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Mastromauro C, Blasetti A, Primavera M, Ceglie L, Mohn A, Chiarelli F, Giannini C. Peculiar characteristics of new-onset Type 1 Diabetes during COVID-19 pandemic. Ital J Pediatr 2022; 48:26. [PMID: 35139895 PMCID: PMC8827260 DOI: 10.1186/s13052-022-01223-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/22/2022] [Indexed: 01/30/2023] Open
Abstract
Background The COVID-19 pandemic period is having a strong impact on the management of diabetes as well as other chronic diseases as shown by the most severe clinical presentation at onset. The aim of this study was to evaluate the severity of diabetic ketoacidosis (DKA) in youth with newly diagnosed type 1 diabetes in “Santissima Annunziata Hospital” (Chieti, Italy) during COVID-19 pandemic in comparison to the five previous years. Methods A retrospective population-based incidence study was performed. Data were obtained from hospital records of 172 patients with new onset type 1 diabetes divided into two groups according to the diagnosis: Group I, between January 2015 and February 2020; Group II, between March 2020 and April 2021. Data regarding anthropometric, socio-economic and laboratory test were analyzed. DKA (pH < 7.30) and different severity of the disease (severe pH < 7.10; moderate pH < 7.20, mild pH < 7.30) were evaluated. A Spearman correlation between pH values and the main variables of interest was performed. Results DKA frequency was increased by 19 percentage in Group II compared to Group I (55% vs 36%; P = 0.03) with a significant increased risk of severe DKA cases compared to the previous five years (severe DKA 22.5% vs. 8.4%, P = 0.01). pH values were significantly related with HbA1c, blood glucose and c-peptide values in all groups. In addition, in Group II but not in Group I, pH values correlated with Triglycerides and TG/HDL cholesterol ratio. Conclusions During COVID-19 pandemic the risk of more severe clinical presentation of type 1 diabetes at onset is increased. The correlation with lipid profile might suppose an additional effect of lifestyle changes beside the delay in the diagnosis. Modifications of health care system need to be implemented during this peculiar situation in order to avoid such a relevant complication at onset.
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Affiliation(s)
- Concetta Mastromauro
- Department of Pediatrics, University of Chieti, Chieti, Italy.,Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Annalisa Blasetti
- Department of Pediatrics, University of Chieti, Chieti, Italy.,Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Marina Primavera
- Department of Pediatrics, University of Chieti, Chieti, Italy.,Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Lucio Ceglie
- Department of Pediatrics, University of Chieti, Chieti, Italy.,Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Angelika Mohn
- Department of Pediatrics, University of Chieti, Chieti, Italy.,Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Francesco Chiarelli
- Department of Pediatrics, University of Chieti, Chieti, Italy.,Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Cosimo Giannini
- Department of Pediatrics, University of Chieti, Chieti, Italy. .,Department of Pediatrics, University of Chieti, Chieti, Italy.
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A Comparative Study of the Triglycerides/HDL Ratio and Pseudocholinesterase Levels in Patients with Bladder Cancer. Diagnostics (Basel) 2022; 12:diagnostics12020431. [PMID: 35204522 PMCID: PMC8871224 DOI: 10.3390/diagnostics12020431] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 01/28/2022] [Accepted: 02/03/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Lipid alterations may serve as potential tumour biomarkers. The ratio of triglycerides to HDL cholesterol (TG/HDL ratio) is associated with various cancers. Pseudocholinesterase (PChE) activity, involved in TG hydrolysis, plays an important role in the metabolism of lipoprotein. There is scarce data assessing the reliability of both the TG/HDL ratio and PChE levels in correctly classifying patients suffering from bladder cancer. METHODS Three hundred and ninety-six patients undergoing cystoscopy or transurethral resection of the bladder (TURB), broken into two major groups, i.e., patients with histologically confirmed, non-metastatic bladder cancer (n = 208) and without bladder cancer (no bladder cancer, n = 188), formed the study population. The last group was split into two subgroups consisting of a cohort of patients never suffering from bladder cancer but with other bladder diseases (no CaBD, n = 100) and another cohort formed by patients characterised by eradicated bladder cancer after TURB with no recurrence during a three-month follow-up (previous bladder cancer, n = 88). Pieces of information by both metabolic derangement (the presence of type 2 diabetes mellitus), hypertension and lipid profile were retrieved from patient records upon entry to the study. Sensitivity, specificity, areas under the ROC (AUROC) of the TG/HDL ratio, and PChE levels were used in diagnostic decision making. RESULTS The TG/HDL ratio as well as PChE concentrations of bladder cancer patients were significantly different when compared to those with previous bladder cancer and the no CaBD patients (p = 0.023 and 0.0004, respectively). There was an independent role of both the TG/HDL ratio and PChE levels in predicting the presence of bladder cancer (OR: 1.22 and 0.99, respectively), but the reliability of the TG/HDL ratio (AUROC: 0.587) was superior to that of PChE levels (AUROC: 0.374). The AUROC of a new parameter resulting from the combination of the TG/HDL ratio with PChE levels showed a further increment in the discriminant power of the bladder cancer presence (0.6298), interestingly with a negative predictive value (89%) according to the Bayesian approach. The cut-off of the TG/HDL ratio, the main marker of the present study that better distinguishes bladder cancer from no bladder cancer patients, was 2.147. DISCUSSION AND CONCLUSIONS The reliability of the TG/HDL ratio is based on the fact that this parameter likely mirrors the insulin resistance (IR) underlying bladder cancer patients. Furthermore, PChE levels evidence both IR and the associated non-alcoholic fatty liver disease. The TG/HDL ratio and PChE levels as well as their combined use could help physicians to assess/confirm the presence of this very common cancer, where early detection is important to ensure the best therapeutical approach.
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Chen Y, Chang Z, Liu Y, Zhao Y, Fu J, Zhang Y, Liu Y, Fan Z. Triglyceride to high-density lipoprotein cholesterol ratio and cardiovascular events in the general population: A systematic review and meta-analysis of cohort studies. Nutr Metab Cardiovasc Dis 2022; 32:318-329. [PMID: 34953633 DOI: 10.1016/j.numecd.2021.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/20/2021] [Accepted: 11/11/2021] [Indexed: 01/06/2023]
Abstract
AIMS The ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) has been regarded as a novel surrogate indicator of insulin resistance and the atherogenic index of plasma. This meta-analysis aimed to evaluate the association between the TG/HDL-C ratio and the incidence of cardiovascular events in the general population. DATA SYNTHESIS Cohort studies reporting the association between the TG/HDL-C ratio and cardiovascular events in the general population were obtained by a systematic literature search of PubMed, Embase and Web of Science databases until April 11, 2021. 13 cohort studies with a total of 207,515 participants were included in this meta-analysis. In a random-effects model, compared with those with the lowest category of the TG/HDL-C ratio, participants with the highest category were independently associated with a higher risk of cardiovascular events (pooled HR: 1.43, 95%CI: 1.26-1.62, I2 = 72.9%). For the presence of publication bias detected by the Egger's test (p = 0.011), correction for publication bias using the trim-and-fill method reduced the HR to 1.26 (95%CI: 1.11-1.44). This result was consistent with the finding of the TG/HDL-C ratio analyzed as a continuous variable (pooled HR per unit increment of the TG/HDL-C ratio: 1.08, 95%CI: 1.04-1.12, I2 = 67.0%). Subgroup analyses indicated that population gender, geographical region, duration of follow-up, adjustment for other lipid parameters, adjustment for diabetes and categorical number did not significantly vary the relationship. CONCLUSION Elevated TG/HDL-C ratio may be independently associated with an increased risk of cardiovascular events in the general population. More well-designed studies are needed to confirm the current findings. REGISTRATION NUMBER IN PROSPERO CRD42021244583.
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Affiliation(s)
- Yuxiong Chen
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Zhen'ge Chang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Yijie Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Yakun Zhao
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Jia Fu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Yongqiao Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Yanbo Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China.
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Xu H, Han G, Wang L, Ding H, Wang C, Ping X, Dong C, Zhang D, Dai Y, Li N, Li Y, Yang H, Zhu H, Pan H, Gong F, Chen J, Xing X. 25-hydroxyvitamin D levels are inversely related to metabolic syndrome risk profile in northern Chinese subjects without vitamin D supplementation. Diabetol Metab Syndr 2022; 14:23. [PMID: 35093150 PMCID: PMC8800320 DOI: 10.1186/s13098-022-00793-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/12/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The comparatively low 25 hydroxyvitamin D [25(OH)D] levels have been reported in patients with metabolic syndrome (MetS). Herein we investigated the cross-sectional and longitudinal relationships between serum 25(OH)D levels and MetS risk profile in northern middle-aged Chinese subjects without vitamin D supplementation. METHODS A cohort of 211 participants including 151 MetS patients and 60 controls at 20-69 years of age were enrolled from suburban Beijing, China. The recruited MetS patients were subjected to diet and exercise counselling for 1-year. All subjects at baseline and MetS patients after intervention underwent clinical evaluations. RESULTS Serum 25(OH)D levels were significantly decreased in MetS patients. 25(OH)D levels were inversely related to MetS score, fasting blood glucose (FBG) and triglyceride-glucose index (TyG) after adjusting for cofounders (all P < 0.05). Participants in the lowest tertile of 25(OH)D levels had increased odds for MetS (P = 0.045), elevated FBG (P = 0.004) in all subjects, and one MetS score gain in MetS patients (P = 0.005). Longitudinally, the metabolic statuses as well as 25(OH)D levels of MetS patients were significantly improved (all P < 0.05), and the increase of 25(OH)D levels were inversely related to MetS scores, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), FBG, and TyG, while positively related to high-density lipoprotein cholesterol (HDL-C) after adjusting for confounders. CONCLUSIONS 25(OH)D levels were significantly decreased in MetS patients, and it was negatively associated with metabolic dysfunctions at baseline and 1-year after. Metabolic aberrations of MetS patients were significantly ameliorated with 1-year follow-up counselling accompanying by notably elevated 25(OH)D levels.
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Affiliation(s)
- Hanyuan Xu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guiyan Han
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Linjie Wang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huihua Ding
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chunyan Wang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaochuan Ping
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Caixia Dong
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dianxi Zhang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yufei Dai
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Naishi Li
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yufeng Li
- Department of Endocrinology, Beijing Friendship Hospital Pinggu Campus, Capital Medical University, Beijing, China
| | - Hongbo Yang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huijuan Zhu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Pan
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengying Gong
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Jichun Chen
- Nutrition department, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, China.
| | - Xiaoping Xing
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Lee J, Ah Lee Y, Yong Lee S, Ho Shin C, Hyun Kim J. Comparison of Lipid-Derived Markers for Metabolic Syndrome in Youth: Triglyceride/HDL Cholesterol Ratio, Triglyceride-Glucose Index, and non-HDL Cholesterol. TOHOKU J EXP MED 2022; 256:53-62. [PMID: 35082184 DOI: 10.1620/tjem.256.53] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Triglyceride/high-density lipoprotein (HDL) cholesterol ratio (TG/HDL-C), triglyceride-glucose index (TyG), and non-HDL cholesterol level (non-HDL-C) have been proposed as surrogate markers for predicting metabolic syndrome (MetS). This study investigated whether these lipid-derived surrogate markers can predict MetS in Korean children and adolescents. Data from 1,814 participants were analyzed from the 2013-2016 Korean National Health and Nutrition Examination Survey. MetS was defined using three sets of criteria: Cook et al. (MetS1), de Ferranti et al. (MetS2), and the International Diabetes Federation (MetS3). The prevalence of MetS1, MetS2, and MetS3 was 4.6%, 11.3%, and 2.7%, respectively. In receiver operating characteristic curve analysis of MetS and lipid-derived surrogate markers, TG/HDL-C (0.937 for MetS1, 0.894 for MetS2, and 0.897 for MetS3) had the largest area under the curve (AUC), followed by TyG (0.906 for MetS1, 0.864 for MetS2, and 0.887 for MetS3), and non-HDL-C (0.752 for MetS1, 0.708 for MetS2, and 0.703 for MetS3) (all P < 0.001). The cutoff values for detecting MetS with TG/HDL-C, TyG, and non-HDL-C were 2.64, 8.52, and 111.6 for MetS1; 2.23, 8.47, and 110.7 for MetS2; and 2.64, 8.74, and 110.8 for MetS3, respectively. In conclusion, TG/HDL-C and TyG were similarly predictive of MetS. We propose using TG/HDL-C and TyG as surrogate markers for assessing MetS in Korean children and adolescents.
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Affiliation(s)
- Jieun Lee
- Departmentn of Pediatrics, Inje University College of Medicine, Ilsan Paik Hospital
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University College of Medicine.,Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine
| | - Seong Yong Lee
- Department of Pediatrics, Seoul National University College of Medicine.,Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University College of Medicine.,Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine
| | - Jae Hyun Kim
- Department of Pediatrics, Seoul National University College of Medicine.,Department of Pediatrics, Seoul National University Bundang Hospital
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Nur Zati Iwani AK, Jalaludin MY, Yahya A, Mansor F, Md Zain F, Hong JYH, Wan Mohd Zin RM, Mokhtar AH. TG: HDL-C Ratio as Insulin Resistance Marker for Metabolic Syndrome in Children With Obesity. Front Endocrinol (Lausanne) 2022; 13:852290. [PMID: 35370951 PMCID: PMC8965646 DOI: 10.3389/fendo.2022.852290] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/14/2022] [Indexed: 01/28/2023] Open
Abstract
Insulin resistance (IR) is an important variable in the diagnosis of metabolic syndrome (MetS). Currently, IR is not part of the existing pediatric definition of MetS, instead elevated fasting blood glucose (FBG) is measured as an indicator of hyperglycemia. Arguably, many obese children with severe IR are still able to regulate their FBG well. Hence, this study aimed to assess the utility of triglyceride-to-high-density lipoprotein cholesterol (TG : HDL-C) ratio as an IR marker in the modeling of pediatric MetS among children with obesity using structural equation modeling (SEM). A total of 524 blood samples from children with obesity (age 10-16 years old) were analyzed for FBG, lipids, insulin, leptin, and adiponectin. Both exploratory (EFA) and confirmatory factor analysis (CFA) were used to examine TG : HDL-C ratio as an IR marker in pediatric MetS. EFA shows that TG: HDL-C ratio (standardized factor loading = 0.904) groups together with homeostasis model assessment-estimated insulin resistance (HOMA-IR) (standardized factor loading = 0.664), indicating a strong correlation to the IR factor. Replacing FBG with TG: HDL-C ratio improved the modeling of MetS structure in children with obesity. Our MetS model of TG: HDL-C ratio as IR component shows comparable model fitness indices (goodness of fit, Akaike's information criterion, and Bayesian information criterion) with leptin:adiponectin ratio (platinum standard for adiposity:IR marker) model. The least model fit was seen when using FBG as an IR surrogate. TG : HDL-C ratio performed better as IR surrogate in MetS structures (standardized factor loading = 0.39) compared to FBG (standardized factor loading = 0.27). TG: HDL-C ratio may be considered as an IR component in pediatric MetS.
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Affiliation(s)
- Ahmad Kamil Nur Zati Iwani
- Endocrine and Metabolic Unit, Institute for Medical Research, Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Muhammad Yazid Jalaludin
- Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
- *Correspondence: Muhammad Yazid Jalaludin, ;
| | - Abqariyah Yahya
- Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Fazliana Mansor
- Endocrine and Metabolic Unit, Institute for Medical Research, Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Fuziah Md Zain
- Department of Pediatrics, Hospital Putrajaya, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Janet Yeow Hua Hong
- Department of Pediatrics, Hospital Putrajaya, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Ruziana Mona Wan Mohd Zin
- Endocrine and Metabolic Unit, Institute for Medical Research, Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Abdul Halim Mokhtar
- Department of Sports Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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Liu H, Liu J, Liu J, Xin S, Lyu Z, Fu X. Triglyceride to High-Density Lipoprotein Cholesterol (TG/HDL-C) Ratio, a Simple but Effective Indicator in Predicting Type 2 Diabetes Mellitus in Older Adults. Front Endocrinol (Lausanne) 2022; 13:828581. [PMID: 35282431 PMCID: PMC8907657 DOI: 10.3389/fendo.2022.828581] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/31/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND A simple and readily available biomarker can provide an effective approach for the surveillance of type 2 diabetes mellitus (T2DM) in the elderly. In this research, we aim to evaluate the role of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio as an indicator for new-onset T2DM in an elderly Chinese population aged over 75 years. METHODS This longitudinal retrospective cohort study was conducted using a free database from a health check screening project in China. Participants with baseline TG and HDL measurements were enrolled, and the data of T2DM development were collected. The cumulative incident T2DM rates in different quintile groups of TG/HDL-C ratio (Q1 to Q5) were calculated and plotted. The independent effect of baseline TG/HDL-C ratio on T2DM risk during the follow-up period was tested by the Cox proportional hazard model. Subgroup analysis was also conducted to clarify the role of TG/HDL-C ratio in specific populations. RESULTS A total of 231 individuals developed T2DM among 2,571 subjects aged over 75 years during follow-up. Regardless of adjustment for potential confounding variables, elevated TG/HDL-C ratio independently indicated a higher risk of incident T2DM [hazard ratio (HR) = 1.29; 95% confidence interval (CI), 1.14-1.47; P < 0.01. As compared with the lowest quintile (Q1), elevated TG/HDL-C ratio quintiles (Q2 to Q5) were associated with larger HR estimates of incident T2DM [HR (95% CI), 1.35 (0.85-2.17), 1.31 (0.83-2.06), 1.85 (1.20-2.85), and 2.10 (1.38-3.20), respectively]. In addition, a non-linear correlation was found between TG/HDL-C ratio and the risk of T2DM, and the slope of the curve decreased after the cutoff point of 2.54. Subgroup analysis revealed a stronger positive correlation among male individuals and those with body mass index <24 kg/m2. CONCLUSIONS Increased TG/HDL-C ratio indicates a greater risk of new-onset T2DM regardless of confounding variables. TG/HDL-C ratio is a simple but effective indicator in predicting T2DM in older adults. More future investigations are warranted to further promote the clinical application of TG/HDL-C ratio.
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Affiliation(s)
- Hongzhou Liu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- Department of Endocrinology, First Hospital of Handan City, Handan, China
| | - Jing Liu
- Clinics of Cadre, Department of Outpatient, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jixiang Liu
- Department of Cerebral Surgery, First Hospital of Handan City, Handan, China
| | - Shuanli Xin
- Department of Cardiology, First Hospital of Handan City, Handan, China
| | - Zhaohui Lyu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Xiaomin Fu, ; Zhaohui Lyu,
| | - Xiaomin Fu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Xiaomin Fu, ; Zhaohui Lyu,
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Ting YW, Jalaludin MY, Zaini AA, Mohamed R. Triglyceride to high-density lipoprotein cholesterol ratio is an independent predictor of liver fibrosis among pediatrics non-alcoholic fatty liver disease. Front Endocrinol (Lausanne) 2022; 13:1071350. [PMID: 36589844 PMCID: PMC9800858 DOI: 10.3389/fendo.2022.1071350] [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: 10/16/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Insulin resistance (IR), one of the key components of the metabolic syndrome, is recognized as the pathophysiological hallmark of non-alcoholic fatty liver disease (NAFLD). This study aims to investigate the relationship between surrogate markers of IR and the severity of NAFLD among overweight or obese children. METHODOLOGY A total of 56 consecutive children aged 6 to 18 years old were recruited from the pediatric obesity and type 2 diabetes mellitus (T2DM) clinic in University Malaya Medical Centre (UMMC) from 2016 to 2019. Data on anthropometric measurements, clinical components of metabolic syndrome and fasting serum insulin were collected. Triglyceride to high-density lipoprotein cholesterol ratio (TG: HDL-C), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and Single Point Insulin Sensitivity Estimator (SPISE) were calculated. Transient elastography was performed with hepatic steatosis and liver fibrosis assessed by controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), respectively. RESULTS A total of 44 children (78.6%) had liver steatosis and 35.7% had presence of significant liver fibrosis (stage F≥2). Majority (89.3%) are obese and 24 children (42.9%) were diagnosed with metabolic syndrome. Higher number of children with T2DM and significant liver fibrosis were associated with higher tertiles of TG: HDL-C ratio (p<0.05). Top tertile of TG: HDL-C ratio was an independent predictor of liver fibrosis (OR=8.14, 95%CI: 1.24-53.36, p=0.029). ROC analysis showed that the area under the curve (AUC) of HOMA-IR (0.77) and TG: HDL-C ratio (0.71) were greater than that of metabolic syndrome (0.70), T2DM (0.62) and SPISE (0.22). The optimal cut-off values of HOMA-IR and TG: HDL-C ratio for detecting liver fibrosis among children with NAFLD are 5.20 and 1.58, respectively. CONCLUSION Children with NAFLD and higher TG: HDL-C ratio are more likely to have liver fibrosis. TG: HDL-C ratio is a promising tool to risk stratify those with NAFLD who are at risk of developing advanced liver disease.
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Affiliation(s)
- Yi-Wen Ting
- Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Muhammad Yazid Jalaludin
- Endocrinology Unit, Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
- *Correspondence: Muhammad Yazid Jalaludin,
| | - Azriyanti Anuar Zaini
- Endocrinology Unit, Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Rosmawati Mohamed
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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Chen Y, Peng A, Chen Y, Kong X, Li L, Tang G, Li H, Chen Y, Jiang F, Li P, Zhang Q. Association of TyG Index with CT Features in Patients with Tuberculosis and Diabetes Mellitus. Infect Drug Resist 2022; 15:111-125. [PMID: 35068934 PMCID: PMC8767160 DOI: 10.2147/idr.s347089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/30/2021] [Indexed: 12/03/2022] Open
Abstract
Background The purpose of this study was to investigate the association of the triglyceride glucose (TyG) index, a surrogate marker of insulin resistance (IR) with a high sensitivity of 96.5% and a specificity of 85.0% for the diagnosis of IR, with computed tomography (CT) features in patients with tuberculosis and diabetes mellitus. Methods A total of 247 subjects were enrolled from July, 2020 to May, 2021. The basic clinical features and CT features were analyzed. In addition, multivariate logistic regression analysis models were employed to evaluate the association of the TyG indicator with CT features in participants. Results In the quartile groups of TyG index, air bronchial sign detection rate was 11.7%, 14.5%, 23.2%, and 44.1%; large segmented leafy shadow detection rate was 27.9%, 40.6%, 46.4%, and 66.2%; thick-walled cavity was found in 38.2%, 43.4%, 57.9%, and 69.1%; the rate of multiple cavities was 17.6%, 27.5%, 36.2%, 52.9%; the rate of lymph node enlargement was 22.1%, 17.4%, 28.9%, and 38.2%, respectively. In addition, the positive relation with the TyG index and the prevalence of abnormal CT signs was observed in the fully adjusted model: TyG, per one-unit increase: air bronchial sign: adjusted odds ratio (AOR) 3.92, 95% CI 1–15.35, P = 0.049; multiple cavities: AOR 4.1, 95% CI 1.26–13.31, P = 0.019; thick-walled cavity: AOR 2.89, 95% CI 1.05–8.03, P = 0.041. In quartile of TyG index, compared with patients in quartile 1, the AOR (95% CI) values for air bronchial sign in quartile 4 was 8.1 (1.7–44), p = 0.011; multiple cavities was 7.1 (1.7–32), p = 0.008; thick-walled cavity was 7.8 (1.9–34.7), p = 0.005. Conclusion The present study showed that an increased TyG index was positively related to the severity of patients with T2DM-PTB.
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Affiliation(s)
- Yong Chen
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
| | - Anzhou Peng
- Department of the Fifth Tuberculosis, Chongqing Public Health Medical Center, Chongqing, People’s Republic of China
| | - Yiqing Chen
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
| | - Xianghua Kong
- Department of the Fifth Tuberculosis, Chongqing Public Health Medical Center, Chongqing, People’s Republic of China
| | - Linyang Li
- Department of the Fifth Tuberculosis, Chongqing Public Health Medical Center, Chongqing, People’s Republic of China
| | - Guangxiao Tang
- Department of Radiology, Chongqing Public Health Medical Center, Chongqing, People’s Republic of China
| | - Huifen Li
- Department of the Fifth Tuberculosis, Chongqing Public Health Medical Center, Chongqing, People’s Republic of China
| | - Yu Chen
- Department of Medical Record Statistics Room, Chongqing Public Health Medical Center, Chongqing, People’s Republic of China
| | - Fan Jiang
- Department of the Fifth Tuberculosis, Chongqing Public Health Medical Center, Chongqing, People’s Republic of China
| | - Peibo Li
- Department of Physician Assistant, Chongqing Public Health Medical Center, Chongqing, People’s Republic of China
| | - Qiu Zhang
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
- Correspondence: Qiu Zhang; Peibo Li Tel +8613965015060; +8618709843713 Email ;
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Nosrati M, Safari M, Alizadeh A, Ahmadi M, Mahrooz A. The Atherogenic Index Log (Triglyceride/HDL-Cholesterol) as a Biomarker to Identify Type 2 Diabetes Patients with Poor Glycemic Control. Int J Prev Med 2021; 12:160. [PMID: 35070193 PMCID: PMC8724629 DOI: 10.4103/ijpvm.ijpvm_357_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/25/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Identifying appropriate biomarkers for predicting type 2 diabetes (T2D) patients with increased HbA1c may prove helpful in preventing increased risk of cardiovascular disease (CVD). The present study was conducted to analyze the diagnostic performance of the atherogenic index log (TG/HDL-C) in T2D patients with increased HbA1c. METHODS Patients with T2D were classified into two groups according to having an HbA1c <8% or ≥8%. Atherogenic index was calculated from the logarithmic transformation of TG/HDL-C. Receiver operating characteristic curve was used to evaluate the diagnostic performance of log (TG/HDL-C). Insulin and fasting glucose concentrations were used to determine homeostasis model assessment for insulin resistance (HOMA-IR). RESULTS Compared with the patients with HbA1c <8%, log (TG/HDL-C) was significantly higher in the patients with HbA1c ≥8% (p = 0.025). The atherogenic index was a biomarker for the prediction of T2D patients with HbA1c ≥8% versus patients with HbA1c <8%, as shown in the area under the curve (AUC = 0.61, P = 0.013). The best cut-off point of log (TG/HDL-C) for the discrimination between patients with HbA1c ≥8% versus patients with HbA1c <8% determined to be 0.44. Atherogenic index was significantly and positively correlated with HOMA-IR in female patients (r = 0.313, P = 0.003) and in patients with an age ≥5o (r = 0.253, P = 0.021). CONCLUSION The log (TG/HDL-C) in addition to its known association with enhanced CVD risk could be considered as a biomarker to predict T2D patients with poor glycemic control. Therefore, the increased ratio may provide a simple and useful way of identifying poor glycemic T2D patients who are possibly to be at elevated risk of CVD.
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Affiliation(s)
- Mani Nosrati
- Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mina Safari
- Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahad Alizadeh
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mehran Ahmadi
- Department of Biochemistry, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Abdolkarim Mahrooz
- Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran,Address for correspondence: Dr. Abdolkarim Mahrooz, Ph.D., Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Km 17 Khazarabad Road, Sari, Iran. E-mail:
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A novel diagnostic tool in determining insulin resistance in obese children: Triglyceride / HDL ratio. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.863978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Magen D, Halloun R, Galderisi A, Caprio S, Weiss R. Relation of glomerular filtration to insulin resistance and related risk factors in obese children. Int J Obes (Lond) 2021; 46:374-380. [PMID: 34725443 DOI: 10.1038/s41366-021-01001-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVE Childhood obesity is associated with later development of significant renal morbidity. We evaluated the impact of the degree of insulin sensitivity on estimated glomerular filtration rate (eGFR) and determined the factors associated with eGFR in obese children. We further tested the relation of eGFR to clinical outcomes such as blood pressure and microalbuminuria. MATERIALS AND METHODS We evaluated the relation of whole body insulin sensitivity and estimated glomerular filtration rate (eGFR) across the spectrum of obesity in children and adolescents. eGFR was calculated using the iCARE formula, which has been validated in obese children with varying glucose tolerance. RESULTS 1080 children and adolescents with overweight and obesity (701 females and 379 males) participated. Insulin sensitivity was a strongly negatively associated with (B = -2.72, p < 0.001) eGFR), even after adjustment for potential confounders. Male sex emerged to be significantly associated with eGFR with boys having greater values than girls (B = 18.82, p < 0.001). Age was a positively associated (B = 2.86, p < 0.001) with eGFR. Whole body and hepatic insulin sensitivity decreased across eGFR quartiles. Adjusted eGFR was tightly positively associated with systolic blood pressure (B = 0.09, p = 0.003) and negatively associated with the presence of microalbuminuria (B = -2.18, p = 0.04). CONCLUSIONS eGFR tends to increase with greater degrees of insulin resistance in children and adolescents representing hyperfiltration and is associated with cardiovascular risk factors. Longitudinal studies are needed to determine the natural history of childhood insulin resistance related hyperfiltration in regards to future kidney disease.
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Affiliation(s)
- Daniella Magen
- Department of Pediatrics, Ruth Children's Hospital, Rambam Medical Center, Haifa, Israel.,The Department of Pediatrics, Yale University, New-Haven, CT, USA
| | - Rana Halloun
- Department of Pediatrics, Ruth Children's Hospital, Rambam Medical Center, Haifa, Israel.,The Department of Pediatrics, Yale University, New-Haven, CT, USA
| | - Alfonso Galderisi
- Department of Woman and Child's Health, University of Padova, Padova, Italy
| | - Sonia Caprio
- The Department of Pediatrics, Yale University, New-Haven, CT, USA
| | - Ram Weiss
- Department of Pediatrics, Ruth Children's Hospital, Rambam Medical Center, Haifa, Israel. .,The Department of Pediatrics, Yale University, New-Haven, CT, USA.
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Eslam M, Alkhouri N, Vajro P, Baumann U, Weiss R, Socha P, Marcus C, Lee WS, Kelly D, Porta G, El-Guindi MA, Alisi A, Mann JP, Mouane N, Baur LA, Dhawan A, George J. Defining paediatric metabolic (dysfunction)-associated fatty liver disease: an international expert consensus statement. Lancet Gastroenterol Hepatol 2021; 6:864-873. [PMID: 34364544 DOI: 10.1016/s2468-1253(21)00183-7] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 12/11/2022]
Abstract
The term non-alcoholic fatty liver disease (NAFLD), and its definition, have limitations for both adults and children. The definition is most problematic for children, for whom alcohol consumption is usually not a concern. This problematic definition has prompted a consensus to rename and redefine adult NAFLD associated with metabolic dysregulation to metabolic (dysfunction)-associated fatty liver disease (MAFLD). Similarities, distinctions, and differences exist in the causes, natural history, and prognosis of fatty liver diseases in children compared with adults. In this Viewpoint we, an international panel, propose an overarching framework for paediatric fatty liver diseases and an age-appropriate MAFLD definition based on sex and age percentiles. The framework recognises the possibility of other coexisting systemic fatty liver diseases in children. The new MAFLD diagnostic criteria provide paediatricians with a conceptual scaffold for disease diagnosis, risk stratification, and improved clinical and multidisciplinary care, and they align with a definition that is valid across the lifespan.
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Affiliation(s)
- Mohammed Eslam
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, NSW, Australia.
| | - Naim Alkhouri
- Department of Hepatology, Arizona Liver Health, Chandler, AZ, USA
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Italy
| | - Ulrich Baumann
- Division of Pediatric Gastroenterology and Hepatology, Department of Pediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Ram Weiss
- Department of Pediatrics, Ruth Rappaport Children's Hospital, Rambam Medical Center, Technion School of Medicine, Haifa, Israel
| | - Piotr Socha
- Department of Gastroenterology, Hepatology, Nutritional Disorders and Paediatrics, Children's Memorial Health Institute, Warsaw, Poland
| | - Claude Marcus
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Way Seah Lee
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Deirdre Kelly
- The Liver Unit, Birmingham Women's & Children's Hospital, University of Birmingham, Birmingham, UK
| | - Gilda Porta
- Pediatric Hepatology, Transplant Unit, Hospital Sírio-Libanês, Hospital Municipal Infantil Menino Jesus, San Paulo, Brazil
| | - Mohamed A El-Guindi
- Department of Pediatric Hepatology, Gastroenterology and Nutrition, National Liver Institute, Menoufia University, Menoufia, Egypt
| | - Anna Alisi
- Research Unit of Molecular Genetics and Complex Phenotypes, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Jake P Mann
- Metabolic Research Laboratories, Institute of Metabolic Science, and Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Nezha Mouane
- Department of Pediatric Hepatology, Gastroenterology and Nutrition, Academic Children's Hospital, Mohammed V University, Rabat, Morocco; Department of Pediatric Hepatology, Gastroenterology and Nutrition, Children's Hospital of Rabat, Rabat, Morocco
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Anil Dhawan
- Paediatric Liver, GI and Nutrition Centre, and MowatLabs, King's College Hospital, London, UK
| | - Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, NSW, Australia
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Blum MR, Popat RA, Nagy A, Cataldo NA, McLaughlin TL. Using metabolic markers to identify insulin resistance in premenopausal women with and without polycystic ovary syndrome. J Endocrinol Invest 2021; 44:2123-2130. [PMID: 33687700 DOI: 10.1007/s40618-020-01430-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/17/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Insulin resistance (IR) is associated with increased risk for type 2 diabetes mellitus and cardiovascular disease. Quantifying IR is invasive and time-consuming, and thus not routinely used in clinical practice. Simple metabolic markers to predict IR exist, but have not been validated in premenopausal women or women with polycystic ovary syndrome (PCOS). OBJECTIVE To evaluate the ability of metabolic markers to identify premenopausal women with/without PCOS who are insulin resistant. DESIGN/SETTING Cross-sectional analysis. PARTICIPANTS One hundred and seventy-one non-diabetic premenopausal overweight/obese women without PCOS and 71 women with PCOS. METHODS IR was quantified by the steady-state plasma glucose during the modified insulin-suppression test. Metabolic markers (BMI, lipid/lipoprotein concentrations, and fasting glucose) were evaluated for their discriminative ability to identify IR, using area under the receiver-operating-characteristic curve (AUROC) analysis. Optimal cut-points were evaluated for predictive power. RESULTS In the non-PCOS group, the triglyceride/HDL cholesterol ratio (TG/HDL-C) was the best marker (AUROC 0.73). Optimal diagnostic cut-point was 1.9. In the PCOS group, the TG/HDL-C ratio, cholesterol/HDL-C ratio (TC/HDL-C), and HDL-C performed well (AUROC > 0.80), with optimal cut-points for TG/HDL-C 1.3, TC/HDL-C 3.4, and HDL-C 52 mg/dL: TG/HDL-C was more sensitive, but HDL-C had a higher PPV for IR. CONCLUSION TG/HDL-C can identify IR in premenopausal women with and/without PCOS; diagnostic cut-points differ from those of men and postmenopausal women. HDL-C is an alternative predictor in women with PCOS. These simple metabolic markers, which are standardized between labs, inexpensive, and routinely measured, can be used to tailor lifestyle and medical interventions to improve health outcomes in insulin-resistant premenopausal women.
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Affiliation(s)
- M R Blum
- Department of Health Research and Policy (Division of Epidemiology), Stanford University School of Medicine, Stanford, CA, USA
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - R A Popat
- Department of Health Research and Policy (Division of Epidemiology), Stanford University School of Medicine, Stanford, CA, USA
| | - A Nagy
- Division of Endocrinology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - N A Cataldo
- America Institute for Reproductive Medicine, Alabama, One Independence Plaza, Suite 810, Birmingham, AL, USA
| | - T L McLaughlin
- Division of Endocrinology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA.
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Sánchez-Escudero V, García Lacalle C, González Vergaz A, Mateo LR, Marqués Cabrero A. The triglyceride/glucose index as an insulin resistance marker in the pediatric population and its relation to eating habits and physical activity. ENDOCRINOL DIAB NUTR 2021; 68:296-303. [PMID: 34556259 DOI: 10.1016/j.endien.2020.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 08/27/2020] [Indexed: 10/20/2022]
Abstract
INTRODUCTION To examine the triglyceride/glucose index (TyG) as an insulin resistance marker in obese children and adolescents and its relation to clinical and biochemical parameters, body composition and lifestyle. PATIENTS AND METHOD Sixty patients aged 7-16 years of age were enrolled. Anthropometric variables were recorded, together with pubertal stage, blood pressure and body composition assessed by bioimpedance. The TyG index was calculated as ln (fasting glucose (mg/dL) × triglycerides (mg/dL))/2 and the HOMA (homeostatic model assessment) index as fasting insulin (μU/mL) × fasting glucose (mmol/L)/22.5. Feeding habits were documented by adherence to the Mediterranean dietary pattern questionnaire, while physical activity was assessed using the International Sedentary Assessment Tool (ISAT), as well as accelerometry (Actigraph wGT3X+). RESULTS The mean TyG index was 4.45 ± 0.18, and proved higher in the pubertal group. We found a positive correlation with the HOMA index (r = 0.39; P = 0.03) and TG/HDL-c index (r = 0.53; P < 0.001). The best cut-off point of the TyG index for predicting insulin resistance was 4.21 in prepubertal children (sensitivity 84%, specificity 100%; AUC: 0.84) and 4.33 in pubertal children (sensitivity 89%, specificity 69%; AUC: 0.61). A positive correlation was found with screen time (r = 0.39; P = 0.01), as well as a negative correlation with caloric expenditure (Kcal/day) in the prepubertal group (r = -0.81; P = 0.005). CONCLUSIONS The TyG index could be a useful insulin resistance marker in the pediatric population. Moderate to vigorous physical activity should be encouraged, as well as restricting screen time for leisure purposes, mainly in the prepubertal group.
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Affiliation(s)
| | - Concepción García Lacalle
- Servicio de Análisis Clínicos y Bioquímica Clínica, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - Amparo González Vergaz
- Unidad de Endocrinología Pediátrica, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - Laura Remedios Mateo
- Unidad de Endocrinología Pediátrica, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - Araceli Marqués Cabrero
- Unidad de Endocrinología Pediátrica, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
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Moran-Ramos S, Macias-Kauffer L, López-Contreras BE, Villamil-Ramírez H, Ocampo-Medina E, León-Mimila P, Del Rio-Navarro BE, Granados-Portillo O, Ibarra-Gonzalez I, Vela-Amieva M, Tovar AR, Torres N, Gomez-Perez FJ, Aguilar-Salinas C, Canizales-Quinteros S. A higher bacterial inward BCAA transport driven by Faecalibacterium prausnitzii is associated with lower serum levels of BCAA in early adolescents. Mol Med 2021; 27:108. [PMID: 34525937 PMCID: PMC8444488 DOI: 10.1186/s10020-021-00371-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/31/2021] [Indexed: 01/19/2023] Open
Abstract
Background Elevations of circulating branched-chain amino acids (BCAA) are observed in humans with obesity and metabolic comorbidities, such as insulin resistance. Although it has been described that microbial metabolism contributes to the circulating pool of these amino acids, studies are still scarce, particularly in pediatric populations. Thus, we aimed to explore whether in early adolescents, gut microbiome was associated to circulating BCAA and in this way to insulin resistance. Methods Shotgun sequencing was performed in DNA from fecal samples of 23 early adolescents (10–12 years old) and amino acid targeted metabolomics analysis was performed by LC–MS/MS in serum samples. By using the HUMAnN2 algorithm we explored microbiome functional profiles to identify whether bacterial metabolism contributed to serum BCAA levels and insulin resistance markers. Results We identified that abundance of genes encoding bacterial BCAA inward transporters were negatively correlated with circulating BCAA and HOMA-IR (P < 0.01). Interestingly, Faecalibacterium prausnitzii contributed to approximately ~ 70% of bacterial BCAA transporters gene count. Moreover, Faecalibacterium prausnitzii abundance was also negatively correlated with circulating BCAA (P = 0.001) and with HOMA-IR (P = 0.018), after adjusting for age, sex and body adiposity. Finally, the association between Faecalibacterium genus and BCAA levels was replicated over an extended data set (N = 124). Conclusions We provide evidence that gut bacterial BCAA transport genes, mainly encoded by Faecalibacterium prausnitzii, are associated with lower circulating BCAA and lower insulin resistance. Based on the later, we propose that the relationship between Faecalibacterium prausnitzii and insulin resistance, could be through modulation of BCAA.
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Affiliation(s)
- Sofia Moran-Ramos
- Consejo Nacional de Ciencia y Tecnología (CONACYT), Mexico City, Mexico. .,Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Periférico Sur No. 4809, Tlalpan, 14610, Mexico City, Mexico.
| | - Luis Macias-Kauffer
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Periférico Sur No. 4809, Tlalpan, 14610, Mexico City, Mexico
| | - Blanca E López-Contreras
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Periférico Sur No. 4809, Tlalpan, 14610, Mexico City, Mexico
| | - Hugo Villamil-Ramírez
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Periférico Sur No. 4809, Tlalpan, 14610, Mexico City, Mexico
| | - Elvira Ocampo-Medina
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Periférico Sur No. 4809, Tlalpan, 14610, Mexico City, Mexico
| | - Paola León-Mimila
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Periférico Sur No. 4809, Tlalpan, 14610, Mexico City, Mexico
| | | | - Omar Granados-Portillo
- Departamento de Fisiología de la Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Isabel Ibarra-Gonzalez
- Instituto de Investigaciones Biomédicas, UNAM - Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Marcela Vela-Amieva
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Armando R Tovar
- Departamento de Fisiología de la Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Nimbe Torres
- Departamento de Fisiología de la Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Francisco J Gomez-Perez
- Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas Y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Carlos Aguilar-Salinas
- Unidad de Investigación en Enfermedades Metabólicas and Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.,Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, 64710, Monterrey, NL, Mexico
| | - Samuel Canizales-Quinteros
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Periférico Sur No. 4809, Tlalpan, 14610, Mexico City, Mexico
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Rao C, Ping F. Second-trimester maternal lipid profiles rather than glucose levels predict the occurrence of neonatal macrosomia regardless of glucose tolerance status: A matched cohort study in Beijing. J Diabetes Complications 2021; 35:107948. [PMID: 34024685 DOI: 10.1016/j.jdiacomp.2021.107948] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/18/2021] [Accepted: 05/08/2021] [Indexed: 01/15/2023]
Abstract
AIMS The mechanism underlying fetal overgrowth during pregnancy remains elusive. We aimed to establish a predictive model to identify the high-risk individuals with macrosomia in the second trimester of pregnancy. DESIGN A total of 2577 pregnant women with a routine 75-g oral glucose tolerance test during 24-28 gestational weeks were screened in a prospective cohort. Gestational diabetes mellitus (GDM) cases were 1:1 matching with age (±2 years) in normal glucose tolerance (NGT) ones from the same region. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve were performed to determine the index and its inflection point for predicting macrosomia occurrence. RESULTS The data of perinatal outcomes of 565 GDM and 549 NGT who had given birth to single live babies at term were analyzed. Notably, we found serum apolipoprotein B (ApoB) level higher than 4.04 g/L combined with triglycerides (TG)/high-density lipoprotein cholesterol (HDLC) ratio above 1.36 formed the predictive model in both groups. The area under the ROC curve of this predictive model included ApoB and TG/HDL-C reached 0.807 (95% CI: 0.771-0.873) with a sensitivity of 71.9% and a specificity of 78.6%. Mediation analysis revealed that ApoB and TG/HDL-C ratio mediated the harmful effect of FBG on the risk of macrosomia. CONCLUSION Maternal ApoB levels and TG/HDL-C ratio could predict macrosomia occurrence in pregnancy, which might be a new target for early intervention to prevent excess fetal growth.
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Affiliation(s)
- Chong Rao
- Department of Endocrinology, Beijing ChuiYangLiu Hospital, Beijing 100022, China
| | - Fan Ping
- Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Endocrinology Assigned by Ministry of Health, Beijing 100730, China.
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Wu Z, Zhou D, Liu Y, Li Z, Wang J, Han Z, Miao X, Liu X, Li X, Wang W, Guo X, Tao L. Association of TyG index and TG/HDL-C ratio with arterial stiffness progression in a non-normotensive population. Cardiovasc Diabetol 2021; 20:134. [PMID: 34229681 PMCID: PMC8262008 DOI: 10.1186/s12933-021-01330-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/28/2021] [Indexed: 12/17/2022] Open
Abstract
Background Cross-sectional studies have reported that insulin resistance (IR) is associated with arterial stiffness. However, the relationship between IR and arterial stiffness progression remains unclear. This study aims to evaluate the association of triglyceride glucose (TyG) index and triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio with arterial stiffness progression in a non-normotensive population. Methods A total of 1895 prehypertensive (systolic pressure 120–139 mmHg or diastolic pressure 80–90 mmHg) or hypertensive (systolic pressure ≥ 140 mmHg or diastolic pressure ≥ 90 mmHg or using antihypertensive medication) participants were enrolled in 2013 and 2014, and followed until December 31, 2019. Arterial stiffness progression was measured by brachial-ankle pulse wave velocity (baPWV) change (absolute difference between baseline and last follow-up), baPWV change rate (change divided by following years), and baPWV slope (regression slope between examination year and baPWV). Results During a median follow-up of 4.71 years, we observed an increasing trend of baPWV in the population. There were linear and positive associations of the TyG index and TG/HDL-C ratio with the three baPWV parameters. The difference (95% CI) in baPWV change (cm/s) comparing participants in the highest quartile versus the lowest of TyG index and TG/HDL-C ratio were 129.5 (58.7–200.0) and 133.4 (52.0–214.9), respectively. Similarly, the evaluated baPWV change rates (cm/s/year) were 37.6 (15.3–60.0) and 43.5 (17.8–69.2), while the slopes of baPWV were 30.6 (9.3–51.8) and 33.5 (9.0–58.0). The observed association was stronger in the hypertensive population. Conclusion Our study indicates that the TyG index and TG/HDL-C ratio are significantly associated with arterial stiffness progression in hypertensive population, not in prehypertensive population. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-021-01330-6.
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Affiliation(s)
- Zhiyuan Wu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Di Zhou
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Yue Liu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Zhiwei Li
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Jinqi Wang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Ze Han
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xinlei Miao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xiangtong Liu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - Wei Wang
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Xiuhua Guo
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China. .,Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia.
| | - Lixin Tao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China. .,Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia.
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Zhang F, Zhang Y, Guo Z, Yang H, Ren M, Xing X, Cong H. The association of triglyceride and glucose index, and triglyceride to high-density lipoprotein cholesterol ratio with prehypertension and hypertension in normoglycemic subjects: A large cross-sectional population study. J Clin Hypertens (Greenwich) 2021; 23:1405-1412. [PMID: 34118112 PMCID: PMC8678664 DOI: 10.1111/jch.14305] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/13/2021] [Accepted: 05/22/2021] [Indexed: 12/22/2022]
Abstract
Insulin resistance (IR) plays an important role in the development of hypertension. Triglyceride and glucose index (TyG index), and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-c) as effective IR surrogate indexes have been verified in numerous studies. Therefore, the authors conducted a large cross-sectional study to explore the association of TyG index and TG/HDL-c with prehypertension and hypertension in the same normoglycemic subjects from Tianjin, China. A total of 32 124 adults were eligible for this study. According to the level of blood pressure, the enrolled individuals were divided into three groups, which were normotension, prehypertension, and hypertension. In multiple logistic regression analysis, there was associated with prehypertension and hypertension when comparing the highest TyG index to the lowest TyG index and corresponding ORs were 1.795 (1.638, 1.968) and 2.439 (2.205, 2.698), respectively. For TG/HDL-c, the corresponding ORs were 1.514 (1.382, 1.658) and 1.934 (1.751, 2.137), respectively. Furthermore, when comparing the fourth quartile to the first quartile of TyG index and TG/HDL-c, respectively, both corresponding ORs of hypertension were higher than prehypertension. Elevated TyG index and TG/HDL-c levels were associated with prehypertension and hypertension in normoglycemic individuals. Moreover, the TyG index was more significant than TG/HDL-c in distinguishing hypertension. They have the potential to become cost-effective monitors in the hierarchical management of prehypertension and hypertension.
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Affiliation(s)
| | | | | | - Hua Yang
- Tianjin Chest Hospital, Tianjin, China
| | - Min Ren
- Tianjin Cardiovascular Institute, Tianjin, China
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Maguolo A, Olivieri F, Zusi C, Miraglia Del Giudice E, Morandi A, Maffeis C. The risk of metabolic derangements is higher in children and adolescents with overweight or obesity born small for gestational age. Nutr Metab Cardiovasc Dis 2021; 31:1903-1910. [PMID: 33941428 DOI: 10.1016/j.numecd.2021.02.025] [Citation(s) in RCA: 3] [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] [Received: 09/22/2020] [Revised: 02/01/2021] [Accepted: 02/22/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Birth weight (BW) has been associated with the risk of obesity and metabolic derangements in children and adults. The aims of this study were: i. to evaluate the distribution of BW in a sample of overweight and obese children and adolescents compared with the general reference population; ii. to explore the relationship between the BW and insulin resistance and other cardiometabolic derangements in a population of children and adolescents with overweight and obesity. METHODS AND RESULTS 710 overweight and obese children and adolescents were recruited and categorized into small (SGA), appropriate (AGA), and large (LGA) for gestational age, according to the BW percentile. Arterial blood pressure, lipid profile, glucose metabolism and hepatic steatosis were evaluated to assess cardiometabolic obesity-related derangements. The distribution of BW categories in our population was significantly different compared with the general population (SGA 6.9% vs. 8.6%, AGA 74.6% vs. 81.4%, LGA 18.5% vs. 10%; p < 0.0001). We found a higher frequency of prediabetes conditions (21.7% vs 8.9%, OR 2.97, 95% CI 1.38-6.38, p = 0.005) and borderline/high low-density lipoprotein cholesterol (31.8% vs 18.6%, OR 2.13, 95% CI 1.09-4.18, p = 0.033) in overweight and obese children born SGA compared to those born non-SGA, independently of age, sex, and BMI. CONCLUSIONS BW is a risk factor of cardiometabolic derangements in a population of children and adolescents with overweight and obesity. Therefore, adequate obesity prevention strategies should be planned for children born SGA to minimize their risk to become obese and to reduce their short- and long-term cardiometabolic risks.
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Affiliation(s)
- Alice Maguolo
- Pediatric Diabetes and Metabolic Disorders, Department of Surgical Sciences, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
| | - Francesca Olivieri
- Pediatric Diabetes and Metabolic Disorders, Department of Surgical Sciences, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
| | - Chiara Zusi
- Pediatric Diabetes and Metabolic Disorders, Department of Surgical Sciences, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
| | - Emanuele Miraglia Del Giudice
- Department of the Woman, Child, General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Anita Morandi
- Pediatric Diabetes and Metabolic Disorders, Department of Surgical Sciences, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders, Department of Surgical Sciences, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy.
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Jachthuber Trub C, Balikcioglu M, Freemark M, Bain J, Muehlbauer M, Ilkayeva O, White PJ, Armstrong S, Østbye T, Grambow S, Gumus Balikcioglu P. Impact of lifestyle Intervention on branched-chain amino acid catabolism and insulin sensitivity in adolescents with obesity. ENDOCRINOLOGY DIABETES & METABOLISM 2021; 4:e00250. [PMID: 34277974 PMCID: PMC8279626 DOI: 10.1002/edm2.250] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Revised: 02/16/2021] [Accepted: 03/13/2021] [Indexed: 12/30/2022]
Abstract
Insulin resistance in adolescents with obesity associates with a sex‐dependent metabolic ‘signature’ comprising branched‐chain amino acids (BCAAs), glutamate and C3/C5 acylcarnitines (C3/C5), implicating altered flux through BCAA catabolic pathways. Here, we investigated the effects of lifestyle intervention on BCAA catabolism and insulin sensitivity. We hypothesized (1) weight reduction and improved insulin sensitivity associate with enhanced BCAA catabolism; (2) baseline BCAAs and their metabolic by‐products predict changes in weight and insulin sensitivity during lifestyle intervention.
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Affiliation(s)
| | | | - Michael Freemark
- Division of Pediatric Endocrinology and Diabetes and the Duke Molecular Physiology Institute Duke University Medical Center Durham NC USA
| | - James Bain
- Duke Molecular Physiology Institute Duke Molecular Physiology Institute Duke University Medical Center Durham NC USA
| | - Michael Muehlbauer
- Duke Molecular Physiology Institute Duke Molecular Physiology Institute Duke University Medical Center Durham NC USA
| | - Olga Ilkayeva
- Duke Molecular Physiology Institute Duke Molecular Physiology Institute Duke University Medical Center Durham NC USA
| | - Phillip J White
- Duke Molecular Physiology Institute Duke Molecular Physiology Institute Duke University Medical Center Durham NC USA
| | - Sarah Armstrong
- Division of General Pediatrics Duke University Medical Center Durham NC USA.,Department of Family Medicine and Community Health Duke University Medical Center Durham NC USA.,Department of Population Health Sciences Duke University Medical Center Durham NC USA.,Duke Clinical Research Institute Duke University Medical Center Durham NC USA
| | - Truls Østbye
- Department of Family Medicine and Community Health Duke University Medical Center Durham NC USA
| | - Steven Grambow
- Department of Biostatistics and Bioinformatics Duke University Medical Center Durham NC USA
| | - Pinar Gumus Balikcioglu
- Division of Pediatric Endocrinology and Diabetes and the Duke Molecular Physiology Institute Duke University Medical Center Durham NC USA
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Value of simple clinical parameters to predict insulin resistance among newly diagnosed patients with type 2 diabetes in limited resource settings. PLoS One 2021; 16:e0248469. [PMID: 33788827 PMCID: PMC8011789 DOI: 10.1371/journal.pone.0248469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 02/09/2021] [Indexed: 11/19/2022] Open
Abstract
Background Insulin resistance (IR) has been considered as a therapeutic target in the management of type 2 diabetes mellitus (T2DM). Readily available, simple and low cost measures to identify individuals with IR is of utmost importance for clinicians to plan optimal management strategies. Research on the associations between surrogate markers of IR and routine clinical and lipid parameters have not been carried out in Sri Lanka, a developing country with rising burden of T2DM with inadequate resources. Therefore, we aimed to study the utility of readily available clinical parameters such as age, body mass index (BMI), waist circumference (WC) and triglyceride to high density lipoprotein cholesterol ratio (TG/HDL-C) in the fasting lipid profile in predicting IR in a cohort of patients with newly diagnosed T2DM in Sri Lanka. Methods and findings We conducted a community based cross sectional study involving of 147 patients (age 30–60 years) with newly diagnosed T2DM in a suburban locality in Galle district, Sri Lanka. Data on age, BMI, WC, fasting plasma glucose (FPG) concentration, fasting insulin concentration and serum lipid profile were collected from each subject. The indirect IR indices namely homeostasis model assessment (HOMA), quantitative insulin sensitivity check index (QUICKI) and McAuley index (MCA) were estimated. Both clinical and biochemical parameters across the lowest and the highest fasting insulin quartiles were compared using independent sample t-test. Linear correlation analysis was performed to assess the correlation between selected clinical parameters and indirect IR indices. The area under the receiver operating characteristic (ROC) curve was obtained to calculate optimal cut-off values for the clinical markers to differentiate IR. BMI (p<0.001) and WC (p = 0.01) were significantly increased whereas age (p = 0.06) was decreased and TG/HDL-C (p = 0.28) was increased across the insulin quartiles. BMI and WC were significantly correlated (p<0.05) with HOMA, QUICKI and MCA. Out of the clinical parameters, age showed a borderline significant correlation with QUICKI and TG/HDL-C showed a significant correlation only with MCA. The area under ROC of BMI was 0.728 (95% CI 0.648–0.809; p<0.001) and for WC, it was 0.646 (95% CI 0.559–0.734; p = 0.003). The optimized cut-off value for BMI and WC were 24.91 kg/m2 and 81.5 cm respectively to differentiate the patients with IR or ID. Study limitations include small sample size due to recruitment of patients only from a limited geographical locality of the country and not totally excluding of the possibility of inclusion of some patients with slowly progressive type 1 DM or Latent onset diabetes of adulthood from the study population. Conclusions The results revealed that there was a significant positive correlation between BMI, WC and HOMA while a significant negative correlation with QUICKI and MCA among the cohort of patients with newly diagnosed T2DM. The cut-off values of BMI and WC as 24.91 kg/m2 and 81.5 cm respectively could be used as simple clinical parameters to identify IR in newly diagnosed patients with T2DM. Our results could be beneficial in rational decision making in the management of newly diagnosed patients with T2DM in limited resource settings.
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Nie G, Hou S, Zhang M, Peng W. High TG/HDL ratio suggests a higher risk of metabolic syndrome among an elderly Chinese population: a cross-sectional study. BMJ Open 2021; 11:e041519. [PMID: 33753431 PMCID: PMC7986938 DOI: 10.1136/bmjopen-2020-041519] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES To investigate the relationship between triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio and metabolic syndrome in the elderly population of China, and to determine the best critical value of TG/HDL-C in higher risk of metabolic syndrome in this population. DESIGN Cross-sectional study. SETTING Our study was conducted in a community physical examination centre in Wuhan, China between 1 January 2016 and 31 December 2016. PARTICIPANTS The physical examination data from 1267 elderly people (aged over 65 years) in the community were analysed in this study. The average age of the study participants was 71.64±5.605 years. PRIMARY OUTCOME MEASURES Correlation between the TG/HDL-C ratio and metabolic syndrome; the optimum cut-off of the TG/HDL-C ratio for the prediction of metabolic syndrome. RESULTS The TG/HDL-C ratio showed a significant positive correlation with metabolic syndrome (r=0.420, p<0.001) in the elderly Chinese population. Binary logistic regression analysis showed that the TG/HDL-C ratio was an independent risk factor for metabolic syndrome (OR=3.07 (95% CI: 2.402 to 3.924), p<0.001) after adjusting for blood pressure, blood glucose, age, sex and body mass index. The receiver operating characteristic curves of TG/HDL-C ratio and metabolic syndrome showed that in the elderly population, a TG/HDL-C ratio of 1.49 can be used as the critical value for a higher risk of metabolic syndrome. At this value, the specificity and sensitivity of the measure were optimal (80.8% and 72.4%, respectively). CONCLUSION In this study, we found a significant correlation between TG/HDL-C ratio and metabolic syndrome. And high TG/HDL ratio suggests a higher risk of metabolic syndrome among an elderly Chinese population.
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Affiliation(s)
- Guqiao Nie
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, Hubei, China
| | - Shukai Hou
- Community health service center, Gutian street, Qiaokou District, WuHan, HuBei, China
| | - Meng Zhang
- Department of General practice, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, HuBei, China
| | - Wen Peng
- Department of General Practice, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, Hubei, China
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Shen M, Xu X, Liu X, Wang Q, Li W, You X, Peng R, Yuan Y, Long P, Niu R, Yang H, Cheng X, Pan A, Tanguay RM, Zhang X, He M, Wang C, Liang L, Wu T. Prospective Study on Plasma MicroRNA-4286 and Incident Acute Coronary Syndrome. J Am Heart Assoc 2021; 10:e018999. [PMID: 33719498 PMCID: PMC8174203 DOI: 10.1161/jaha.120.018999] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Mounting evidence suggests that circulating microRNAs (miRNAs) are critical indicators of cardiovascular disease. However, prospective studies linking circulating miRNAs to incident acute coronary syndrome (ACS) are limited, and the underlying effect of associated miRNA on incident ACS remains unknown. Methods and Results Based on a 2-stage prospective nested case-control design within the Dongfeng-Tongji cohort, we profiled plasma miRNAs from 23 pairs of incident ACS cases and controls by microarray and validated the candidate miRNAs in 572 incident ACS case-control pairs using quantitative real-time polymerase chain reaction. We observed that plasma miR-4286 was associated with higher risk of ACS (adjusted odds ratio according to an interquartile range increase, 1.26 [95% CI, 1.07-1.48]). Further association analysis revealed that triglyceride was positively associated with plasma miR-4286, and an interquartile range increase in triglyceride was associated with an 11.04% (95% CI, 3.77%-18.83%) increase in plasma miR-4286. In addition, the Mendelian randomization analysis suggested a potential causal effect of triglyceride on plasma miR-4286 (β coefficients: 0.27 [95% CI, 0.01-0.53] and 0.27 [95% CI, 0.07-0.47] separately by inverse variance-weighted and Mendelian randomization-pleiotropy residual sum and outlier tests). Moreover, the causal mediation analysis indicated that plasma miR-4286 explained 5.5% (95% CI, 0.7%-17.0%) of the association of triglyceride with incident ACS. Conclusions Higher level of plasma miR-4286 was associated with an increased risk of ACS. The upregulated miR-4286 in plasma can be attributed to higher triglyceride level and may mediate the effect of triglyceride on incident ACS.
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Affiliation(s)
- Miaoyan Shen
- Department of Occupational and Environmental Health Key Laboratory of Environment and Health Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Xuedan Xu
- Department of Occupational and Environmental Health Key Laboratory of Environment and Health Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Xuezhen Liu
- Department of Occupational and Environmental Health Key Laboratory of Environment and Health Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Qiuhong Wang
- Department of Occupational and Environmental Health Key Laboratory of Environment and Health Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Wending Li
- Department of Occupational and Environmental Health Key Laboratory of Environment and Health Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Xiaomin You
- Department of Occupational and Environmental Health Key Laboratory of Environment and Health Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Rong Peng
- Department of Occupational and Environmental Health Key Laboratory of Environment and Health Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Yu Yuan
- Department of Occupational and Environmental Health Key Laboratory of Environment and Health Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Pinpin Long
- Department of Occupational and Environmental Health Key Laboratory of Environment and Health Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Rundong Niu
- Department of Occupational and Environmental Health Key Laboratory of Environment and Health Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Handong Yang
- Department of Cardiovascular Diseases Sinopharm Dongfeng General HospitalHubei University of Medicine Shiyan China
| | - Xiang Cheng
- Laboratory of Cardiovascular Immunology Department of Cardiology Union HospitalTongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - An Pan
- Department of Epidemiology and Biostatistics School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Robert M Tanguay
- Laboratory of Cellular and Developmental Genetics Department of Molecular Biology, Medical Biochemistry and Pathology Faculty of Medicine IBIS and PROTEOUniversité Laval Québec Canada
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health Key Laboratory of Environment and Health Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Meian He
- Department of Occupational and Environmental Health Key Laboratory of Environment and Health Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Chaolong Wang
- Department of Epidemiology and Biostatistics School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Liming Liang
- Department of Biostatistics and Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA
| | - Tangchun Wu
- Department of Occupational and Environmental Health Key Laboratory of Environment and Health Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology Wuhan China
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Xue J, Wang Y, Li B, Yu S, Wang A, Wang W, Gao Z, Tang X, Yan L, Wan Q, Qin G, Chen L, Ning G, Mu Y. Triglycerides to high-density lipoprotein cholesterol ratio is superior to triglycerides and other lipid ratios as an indicator of increased urinary albumin-to-creatinine ratio in the general population of China: a cross-sectional study. Lipids Health Dis 2021; 20:13. [PMID: 33588849 PMCID: PMC7883433 DOI: 10.1186/s12944-021-01442-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Abstract
Background Dyslipidemia contributes to the pathogenesis of renal dysfunction. Previous research demonstrated that triglycerides (TG), instead of other individual lipid indexes, has a significant link with elevated urinary albumin-to-creatinine ratio (UACR). However, it is unclear whether lipid ratios are superior indicators of increased UACR compared with TG. This research is to determine whether there are close relationships of lipid ratios with UACR in a general population. Methods 35,751 participants from seven centers across China were enrolled. UACR equal or higher than 30 mg/g was recognized as increased albuminuria. The associations of TG, low-density lipoprotein cholesterol (LDL-C)/ high-density lipoprotein cholesterol (HDL-C), TG/HDL-C and non-high-density lipoprotein cholesterol (non-HDL-C)/HDL-C with increased UACR were evaluated by linear and logistic regression analyses in females and males separately. Results There were 3692 (14.8%) female subjects, and 1307 (12.0%) male subjects characterized as having increased UACR. There were significantly differences in TG/HDL-C and non-HDL-C/HDL-C between the normal UACR group and the increased UACR group, while LDL-C/HDL-C was not. Furthermore, linear regression analysis was implemented and showed that TG and TG/HDL-C were both positively related to UACR even after a variety of potential confounders were adjusted regardless of sexes, while the correlation between non-HDL-C/HDL-C and elevated UACR were only significant in females. Further analyses utilizing logistic regression demonstrated that compared with non-HDL-C/HDL-C and TG, TG/HDL-C showed the strongest association with increased UACR (quartile 1 of TG/HDL-C as a reference; OR [95% CI] of quartile 4: 1.28 [1.13–1.44] in women, 1.24 [1.02–1.50] in men) after fully adjusting for potential confounding factors. Stratified analyses revealed that in males who were overweight and in females who were overweight or over 55 years or had prediabetes or prehypertension, TG/HDL-C had significant associations with abnormal UACR. Conclusions Compared with TG and other routine lipid ratios, TG/HDL-C is a superior indicator for increased UACR. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01442-8.
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Affiliation(s)
- Jing Xue
- Medical School of Chinese PLA, Beijing, China.,Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Haidian district, Beijing, 100853, China
| | - Yuxia Wang
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Haidian district, Beijing, 100853, China
| | - Bing Li
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Haidian district, Beijing, 100853, China
| | - Songyan Yu
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Haidian district, Beijing, 100853, China
| | - Anping Wang
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Haidian district, Beijing, 100853, China
| | - Weiqing Wang
- Shanghai Jiaotong University Affiliated Ruijin Hospital, Shanghai, China
| | - Zhengnan Gao
- Center Hospital of Dalian, Dalian, Liaoning, China
| | - Xulei Tang
- First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Li Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qin Wan
- Affiliated Hospital of Luzhou Medical College, Luzhou, Sichuan, China
| | - Guijun Qin
- Zhengzhou University First affiliated Hospital, Zhengzhou, Henan, China
| | - Lulu Chen
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Guang Ning
- Shanghai Jiaotong University Affiliated Ruijin Hospital, Shanghai, China
| | - Yiming Mu
- Medical School of Chinese PLA, Beijing, China. .,Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Haidian district, Beijing, 100853, China.
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Sánchez-Escudero V, García Lacalle C, González Vergaz A, Remedios Mateo L, Marqués Cabrero A. The triglyceride / glucose index as an insulin resistance marker in the pediatric population and its relation to eating habits and physical activity. ACTA ACUST UNITED AC 2021; 68:296-303. [PMID: 33579639 DOI: 10.1016/j.endinu.2020.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION To examine the triglyceride/glucose index (TyG) as an insulin resistance marker in obese children and adolescents and its relation to clinical and biochemical parameters, body composition and lifestyle. PATIENTS AND METHOD Sixty patients aged 7-16 years of age were enrolled. Anthropometric variables were recorded, together with pubertal stage, blood pressure and body composition assessed by bioimpedance. The TyG index was calculated as ln (fasting glucose (mg/dL)×triglycerides (mg/dL))/2 and the HOMA (homeostatic model assessment) index as fasting insulin (μU/mL)×fasting glucose (mmol/L)/22.5. Feeding habits were documented by adherence to the Mediterranean dietary pattern questionnaire, while physical activity was assessed using the International Sedentary Assessment Tool (ISAT), as well as accelerometry (Actigraph wGT3X+). RESULTS The mean TyG index was 4.45±0.18, and proved higher in the pubertal group. We found a positive correlation with the HOMA index (r=0.39; P=.03) and TG/HDL-c index (r=0.53; P<.001). The best cut-off point of the TyG index for predicting insulin resistance was 4.21 in prepubertal children (sensitivity 84%, specificity 100%; AUC: 0.84) and 4.33 in pubertal children (sensitivity 89%, specificity 69%; AUC: 0.61). A positive correlation was found with screen time (r=0.39; P=.01), as well as a negative correlation with caloric expenditure (Kcal/day) in the prepubertal group (r=-0.81; P=.005). CONCLUSIONS The TyG index could be a useful insulin resistance marker in the pediatric population. Moderate to vigorous physical activity should be encouraged, as well as restricting screen time for leisure purposes, mainly in the prepubertal group.
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Affiliation(s)
| | - Concepción García Lacalle
- Servicio de Análisis Clínicos y Bioquímica Clínica, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
| | - Amparo González Vergaz
- Unidad de Endocrinología Pediátrica, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
| | - Laura Remedios Mateo
- Unidad de Endocrinología Pediátrica, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
| | - Araceli Marqués Cabrero
- Unidad de Endocrinología Pediátrica, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
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78
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Gender dependent differences in lipid metabolism in individuals with type 2 diabetes mellitus. J Diabetes Metab Disord 2021; 19:967-977. [PMID: 33520816 DOI: 10.1007/s40200-020-00589-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/13/2020] [Indexed: 12/18/2022]
Abstract
Aim The present study investigates gender dependent effects of insulin resistance on lipid profile and adipocytokines in individuals with diabetes receiving oral antidiabetic drugs (OADs). The aim was also to reveal the changes in the expression of genes involved in lipid metabolism and inflammation. Methods Lipid profile, adipocytokine levels and homeostatic model assessment of insulin resistance (HOMA-IR) was assessed in 100 patients with diabetes (M = 43, F = 57) matched for age and gender with healthy individuals (M = 45, F = 55). The expression pattern of genes was analyzed by quantitative real time PCR. Results Males consuming metformin with other drugs exhibited a positive association between HOMA-IR and cholesterol, triglyceride and very low density lipoprotein (VLDL). Females consuming only metformin and metformin with other drugs, showed a positive association of HOMA-IR with cholesterol and a negative association with adiponectin. In males and females with diabetes, a comparable expression of peroxisome proliferator activated receptor γ (PPARγ) while higher expression of sterol regulatory element binding protein 1 (SREBP1) was observed. Expression of fatty acid synthase (FAS), long chain acyl CoA Synthetases (ACSL), malonyl-CoA-acyl carrier protein transacylase (MCAT) and nuclear factor kappa β (NFkβ) was higher in men with diabetes than healthy males. Expression of tumor necrosis factor α (TNF-α) was higher in males and females with diabetes than respective healthy genders. Conclusion Insulin resistance adversely affects lipid profile, adipocytokines in males with type 2 diabetes. Expression of genes involved in lipid metabolism and inflammation is found to be undesirably and differentially altered in both the genders.
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79
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Senoymak MC, Ozkan H. Evaluation of the Relationship between Insulin Resistance and HBV DNA Level in Patients with HBeAg-negative Chronic HBV Infection (Natural Course Phase 3). Euroasian J Hepatogastroenterol 2021; 10:85-91. [PMID: 33511070 PMCID: PMC7801890 DOI: 10.5005/jp-journals-10018-1329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background and aims Chronic hepatitis B (CHB) infection is an important cause of morbidity and mortality worldwide with an increased risk of liver failure, cirrhosis, and hepatocellular carcinoma. Hepatitis B virus (HBV) DNA level, the marker of viral load in the host, is a parameter affected by host factors. In this study, we investigated the relationship between HBV DNA level and insulin resistance as a host factor. Methods In this study, 146 patients diagnosed with “HBeAg-negative chronic HBV infection” (natural course phase 3, inactive carrier) according to the European Association for the Study of the Liver (EASL) 2017 guidelines were retrospectively analyzed and demographic, anthropometric, histopathological, radiological and laboratory data of the patients were recorded. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) levels of the patients were calculated, and according to the value, the patients were divided into two groups as insulin resistant and non-insulin resistant. All parameters, including HBV DNA, were evaluated and compared between the two groups. Results 77 patients (52.7%) were insulin resistant with a HOMA-IR value of 2.5 or more. The remaining 69 patients (47.3%) whose HOMA-IR value less than 2.5 were non-insulin resistant. The median HBV DNA was 410 IU in the insulin-resistant group and 350 IU in the other group, and there was no statistical significance between the two groups (p: 0.537). HBV DNA level was only positive correlated with HBsAg level and negatively correlated with anti-Hbs level and age (p < 0.005). Compared to the non-insulin resistant group, body mass index (BMI), presence of hepatosteatosis on ultrasonography (USG), fasting blood sugar, fasting insulin, total protein, gamma glutamyl transferase (GGT), triglyceride (TG), very-low-density lipoprotein (VLDL), uric acid level, triglyceride/high-density lipoprotein (HDL) ratio were significantly higher and HDL levels were significantly lower in the insulin-resistant group (p < 0.005). GGT levels and TG/HDL ratio were found to be higher in patients with hepatosteatosis on ultrasonography than in patients without hepatosteatosis (p < 0.005). TG/HDL ratio was found to be an independent factor in predicting insulin resistance and every 1 unit increase of this ratio increases the risk of developing insulin resistance 2.1 times. Conclusion In this study, no significant relationship was found between insulin resistance and HBV DNA levels in chronic inactive HBV carriers. In addition, insulin resistance was observed more frequently in these patients compared to the general population, and insulin resistance was found to be associated with high BMI, hepatosteatosis rate, VLDL, TG, GGT, total protein, uric acid, TG/HDL ratio, and low HDL. TG/HDL ratio was found to be successful in predicting insulin resistance. How to cite this article Senoymak MC, Ozkan H. Evaluation of the Relationship between Insulin Resistance and HBV DNA Level in Patients with HBeAg-negative Chronic HBV Infection (Natural Course Phase 3). Euroasian J Hepatogastroenterol 2020;10(2):85–91.
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Affiliation(s)
- Mustafa C Senoymak
- Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Hasan Ozkan
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
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80
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Castorani V, Polidori N, Giannini C, Blasetti A, Chiarelli F. Insulin resistance and type 2 diabetes in children. Ann Pediatr Endocrinol Metab 2020; 25:217-226. [PMID: 33401880 PMCID: PMC7788344 DOI: 10.6065/apem.2040090.045] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/05/2020] [Indexed: 12/27/2022] Open
Abstract
Type 2 diabetes (T2D) is an emerging health risk in obese children and adolescents. Both environmental (lack of physical activity, excess nutritional intake, sedentary lifestyle) and genetic factors contribute to this global epidemic. The growing prevalence of T2D in youth is also associated with a consistently increased incidence of metabolic and cardiovascular complications. Insulin resistance (IR), i.e., whole-body decreased glucose uptake in response to physiological insulin levels, determines impaired glucose homeostasis and it is recognized as cardinal trigger of T2D and cardiovascular disease in both adults and children. In particular, IR and beta-cell dysfunction lead to the persistent hyperglycemia which characterizes T2D. Indeed, both pathological states influence each other and presumably play a crucial, synergistic role in the pathogenesis of T2D, although the precise mechanisms are not completely understood. However, beta-cell dysfunction and IR induce impaired glucose metabolism, thus leading to the progression to T2D. Therefore, understanding the mechanisms correlated with the decline of beta-cell function and IR is crucial in order to control, prevent, and treat T2D in youth. This review focuses on the current knowledge regarding IR and T2D in children and adolescents and showcases interesting opportunities and stimulating challenges for the development of new preventative approaches and therapeutic strategies for young patients with T2D.
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Affiliation(s)
| | - Nella Polidori
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Cosimo Giannini
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | | | - Francesco Chiarelli
- Department of Pediatrics, University of Chieti, Chieti, Italy,Address for correspondence: Francesco Chiarelli, MD, PhD Department of Pediatrics, University of Chieti, Via dei Vestini, 5, I-66100 Chieti, Italy Tel: +39-0871-358015 Fax: +39-0871-574538 E-mail:
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81
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Angi A, Chiarelli F. Obesity and Diabetes: A Sword of Damocles for Future Generations. Biomedicines 2020; 8:E478. [PMID: 33171922 PMCID: PMC7694547 DOI: 10.3390/biomedicines8110478] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 02/07/2023] Open
Abstract
Childhood obesity is one of the most challenging problem of the 21st century. The prevalence has increased, reaching an alarming rate. Furthermore, the problem is global and is also affecting low- and middle-income countries. This global obesity epidemic explains how the roots of cardiovascular disease, the most common cause of mortality among adults, begin in childhood. Overweight and obese children are likely to stay obese into adulthood and to develop noncommunicable diseases such as diabetes and cardiovascular diseases at a younger age. Thus, prevention should be the major goal and should start early in life. The aim of this review is to present an updated framework of the current understanding of the cardiovascular and metabolic risks in obese children and adolescents and to discuss the available therapeutic options.
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Affiliation(s)
- Alessia Angi
- Department of Pediatrics, University of Chieti, 66100 Chieti, Italy;
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82
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Okui T. An Age-Period-Cohort Analysis of Biomarkers of Lifestyle-Related Diseases Using the National Health and Nutrition Survey in Japan, 1973-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8159. [PMID: 33158284 PMCID: PMC7663829 DOI: 10.3390/ijerph17218159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 11/03/2020] [Accepted: 11/03/2020] [Indexed: 12/15/2022]
Abstract
Studies of biomarkers of lifestyle-related diseases in Japanese cohorts are scarce. This study aimed to analyze trends in risk markers of lifestyle-related diseases using age-period-cohort (APC) analysis. Data on systolic blood pressure and BMI from 1973 to 2018 and serum glucose, triglyceride, and high-density lipoprotein cholesterol levels from 1989 to 2018 available from the National Health and Nutrition Survey were used. Values for each of the risk markers for each age, period, and cohort were estimated using APC analysis. For women, a decrease in all the risk markers of lifestyle-related diseases was observed in individuals born between the 1930s and approximately 1970. Therefore, female individuals born in approximately 1970 were considered to have the lowest risk of developing lifestyle-related and cardiovascular diseases. Meanwhile, the cohort effect on all the risk markers deteriorated for the younger cohorts, and changes in lifestyle behavior are needed for cohorts born more recently. For men, the trends in risk markers across the cohorts differed, and the relative risk of lifestyle-related diseases for each cohort differed according to disease. These results could help understand cohort-specific risks for lifestyle-related disease and enable identification of high-risk populations who could benefit from preventive measures.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka 812-8582, Japan
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83
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Vargas-Sánchez K, Vargas L, Urrutia Y, Beltrán I, Rossi AB, Lozano HY, Guarín J, Losada-Barragán M. PPARα and PPARβ/δ are negatively correlated with proinflammatory markers in leukocytes of an obese pediatric population. J Inflamm (Lond) 2020; 17:35. [PMID: 33292260 PMCID: PMC7602348 DOI: 10.1186/s12950-020-00264-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/20/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Obesity configures a pathophysiological profile that predisposes the development of metabolic and cardiovascular diseases, critically impacting public health. The chronic dysregulation of immuno-metabolic components triggered by pediatric obesity is a common but scarcely understood aspect of the disease. Peroxisome proliferator-activated receptors (PPARs) are a group of transcription factors essential for energy and immune homeostasis of different tissues. Besides, the glucagon-like peptide-1 receptor (GLP-1R) activation influences insulin secretion, but also regulates the cytokine profile possibly mediated through a PPAR isotype. However, the role of PPARs and GLP-1R in leukocytes from obese pediatric patients remains unclear. Therefore, we examined the expression of PPARs isotypes and GLP-1R in leukocytes, and its correlation with metabolic, hormonal, inflammatory, and anthropometric markers in an obese pediatric population. RESULTS Obese children and adolescents presented a significant increase in anthropometric and body composition parameters, TG, VLDL, TG/HDL, android fat (%)/gynoid fat (%) (A/G%) index, and HOMA score when compared with the control group. Obese participants exhibited a pro-inflammatory profile with an augment of IL-8 (p = 0,0081), IL-6 (p = 0,0005), TNF-α (p = 0,0004), IFN-γ (p = 0,0110), MCP-1 (p = 0,0452), and adipsin (p = 0,0397), whereas displayed a reduction of adiponectin (p = 0,0452). The expression of PPARα and GLP-1R was lower in the leukocytes from obese participants than in lean subjects. Furthermore, PPARα correlates negatively with TNF-α (p = 0,0383), while GLP-1R did not show correlation with any inflammatory variable. However, both receptors correlate negatively with the abdominal skinfold. Although PPARβ/δ expression was similar between groups, it was negatively associated with IL-8 levels (p = 0,0085). CONCLUSIONS PPARα and PPARβ/δ expression are negatively correlated with the proinflammatory markers TNF-α and IL-8, respectively, suggesting participation in the regulation of inflammation which was observed to be altered in pediatric obesity. Furthermore, PPARα and GLP-1R are downregulated in leukocytes from obese participants. The low expression of both receptors is correlated with an increase in abdominal skinfold, suggesting a role in fat distribution that could indirectly affect cytokine secretion from different immune and adipose cells, likely triggering an inflammatory profile as a consequence of obesity. Altogether, these findings may impact the understanding and implementation of PPARα or GLP-1R agonists in the clinic.
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Affiliation(s)
- Karina Vargas-Sánchez
- Research group of Translational Neurosciences, School of Medicine, Universidad de los Andes, Bogotá, 111711, Colombia.
| | - Laura Vargas
- Biología celular y funcional e ingeniería de biomoléculas, Universidad Antonio Nariño, Bogotá, Colombia
| | - Yenny Urrutia
- Biología celular y funcional e ingeniería de biomoléculas, Universidad Antonio Nariño, Bogotá, Colombia
| | - Iván Beltrán
- Biología celular y funcional e ingeniería de biomoléculas, Universidad Antonio Nariño, Bogotá, Colombia
| | | | | | - Jorge Guarín
- GRINCIBIO. Universidad Antonio Nariño, Bogotá, Colombia
| | - Monica Losada-Barragán
- Biología celular y funcional e ingeniería de biomoléculas, Universidad Antonio Nariño, Bogotá, Colombia.
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Wen J, Wang A, Liu G, Wang M, Zuo Y, Li W, Zhai Q, Mu Y, Gaisano HY, He Y, Dou J. Elevated triglyceride-glucose (TyG) index predicts incidence of Prediabetes: a prospective cohort study in China. Lipids Health Dis 2020; 19:226. [PMID: 33059672 PMCID: PMC7565371 DOI: 10.1186/s12944-020-01401-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/06/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Prediabetes has become a pandemic. This study aimed to identify a better predictor for the incidence of prediabetes, which we hypothesize to be the triglyceride-glucose (TyG) index, a simplified insulin resistance index. We compared its predictive value with the other common risk factors of prediabetes. METHODS The participants of this analysis were derived from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study. A total of 4543 participants without initial prediabetes or diabetes were followed up for 3.25 years. Using multivariate logistic regression model, the associations between baseline obesity, lipid profiles and non-insulin-based insulin resistance indices with the incidence of prediabetes were analyzed. To assess which is better predictor for the incidence of prediabetes, the area under curves (AUCs) calculated from the receiver operating characteristic curve analyses were used to evaluate and compare with the predictive value of the different indices. RESULTS During the 3.25 years, 1071 out of the 4543 participants developed prediabetes. Using the logistic regression analysis adjusted for some potential confounders, the risk of incidence of prediabetes increased 1.38 (1.28-1.48) fold for each 1-SD increment of TyG index. The predictive ability (assessed by AUCs) of TyG index for predicting prediabetes was 0.60 (0.58-0.62), which was superior to the indices of obesity, lipid profiles and other non-insulin-based insulin resistance indices. Although the predictive ability of the TyG index was overall similar to fasting plasma glucose (FPG) (P = 0.4340), TyG index trended higher than FPG in females (0.62 (0.59-0.64) vs. 0.59 (0.57-0.61), P = 0.0872) and obese subjects (0.59 (0.57-0.62) vs. 0.57 (0.54-0.59), P = 0.1313). TyG index had superior predictive ability for the prediabetic phenotype with isolated impaired glucose tolerance compared with FPG (P < 0.05) and other indices. Furthermore, TyG index significantly improved the C statistic (0.62 (0.60-0.64)), integrated discrimination improvement (1.89% (1.44-2.33%)) and net reclassification index (28.76% (21.84-35.67%)) of conventional model in predicting prediabetes than other indices. CONCLUSIONS TyG could be a potential predictor to identify the high risk individuals of prediabetes.
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Affiliation(s)
- Jing Wen
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Anping Wang
- Department of Endocrinology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Guangxu Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Meiping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Yingting Zuo
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Wei Li
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Qi Zhai
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Yiming Mu
- Department of Endocrinology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | | | - Yan He
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China. .,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| | - Jingtao Dou
- Department of Endocrinology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.
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85
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Cachay-Barboza EP. [Relationship between nutritional status and triglyceride/c-hdl index in adolescents treated in a public hospital]. ARCHIVOS PERUANOS DE CARDIOLOGIA Y CIRUGIA CARDIOVASCULAR 2020; 1:215-221. [PMID: 38268506 PMCID: PMC10804817 DOI: 10.47487/apcyccv.v1i4.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 12/10/2020] [Indexed: 01/26/2024]
Abstract
Objective To determine the relationship between nutritional status according to body mass index (BMI) and triglyceride index/c-HDL in adolescents treated in a public hospital. Materials and methods Observational, transversal, and retrospective study of the nutritional education database program of Hospital I - Rioja - EsSalud, from March 2017 to June 2018. The nutritional status was determined according to the body mass index for age (BMI/age) and the index of Tg/c-HDL as the ratio between triglycerides and HDL cholesterol. Results The study was made up of 130 adolescents (70 females and 60 males) between 10 - 18 years old, who were treated in the nutrition service of Hospital I - Rioja- EsSalud. The average age of the adolescents was 12.6 ± 2.2 years. The average Tg/c-HDL index was 2.41 ± 0.48; it was higher in males (2.46 ± 0.51) than in females (2.37 ± 0.44); likewise, obesity (2.70 ± 0.49), overweight (2.46 ± 0.41) and the risk of underweight (2.36 ± 0.55) were the nutritional states that presented the highest Tg/c-HDL index. A positive and significant correlation (r=0.447, p=0.000) was found between BMI and Tg/c-HDL index. Conclusions There was a positive and statistically significant relationship between the body mass index and the Tg / HDL-c index in this adolescent population. The Tg / HDL-c index was higher in the nutritional status of obesity and overweight, exceeding the value of the media population.
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Affiliation(s)
- Edwar Paul Cachay-Barboza
- Nutricionista. Maestrando en Nutrición Clínica, Unidad de Posgrado Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú. Universidad Nacional Mayor de San Marcos Unidad de Posgrado Facultad de Medicina Universidad Nacional Mayor de San Marcos Lima Peru
- Instituto Nacional Cardiovascular - INCOR, EsSalud, Lima, Perú Instituto Nacional Cardiovascular - INCOR, EsSalud Lima Perú
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86
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Cao J, Zhang L, Li J, Sun L, Liu S, Zhang J, Zhao H. Pubertal maturation and weight status are associated with dyslipidemia among children and adolescents in Northwest China. Sci Rep 2020; 10:16344. [PMID: 33004971 PMCID: PMC7530767 DOI: 10.1038/s41598-020-73507-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 09/18/2020] [Indexed: 01/19/2023] Open
Abstract
Dyslipidemia is one of major risk factors for cardiovascular disease. The early detection and treatment of dyslipidemia can reduce cardiovascular disease risk. A cross-sectional study was carried out in Ningxia, China to determine the prevalence of dyslipidemia and its association with body mass index (BMI) and pubertal stage. A total of 1783 students were selected from middle schools and high schools in September 2014 using stratified random cluster sampling. Serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured by using MOL-300 automatic biochemical analyzer with associated kits. The prevalence of adolescents with one abnormal serum lipid component was 43.2% and was significantly different across three pubertal stages (p < 0.0001). The abnormal rates of HDL-C and TG increased as the students maturated through the early, middle, and late stages of puberty (all p < 0.0001). Similar results were obtained when separate analyses were performed for boys and girls. In linear regression analysis, BMI was positively associated with serum levels of TC, LDL-C, and TG, but inversely associated with serum levels of HDL-C after the adjustment for age, sex, and race. In multivariable logistic regression analysis, obesity was associated with an increased risk of developing high TC, while pubertal maturation was associated with an elevated risk of experiencing low HDL-C and high TG (all p < 0.05). In conclusions, dyslipidemia is common in an adolescent population of Northwest China and its prevalence rates substantially vary with weight status and pubertal stage.
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Affiliation(s)
- Juan Cao
- Department of Child and Adolescent Health, School of Public Health and Management, Ningxia Medical University, Shengli Street, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
| | - Ling Zhang
- Department of Child and Adolescent Health, School of Public Health and Management, Ningxia Medical University, Shengli Street, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
| | - Jing Li
- Department of Child and Adolescent Health, School of Public Health and Management, Ningxia Medical University, Shengli Street, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
| | - Lijiao Sun
- Department of Child and Adolescent Health, School of Public Health and Management, Ningxia Medical University, Shengli Street, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
| | - Shanghong Liu
- Department of Child and Adolescent Health, School of Public Health and Management, Ningxia Medical University, Shengli Street, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
| | - Jianjun Zhang
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, 1050 Wishard Boulevard, RG5118, Indianapolis, IN, 46202, USA.
| | - Haiping Zhao
- Department of Child and Adolescent Health, School of Public Health and Management, Ningxia Medical University, Shengli Street, Yinchuan, 750004, Ningxia Hui Autonomous Region, China.
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Kabakoğlu Ünsür E, Kutlusoy Güçlü F. Triglyceride-to-high density lipoprotein cholesterol ratio and triglyceride-glucose index in the perinatal period of neonates. J Matern Fetal Neonatal Med 2020; 34:810-817. [PMID: 32998600 DOI: 10.1080/14767058.2020.1826926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Environmental factors and growth disturbances, either intra-uterine, or post-natal, can result in permanent changes in tissues and also long-term effects that may present themselves as pathological conditions in adulthood, including increased incidence of insulin resistance, impaired glucose tolerance, and also higher likelihood for diabetes mellitus. The triglyceride to glucose index (TyG) and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-c) have been proposed as reliable and simple alternatives for the evaluation of insulin resistance. To date, there was limited data regarding the TyG index and TG/HDL-c ratio in the perinatal period of neonates. We aimed to investigate the possible relationships between HOMA-IR, TyG index, and TG/HDL-c in the cord blood of neonates. MATERIALS-METHODS One hundred and six pregnant women with singleton gestation who gave birth to full-term, normal-weight Turkish neonates without fetal distress were included in the study. The samples of maternal serum and cord blood in neonates were obtained after delivery. RESULTS Mean TyG index was 3.71 ± 0.38 and the mean TG/HDL-c ratio was 3.12 ± 3.00 in this group. Correlations were found between maternal age and neonate glucose levels and HOMA-IR (p < .05). HOMA-IR was negatively correlated with triglyceride, TG/HDL-c ratio, TyG index + TG/HDL, and positively correlated with HDL and TyG index. CONCLUSIONS Our study indicates that the TyG index and TG/HDL-C may be used as an indicator of insulin sensitivity in the perinatal period of neonates. However, the validity of these results should be tested in other centers with a larger neonate population in order to evaluate whether ethnic and racial diversity influence these relationships.
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Affiliation(s)
- Emel Kabakoğlu Ünsür
- Department of Pediatrics, Acıbadem Kayseri Hospital, Acıbadem unıversity, Istanbul, Turkey
| | - Fatma Kutlusoy Güçlü
- Department of Obstetrics and Gynecology, Acıbadem Kayseri Hospital, Istanbul, Turkey
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88
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Validity assessment of the single-point insulin sensitivity estimator (spise) for diagnosis of cardiometabolic risk in post-pubertal hispanic adolescents. Sci Rep 2020; 10:14399. [PMID: 32873820 PMCID: PMC7462984 DOI: 10.1038/s41598-020-71074-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 08/10/2020] [Indexed: 11/29/2022] Open
Abstract
Insulin measurements are not advised for cardiometabolic risk screening in large groups. Here we assessed the accuracy of the single-point insulin sensitivity estimator (SPISE) to diagnose cardiometabolic risk in Chilean adolescents. In 678 post-pubertal adolescents (52% males, M(SD) age = 16.8 (0.2) years), height, weight, waist circumference, blood lipids, glucose, insulin, and blood pressure were measured. BMI, HOMA-IR, and SPISE were estimated; HOMA-IR values ≥ 2.6 were considered insulin resistance (IR). Metabolic syndrome (MetS) was defined with the joint IDF/AHA/NHBLI standard. Using receiver operating characteristic curves, we obtained optimal SPISE cutpoints for IR and MetS diagnosis. The prevalence of MetS and IR was 8.2% and 17.1%, respectively. In males, the optimal cutoff for MetS diagnosis was 5.0 (sensitivity: 97%; specificity: 82%), and the optimal cutoff for IR diagnosis was 5.9 (sensitivity: 71%; specificity: 83%). In females, a SPISE of 6.0 had the highest sensitivity (90%) and specificity (74%) for MetS diagnosis. A SPISE of 6.4 was the optimal cutoff for IR diagnosis; however, sensitivity and specificity were 61% and 75%. In males and female post-pubertal adolescents, SPISE had a very good and good diagnostic performance, respectively, in predicting MetS. It was an accurate diagnostic tool for IR prediction in males, but not necessarily in females.
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89
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Rodríguez-Gutiérrez N, Vanoye Tamez M, Vázquez-Garza E, Villarreal-Calderón JR, Castillo EC, Laresgoiti-Servitje E, Elizondo-Montemayor L, García-Rivas G. Association of the Triglyceride/High-Density Lipoprotein Cholesterol Index with Insulin Resistance in a Pediatric Population in Northeast Mexico. Metab Syndr Relat Disord 2020; 18:333-340. [DOI: 10.1089/met.2020.0046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Nora Rodríguez-Gutiérrez
- Tecnologico de Monterrey, Escuela Medicina y Ciencias de la Salud, Grupo de Enfoque en Medicina Cardiovascular y Metabolómica, Monterrey, México
- Clínica de Obesidad, Departamento de Endocrinología Pediátrica, Hospital Materno Infantil de Alta Especialidad, Secretaría de Salud, Guadalupe, Nuevo León, México
| | - Mariana Vanoye Tamez
- Tecnologico de Monterrey, Escuela Medicina y Ciencias de la Salud, Grupo de Enfoque en Medicina Cardiovascular y Metabolómica, Monterrey, México
| | - Eduardo Vázquez-Garza
- Tecnologico de Monterrey, Escuela Medicina y Ciencias de la Salud, Grupo de Enfoque en Medicina Cardiovascular y Metabolómica, Monterrey, México
| | - José R. Villarreal-Calderón
- Tecnologico de Monterrey, Escuela Medicina y Ciencias de la Salud, Grupo de Enfoque en Medicina Cardiovascular y Metabolómica, Monterrey, México
| | - Elena C. Castillo
- Tecnologico de Monterrey, Escuela Medicina y Ciencias de la Salud, Grupo de Enfoque en Medicina Cardiovascular y Metabolómica, Monterrey, México
| | - Estibalitz Laresgoiti-Servitje
- Tecnologico de Monterrey, Escuela Medicina y Ciencias de la Salud, Grupo de Enfoque en Medicina Cardiovascular y Metabolómica, Monterrey, México
| | - Leticia Elizondo-Montemayor
- Tecnologico de Monterrey, Escuela Medicina y Ciencias de la Salud, Grupo de Enfoque en Medicina Cardiovascular y Metabolómica, Monterrey, México
- Tecnologico de Monterrey, Escuela Medicina y Ciencias de la Salud, Centro de Investigación en Nutrición Clínica y Obesidad, Monterrey, México
| | - Gerardo García-Rivas
- Tecnologico de Monterrey, Escuela Medicina y Ciencias de la Salud, Grupo de Enfoque en Medicina Cardiovascular y Metabolómica, Monterrey, México
- Tecnologico de Monterrey, Hospital Zambrano-Hellion, Centro de Investigación Biomédica, San Pedro Garza-García, México
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90
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Aslan Çin NN, Yardımcı H, Koç N, Uçaktürk SA, Akçil Ok M. Triglycerides/high-density lipoprotein cholesterol is a predictor similar to the triglyceride-glucose index for the diagnosis of metabolic syndrome using International Diabetes Federation criteria of insulin resistance in obese adolescents: a cross-sectional study. J Pediatr Endocrinol Metab 2020; 33:777-784. [PMID: 32447329 DOI: 10.1515/jpem-2019-0310] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 03/16/2020] [Indexed: 01/11/2023]
Abstract
Objectives Metabolic syndrome (MS) is a fatal endocrinopathy that begins with insulin resistance (IR) and causes abdominal obesity, glucose intolerance, or systemic disorders. This study was aimed to determine the cut-off values for the triglyceride (TG)/high-density lipoprotein cholesterol (TG/HDL-C) ratio, the TG glucose (TyG) index and homeostasis model assessment (HOMA-IR) for the diagnosis of MS in obese adolescents, and to compare which of the three indexes would offer a more accurate approach to diagnosis. Methods The study population comprised 1,171 obese adolescents (639 females and 532 males aged 10-16 years, Body Mass Index (BMI)>=95th percentile). Indirect measures of IR screening for MS were the TG/HDL ratio, TyG index, and HOMA-IR. The cut-off values of the TG/HDL ratio, TyG index, and HOMA-IR were obtained from receiver operation characteristic (ROC) curves. Results HOMA-IR had a significant positive correlation with the TyG index (r=0.352, p<0.001) and TG/HDL-C (r=0.291, p<.001). The TyG index and TG/HDL-C showed a strong positive correlation (r=0.901, p<0.001). The TG/HDL-C ratio showed a larger ROC Area under Curve (AUC=0.849) than HOMA-IR index (AUC=0.689), but as a predictor similar to TyG index (AUC=0.833) when screening for MS. The cut-off values for MS were as follows: TG/HDL-C ratio>2.16 (sensitivity: 88.8%; specificity: 49.7%), TyG index>8.50 (sensitivity: 85.6%; specificity: 57.0%) and HOMA-IR>2.52 (sensitivity: 83.2%; specificity: 40.4%). Conclusions Both the TyG index and TG/HDL-C ratio are better markers than HOMA-IR to determine the risk of metabolic syndrome according to IDF criteria. Besides, the TyG index and TG/HDL-C ratio have similar differentiating powers to determine this risk in obese Turkish adolescents.
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Affiliation(s)
- Nazlı Nur Aslan Çin
- Ankara University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Fatih Cad. Tepebaşı Mah, No:197/A, 06300, Ankara, Kecioren, Turkey
| | - Hülya Yardımcı
- Ankara University Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara, Turkey
| | - Nevra Koç
- Health Sciences University, Ministry of Health Ankara City Hospital, Department of Child Nutrition and Metabolism, Ankara, Turkey
| | - Seyit Ahmet Uçaktürk
- Health Sciences University, Ministry of Health Ankara City Hospital, Department of Child Nutrition and Metabolism, Ankara, Turkey
| | - Mehtap Akçil Ok
- Baskent University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Baglica Campus, Ankara,Turkey
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91
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Moriyama K. Associations Between the Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Metabolic Syndrome, Insulin Resistance, and Lifestyle Habits in Healthy Japanese. Metab Syndr Relat Disord 2020; 18:260-266. [PMID: 32191558 DOI: 10.1089/met.2019.0123] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: The triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio is related to insulin resistance (IR). However, little information is available on whether TG/HDL-C is associated with IR and components of metabolic syndrome (MetS) and how lifestyle habits affect TG/HDL-C in the healthy Japanese population. Methods: In total, 1068 Japanese subjects who had undergone an annual health examination and who were not receiving medication were recruited. Determinants for TG/HDL-C ratio were investigated using multiple regression analyses. The subjects were divided into three groups by lifestyle habits (i.e., smoking, exercise, and physical activity), homeostasis model assessment of IR (HOMA-IR), and fasting plasma glucose, four groups by alcohol intake, and five groups by numbers of MetS components to compare TG/HDL-C values. All analyses were done separately by sex. Results: Multiple regression analyses revealed that waist circumference and smoking were positively associated with TG/HDL-C in both men and women, whereas physical activity was negatively associated with TG/HDL-C ratio in women. TG/HDL-C increased with increasing number of MetS in both men and women. TG/HDL-C increased as HOMA-IR increased in both men and women, when subjects were stratified according to HOMA-IR. TG/HDL-C values were lower in both men and women who exercised regularly, had high physical activity, or were nonsmokers. Independent of exercise and physical activity, TG/HDL-C was higher in smokers than in nonsmokers for both men and women. The relationship between TG/HDL-C and alcohol intake was not statistically significant in both men and women. Conclusions: The TG/HDL-C ratio is associated with IR, components of MetS, exercise, physical activity, and smoking, but not alcohol intake, in healthy Japanese subjects.
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Affiliation(s)
- Kengo Moriyama
- Department of Clinical Health Science, Tokai University School of Medicine, Tokyo, Japan
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92
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Chen Z, Hu H, Chen M, Luo X, Yao W, Liang Q, Yang F, Wang X. Association of Triglyceride to high-density lipoprotein cholesterol ratio and incident of diabetes mellitus: a secondary retrospective analysis based on a Chinese cohort study. Lipids Health Dis 2020; 19:33. [PMID: 32131838 PMCID: PMC7057518 DOI: 10.1186/s12944-020-01213-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/24/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Previous studies have revealed that triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) is one of major risk factors of insulin resistance and diabetes. However, study on the association between TG/HDL-C and diabetes mellitus (DM) risk is limited, especially in Chinese people. This study was undertaken to investigate the relationship between TG/HDL-C and incident of diabetes in a large cohort in Chinese population. METHODS The present study was a retrospective cohort study. A total of 114,787 adults from Rich Healthcare Group in China, which includes all medical records for participants who received a health check from 2010 to 2016. The target independent variable and the dependent variable were triglyceride to high-density lipoprotein cholesterol ratio measured at baseline and incident of diabetes mellitus appeared during follow-up respectively. Covariates involved in this study included age, gender, body mass index, diastolic blood pressure, systolic blood pressure, fasting plasma glucose, total cholesterol, low density lipoprotein cholesterol, serum creatinine, smoking and drinking status and family history of diabetes. Cox proportional-hazards regression was used to investigate the association of TG/HDL-C and diabetes. Generalized additive models was used to identify non-linear relationships. Additionally, we also performed a subgroup analysis. It was stated that the data had been uploaded to the DATADRYAD website. RESULT After adjusting age, gender, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol, serum creatinine, smoking and drinking status and family history of diabetes, result showed TG/HDL-C was positively associated with incident of diabetes mellitus (HR = 1.159, 95%CI (1.104, 1.215)). A non-linear relationship was detected between TG/HDL-C and incident of diabetes, which had an inflection point of TG/HDL-C was 1.186. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 1.718(1.433,2.060) and 1.049(0.981,1.120), respectively. Subgroup analysis showed, the stronger association can be found in the population with fasting plasma glucose (FPG) < 6.1 mmol/L (P for interaction< 0.0001; HR = 1.296 with FPG < 6.1 mmol/L vs HR = 1.051 with FPG ≥ 6.1 mmol/L).The same trend was also seen in the population with body mass index (BMI)(≥18.5, < 24 kg/m2) (P for interaction = 0.010,HR = 1.324) and family history without diabetes(P for interaction = 0.025, HR = 1.170). CONCLUSION TG/HDL-C is positively associated with diabetes risk. The relationship between TG/HDL-C and incident of diabetes is also non-linear. TG/HDL-C was strong positively related to incident of diabetes when TG/HDL-C is less than 1.186.
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Affiliation(s)
- Zhuangsen Chen
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong Province, China.,Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China.,Shenzhen University Health Science Center, Shenzhen, 518000, Guangdong Province, China
| | - Haofei Hu
- Shenzhen University Health Science Center, Shenzhen, 518000, Guangdong Province, China.,Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China.,Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Miaoling Chen
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong Province, China.,Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China.,Shenzhen University Health Science Center, Shenzhen, 518000, Guangdong Province, China
| | - Xueying Luo
- Department of Plastic and reconstructive, Shenzhen People's Hospital, Shenzhen, 518000, Guangdong, China
| | - Weili Yao
- Department of Endocrinology, Shenzhen Longhua District People's Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Qian Liang
- Department of Endocrinology, Shenzhen People's Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Fan Yang
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong Province, China.,Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China.,Shenzhen University Health Science Center, Shenzhen, 518000, Guangdong Province, China
| | - Xinyu Wang
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong Province, China. .,Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China. .,Shenzhen University Health Science Center, Shenzhen, 518000, Guangdong Province, China.
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93
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Chen Z, Chen G, Qin H, Cai Z, Huang J, Chen H, Wu W, Chen Z, Wu S, Chen Y. Higher triglyceride to high-density lipoprotein cholesterol ratio increases cardiovascular risk: 10-year prospective study in a cohort of Chinese adults. J Diabetes Investig 2020; 11:475-481. [PMID: 31325411 PMCID: PMC7078082 DOI: 10.1111/jdi.13118] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 02/05/2023] Open
Abstract
AIMS/INTRODUCTION A higher ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) is considered as the independent risk index of cardiovascular (CV) events. However, cohort studies regarding this correlation are rarely reported, especially in the Chinese population. The aim of present study was to explore the relationship of the TG/HDL-C ratio with CV risks among Chinese adults during 10-year follow-up period. MATERIALS AND METHODS We carried out a prospective study using data obtained from 96,542 individuals in Kailuan, who were grouped through the median value (0.8533) of the TG/HDL-C ratio. Adverse outcomes mainly referred to major CV events. We used the person-years incidence and cumulative incidence to predict the morbidity. The risk of CV events was estimated through Cox proportional hazard models. RESULTS The mean age of the cohort was 51.5 ± 12.6 years, and 79.6% of participants were men. During a median follow-up period of 9.75 years, 5,422 major CV events occurred, including 1,312 myocardial infarction cases and 4,228 stroke cases. The cumulative incidence of myocardial infarction, stroke and total CV events was 1.36% (range 1.29-1.43%), 4.38% (range 4.25-4.51%) and 5.62% (range 5.47-5.76%), respectively. Compared with low the TG/HDL-C ratio (≤0.8533) group, the high TG/HDL-C ratio (>0.8533) group had higher morbidity of CV events. The hazard ratio of total CV events, stroke and myocardial infarction was 1.19 (95% CI 1.12-1.26), 1.11 (95% CI 1.03-1.18) and 1.50 (95% CI 1.33-1.70), respectively. Furthermore, the TG/HDL-C ratio and major CV events had a line-shaped relationship with each other. CONCLUSIONS Among the Chinese population, a higher TG/HDL-C ratio is correlated with an increased risk of major CV events.
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Affiliation(s)
- Zekai Chen
- Shantou University Medical CollegeShantouChina
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | | | - Hailun Qin
- Shantou University Medical CollegeShantouChina
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Zefeng Cai
- Shantou University Medical CollegeShantouChina
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Jianhuan Huang
- Shantou University Medical CollegeShantouChina
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Haojia Chen
- Shantou University Medical CollegeShantouChina
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Weiqiang Wu
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Zhichao Chen
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Shouling Wu
- Department of CardiologyKailuan HospitalNorth China University of Science and TechnologyTangshanChina
| | - Youren Chen
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
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94
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Zheng D, Li H, Ai F, Sun F, Singh M, Cao X, Jiang J, He Y, Tang Z, Guo X. Association between the triglyceride to high-density lipoprotein cholesterol ratio and the risk of type 2 diabetes mellitus among Chinese elderly: the Beijing Longitudinal Study of Aging. BMJ Open Diabetes Res Care 2020; 8:8/1/e000811. [PMID: 32205325 PMCID: PMC7206911 DOI: 10.1136/bmjdrc-2019-000811] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 01/18/2020] [Accepted: 02/22/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Time-dependent covariates are generally available as longitudinal data were collected periodically in the cohort study. To examine whether time-dependent triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio could predict the future risk of type 2 diabetes mellitus (T2DM) and assess its potential impact on the risk of T2DM incidence. RESEARCH DESIGN AND METHODS This study enrolled 1460 participants without T2DM aged 55 or above in 1992 in the Beijing Longitudinal Study of Aging during 25 years. The questionnaire data were collected in nine surveys from 1992 to 2017. Physical examination and blood laboratory tests including TG and HDL-C concentrations were measured in five surveys. Incident T2DM cases were confirmed via a self-reported history of T2DM or the fasting plasma glucose level. RESULTS 119 new cases of T2DM were identified. In the Cox regression analysis with time-dependent TG/HDL-C ratios and covariates, the adjusted hazard ratios (95% confidence interval) of T2DM incidence were 1.90 (1.12 to 3.23), 2.75 (1.58 to 4.80) and 2.84 (1.69 to 4.77), respectively, for those with TG/HDL-C ratios (both TG and HDL-C were expressed in millimole per liter) in the ranges of 0.87-1.30, 1.31-1.74 and ≥1.75, compared with individuals with TG/HDL-C ratios <0.87. The similar results of subdistribution hazard ratios were obtained by performing the Fine-Gray model with time-dependent TG/HDL-C ratios. This positive association and the statistically significant trend with increased risk of T2DM incidence in the three categories of elevated TG/HDL-C ratio was confirmed by multiple sensitivity analyses. Furthermore, the T2DM discriminatory power of TG/HDL-C ratio combining with other risk factors was moderately high. CONCLUSIONS We found that time-dependent TG/HDL-C ratios were positively associated with the risk of T2DM risk. The elevated TG/HDL-C ratios increased the future risk of T2DM incidence. Lowering the TG/HDL-C ratio could assist in the prevention of diabetes for older adults.
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Affiliation(s)
- Deqiang Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Haibin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Feiling Ai
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Fei Sun
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Manjot Singh
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Xue Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Jiajia Jiang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yan He
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Zhe Tang
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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95
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Li HH, Wang JM, Ji YX, Lin L, Li SW, Cai D, Huang S, Hua F, Liu XZ. Association of Visceral Adiposity Surrogates with Impaired Fasting Glucose in Nonobese Individuals. Metab Syndr Relat Disord 2020; 18:128-133. [PMID: 31999502 DOI: 10.1089/met.2019.0078] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Nonobese individuals with disproportionate body fat distribution are also vulnerable to dysglycemia. This study aimed to evaluate the association between three visceral adiposity surrogates and impaired fasting glucose (IFG) in nonobese Chinese individuals. Methods: A total of 70,200 nonobese adults without diabetes were included in this analysis. Two diagnostic criteria (IFG-ADA and IFG-WHO) were used to define IFG. The values of the visceral adiposity index, lipid accumulation product index (LAP), and cardiometabolic index (CMI) were calculated. Multivariable logistic analysis was used to evaluate the association between these surrogates and IFG. Results: Among the three indicators, only LAP and CMI were positively correlated with fasting plasma glucose (all P < 0.001). After fully adjusting for confounders, only LAP and CMI exhibited significant associations with IFG. For women, the odds ratios (ORs) for IFG-ADA in the highest quartile of the LAP and CMI were 1.967 (95% confidence interval [CI]: 1.645-2.353) and 1.594 (95% CI: 1.383-1.836), respectively; and were 2.025 (95% CI: 1.597-2.567) and 2.017 (95% CI: 1.647-2.470), respectively, for IFG-WHO (all P < 0.001). For men, the ORs for IFG-ADA of the LAP and CMI were 1.503 (95% CI: 1.233-1.833) and 2.045 (95% CI: 1.752-2.388), respectively; and were 1.534 (95% CI: 1.174-2.005) and 2.541 (95% CI: 2.025-3.188), respectively, for IFG-WHO (all P < 0.001). Conclusions: The LAP and CMI, cost-effective and simple visceral adiposity surrogates, are strongly associated with IFG in nonobese Chinese individuals. These surrogates might be potential targets to monitor for the recognition and management of excess visceral adiposity in nonobese individuals with prediabetes.
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Affiliation(s)
- Hui Hua Li
- Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Departmemt of Endocrinology, Shanghai Jiao Tong University School of Medicine, Tongren Hospital, Shanghai, China
| | - Jun Min Wang
- Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, China
| | - Yi Xin Ji
- Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, China
| | - Lin Lin
- Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, China
| | - Shu Wen Li
- Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, China
| | - Da Cai
- Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, China
| | - Shan Huang
- Departmemt of Endocrinology, Shanghai Jiao Tong University School of Medicine, Tongren Hospital, Shanghai, China
| | - Fei Hua
- Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xing Zhen Liu
- Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, China
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96
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Blasetti A, Franchini S, Castorani V, Comegna L, Fornari E, Daniele F, Prezioso G, Piona C, Federico V, Zona D, Bresadola I, Chiarelli F, Maffeis C. Skipping Breakfast Is Associated with an Atherogenic Lipid Profile in Overweight and Obese Prepubertal Children. Int J Endocrinol 2020; 2020:1849274. [PMID: 33101407 PMCID: PMC7569459 DOI: 10.1155/2020/1849274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/14/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Skipping breakfast has been associated with a higher risk of obesity and cardiovascular (CV) risk factors. However, it is not known if skipping breakfast is also correlated with CV risk factors independently from obesity. The mechanisms explaining the role of skipping breakfast on promoting fat accumulation as well as CV risk are not known. Hormones, in particular, insulin-like growth factor-1 (IGF-1), may potentially play a role in the metabolic profile of breakfast skippers. AIM This cross-sectional study aims to test, in a sample of overweight/obese children, the hypotheses that skipping breakfast is associated with a worse metabolic profile and that IGF-1 levels are associated with this unfavorable metabolic profile. METHODS AND RESULTS We enrolled 112 overweight/obese prepubertal children (3-12 years). Anthropometric characteristics (height SDS, weight SDS, and body mass index (BMI) z-score) were measured. Blood samples were collected to evaluate glucose and lipid metabolisms and hormone profile (growth hormone (GH), IGF-1, insulin, and cortisol). The triglycerides/high-density lipoprotein (HDL) cholesterol ratio was calculated as a predictor of cardiovascular risk. Children were divided into two groups according to breakfast habits: consumers (≥5 weekly; N = 76) and skippers (≤4 weekly; N = 36). Glycaemia, total and low-density lipoprotein (LDL) cholesterol, triglycerides (p < 0.05), and triglycerides/HDL cholesterol ratio (p < 0.001) were higher, while HDL cholesterol was lower (p < 0.01) in skippers as compared to consumers. IGF-1 concentrations were inversely correlated with LDL cholesterol (r = -0.279, p=0.013) and directly correlated with HDL cholesterol (r = 0.226, p=0.047). IGF-1 correlated positively with HDL cholesterol (r = 0.266, p=0.045) in consumers and correlated negatively with LDL cholesterol (r = -0.442, p=0.024) in skippers. Breakfast consumption among prepubertal overweight/obese children showed a better lipid profile in comparison with those who skipped breakfast [OR: 0.165 (95% CI: 0.053-0.518), p=0.001]; these latter odds of the increased triglycerides/HDL cholesterol ratio was 6.1-fold higher. CONCLUSIONS Breakfast skippers show a worse lipid profile when compared to breakfast consumers. IGF-1 might play a role as an independent modulator of lipid metabolism.
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Affiliation(s)
- A. Blasetti
- Department of Pediatrics, “G. d'Annunzio” University-Chieti, Pescara, Italy
| | - S. Franchini
- Department of Pediatrics, “G. d'Annunzio” University-Chieti, Pescara, Italy
| | - V. Castorani
- Department of Pediatrics, “G. d'Annunzio” University-Chieti, Pescara, Italy
| | - L. Comegna
- Department of Pediatrics, “G. d'Annunzio” University-Chieti, Pescara, Italy
| | - E. Fornari
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - F. Daniele
- Department of Medical, Oral and Biotechnological Sciences, “G. d'Annunzio” University-Chieti, Pescara, Italy
| | - G. Prezioso
- Department of Pediatrics, “G. d'Annunzio” University-Chieti, Pescara, Italy
| | - C. Piona
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - V. Federico
- SS Annunziata” University Hospital, Unit of Clinical Molecular Biology, “G. d'Annunzio” University-Chieti, Pescara, Italy
| | - D. Zona
- SS Annunziata” University Hospital, Unit of Clinical Molecular Biology, “G. d'Annunzio” University-Chieti, Pescara, Italy
| | - I. Bresadola
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - F. Chiarelli
- Department of Pediatrics, “G. d'Annunzio” University-Chieti, Pescara, Italy
| | - C. Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
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97
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Lin H, Tas E, Børsheim E, Mercer KE. Circulating miRNA Signatures Associated with Insulin Resistance in Adolescents with Obesity. Diabetes Metab Syndr Obes 2020; 13:4929-4939. [PMID: 33328751 PMCID: PMC7735788 DOI: 10.2147/dmso.s273908] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/08/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE MicroRNAs (miRNAs) are implicated in metabolic changes accompanying progression of obesity, insulin resistance (IR), and metabolic disorders in children. Identifying circulating miRNAs that uniquely associate with these disorders may be useful in early identification and prevention of obesity-related complications. We aimed to identify circulating miRNA signatures that distinguish adolescents with obesity and IR from those with obesity unaccompanied by IR. METHODS Adolescents (aged 10-17 years) with obesity were recruited from a weight management clinic. Fasting serum samples were obtained from 33 participants. A total of 179 miRNAs were queried by a quantitative RT-PCR-based miRNA focus panel. Differentially expressed miRNAs were compared between groups using Student's t-test or one-way ANOVA analysis, and the association between IR evaluated by homeostatic model assessment model (HOMA-IR > 4) and body mass index (BMI) status was assessed using Pearson's correlation analysis. RESULTS We found an expression pattern consisting of 12 elevated miRNAs linked to IR in obese adolescents. miR-30d, -221, and -122 were significantly correlated with clinical and biochemical markers of obesity and IR, suggestive of IR in adolescents at risk. CONCLUSION Specific signatures of circulating miRNAs reflected metabolic phenotypes and predicted the presence of IR in adolescents with obesity, suggesting that miRNA indicators may identify obesity-associated complications in childhood. Further studies will be needed to understand cause versus effect and the mechanisms by which IR status links to changes in blood miRNA profiles.
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Affiliation(s)
- Haixia Lin
- Arkansas Children’s Nutrition Center, Little Rock, AR, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Emir Tas
- Arkansas Children’s Nutrition Center, Little Rock, AR, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Endocrinology and Diabetes, Arkansas Children’s Hospital, Little Rock, AR, USA
- Center for Childhood Obesity Prevention, Little Rock, AR, USA
- Arkansas Children’s Research Institute, Little Rock, AR, USA
| | - Elisabet Børsheim
- Arkansas Children’s Nutrition Center, Little Rock, AR, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Center for Childhood Obesity Prevention, Little Rock, AR, USA
- Arkansas Children’s Research Institute, Little Rock, AR, USA
| | - Kelly E Mercer
- Arkansas Children’s Nutrition Center, Little Rock, AR, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Center for Childhood Obesity Prevention, Little Rock, AR, USA
- Correspondence: Kelly E Mercer; Haixia Lin Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR72202, USATel +1-501-364-2706Fax +1-501-364-3161 Email ;
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98
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Yu M, Wang W, Wang H. The Late-Gestational Triglyceride to High-Density Lipoprotein Cholesterol Ratio Is Associated with Neonatal Macrosomia in Women without Diabetes Mellitus. Int J Endocrinol 2020; 2020:7250287. [PMID: 32655633 PMCID: PMC7321524 DOI: 10.1155/2020/7250287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/28/2020] [Accepted: 05/15/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate the associations between late-gestational dyslipidemia, expressed as the ratio between triglycerides (TGs) and high-density lipoprotein cholesterol (HDL), and the risk of macrosomia among nondiabetic pregnant women. METHODS In this case-control study, 171 pregnant women who delivered macrosomia newborns were recruited from a total of 1856 nondiabetic pregnant women who delivered a singleton, nonanomalous newborn. A total of 684 normal controls were one-to-four matched by age. Logistic regression analysis was used to analyze the association between the TG/HDL ratio and the neonatal body weight as well as the risk of macrosomia. RESULTS The maternal serum TG and TG/HDL levels were much higher in the macrosomia group, while the maternal serum HDL-C levels were much lower in the macrosomia group than those in the control group. However, the serum total cholesterol (TC) and LDL-C levels were not significantly different between the two groups. Furthermore, maternal TG/HDL levels were positively associated with neonatal body weight. The confounding factors including maternal age, maternal height, gestational age, maternal body mass index (BMI), FPG, SBP, and neonatal sex were adjusted. A positive association between TG/HDL and neonatal body weight was still found. Moreover, the prevalence of macrosomia increased markedly in a dose-dependent manner as with maternal TG/HDL levels increased. CONCLUSIONS Maternal serum TG/HDL levels at late gestation are positively associated with neonatal body weight and the risk of macrosomia in women without DM. Maintaining maternal lipid levels in an appropriate range is important in the context of fetal overgrowth and primary prevention of macrosomia.
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Affiliation(s)
- Mengru Yu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
| | - Wenting Wang
- Department of Obstetrics and Gynecology, The Second Hospital of Shandong University, Jinan, China
| | - Hong Wang
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
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99
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Kirk IK, Simon C, Banasik K, Holm PC, Haue AD, Jensen PB, Juhl Jensen L, Rodríguez CL, Pedersen MK, Eriksson R, Andersen HU, Almdal T, Bork-Jensen J, Grarup N, Borch-Johnsen K, Pedersen O, Pociot F, Hansen T, Bergholdt R, Rossing P, Brunak S. Linking glycemic dysregulation in diabetes to symptoms, comorbidities, and genetics through EHR data mining. eLife 2019; 8:44941. [PMID: 31818369 PMCID: PMC6904221 DOI: 10.7554/elife.44941] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 11/16/2019] [Indexed: 12/13/2022] Open
Abstract
Diabetes is a diverse and complex disease, with considerable variation in phenotypic manifestation and severity. This variation hampers the study of etiological differences and reduces the statistical power of analyses of associations to genetics, treatment outcomes, and complications. We address these issues through deep, fine-grained phenotypic stratification of a diabetes cohort. Text mining the electronic health records of 14,017 patients, we matched two controlled vocabularies (ICD-10 and a custom vocabulary developed at the clinical center Steno Diabetes Center Copenhagen) to clinical narratives spanning a 19 year period. The two matched vocabularies comprise over 20,000 medical terms describing symptoms, other diagnoses, and lifestyle factors. The cohort is genetically homogeneous (Caucasian diabetes patients from Denmark) so the resulting stratification is not driven by ethnic differences, but rather by inherently dissimilar progression patterns and lifestyle related risk factors. Using unsupervised Markov clustering, we defined 71 clusters of at least 50 individuals within the diabetes spectrum. The clusters display both distinct and shared longitudinal glycemic dysregulation patterns, temporal co-occurrences of comorbidities, and associations to single nucleotide polymorphisms in or near genes relevant for diabetes comorbidities.
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Affiliation(s)
- Isa Kristina Kirk
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Christian Simon
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Peter Christoffer Holm
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Amalie Dahl Haue
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Peter Bjødstrup Jensen
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark.,Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Lars Juhl Jensen
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Cristina Leal Rodríguez
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Mette Krogh Pedersen
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Robert Eriksson
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | | | - Thomas Almdal
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark
| | - Jette Bork-Jensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | | | - Oluf Pedersen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Flemming Pociot
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Clinical Medicine, Herlev-Gentofte Hospital, Herlev, Denmark
| | - Torben Hansen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | | | - Peter Rossing
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark.,Center for Biological Sequence Analysis, Department of Bio and Health Informatics, Technical University of Denmark, Lyngby, Denmark
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100
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Locateli JC, Lopes WA, Simões CF, de Oliveira GH, Oltramari K, Bim RH, de Souza Mendes VH, Remor JM, Lopera CA, Nardo Junior N. Triglyceride/glucose index is a reliable alternative marker for insulin resistance in South American overweight and obese children and adolescents. J Pediatr Endocrinol Metab 2019; 32:1163-1170. [PMID: 31472061 DOI: 10.1515/jpem-2019-0037] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 07/14/2019] [Indexed: 02/07/2023]
Abstract
Background The aim of the present study was to investigate the correlation between the triglyceride/glucose index (TyG index) and homeostasis model assessment of insulin resistance (HOMA-IR). Additionally, we compared the ability of the TyG index and triglycerides/high-density lipoprotein cholesterol (TG/HDL-c) index and the combination of these two indices (TyG index plus TG/HDL-c) to predict insulin resistance (IR) in South American overweight and obese children and adolescents. Methods A cross-sectional study was carried out in 345 overweight adolescents aged 10-18 years, from both the sexes. The TyG index was calculated as Ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL])/2, while the TG/HDL-c index was calculated by the division of TG (mg/dL) by HDL-c (mg/dL). HOMA-IR was calculated with the formula: fasting insulin (FI) (U/mL) × fasting glucose (mmol/L)/22.5. The cut-off point used to determine the presence of IR was HOMA-IR ≥ 3.16. Results The TyG index showed a positive correlation with HOMA-IR. The area under the receiver operating characteristic (ROC) curve of the TyG index was 0.74, indicating good sensitivity (75.7%) and specificity (67.4%). Furthermore, the TyG index cut-off point of >4.44 was established for IR prediction in this population. Conclusions The TyG index is a simple and cost-effective surrogate marker of IR in South American overweight children and adolescents. Moreover, due to its good accessibility, it can be used in large epidemiological studies.
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Affiliation(s)
| | - Wendell Arthur Lopes
- Department of Physical Education, State University of Maringa, Av. Colombo, 5.790, Campus Universitário, Maringa,Paraná 87020-90, Brazil, Phone: +55(44)998794895, E-mail:
| | | | - Gustavo Henrique de Oliveira
- Department of Physical Education, State University of Maringa, Av. Colombo, 5.790, Campus Universitário, Maringa,Paraná 87020-90, Brazil, Phone: +55(44)998794895, E-mail:
| | | | | | | | - Jane Maria Remor
- Department of Physical Education, State University of Maringá, Maringá, Brazil
| | | | - Nelson Nardo Junior
- Department of Physical Education, State University of Maringá, Maringá, Brazil
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