2018] [Indexed: 08/08/2023] Open
Abstract
Background: Insulin resistance (IR) evaluation is a fundamental goal in clinical and epidemiological research. However, the most widely used methods are difficult to apply to populations with low incomes. The triglyceride-glucose index (TGI) emerges as an alternative to use in daily clinical practice. Therefore the objective of this study was to determine an optimal cutoff point for the TGI in an adult population from Maracaibo, Venezuela. Methods: This is a sub-study of Maracaibo City Metabolic Syndrome Prevalence Study, a descriptive, cross-sectional study with random and multi-stage sampling. For this analysis, 2004 individuals of both genders ≥18 years old with basal insulin determination and triglycerides < 500 mg/dl were evaluated.. A reference population was selected according to clinical and metabolic criteria to plot ROC Curves specific for gender and age groups to determine the optimal cutoff point according to sensitivity and specificity.The TGI was calculated according to the equation: ln [Fasting triglyceride (mg / dl) x Fasting glucose (mg / dl)] / 2. Results: The TGI in the general population was 4.6±0.3 (male: 4.66±0.34 vs. female: 4.56±0.33, p=8.93x10 -10). The optimal cutoff point was 4.49, with a sensitivity of 82.6% and specificity of 82.1% (AUC=0.889, 95% CI: 0.854-0.924). There were no significant differences in the predictive capacity of the index when evaluated according to gender and age groups. Those individuals with TGI≥4.5 had higher HOMA2-IR averages than those with TGI <4.5 (2.48 vs 1.74, respectively, p<0.001). Conclusions: The TGI is a measure of interest to identify IR in the general population. We propose a single cutoff point of 4.5 to classify individuals with IR. Future studies should evaluate the predictive capacity of this index to determine atypical metabolic phenotypes, type 2 diabetes mellitus and even cardiovascular risk in our population.
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Affiliation(s)
- Juan Salazar
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Valmore Bermúdez
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - María Calvo
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Luis Carlos Olivar
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Eliana Luzardo
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Carla Navarro
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Heysa Mencia
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - María Martínez
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - José Rivas-Ríos
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
| | - Sandra Wilches-Durán
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Marcos Cerda
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Modesto Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Rosemily Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Carlos Garicano
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Juan Hernández
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Joselyn Rojas
- Endocrine-Metabolic Research Center, , University of Zulia, Maracaibo, Venezuela
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, 02115, USA
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64
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Jian S, Su-Mei N, Xue C, Jie Z, Xue-Sen W. Association and interaction between triglyceride-glucose index and obesity on risk of hypertension in middle-aged and elderly adults. Clin Exp Hypertens 2017; 39:732-739. [PMID: 28737433 DOI: 10.1080/10641963.2017.1324477] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIMS To investigate the association between triglyceride-glucose(TyG) index and the risk of hypertension. METHOD A cross-sectional study was conducted in Bengbu, China. The participants received relevant questionnaire survey, anthropometric tests, and laboratory examination. Multivariate logistic regression analysis was performed to estimate the possible association between TyG index and hypertension risk. The additive interaction evaluated by the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index(SI) was calculated. RESULTS A total of 1777 participants (748 men and 1029 women) were investigated. There was a significant increase in the risk of hypertension and isolated systolic hypertension (ISH) when comparing the highest TyG index (the fourth quartile) to the lowest TyG index (the first quartile) and corresponding ORs were 2.446 (95% CI: 1.746-3.426) and 2.621(95%CI: 1.627-4.224), respectively. However, no significant relationship was observed between TyG index and isolated diastolic hypertension (IDH). In males, significant interactions between TyG index and WHtR (RERI:1.978, 95%CI: 0.162-3.792; AP: 0.359, 0.113-0.605; SI:1.782, 1.017-3.122), smoking (AP: 0.437, 95%CI: 0.048-0.825), family history of hypertension (AP:0.433, 95%CI: 0.203-0.662; SI:2.248, 95%CI: 1.333-3.791) were observed. As for females, there were also significant interactions between TyG index and WHtR (RERI:1.415, 95%CI: 0.693-2.136; AP: 0.198, 95%CI: 0.104-0.291; SI:1.298, 95%CI:1.101-1.530), family history of hypertension (RERI:1.744, 95%CI: 0.221-3.267; AP:0.405, 95%CI: 0.113-0.697) on risk of hypertension. CONCLUSIONS Increased TyG index was significantly associated with higher risk of hypertension and ISH, but not for IDH in middle-aged and elderly adults. Our results also demonstrated interactions of TyG index and abdominal obesity and family history of hypertension on hypertension risk.
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Affiliation(s)
- Song Jian
- a Department of Preventive Medicine , Bengbu medical college , Bengbu , Anhui Province , China
| | - Nie Su-Mei
- b Department of public health , Bengbu Health Board , Bengbu , Anhui Province , China
| | - Chen Xue
- a Department of Preventive Medicine , Bengbu medical college , Bengbu , Anhui Province , China
| | - Zhang Jie
- a Department of Preventive Medicine , Bengbu medical college , Bengbu , Anhui Province , China
| | - Wu Xue-Sen
- a Department of Preventive Medicine , Bengbu medical college , Bengbu , Anhui Province , China
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65
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Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study. Cardiovasc Diabetol 2017; 16:30. [PMID: 28249577 PMCID: PMC5333419 DOI: 10.1186/s12933-017-0514-x] [Citation(s) in RCA: 157] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 02/22/2017] [Indexed: 12/15/2022] Open
Abstract
Background Risk of type 2 diabetes mellitus (T2DM) is increased in metabolically obese but normal-weight people. However, we have limited knowledge of how to prevent T2DM in normal-weight people. We aimed to evaluate the association between triglyceride glucose (TyG) index and incident T2DM among normal-weight people in rural China. Methods We included data from 5706 people with normal body mass index (BMI) (18.5–23.9 kg/m2) without baseline T2DM in a rural Chinese cohort followed for a median of 6.0 years. A Cox proportional-hazard model was used to assess the risk of incident T2DM by quartiles of TyG index and difference in TyG index between follow-up and baseline (TyG-D), estimating hazard ratios (HRs) and 95% confidence intervals (CIs). A generalized additive plot was used to show the nonparametric smoothed exposure–response association between risk of T2DM and TyG index as a continuous variable. TyG was calculated as ln [fasting triglyceride level (mg/dl) × fasting plasma glucose level (mg/dl)/2]. Results Risk of incident T2DM was increased with quartiles 2, 3 and 4 versus quartile 1 of TyG index (adjusted HR [aHR] 2.48 [95% CI 1.20–5.11], 3.77 [1.83–7.79], and 5.30 [2.21–12.71], Ptrend < 0.001 across quartiles of TyG index). Risk of incident T2DM was increased with quartile 4 versus quartile 1 of TyG-D (aHR 3.91 [2.22–6.87]). The results were consistent when analyses were restricted to participants without baseline metabolic syndrome and impaired fasting glucose level. The generalized additive plot showed cumulative increased risk of T2DM with increasing TyG index. Conclusions Risk of incident T2DM is increased with increasing TyG index among rural Chinese people, so the index might be an important indicator for identifying people at high risk of T2DM.
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