101
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Lin JL, Sung KT, Su CH, Chou TH, Lo CI, Tsai JP, Chang SC, Lai YH, Hu KC, Liu CY, Yun CH, Hung CL, Yeh HI, Lam CSP. Cardiac Structural Remodeling, Longitudinal Systolic Strain, and Torsional Mechanics in Lean and Nonlean Dysglycemic Chinese Adults. Circ Cardiovasc Imaging 2019; 11:e007047. [PMID: 29752393 DOI: 10.1161/circimaging.117.007047] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 03/26/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Diabetes mellitus and pre-diabetes mellitus are associated with lower body mass indices and increased risk of cardiovascular events (including heart failure) at lower glucose thresholds in Chinese compared with Western cohorts. However, the extent of cardiac remodeling and regulation on cardiac mechanics in lean and nonlean dysglycemic Chinese adults is understudied. METHODS AND RESULTS We studied 3950 asymptomatic Chinese (aged 49.7±10.7 years; 65% male; body mass index: 24.3±3.5 kg/m2) with comprehensive echocardiography including speckle tracking for left ventricular global longitudinal strain/torsion, with plasma sugar, glycosylated hemoglobin (HbA1c), and insulin resistance (homeostasis model assessment of insulin resistance) obtained. Participants were classified as (1) nondiabetic (fasting glucose <100 mg/mL; HbA1c <5.7%; n=1416), prediabetic (fasting glucose 100-126 mg/dL; HbA1c 5.7%-6.4%; n=2029), or diabetic (n=505) and (2) lean (body mass index <23 kg/m2; n=1445) or nonlean (n=2505). Higher sugar, HbA1c, and homeostasis model assessment of insulin resistance were independently associated with higher left ventricular mass, greater mass-to-volume ratio, more impaired diastolic indices, and worse global longitudinal strain even after adjusting for clinical covariates (adjusted coefficient value: 0.28/0.12 for global longitudinal strain per 1 U HbA1c/homeostasis model assessment of insulin resistance increment; both P<0.001), with a consistent trend toward greater torsion (all trend P<0.001). The optimal cutoffs in identifying subclinical systolic dysfunction (global longitudinal strain more impaired than -18%) for lean versus nonlean individuals were 97 versus 106 mg/dL for fasting sugar, 130 versus 135 mg/mL for postprandial sugar, 5.62% versus 6.28% for HbA1c, and 1.81 versus 2.40 for homeostasis model assessment of insulin resistance, respectively. CONCLUSIONS These data demonstrate the presence of preclinical cardiac remodeling and systolic dysfunction in prediabetic and diabetic Chinese adults, occurring at lower thresholds of glycemic indices than defined by international standards, particularly in lean individuals.
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Affiliation(s)
- Jiun-Lu Lin
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan (J.-L.L., K.-T.S., C.-H.S., C.-I.L., J.-P.T., S.-C.C., C.-L.H.).,Division of Endocrinology and Metabolism, Department of Internal Medicine (J.-L.L.)
| | - Kuo-Tzu Sung
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan (J.-L.L., K.-T.S., C.-H.S., C.-I.L., J.-P.T., S.-C.C., C.-L.H.).,Division of Cardiology, Department of Internal Medicine (K.-T.S., C.-H.S., C.-I.L., J.-P.T., C.-L.H., H.-I.Y.)
| | - Cheng-Huang Su
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan (J.-L.L., K.-T.S., C.-H.S., C.-I.L., J.-P.T., S.-C.C., C.-L.H.).,Division of Cardiology, Department of Internal Medicine (K.-T.S., C.-H.S., C.-I.L., J.-P.T., C.-L.H., H.-I.Y.)
| | | | - Chi-In Lo
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan (J.-L.L., K.-T.S., C.-H.S., C.-I.L., J.-P.T., S.-C.C., C.-L.H.).,Division of Cardiology, Department of Internal Medicine (K.-T.S., C.-H.S., C.-I.L., J.-P.T., C.-L.H., H.-I.Y.)
| | - Jui-Peng Tsai
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan (J.-L.L., K.-T.S., C.-H.S., C.-I.L., J.-P.T., S.-C.C., C.-L.H.).,Division of Cardiology, Department of Internal Medicine (K.-T.S., C.-H.S., C.-I.L., J.-P.T., C.-L.H., H.-I.Y.)
| | - Shun-Chuan Chang
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan (J.-L.L., K.-T.S., C.-H.S., C.-I.L., J.-P.T., S.-C.C., C.-L.H.)
| | - Yau-Huei Lai
- MacKay Memorial Hospital, Taipei, Taiwan. Division of Cardiology, Department of Internal Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan (Y.-H.L.)
| | - Kuang-Chun Hu
- Health Evaluation Center (K.-C.H., C.-Y.L.).,Division of Gastroenterology, Department of Internal Medicine (K.-C.H., C.-Y.L.)
| | - Chia-Yuan Liu
- Health Evaluation Center (K.-C.H., C.-Y.L.).,Division of Gastroenterology, Department of Internal Medicine (K.-C.H., C.-Y.L.)
| | - Chun-Ho Yun
- Health Evaluation Center (K.-C.H., C.-Y.L.).,and Department of Radiology (C.-H.Y.)
| | - Chung-Lieh Hung
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan (J.-L.L., K.-T.S., C.-H.S., C.-I.L., J.-P.T., S.-C.C., C.-L.H.). .,Division of Cardiology, Department of Internal Medicine (K.-T.S., C.-H.S., C.-I.L., J.-P.T., C.-L.H., H.-I.Y.).,Institute of Clinical Medicine (C.-L.H.).,and Cardiovascular Research Center (C.-L.H.)
| | - Hung-I Yeh
- Division of Cardiology, Department of Internal Medicine (K.-T.S., C.-H.S., C.-I.L., J.-P.T., C.-L.H., H.-I.Y.)
| | - Carolyn S P Lam
- National Yang-Ming University, Taipei, Taiwan. National Heart Centre Singapore (C.S.P.L.).,Duke-National University of Singapore (C.S.P.L.)
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Early testing of insulin resistance: a tale of two lipid ratios in a group of 5th graders screened by the Coronary Artery Risk Detection in Appalachian Communities Project (CARDIAC Project). World J Pediatr 2019; 15:398-404. [PMID: 31055781 PMCID: PMC7409539 DOI: 10.1007/s12519-018-00225-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 12/27/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND In West Virginia (WV), 47% of fifth-grade children are either overweight or obese. There is no clear consensus regarding the definition of insulin resistance in children, and directly measuring insulin on the population level is costly. Two proposed measures examined further in this study include triglyceride (TRIG)/high-density lipoprotein cholesterol (HDL-C) ratio and TRIG/low-density lipoprotein (LDL-C) ratio. The purpose of this study is to examine the relationship between TRIG/HDL-C ratio, TRIG/LDL-C ratio and insulin resistance in fifth-graders with acanthosis nigricans (AN). METHODS Between 2007 and 2016, 52,545 fifth-grade students in WV were assessed for AN. Fasting glucose and insulin levels were collected only for a sub-group of students who were AN-positive and was used to determine insulin resistance using the Homeostatic Model for Insulin Resistance (HOMA-IR) equation. Statistical analysis included t tests and logistic regression with receiver operating characteristic curves. RESULTS Of the students assessed for AN, 4.5% (n = 2360) tested positive. The prevalence of insulin resistance was 79% (n = 814) among 1030 with AN and complete HOMA-IR. TRIG/HDL-C ratio and TRIG/LDL-C ratio were significantly associated with insulin resistance (TRIG/HDL-C:Est. = 0.36, P < 0.0001, AUC = 0.68; TRIG/LDL-C: Est. = 0.87, P < 0.0001, AUC = 0.69). Multivariate analysis showed that increased body mass index (Est. = 0.05, P < 0.0001), gender (Est. = 0.49, p < 0.0001) and TRIG/HDL-C ratio (Est. = 0.21, P < 0.0001) were significantly associated with insulin resistance. CONCLUSIONS TRIG/HDL-C is a better surrogate marker of insulin resistance in AN-positive children compared to TRIG/LDL-C ratio; so, on a population-level, cholesterol rather than insulin may be obtained for preliminary testing of early insulin resistance in children.
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103
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Chiavaroli V, Gibbins JD, Cutfield WS, Derraik JGB. Childhood obesity in New Zealand. World J Pediatr 2019; 15:322-331. [PMID: 31079339 DOI: 10.1007/s12519-019-00261-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 04/15/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Paediatric obesity has reached epidemic proportions globally, resulting in significant adverse effects on health and wellbeing. Early life events, including those that happen before, during, and after pregnancy can predispose children to later obesity. The purpose of this review is to examine the magnitude of obesity among New Zealand children and adolescents, and to determine their underlying risk factors and associated comorbidities. DATA SOURCES PubMed, Web of Science, and Google Scholar searches were performed using the key terms "obesity", "overweight", "children", "adolescents", and "New Zealand". RESULTS Obesity is a major public health concern in New Zealand, with more than 33% of children and adolescents aged 2-14 years being overweight or obese. Obesity disproportionately affects Māori (New Zealand's indigenous population) and Pacific children and adolescents, as well as those of lower socioeconomic status. New Zealand's obesity epidemic is associated with numerous health issues, including cardiometabolic, gastrointestinal, and psychological problems, which also disproportionately affect Māori and Pacific children and adolescents. Notably, a number of factors may be useful to identify those at increased risk (such as demographic and anthropometric characteristics) and inform possible interventions. CONCLUSIONS The prevalence of overweight and obese children and adolescents in New Zealand is markedly high, with a greater impact on particular ethnicities and those of lower socioeconomic status. Alleviating the current burden of pediatric obesity should be a key priority for New Zealand, for the benefit of both current and subsequent generations. Future strategies should focus on obesity prevention, particularly starting at a young age and targeting those at greatest risk.
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Affiliation(s)
| | - John D Gibbins
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand. .,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand. .,Endocrinology Department, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China.
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand. .,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand. .,Endocrinology Department, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China. .,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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104
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Association between three non-insulin-based indexes of insulin resistance and hyperuricemia. Clin Rheumatol 2019; 38:3227-3233. [PMID: 31300980 DOI: 10.1007/s10067-019-04671-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/17/2019] [Accepted: 07/01/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The association between hyperuricemia and insulin resistance (IR) has been demonstrated by many studies, but the traditional IR indexes are too impractical to be used in clinical practice for the recognition of the IR state in individuals with hyperuricemia. Therefore, we aimed to further investigate the association between hyperuricemia and three non-insulin-based IR indexes in this large-scale cross-sectional study. METHODS A total of 174,695 adults without self-reported use of antihyperuricemic agents, hypoglycemic agents, or lipid-lowering drugs were included in the current analysis. The triglyceride to high-density lipoprotein cholesterol ratio (TG/HDLc), the product of fasting triglycerides and glucose (TyG), and metabolic score for IR (METS-IR) were calculated. Then, logistic regression analyses were applied to explore their association with hyperuricemia. RESULTS The TG/HDLc, TyG, and METS-IR all had positive correlations with uric acid level. However, only TG/HDLc and TyG were significantly associated with hyperuricemia in both sexes and body mass index (BMI) classification (the ORs of the highest quartile for each were 6.751 and 1.505 in females and 6.487 and 1.646 in males, respectively). The AUC values of TG/HDLc and TyG to discriminate hyperuricemia were also statistically significant in both sexes and BMI classification (all greater than 0.7). CONCLUSIONS TG/HDLc and TyG are strongly associated with hyperuricemia regardless of BMI classification. These two obtainable and cost-effective non-insulin-based IR indexes could be potential monitors during the management of hyperuricemia and prevention of its IR-driven comorbidities. Key Points • In this large-scale study, we identified TG/HDLc and TyG as indicators for identification of IR in patients with hyperuricemia. • These simple and practical IR indicators are of substantial clinical importance for implementing preventive strategies against IR-driven comorbidities of hyperuricemia.
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105
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Liu XZ, Fan J, Pan SJ. METS-IR, a novel simple insulin resistance indexes, is associated with hypertension in normal-weight Chinese adults. J Clin Hypertens (Greenwich) 2019; 21:1075-1081. [PMID: 31282098 DOI: 10.1111/jch.13591] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/29/2019] [Accepted: 05/09/2019] [Indexed: 12/14/2022]
Abstract
Insulin resistance (IR) plays a crucial role in the development of hypertension, so early recognition of IR is of substantial clinical importance for the management of hypertension. But traditional IR indexes are invasive, complex, and impractical. We aimed to evaluate the associations between three simple IR indexes and hypertension in different body mass index (BMI) categories. A total of 142 005 adults who did not take antihypertensive medication were included in this analysis. The ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDLc), the product of fasting triglycerides and glucose (TyG), and metabolic score for IR (METS-IR) were calculated according to the corresponding formulas. The associations between them and hypertension were analyzed by logistic regression. Among the three indicators, only METS-IR had positive correlations with blood pressure levels (all P < 0.001). After full adjustment, METS-IR was significantly associated with hypertension in the normal BMI group but not in the elevated BMI group. The OR for hypertension in the normal BMI group in the highest quartile of METS-IR was 2.884 (95% CI: 2.468-3.369) in the total sample, 1.915 (95% CI: 1.614-2.271) in females and 2.083 (95% CI: 1.717-2.527) in males. Our findings indicate that METS-IR, a simple and cost-effective IR index, was strongly associated with hypertension in normal-weight Chinese subjects. It could help monitor and manage hypertension in normal-weight individuals.
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Affiliation(s)
- Xing Zhen Liu
- Directly Affiliated Convalescence Area, Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, China
| | - Jie Fan
- General Management Office, Zhejiang Police College, Hangzhou, China
| | - Shu Jun Pan
- Directly Affiliated Convalescence Area, Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, China
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106
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Matsumoto T, Ohnishi H, Sato T, Miki T, Akasaka H, Hanawa N, Koyama M, Saitoh S, Miura T. Insulin Resistance is Associated with Longitudinal Changes of Cardiac Repolarization Heterogeneity in Apparently Healthy Subjects. Cardiol Ther 2019; 8:239-251. [PMID: 31273651 PMCID: PMC6828911 DOI: 10.1007/s40119-019-0140-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Increased heterogeneity in ventricular repolarization is a risk factor of sudden cardiac death, but its natural history is unclear. Here we examined whether insulin resistance is associated with longitudinal change in ventricular repolarization heterogeneity in apparently healthy subjects. METHODS The study subjects were participants in health checkups in cohort 1 and cohort 2, which were followed up for 6 years and 5 years, respectively. Subjects with diabetes, cardiovascular disease, or renal disease at baseline were excluded from the analyses. As indices of insulin resistance, the homeostasis model assessment of insulin resistance (HOMA-IR) and triglyceride to HDL-cholesterol ratio (TG/HDL-C) were used in cohort 1 and cohort 2, respectively. Heterogeneity in ventricular repolarization was assessed by heart rate-corrected Tpeak-Tend interval in V5 (cTpTe), QT interval, and QT dispersion. In regression analyses, parameters with a skewed distribution were normalized by logarithmic transformation or by Box-Cox transformation. RESULTS In longitudinal analyses, Box-Cox-transformed cTpTe at the end of follow-up was weakly correlated with log HOMA-IR at baseline in cohort 1 (n = 153, r = - 0.207, 95% CI - 0.354 to - 0.050, p = 0.010) and with log TG/HDL-C at baseline in cohort 2 (n = 738, r = - 0.098, 95% CI - 0.169 to - 0.026, p = 0.008). Multiple regression analysis showed that indices of insulin resistance, but not glycosylated hemoglobin (HbA1c) or plasma glucose, at baseline were significant explanatory variables for cTpTe at the end of follow-up. Neither QT interval nor QT dispersion was correlated with metabolic parameters. CONCLUSION Insulin resistance may be involved in the longitudinal increase of ventricular repolarization heterogeneity in apparently healthy subjects.
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Affiliation(s)
- Tamaki Matsumoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hirofumi Ohnishi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tatsuya Sato
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takayuki Miki
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiroshi Akasaka
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | | | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shigeyuki Saitoh
- Division of Medical and Behavioral Subjects, Department of Nursing, Sapporo Medical University School of Health Sciences, Sapporo, Japan
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
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HDL Triglycerides: A New Marker of Metabolic and Cardiovascular Risk. Int J Mol Sci 2019; 20:ijms20133151. [PMID: 31252694 PMCID: PMC6651243 DOI: 10.3390/ijms20133151] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 01/10/2023] Open
Abstract
While cholesterol content in high-density lipoproteins (HDLs) is a well-established inverse marker of cardiovascular risk, the importance of HDL–triglyceride (HDL-TG) concentration is not well known. We aim to examine plasma HDL-TG concentrations, assessed by 1H-NMR, in patients with metabolic diseases and their association with classical biomarkers. In this cross-sectional study, we included 502 patients with type 2 diabetes or metabolic syndrome attending the lipid unit of our University Hospital. The presence of arteriosclerotic plaques was assessed by ultrasonography. A complete lipoprotein profile was performed by 1H-NMR (Liposcale test). HDL-TG was strongly positively correlated with total triglycerides, glycerol, and fatty liver index, while a strong negative correlation was observed with HDL-cholesterol (HDL-C) and HDL-particle number (HDL-P). HDL-TG was associated with all triglyceride-rich lipoprotein parameters and had an opposite association with HDL-C and HDL-P. It was also significantly correlated with circulating cholesterol ester transfer protein (CETP). HDL-TG concentrations were higher as metabolic syndrome components increased. HDL-TG was also higher with worsening glucose metabolism. Patients with carotid plaques also showed higher HDL-TG. In contrast to HDL-C, HDL-TG is directly associated with metabolism and arteriosclerotic vascular alterations. HDL-TG should be considered a biomarker of metabolic and cardiovascular risk and could be a marker of HDL dysfunction.
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108
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Ruyatkina LA, Ruyatkin DS, Iskhakova IS. Opportunities and options for surrogate assessment of insulin resistance. OBESITY AND METABOLISM 2019. [DOI: 10.14341/omet10082] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The high prevalence of type 2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular diseases (CVD) determines the need for early detection and correction of key markers of cardio-metabolic risk (CMR). This prophylactic direction is closely related to metabolic syndrome (MS) based on the concept of insulin resistance (IR). At the same time, IR is the first link in the pathogenesis of T2DM and is a recognized risk factor for atherothrombosis. Therefore, early diagnosis of IR is of practical importance both for the detection of early disorders of carbohydrate metabolism (DCM) and prognosis of T2DM, and cardiological risk. Alternative indicators have been proposed for evaluating IR with the inclusion of lipid and anthropometric parameters, the diagnostic and prognostic significance of which in terms of CMR (DCM and CVD) has been evaluated in randomized clinical trials in comparison with the HOMA-IR index and clamp. The TyG index (calculated on the basis of plasma glucose and triglycerides) is consistent with the phenomenon of glucolipotoxicity with subsequent metabolic disorders in target organs. Its derivatives are proposed: TyG-WC (TyG / waist circumference) and TYG-BMI (TyG / BMI). Apply LAP indices (lipid accumulation index) and VAI (visceral obesity index), as well as TG / HDL (TG / HDL). Their ethnic and gender differences were revealed, attempts were made to calculate the cut-off points for these indices.
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109
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Fan J, Gao ST, Wang LJ, Qian ZL, Zhou ZQ, Liu XZ. Association of Three Simple Insulin Resistance Indexes with Prehypertension in Normoglycemic Subjects. Metab Syndr Relat Disord 2019; 17:374-379. [PMID: 31211636 DOI: 10.1089/met.2019.0029] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Insulin resistance (IR) is the common pathophysiology of prehypertension and prediabetes. Recognition of IR in one of the two disease states is critical for carrying out preventive strategies of another disease state. This study aimed to explore which simple IR indexes were significantly associated with prehypertension in subjects with normoglycemia. Methods: A total of 108,370 adults without elevated fasting plasma glucose and hypertension were included in this study. The three simple IR indexes [triglycerides to high-density lipoprotein cholesterol ratio, the product of fasting triglycerides and glucose, and metabolic score for IR (METS-IR)] were calculated. Partial correlation was used to analyze the correlation between the three indicators and blood pressure (BP) levels, and logistic regression analysis was used to explore their association with prehypertension. Results: Among the three indicators, only METS-IR had positive correlations with systolic and diastolic blood pressure levels. Furthermore, METS-IR was also significantly associated with prehypertension, irrespective of the categorization of waist circumference (WC). The odds ratios of the highest quartile were 2.223 (95% confidence interval [CI]: 2.044-2.417) in all subjects, 2.022 (95% CI: 1.501-2.725) in elevated WC subgroup, and 1.815 (95% CI: 1.620-2.034) in normal WC subgroup. Conclusions: METS-IR was associated with prehypertension in normoglycemic Chinese subjects, which bypasses the impact of WC and might be valuable for the management of prehypertension and the prevention of prediabetes in different ethnic groups.
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Affiliation(s)
- Jie Fan
- General Management Office, Zhejiang Police College, Hangzhou, Zhejiang, China
| | - Song Ting Gao
- Guali Town Community Health Service Center, Xiaoshan District, Hangzhou, Zhejiang, China
| | - Li Jun Wang
- Directly Affiliated Convalescence Area, Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, Zhejiang, China
| | - Zhong Li Qian
- Directly Affiliated Convalescence Area, Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, Zhejiang, China
| | - Ze Quan Zhou
- Directly Affiliated Convalescence Area, Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, Zhejiang, China
| | - Xing Zhen Liu
- Directly Affiliated Convalescence Area, Hangzhou Aeronautical Sanatorium of Chinese Air Force, Hangzhou, Zhejiang, China
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Gharipour M, Sadeghi M, Nezafati P, Dianatkhah M, Sarrafzadegan N. Cardiovascular Disease Risk Assessment: Triglyceride/High-Density Lipoprotein versus Metabolic Syndrome Criteria. J Res Health Sci 2019; 19:e00442. [PMID: 31278212 PMCID: PMC7183547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 04/27/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND As finding subjects at risk of cardiovascular diseases based on the presence of metabolic syndrome (MetS) is time-consuming for physicians, we aimed to compare the effectiveness of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) compared to MetS criteria in identifying high-risk individuals. STUDY DESIGN A prospective cohort study. METHODS Isfahan cohort study was a longitudinal population-based study conducted on adults aged 35 yr or older, living in three districts in central part of Iran from Jan 2, 2001 to Sep 28, 2001. After 10 years of follow-up, participants were re-evaluated. The hazard ratio (HR) for cardiovascular disease events based on TG/HDL-C, sex-specific cut-off points, and MetS were also estimated. Akaike's information criteria (AIC) were used as indicators of the goodness of fit of the model and prediction error. RESULTS TG/HDL-C alternate cut-off points of 3.76 and 4.42 had a strong predictive value for CVD events but did not perform as well as MetS criteria. The unadjusted HR was greatest in the high-risk individuals by the MetS criteria (HR=2.08, 95% CI: 1.80, 2.41) compared to those identified as high-risks by the TG/HDL cut-off points and continued to be greatest after adjustments in different models. Based on the AIC, the best model is adjusted for sex, age, diabetes, total cholesterol levels, current smoker, diet, physical activity, and BMI. CONCLUSION MetS criteria appears to be a superior marker compared to TC/HDL-C to identify patients at cardiovascular risk, though lipid ratio also shows a remarkable predictive value and could be considered to achieve this goal when appropriate.
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Affiliation(s)
- Mojgan Gharipour
- 1Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- 2Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,Correspondence : Masoumeh Sadeghi (MD) Tel: +98 31 36115208 E-mail1: E-mail2:
| | - Pouya Nezafati
- 3Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Minoo Dianatkhah
- 4Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- 1Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Chu SY, Jung JH, Park MJ, Kim SH. Risk assessment of metabolic syndrome in adolescents using the triglyceride/high-density lipoprotein cholesterol ratio and the total cholesterol/high-density lipoprotein cholesterol ratio. Ann Pediatr Endocrinol Metab 2019; 24:41-48. [PMID: 30943679 PMCID: PMC6449623 DOI: 10.6065/apem.2019.24.1.41] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/24/2018] [Indexed: 12/29/2022] Open
Abstract
PURPOSE This study was conducted to investigate the distributions of the triglyceride (TG) to high-density lipoprotein-cholesterol (HDL-C) ratio and total cholesterol (TC) to HDL-C ratio, and to explore their usefulness as markers of metabolic syndrome (MetS) in Korean adolescents. METHODS We obtained data for 2,721 adolescents (1,436 boys and 1,285 girls) aged 10-18 years who participated in the Korean National Health and Nutrition Examination Surveys from 2008 to 2010. International Diabetes Federation criteria were used to define MetS. RESULTS There were no significant gender-related differences in TG/HDL-C or TC/HDL-C ratios. These lipid ratios showed significant associations with homeostatic model assessment for insulin resistance (HOMA-IR) and waist circumference. Areas under the receiver operating characteristic curve to identify MetS were 0.947 for TG/HDL-C and 0.924 for TC/HDL-C, which were higher than that of HOMA-IR (0.822). Optimal cutoff values (sensitivity, specificity) of TG/HDL-C and TC/HDL-C ratios for MetS prediction were 3.3 (85.7%, 89.9%), and 3.8 (92.9%, 82.8%), respectively. Odds ratio (OR; 95% confidence intervals [CIs]) for MetS in adolescents with TC/HDL-C ratio above the cutoff value was 14.8 (2.8-77.4), while that for TG/HDL-C ratio about the cutoff value was 30.6 (6.0-157.6). In adolescents who had both lipid ratios above the cutoff values, the OR (95% CI) for MetS was 36.2 (7.2-186.2). CONCLUSION TG/HDL-C and TC/HDL-C ratios are useful markers of metabolic syndrome with high predictive value in Korean adolescents.
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Affiliation(s)
- Shou-Yu Chu
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Ji-Hyun Jung
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Mi-Jung Park
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Shin-Hye Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea,Address for correspondence: Shin-Hye Kim, MD, PhD Department of Pediatrics, Inje University Sanggye Paik Hospital, 1342, Dongilro, Nowon-gu, Seoul 01757, Korea Tel: +82-2-950-1071 Fax: +82-2-950-1246 E-mail:
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112
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Galmés S, Cifre M, Palou A, Oliver P, Serra F. A Genetic Score of Predisposition to Low-Grade Inflammation Associated with Obesity May Contribute to Discern Population at Risk for Metabolic Syndrome. Nutrients 2019; 11:E298. [PMID: 30704070 PMCID: PMC6412420 DOI: 10.3390/nu11020298] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/16/2019] [Accepted: 01/24/2019] [Indexed: 12/26/2022] Open
Abstract
Omega-3 rich diets have been shown to improve inflammatory status. However, in an ex vivo system of human blood cells, the efficacy of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) modulating lipid metabolism and cytokine response is attenuated in overweight subjects and shows high inter-individual variability. This suggests that obesity may be exerting a synergistic effect with genetic background disturbing the anti-inflammatory potential of omega-3 long-chain polyunsaturated fatty acids (PUFA). In the present work, a genetic score aiming to explore the risk associated to low grade inflammation and obesity (LGI-Ob) has been elaborated and assessed as a tool to contribute to discern population at risk for metabolic syndrome. Pro-inflammatory gene expression and cytokine production as a response to omega-3 were associated with LGI-Ob score; and lower anti-inflammatory effect of PUFA was observed in subjects with a high genetic score. Furthermore, overweight/obese individuals showed positive correlation of both plasma C-Reactive Protein and triglyceride/HDLc-index with LGI-Ob; and high LGI-Ob score was associated with greater hypertension (p = 0.047), Type 2 diabetes (p = 0.026), and metabolic risk (p = 0.021). The study shows that genetic variation can influence inflammation and omega-3 response, and that the LGI-Ob score could be a useful tool to classify subjects at inflammatory risk and more prone to suffer metabolic syndrome and associated metabolic disturbances.
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Affiliation(s)
- Sebastià Galmés
- NUO Group, Laboratory of Molecular Biology, Nutrition and Biotechnology, Universitat de les Illes Balears, 07122 Palma, Spain.
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain.
- Institut d'Investigació Sanitària Illes Balears (IdISBa), 07120 Palma, Spain.
| | - Margalida Cifre
- NUO Group, Laboratory of Molecular Biology, Nutrition and Biotechnology, Universitat de les Illes Balears, 07122 Palma, Spain.
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain.
| | - Andreu Palou
- NUO Group, Laboratory of Molecular Biology, Nutrition and Biotechnology, Universitat de les Illes Balears, 07122 Palma, Spain.
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain.
- Institut d'Investigació Sanitària Illes Balears (IdISBa), 07120 Palma, Spain.
| | - Paula Oliver
- NUO Group, Laboratory of Molecular Biology, Nutrition and Biotechnology, Universitat de les Illes Balears, 07122 Palma, Spain.
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain.
- Institut d'Investigació Sanitària Illes Balears (IdISBa), 07120 Palma, Spain.
| | - Francisca Serra
- NUO Group, Laboratory of Molecular Biology, Nutrition and Biotechnology, Universitat de les Illes Balears, 07122 Palma, Spain.
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain.
- Institut d'Investigació Sanitària Illes Balears (IdISBa), 07120 Palma, Spain.
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113
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Hemnes AR, Luther JM, Rhodes CJ, Burgess JP, Carlson J, Fan R, Fessel JP, Fortune N, Gerszten RE, Halliday SJ, Hekmat R, Howard L, Newman JH, Niswender KD, Pugh ME, Robbins IM, Sheng Q, Shibao CA, Shyr Y, Sumner S, Talati M, Wharton J, Wilkins MR, Ye F, Yu C, West J, Brittain EL. Human PAH is characterized by a pattern of lipid-related insulin resistance. JCI Insight 2019; 4:e123611. [PMID: 30626738 PMCID: PMC6485674 DOI: 10.1172/jci.insight.123611] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/27/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) is a deadly disease of the small pulmonary vasculature with an increased prevalence of insulin resistance (IR). Insulin regulates both glucose and lipid homeostasis. We sought to quantify glucose- and lipid-related IR in human PAH, testing the hypothesis that lipoprotein indices are more sensitive indices of IR in PAH. METHODS Oral glucose tolerance testing in PAH patients and triglyceride-matched (TG-matched) controls and proteomic, metabolomics, and lipoprotein analyses were performed in PAH and controls. Results were validated in an external cohort and in explanted human PAH lungs. RESULTS PAH patients were similarly glucose intolerant or IR by glucose homeostasis metrics compared with control patients when matched for the metabolic syndrome. Using the insulin-sensitive lipoprotein index, TG/HDL ratio, PAH patients were more commonly IR than controls. Proteomic and metabolomic analysis demonstrated separation between PAH and controls, driven by differences in lipid species. We observed a significant increase in long-chain acylcarnitines, phosphatidylcholines, insulin metabolism-related proteins, and in oxidized LDL receptor 1 (OLR1) in PAH plasma in both a discovery and validation cohort. PAH patients had higher lipoprotein axis-related IR and lipoprotein-based inflammation scores compared with controls. PAH patient lung tissue showed enhanced OLR1 immunostaining within plexiform lesions and oxidized LDL accumulation within macrophages. CONCLUSIONS IR in PAH is characterized by alterations in lipid and lipoprotein homeostasis axes, manifest by elevated TG/HDL ratio, and elevated circulating medium- and long-chain acylcarnitines and lipoproteins. Oxidized LDL and its receptor OLR1 may play a role in a proinflammatory phenotype in PAH. FUNDING NIH DK096994, HL060906, UL1 RR024975-01, UL1 TR000445-06, DK020593, P01 HL108800-01A1, and UL1 TR002243; American Heart Association 13FTF16070002.
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Affiliation(s)
- Anna R. Hemnes
- Division of Allergy, Pulmonary and Critical Care Medicine and
| | - J. Matthew Luther
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christopher J. Rhodes
- Centre for Pharmacology and Therapeutics, Department of Medicine, Hammersmith Campus, Imperial College, London, United Kingdom
| | | | - James Carlson
- RTI International, Research Triangle Park, North Carolina, USA
| | - Run Fan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Niki Fortune
- Division of Allergy, Pulmonary and Critical Care Medicine and
| | - Robert E. Gerszten
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Rezzan Hekmat
- Cardiovascular Medicine Division, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Luke Howard
- National Heart and Lung Institute, Imperial College, London and National Pulmonary Hypertension Service, Hammersmith Hospital, London, United Kingdom
| | - John H. Newman
- Division of Allergy, Pulmonary and Critical Care Medicine and
| | | | | | - Ivan M. Robbins
- Division of Allergy, Pulmonary and Critical Care Medicine and
| | - Quanhu Sheng
- Division of Cancer Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Cyndya A. Shibao
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Yu Shyr
- Division of Cancer Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Susan Sumner
- NIH Common Fund Eastern Regional Comprehensive Metabolomics Resource Core, School of Public Health, University of North Carolina at Chapel Hill, Kannapolis, North Carolina, USA
| | - Megha Talati
- Division of Allergy, Pulmonary and Critical Care Medicine and
| | - John Wharton
- Centre for Pharmacology and Therapeutics, Department of Medicine, Hammersmith Campus, Imperial College, London, United Kingdom
| | - Martin R. Wilkins
- Centre for Pharmacology and Therapeutics, Department of Medicine, Hammersmith Campus, Imperial College, London, United Kingdom
| | - Fei Ye
- Division of Cancer Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Chang Yu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James West
- Division of Allergy, Pulmonary and Critical Care Medicine and
| | - Evan L. Brittain
- Cardiovascular Medicine Division, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Arun Thomas ET, Shaji B, Gracious N. The ongoing epidemic of diabetes mellitus in India: genetics or lifestyle? Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-018-0630-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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115
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Tagi VM, Giannini C, Chiarelli F. Insulin Resistance in Children. Front Endocrinol (Lausanne) 2019; 10:342. [PMID: 31214120 PMCID: PMC6558106 DOI: 10.3389/fendo.2019.00342] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/13/2019] [Indexed: 12/28/2022] Open
Abstract
Insulin resistance (IR) is a pathological condition strongly associated with obesity. However, corticosteroids or growth hormone therapy and genetic diseases may affect insulin sensitivity lifelong. In obese children and adolescents of any age there is an evident association between IR and an increased prevalence of type 2 diabetes (T2D) and other elements contributing to the metabolic syndrome, leading to a higher cardiovascular risk. Therefore, early diagnosis and interventions in the attempt to prevent T2D when glycemia values are still normal is fundamental. The gold standard technique used to evaluate IR is the hyperinsulinemic euglycemic clamp, however it is costly and difficult to perform in clinical and research sets. Therefore, several surrogate markers have been proposed. Although the treatment of insulin resistance in children is firstly targeted to lifestyle interventions, in selected cases the integration of a pharmacological intervention might be taken into consideration. The aim of this review is to present the current knowledge on IR in children, starting with an outline of the recent evidences about the congenital forms of deficiency in insulin functioning and therefore focusing on the physiopathology of IR, its appropriate measurement, consequences, treatment options and prevention strategies.
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116
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Nur Zati Iwani AK, Jalaludin MY, Wan Mohd Zin RM, Fuziah MZ, Hong JYH, Abqariyah Y, Mokhtar AH, Wan Mohamud WN. TG : HDL-C Ratio Is a Good Marker to Identify Children Affected by Obesity with Increased Cardiometabolic Risk and Insulin Resistance. Int J Endocrinol 2019; 2019:8586167. [PMID: 31885562 PMCID: PMC6914959 DOI: 10.1155/2019/8586167] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/26/2019] [Indexed: 01/03/2023] Open
Abstract
Metabolic syndrome (MetS) is an important predictor of cardiovascular diseases in adulthood. This study aims to examine the clinical utility of triglyceride to high-density lipoprotein ratio (TG : HDL-C) in identifying cardiometabolic risk and insulin resistance (IR) among children with obesity, in comparison with MetS as defined by the International Diabetes Federation (IDF). Data of 232 children with obesity aged 10-16 years were obtained from our study, MyBFF@school study, conducted between January and December 2014. Children were divided into tertiles of TG : HDL-C ratio. The minimum value of the highest tertile was 1.11. Thus, elevated TG : HDL-C ratio was defined as TG : HDL-C ≥1.11. Children with MetS were categorized based on the definition established by the IDF. Out of 232 children, 23 (9.9%) had MetS, out of which 5.6% were boys. Almost twofold of boys and girls had elevated TG : HDL-C ratio compared to MetS: 13.8% vs. 5.6% and 13.8% vs. 4.3%, respectively. Children with elevated TG : HDL-C ratio had lower fasting glucose compared to children with MetS (boys = 5.15 ± 0.4 vs. 6.34 ± 2.85 mmol/l, p=0.02; girls = 5.17 ± 0.28 vs. 6.8 ± 4.3 mmol/l, p=0.03). Additionally, boys with elevated TG : HDL-C ratio had a higher HDL-C level compared to those with MetS (1.08 ± 0.18 vs. 0.96 ± 0.1 mmol/l, p=0.03). There was no significant difference across other MetS-associated risk factors. Overall, TG : HDL-C ratio demonstrated higher sensitivity (42.7% vs. 12.9%) but lower specificity (74.8% vs. 93.2%) than MetS in identifying IR, either in HOMA-IR ≥2.6 for prepubertal children or HOMA-IR ≥4 for pubertal children. TG : HDL-C ratio in children with obesity is thus as useful as the diagnosis of MetS. It should be considered an additional component to MetS, especially as a surrogate marker for IR.
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Affiliation(s)
- Ahmad Kamil Nur Zati Iwani
- Department of Pediatrics, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
- Endocrine and Metabolic Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Muhammad Yazid Jalaludin
- Department of Pediatrics, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ruziana Mona Wan Mohd Zin
- Department of Pediatrics, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
- Endocrine and Metabolic Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Md Zain Fuziah
- Department of Pediatrics, Putrajaya Hospital, 62250 Putrajaya, Malaysia
| | | | - Yahya Abqariyah
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Abdul Halim Mokhtar
- Department of Sports Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Selangor, Malaysia
| | - Wan Nazaimoon Wan Mohamud
- Endocrine and Metabolic Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
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117
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Hagman E, Hecht L, Marko L, Azmanov H, Groop L, Santoro N, Caprio S, Weiss R. Predictors of responses to clinic-based childhood obesity care. Pediatr Diabetes 2018; 19:1351-1356. [PMID: 30225917 DOI: 10.1111/pedi.12774] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/03/2018] [Accepted: 09/09/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/OBJECTIVE Lifestyle modification is the therapy of choice for childhood obesity, yet the response rate is variable and may be affected by genetic factors. We aimed to investigate predictors of poor response to lifestyle modification obesity treatment in children. METHODS A prospective cohort study of 434 youths (64.5% females) between 4 and 20 years of age undergoing a standard care of lifestyle modification obesity management for 35.9 ± 20.8 months at Yale Childhood Obesity Clinic, USA. The primary outcome was a "poor response," defined as the quintile with the largest increase in BMI Z-score over time. The secondary outcome was the endpoint BMI Z-score. Covariates investigated were sex, baseline pubertal status and degree of obesity, race, biochemical profile, and family history of overweight. A subsample (n = 214) had FTO genotyping (SNP rs8050136) tested. RESULTS Males (hazard ratio [HR] = 5.35, 95% confidence interval [CI] [3.32-8.61], P < 0.0001) and pubertal adolescents (HR = 2.78, [1.40-5.50], P = 0.003) compared to prepubertal children were more prone to respond poorly. Baseline degree of obesity was associated with relative protection from responding poorly (HR per BMI Z-score unit = 0.32, [0.17-0.61], P = 0.0006). Carriers of the FTO obesity-predisposing allele (AA genotype) were protected from responding poorly compared to non-carriers (CC genotype) (HR = 0.33, [0.12-0.88], P = 0.028). CONCLUSIONS Boys and pubertal adolescents are more prone to respond poorly to standard obesity care while those with greater baseline degree of obesity and carriers of the FTO obesity-predisposing allele are not.
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Affiliation(s)
- Emilia Hagman
- Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem, Israel.,Department of Clinical Science, Intervention and Technology, Karolinska Insitutet, Stockholm, Sweden
| | - Lior Hecht
- Ruth Rappaport Children's Hospital, Rambam Medical Center, Haifa, Israel
| | - Limor Marko
- Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem, Israel
| | - Henny Azmanov
- Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem, Israel
| | - Leif Groop
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University, Malmö, Sweden
| | - Nicola Santoro
- Department of Pediatrics, Yale University, New Haven, Connecticut
| | - Sonia Caprio
- Department of Pediatrics, Yale University, New Haven, Connecticut
| | - Ram Weiss
- Ruth Rappaport Children's Hospital, Rambam Medical Center, Haifa, Israel.,Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem, Israel
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Abstract
PURPOSE OF REVIEW Insulin resistance (IR) is recognized to play an important role in the pathogenesis of dyslipidemia. This review summarizes the complex interplay between IR and dyslipidemia in people with and without diabetes. RECENT FINDINGS IR impacts the metabolism of triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and very low-density lipoprotein cholesterol (VLDL-C) by several mechanisms. Trials with insulin sensitizing therapies, including biguanides and thiazolidinediones, have provided inconsistent results on lipid lowering in people with and without diabetes. In this review, we focus on the pathophysiological interplay between IR and dyslipidemia and recapitulate lipid and lipoprotein data from insulin-sensitizing trials. Further research elucidating the reciprocal relationship between IR and dyslipidemia is needed to better target these important risk factors for cardiovascular disease.
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Affiliation(s)
- Petter Bjornstad
- Department of Pediatrics, Division of Endocrinology, University of Colorado School of Medicine, 13123 East 16th Ave, Box B26, Aurora, CO, 80045, USA.
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado School of Medicine, Aurora, CO, USA.
| | - Robert H Eckel
- Department of Medicine, Division of Endocrinology and Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA.
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119
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Epidemic obesity in children and adolescents: risk factors and prevention. Front Med 2018; 12:658-666. [PMID: 30280308 DOI: 10.1007/s11684-018-0640-1] [Citation(s) in RCA: 188] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 04/25/2018] [Indexed: 01/11/2023]
Abstract
The prevalence of obesity among children and adolescents (aged 2-18 years) has increased rapidly, with more than 100 million affected in 2015. Moreover, the epidemic of obesity in this population has been an important public health problem in developed and developing countries for the following reasons. Childhood and adolescent obesity tracks adulthood obesity and has been implicated in many chronic diseases, including type 2 diabetes, hypertension, and cardiovascular disease. Furthermore, childhood and adolescent obesity is linked to adulthood mortality and premature death. Although an imbalance between caloric intake and physical activity is a principal cause of childhood and adolescent obesity, environmental factors are exclusively important for development of obesity among children and adolescents. In addition to genetic and biological factors, socioenvironmental factors, including family, school, community, and national policies, can play a crucial role. The complexity of risk factors for developing obesity among children and adolescents leads to difficulty in treatment for this population. Many interventional trials for childhood and adolescent obesity have been proven ineffective. Therefore, early identification and prevention is the key to control the global epidemic of obesity. Given that the proportion of overweight children and adolescents is far greater than that of obesity, an effective prevention strategy is to focus on overweight youth, who are at high risk for developing obesity. Multifaceted, comprehensive strategies involving behavioral, psychological, and environmental risk factors must also be developed to prevent obesity among children and adolescents.
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Jung MK, Yoo EG. Hypertriglyceridemia in Obese Children and Adolescents. J Obes Metab Syndr 2018; 27:143-149. [PMID: 31089556 PMCID: PMC6504196 DOI: 10.7570/jomes.2018.27.3.143] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 08/09/2018] [Accepted: 09/12/2018] [Indexed: 02/06/2023] Open
Abstract
The increasing prevalence of obesity in children and adolescents is a serious public health concern. Hypertriglyceridemia is common in obese children and adolescents, and elevated triglyceride (TG) level is a known biomarker of cardiometabolic risk. Results from genetic studies suggest that TG and TG-rich lipoproteins and, more specifically, remnant cholesterol are in the causal pathway of cardiovascular disease. However, simultaneous measurement of all remnants has not yet been established, and plasma TG level can be used as a useful marker of remnant cholesterol. Adipose tissue dysfunction, including impaired adipocyte TG storage and release of fatty acids, mediates the development of obesity-related complications. The prevalence of hypertriglyceridemia increases in overweight or obese children and is associated with other cardiometabolic risk factors. Recently, the TG/high-density lipoprotein cholesterol (HDL-C) ratio was recognized as a marker of structural vascular changes and insulin resistance in obese youth. Recent guidelines recommend universal lipid screening with nonfasting non-HDL-C measurement in children at 9–11 years of age; however, fasting lipid profiles should be measured in obese children and overweight adolescents and in those with high non-HDL-C in universal screening. The primary approach to lower TG in children includes dietary and lifestyle modifications; however, children with severe hypertriglyceridemia should also be referred to a pediatric lipid specialist.
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Affiliation(s)
- Mo Kyung Jung
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Eun-Gyong Yoo
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Davis PJ, Liu M, Sherman S, Natarajan S, Alemi F, Jensen A, Avramovic S, Schwartz MD, Hayes RB. HbA1c, lipid profiles and risk of incident type 2 Diabetes in United States Veterans. PLoS One 2018; 13:e0203484. [PMID: 30212478 PMCID: PMC6136717 DOI: 10.1371/journal.pone.0203484] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 08/21/2018] [Indexed: 01/24/2023] Open
Abstract
United States Veterans are at excess risk for type 2 diabetes, but population differentials in risk have not been characterized. We determined risk of type 2 diabetes in relation to prediabetes and dyslipidemic profiles in Veterans at the VA New York Harbor (VA NYHHS) during 2004-2014. Prediabetes was based on American Diabetes Association hemoglobin A1c (HbA1c) testing cut-points, one of several possible criteria used to define prediabetes. We evaluated transition to type 2 diabetes in 4,297 normoglycemic Veterans and 7,060 Veterans with prediabetes. Cox proportional hazards regression was used to relate HbA1c levels, lipid profiles, demographic, anthropometric and comorbid cardiovascular factors to incident diabetes (Hazard Ratio [HR] and 95% confidence intervals). Compared to normoglycemic Veterans (HbA1c: 5.0-5.6%; 31-38 mmol/mol), risks for diabetes were >2-fold in the moderate prediabetes risk group (HbA1c: 5.7-5.9%; 39-41 mmol/mol) (HR 2.37 [1.98-2.85]) and >5-fold in the high risk prediabetes group (HbA1c: 6.0-6.4%; 42-46 mmol/mol) (HR 5.59 [4.75-6.58]). Risks for diabetes were increased with elevated VLDL (≥40mg/dl; HR 1.31 [1.09-1.58]) and TG/HDL (≥1.5mg/dl; HR 1.34 [1.12-1.59]), and decreased with elevated HDL (≥35mg/dl; HR 0.80 [0.67-0.96]). Transition to diabetes in Veterans was related in age-stratified risk score analyses to HbA1c, VLDL, HDL and TG/HDL, BMI, hypertension and race, with 5-year risk differentials of 62% for the lowest (5-year risk, 13.5%) vs. the highest quartile (5-year risk, 21.9%) of the risk score. This investigation identified substantial differentials in risk of diabetes in Veterans, based on a readily-derived risk score suitable for risk stratification for type 2 diabetes prevention.
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Affiliation(s)
- P. Jordan Davis
- Department of Population Health, NYU School of Medicine, New York, NY, United States of America
| | - Mengling Liu
- Department of Population Health, NYU School of Medicine, New York, NY, United States of America
| | - Scott Sherman
- Department of Population Health, NYU School of Medicine, New York, NY, United States of America
- VA New York Harbor Healthcare System, New York, NY, United States of America
| | - Sundar Natarajan
- Department of Population Health, NYU School of Medicine, New York, NY, United States of America
- VA New York Harbor Healthcare System, New York, NY, United States of America
| | - Farrokh Alemi
- George Mason University, Fairfax, VA, United States of America
| | - Ashley Jensen
- VA New York Harbor Healthcare System, New York, NY, United States of America
| | - Sanja Avramovic
- George Mason University, Fairfax, VA, United States of America
| | - Mark D. Schwartz
- Department of Population Health, NYU School of Medicine, New York, NY, United States of America
- VA New York Harbor Healthcare System, New York, NY, United States of America
| | - Richard B. Hayes
- Department of Population Health, NYU School of Medicine, New York, NY, United States of America
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Yeom H, Kim HC, Lee JM, Jeon Y, Suh I. Triglyceride to high density lipoprotein cholesterol ratio among adolescents is associated with adult hypertension: the Kangwha study. Lipids Health Dis 2018; 17:212. [PMID: 30200983 PMCID: PMC6131866 DOI: 10.1186/s12944-018-0861-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 08/31/2018] [Indexed: 11/11/2022] Open
Abstract
Background The triglyceride to high density lipoprotein cholesterol (TG/HDL-C) ratio associated with hypertension in adults. However, whether the TG/HDL-C ratio in adolescents predicts future hypertension remains unclear. Here, we evaluated the prospective association between the TG/HDL-C ratio in adolescents and hypertension in early adulthood. Methods The Kangwha Study is an ongoing prospective cohort study that has tracked the blood pressure of first grade elementary school students since 1986. We followed up 272 participants who completed health examinations at the age of 16 and 35 years. We excluded 27 participants with adolescent hypertension, defined as those whose blood pressures were above the age- and sex-specific 95th percentiles of the Korean population, and finally analysed 245 participants. We defined high and low TG/HDL-C ratio groups according to the age- and sex-specific 75th percentile of the TG/HDL-C ratio (1.04 for boys and 0.81 for girls) of the Korean population. Adult hypertension was defined by a systolic/diastolic blood pressure ≥ 140/90 mmHg or by taking antihypertensive medication at the age of 35 years. Logistic regression analysis was performed to evaluate the association between adolescent TG/HDL-C ratio and adult hypertension after adjusting for age at follow-up, sex, baseline systolic blood pressure, waist circumference, and total cholesterol and fasting glucose levels. Results During the 20-year follow-up, 11 (18.3%) individuals developed hypertension in the high TG/HDL-C ratio group and 10 (5.4%) individuals developed hypertension in the low TG/HDL-C ratio group. The adjusted odds ratio for incident hypertension in the high TG/HDL-C ratio group, compared with the low TG/HDL-C ratio group, was 3.40 (95% confidence interval 1.24–9.31). Conclusions High TG/HDL-C ratio in adolescence is associated with hypertension in early adulthood. Electronic supplementary material The online version of this article (10.1186/s12944-018-0861-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hyungseon Yeom
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Ju-Mi Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Yongwoo Jeon
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Il Suh
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Hetherington-Rauth M, Bea JW, Lee VR, Blew RM, Funk JL, Lohman TG, Going SB. Relationship between fat distribution and cardiometabolic risk in Hispanic girls. Am J Hum Biol 2018; 30:e23149. [PMID: 30129276 DOI: 10.1002/ajhb.23149] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 04/23/2018] [Accepted: 05/28/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE In adults, certain body fat depots have greater impact on cardiometabolic risk than total adiposity. Whether similar relationships exist in children is uncertain. The aim of this study was to examine the relationships among dual x-ray absorptiometry (DXA) measures of body fat distribution and total body adiposity with cardiometabolic risk factors in Hispanic girls. METHODS Measures of total percent body fat, percent of total fat within the android, gynoid, leg, and trunk regions, and cardiometabolic biomarkers (insulin, glucose, homeostatic model assessment of insulin resistance (HOMA-IR), triglycerides (TG), low and high lipoprotein cholesterol (LDL-C, HDL-C)) were obtained from 232 Hispanic girls (age 10.7 ±1.1 years). Regression models for each metabolic parameter were run against adiposity measures. Partial correlations of the adiposity measures were used to compare associations between adiposity measures and the cardiometabolic risk factors, controlling for somatic maturation. RESULTS Total and regional adiposity were significantly related with cardiometabolic risk factors (P < 0.05) except fasting glucose. The partial correlations of total and regional adiposity measures with each cardiometabolic biomarker were similar. More variance was explained for insulin and the HOMA-IR (33%-43%) than other risk factors. Partial correlations for the percentage of total fat in the gynoid and leg regions with insulin, HOMA-IR, TG, and LDL-C were negative, and positive with HDL-C. CONCLUSION Measures of total and regional fat perform similarly in predicting cardiometabolic risk in Hispanic girls. A higher proportion of fat distributed in the gynoid or leg region is associated with lower cardiometabolic risk.
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Affiliation(s)
| | - Jennifer W Bea
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona.,Departments of Medicine, University of Arizona, Tucson, Arizona.,University of Arizona Cancer Center, Tucson, Arizona
| | - Vinson R Lee
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona
| | - Robert M Blew
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona
| | - Janet L Funk
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona.,Departments of Medicine, University of Arizona, Tucson, Arizona
| | - Timothy G Lohman
- Department of Physiology, University of Arizona, Tucson, Arizona
| | - Scott B Going
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona
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Wang B, Zhang M, Liu Y, Sun X, Zhang L, Wang C, Li L, Ren Y, Han C, Zhao Y, Zhou J, Pang C, Yin L, Feng T, Zhao J, Hu D. Utility of three novel insulin resistance-related lipid indices for predicting type 2 diabetes mellitus among people with normal fasting glucose in rural China. J Diabetes 2018; 10:641-652. [PMID: 29322661 DOI: 10.1111/1753-0407.12642] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 12/17/2017] [Accepted: 01/07/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Inexpensive and easily measured indices are needed for the early prediction of type 2 diabetes mellitus (T2DM) in rural areas of China. The aim of this study was to compare triglyceride glucose (TyG), visceral adiposity (VAI), and lipid accumulation product (LAP) with traditional individual measures and their ratios for predicting T2DM. METHODS Data for 11 113 people with baseline normal fasting glucose in a rural Chinese cohort were followed for a median of 6.0 years. Cox proportional hazards regression was used to calculate covariate-adjusted hazard ratios (aHRs) and 95% confidence intervals (95% CIs) and receiver operating characteristic analysis was used to compare the ability of traditional measures and TyG, VAI, and LAP at baseline to predict T2DM at follow-up. RESULTS Among individual measures, fasting plasma glucose (FPG) and waist circumference (WC) were strongly associated with T2DM. Of all lipid ratios, an elevated triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio was associated the most with T2DM. Compared with the first quartiles of TyG, VAI, and LAP, their fourth quartiles were associated with T2DM for men (aHR 3.54 [95% CI 2.08-6.03], 2.89 [1.72-4.87], and 5.02 [2.85-8.85], respectively) and women (6.15 [3.48-10.85], 4.40 [2.61-7.42], and 6.49 [3.48-12.12], respectively). For predicting T2DM risk, TyG, VAI, and LAP were mostly superior to the TG: HDL-C ratio, but did not differ from FPG and WC. CONCLUSIONS Prediction of T2DM was not improved by TyG, VAI, and LAP versus FPG or WC alone. Therefore, TyG, VAI, and LAP may not be inexpensive tools for predicting T2DM in rural Chinese people.
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Affiliation(s)
- Bingyuan Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Science Center, Shenzhen, China
| | - Yu Liu
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Xizhuo Sun
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Lu Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Linlin Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yongcheng Ren
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Department of Preventive Medicine, Shenzhen University Health Science Center, Shenzhen, China
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Chengyi Han
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Department of Preventive Medicine, Shenzhen University Health Science Center, Shenzhen, China
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Department of Preventive Medicine, Shenzhen University Health Science Center, Shenzhen, China
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Junmei Zhou
- Department of Preventive Medicine, Shenzhen University Health Science Center, Shenzhen, China
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Chao Pang
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Lei Yin
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Tianping Feng
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Jingzhi Zhao
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
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Luo Y, Li Z, Zhang J, Li J, Lu Z. Dyslipidaemia was correlated to the posterior circulation infarction in non-diabetic populations. Lipids Health Dis 2018; 17:150. [PMID: 29945627 PMCID: PMC6020360 DOI: 10.1186/s12944-018-0799-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 06/12/2018] [Indexed: 01/29/2023] Open
Abstract
Background Diabetes mellitus (DM) was prone to happening in posterior circulation infarction (POCI) and DM also has the impact on the lipids, our study was to investigate the correlation between lipid compositions and POCI. Methods Data was collected from the patients with acute ischemic stroke (AIS) hospitalization in Affiliated Drum Tower Hospital of Nanjing University Medical School from October 2008 to May 2012. Lipids and other risk factors in the different populations were investigated in relation to occurrence of POCI based on the infarction location. Results Six hundred ten patients with AIS were included in this study, which had 428 with anterior circulation infarction (ACI) and 182 with POCI. Elevated Triglyceride (TG) and decreased High density lipoprotein cholesterol (HDL-C) were seen in the POCI of total populations and AIS without DM compared to the ACI, but not in the populations of AIS with DM, so did the elevated TG/HDL-C ratios. Also, the percent of low HDL-C level and high TG level were higher in POCI group than that in ACI group. Furthermore, single factors logistic regression demonstrated that TG, HDL-C and TG/HDL-C ratio were correlated to the POCI whatever in the total populations or AIS without DM, but this kind of trend just maintained in the populations of AIS without DM after adjusting by relative interference factors. Conclusion Dyslipidaemia was prone to happening in POCI compared to ACI in the non-diabetic populations, which was correlated to the pathogenesis of POCI.
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Affiliation(s)
- Yun Luo
- Department of Neurology, Affiliated Drum Tower Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Gulou District, Nanjing, 210008, Jiangsu Province, China.
| | - Zheng Li
- Department of Rehabilitation Medicine, Affiliated Drum Tower Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Gulou District, Nanjing, 210008, Jiangsu Province, China
| | - Jiahui Zhang
- Department of Neurology, Affiliated Drum Tower Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Gulou District, Nanjing, 210008, Jiangsu Province, China
| | - Jingwei Li
- Department of Neurology, Affiliated Drum Tower Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Gulou District, Nanjing, 210008, Jiangsu Province, China
| | - Zhengjuan Lu
- Department of Neurology, Affiliated Drum Tower Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Gulou District, Nanjing, 210008, Jiangsu Province, China
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Van Hemelrijck M, Ulmer H, Nagel G, Peter RS, Fritz J, Myte R, van Guelpen B, Föger B, Concin H, Häggström C, Stattin P, Stocks T. Longitudinal study of body mass index, dyslipidemia, hyperglycemia, and hypertension in 60,000 men and women in Sweden and Austria. PLoS One 2018; 13:e0197830. [PMID: 29897925 PMCID: PMC5999071 DOI: 10.1371/journal.pone.0197830] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/07/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Obesity is suggested to underlie development of other metabolic aberrations, but longitudinal relationships between metabolic factors at various ages has not been studied in detail. METHODS Data from 27,379 men and 32,275 women with in total 122,940 health examinations in the Västerbotten Intervention Project, Sweden and the Vorarlberg Health Monitoring and Prevention Programme, Austria were used to investigate body mass index (BMI), mid-blood pressure, and fasting levels of glucose, triglycerides, and total cholesterol at baseline in relation to 10-year changes of these factors and weight. We included paired examinations performed 10±2 years apart and used them for longitudinal analysis with linear regression of changes between the ages 30 and 40, 40 and 50, or 50 and 60 years. RESULTS Higher levels of BMI were associated with increases in glucose and mid-blood pressure as well as triglycerides levels, and, to a lesser extent, decreases in cholesterol levels. For instance, per 5 kg/m2 higher BMI at age 40, glucose at age 50 increased by 0.24 mmol/l (95%CI: 0.22-0.26) and mid-blood pressure increased by 1.54 mm Hg (95%CI: 1.35-1.74). The strongest association observed was between BMI at age 30 and mid-blood pressure, which was 2.12 mm Hg (95% CI: 1.79-2.45) increase over ten years per 5 kg/m2 higher BMI level. This association was observed at an age when blood pressure levels on average remained stable. Other associations than those with BMI at baseline were much weaker. However, triglyceride levels were associated with future glucose changes among individuals with elevated BMI, particularly in the two older age groups. CONCLUSION BMI was most indicative of long-term changes in metabolic factors, and the strongest impact was observed for increases in blood pressure between 30 and 40 years of age. Our study supports that lifestyle interventions preventing metabolic aberrations should focus on avoiding weight increases.
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Affiliation(s)
- Mieke Van Hemelrijck
- King’s College London, Division of Cancer Studies, Translational Oncology & Urology Research, London, United Kingdom
| | - Hanno Ulmer
- Medical University Innsbruck, Department of Medical Statistics, Informatics, and Health Economics, Innsbruck, Austria
| | - Gabriele Nagel
- Ulm University, Institute of Epidemiology and Medical Biometry, Ulm, Germany
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Raphael Simon Peter
- Ulm University, Institute of Epidemiology and Medical Biometry, Ulm, Germany
| | - Josef Fritz
- Medical University Innsbruck, Department of Medical Statistics, Informatics, and Health Economics, Innsbruck, Austria
| | - Robin Myte
- Umeå University, Department of Radiation Sciences, Umeå, Sweden
| | | | - Bernhard Föger
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Christel Häggström
- Umeå University, Department of Biobank Research, Umeå, Sweden
- Uppsala University, Department of Surgical Sciences, Uppsala, Sweden
- Umeå University, Department of Public Health and Clinical Medicine, Nutritional Research, Umeå, Sweden
| | - Pär Stattin
- Uppsala University, Department of Surgical Sciences, Uppsala, Sweden
| | - Tanja Stocks
- Lund University, Department of Clinical Sciences Malmö, Malmö, Sweden
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Franch-Nadal J, Caballeria L, Mata-Cases M, Mauricio D, Giraldez-García C, Mancera J, Goday A, Mundet-Tudurí X, Regidor E. Fatty liver index is a predictor of incident diabetes in patients with prediabetes: The PREDAPS study. PLoS One 2018; 13:e0198327. [PMID: 29856820 PMCID: PMC5983533 DOI: 10.1371/journal.pone.0198327] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 05/17/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES We evaluated the ability of the Fatty Liver Index (FLI), a surrogate marker of hepatic steatosis, to predict the development of type 2 diabetes (T2D) at 3 years follow-up in a Spanish cohort with prediabetes from a prospective observational study in primary care (PREDAPS). METHODS FLI was calculated at baseline for 1,142 adult subjects with prediabetes attending primary care centers, and classified into three categories: FLI <30 (no steatosis), FLI 30-60 (intermediate) and FLI ≥60 (hepatic steatosis). We estimated the incidence rate of T2D in each FLI category at 3 years of follow-up. The association between FLI and incident T2D was calculated using Cox regression models adjusted for age, sex, educational level, family history of diabetes, lifestyles, hypertension, lipid profile and transaminases. RESULTS The proportion of subjects with prediabetes and hepatic steatosis (FLI ≥60) at baseline was 55.7%. The incidence rate of T2D at 3 years follow-up was 1.3, 2.9 and 6.0 per 100 person-years for FLI<30, FLI 30->60 and FLI ≥60, respectively. The most significant variables increasing the risk of developing T2D were metabolic syndrome (hazard ratio [HR] = 3.02; 95% confidence interval [CI] = 2.14-4.26) and FLI ≥60 (HR = 4.52; 95%CI = 2.10-9.72). Moreover, FLI ≥60 was independently associated with T2D incidence: the HR was 4.97 (95% CI: 2.28-10.80) in the base regression model adjusted by sex, age and educational level, and 3.21 (95%CI: 1.45-7.09) in the fully adjusted model. CONCLUSIONS FLI may be considered an easy and valuable early indicator of high risk of incident T2D in patients with prediabetes attended in primary care, which could allow the adoption of effective measures needed to prevent and reduce the progression of the disease.
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Affiliation(s)
- Josep Franch-Nadal
- redGDPS Foundation, Madrid, Spain
- Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Diabetes and Associated Metabolic Diseases Networking Biomedical Research Centre (CIBERDEM), Madrid, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Llorenç Caballeria
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Liver and Digestive Diseases Networking Biomedical Research Centre (CIBEREHD), Madrid, Spain
- Unitat de Suport a la Recerca Barcelonès Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Manel Mata-Cases
- redGDPS Foundation, Madrid, Spain
- Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Diabetes and Associated Metabolic Diseases Networking Biomedical Research Centre (CIBERDEM), Madrid, Spain
| | - Didac Mauricio
- redGDPS Foundation, Madrid, Spain
- Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Diabetes and Associated Metabolic Diseases Networking Biomedical Research Centre (CIBERDEM), Madrid, Spain
- Department of Endocrinology and Nutrition, Health Sciences Research Institute & University Hospital Germans Trias i Pujol, Badalona, Spain
| | - Carolina Giraldez-García
- redGDPS Foundation, Madrid, Spain
- Preventive Medicine Service, University Hospital Infanta Elena, Madrid, Spain
- Preventive Medicine, Public Health and History of Science Department, Complutense University of Madrid, Madrid, Spain
| | - José Mancera
- redGDPS Foundation, Madrid, Spain
- Health Center Ciudad Jardín, Málaga, Spain
| | - Albert Goday
- redGDPS Foundation, Madrid, Spain
- Endocrinology Service, Hospital del Mar, Barcelona, Spain
| | - Xavier Mundet-Tudurí
- redGDPS Foundation, Madrid, Spain
- Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Autonomous University of Barcelona, Bellaterra, Spain
| | - Enrique Regidor
- redGDPS Foundation, Madrid, Spain
- Preventive Medicine, Public Health and History of Science Department, Complutense University of Madrid, Madrid, Spain
- Epidemiology and Public Health Networking Biomedical Research Centre (CIBERESP), Madrid, Spain
- Health Research Institute, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Lee D, Yoo JH, Lee BC. Therapeutic Effect of Cucumis melo L. Extract on Insulin Resistance and the Gut Microbiome in Lep ob/Lep ob Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:8159261. [PMID: 29636788 PMCID: PMC5830983 DOI: 10.1155/2018/8159261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/01/2018] [Indexed: 01/01/2023]
Abstract
Obesity results in the progression of metabolic disorders, especially type 2 diabetes (T2DM). Obesity-induced insulin resistance (IR) is a causative factor of T2DM morbidity in obese people. It is generally held by clinicians that IR is caused by adiposity-related inflammation that is mediated by changes in composite ions in the gut microbiome. This experimental study was designed to investigate the effects of Cucumis melo L. (Cucumis) on obesity-induced IR in genetically leptin-deficient Lepob/Lepob mice. Specifically, we examined the anti-inflammatory effects of Cucumis and the effects of Cucumis on the gut microbiota. We evaluated glucose control by measuring FBS, performing the OGTT, quantifying serum IR, calculating the HOMA-IR, and determining the lipid profiles. To see whether inflammation was reduced, we analyzed adipose tissue macrophages as well as monocytes in the blood. We also profiled the gut microbiota to determine whether the ratios of microbial phyla changed. We found that Cucumis improved IR in obese mice and relieved inflammation in adipose tissue and blood. Simultaneously, the microbiota composition ratios changed. In conclusion, administration of Cucumis improved IR by reducing inflammation, thereby changing the gut microbiota composition. Cucumis is thus a promising treatment for obesity-induced insulin resistance and the inflammatory state.
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Affiliation(s)
- Daeun Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Jung Hwa Yoo
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Byung-Cheol Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
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Aguirre M, Briceño Y, Gómez-Pérez R, Zerpa Y, Camacho N, Paoli M. Triglycerides/High density lipoprotein cholesterol ratio as a cardiometabolic risk marker in children and adolescents from Mérida city, Venezuela. ENDOCRINOL DIAB NUTR 2018; 65:74-83. [PMID: 29290474 DOI: 10.1016/j.endinu.2017.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/21/2017] [Accepted: 10/28/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To determine the behavior of the triglycerides/HDL-cholesterol ratio (TG/HDL) as a cardiometabolic risk marker in children and adolescents from Mérida, Venezuela. METHODS A total of 1292 children and adolescents aged 7-18 years who attended educational institutions in the Libertador Municipality were enrolled into this study. Anthropometric measurements and blood pressure values were recorded. Fasting blood glucose, insulin and lipid levels were measured. The TG/HDL ratio, HOMA-IR, and QUICKI indexes were calculated. Subjects were categorized as with and without cardiometabolic risk based on the presence or absence of 2or more risk factors. Cut-off points for the TG/HDL ratio were determined by constructing ROC curves. RESULTS Significantly higher mean TG/HDL ratios were found in pubertal (2.2 ± 1.7) as compared to prepubertal subjects (1.8 ± 1.5; P=.001), with no sex differences. Two or more risk factors were found in 14.7% (n=192) of the participants, in whom TG/HDL ratios were significantly higher as compared to those with no risk (3.5±2.9 versus 1.6±0.8 in prepubertal and 4.1 ± 3.5 versus 1.8 ± 0.9 in pubertal subjects; P=.0001). According to cardiometabolic risk, cut-off points for the TG/HDL ratio of 1.8 and 2.5 were found for prepubertal and pubertal children respectively. These cut-off points showed risks (odds ratio) higher than 2.5 for conditions such as metabolic syndrome, elevated non-HDL-C, abdominal obesity, and elevated HOMA-IR. CONCLUSION In this sample of children and adolescents, an elevated TG/HDLc ratio was found to be a good marker for predicting cardiometabolic risk.
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Affiliation(s)
- Miguel Aguirre
- Centro de Investigaciones Endocrino-Metabólicas Dr. Félix Gómez, Facultad de Medicina, Universidad del Zulia, Servicio de Endocrinología, Hospital Universitario de Maracaibo, Maracaibo, Estado Zulia, Venezuela
| | - Yajaira Briceño
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de Los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Roald Gómez-Pérez
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de Los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Yajaira Zerpa
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de Los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Nolis Camacho
- Unidad de Nutrición, Crecimiento y Desarrollo Infantil, Instituto Autónomo Hospital Universitario de Los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Mariela Paoli
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de Los Andes, Universidad de Los Andes, Mérida, Venezuela.
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Poveda NE, Garcés MF, Darghan AE, Jaimes SAB, Sánchez EP, Díaz-Cruz LA, Garzón-Olivares CD, Parra-Pineda MO, Bautista-Charry AA, Müller EÁ, Alzate HFS, Acosta LMM, Sanchez E, Ruíz-Parra AI, Caminos JE. Triglycerides/Glucose and Triglyceride/High-Density Lipoprotein Cholesterol Indices in Normal and Preeclamptic Pregnancies: A Longitudinal Study. Int J Endocrinol 2018; 2018:8956404. [PMID: 30158976 PMCID: PMC6109518 DOI: 10.1155/2018/8956404] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 06/10/2018] [Accepted: 07/10/2018] [Indexed: 11/28/2022] Open
Abstract
Metabolic changes have been correlated with adverse pregnancy outcomes. The aim of the present study is to determine the TyG and TG/HDL-c indices in a cohort of healthy pregnant (n = 142), preeclamptic (n = 18), and healthy nonpregnant women (n = 56). Preeclamptic women were selected from the same cohort. Pregnant women were followed during three periods of pregnancy and postpartum. The results showed a significant increase in the values of TyG and TG/HDL-c (p < 0.01) as pregnancy progresses, without significant differences between healthy and preeclamptic women. TyG and TG/HDL-c indices are significantly low in nonpregnant and three months' postpartum women when compared with each gestational period studied. TyG and TG/HDL-c indices are positively correlated with HOMA-IR in the early and middle pregnancy (p < 0.05). Multiple linear regression using the TyG and TG/HDL-c indices as dependent variables showed that TyG index was significantly associated with HOMA-IR, gestational age, HDL-c, TC, LDL, fasting insulin, and mean BP (p < 0.001); meanwhile, TG/HDL-c index was only associated with HOMA-IR (p < 0.0242) and gestational age (p < 0.001). In conclusion, the TyG and TG/HDL-c indices could be useful in monitoring insulin resistance during pregnancy.
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Affiliation(s)
- Natalia Elvira Poveda
- Department of Physiology, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
| | - María Fernanda Garcés
- Department of Physiology, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
| | - Aquiles Enrique Darghan
- Department of Physiology, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
| | | | - Estefania Pulido Sánchez
- Department of Physiology, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
| | - Luz Amparo Díaz-Cruz
- Department of Obstetrics and Gynecology, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
| | | | - Mario Orlando Parra-Pineda
- Department of Obstetrics and Gynecology, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
| | | | - Edith Ángel Müller
- Department of Obstetrics and Gynecology, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
| | | | | | - Elizabeth Sanchez
- Department of Physiology, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
| | - Ariel Iván Ruíz-Parra
- Department of Obstetrics and Gynecology, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
| | - Jorge Eduardo Caminos
- Department of Physiology, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
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131
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Lee JS, Cheong HS, Shin HD. Prediction of cholesterol ratios within a Korean population. ROYAL SOCIETY OPEN SCIENCE 2018; 5:171204. [PMID: 29410832 PMCID: PMC5792909 DOI: 10.1098/rsos.171204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 11/29/2017] [Indexed: 06/08/2023]
Abstract
Cholesterol ratios (total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-c) and triglyceride (TG)/HDL-c) have been suggested as better indicators to predict various clinical features such as insulin resistance and heart disease. Therefore, we aimed to build a single nucleotide polymorphism (SNP) set to predict constitutional lipid metabolism. The genotype data of 7795 samples were obtained from the Korea Association Resource. Among the total of 7795 samples, 7016 subjects were used to perform 10-fold cross-validation. We selected the SNPs that showed significance constantly throughout all 10 cross-validation sets; another 779 samples were used as the final validation set. After performing the 10-fold cross-validation, the six SNPs (rs4420638 (APOC1), rs12421652 (BUD13), rs17411126 (LPL), rs6589566 (ZPR1), rs16940212 (LOC101928635) and rs10852765 (ABCA8)) were finally selected for predicting cholesterol ratios. The weighted genetic risk scores (wGRS) were calculated based on the regression slopes of the six selected SNPs. Our results showed upward trends of wGRS for both the TC/HDL-c and TG/HDL-c ratios within the 10-fold cross-validation. Similarly, the wGRS of the six SNPs also showed upward trends in analyses using the SNP selection set and final validation set. The selected six SNPs can be used to explain both the TC/HDL-c and TG/HDL-c ratios. Our results may be useful for the prospective predictions of cholesterol-related diseases.
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Affiliation(s)
- Jin Sol Lee
- Department of Life Science, Sogang University, Baekbumro 35, Mapo-gu, Seoul 04107, Republic of Korea
- Research Institute for Basic Science, Sogang University, Mapo-gu, Seoul, 121-742, Republic of Korea
| | - Hyun Sub Cheong
- Department of Genetic Epidemiology, SNP Genetics, Inc., Taihard building 1007, Sogang University, Baekbumro 35, Mapo-gu, Seoul, Republic of Korea
| | - Hyoung Doo Shin
- Department of Life Science, Sogang University, Baekbumro 35, Mapo-gu, Seoul 04107, Republic of Korea
- Research Institute for Basic Science, Sogang University, Mapo-gu, Seoul, 121-742, Republic of Korea
- Department of Genetic Epidemiology, SNP Genetics, Inc., Taihard building 1007, Sogang University, Baekbumro 35, Mapo-gu, Seoul, Republic of Korea
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132
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Ighbariya A, Weiss R. Insulin Resistance, Prediabetes, Metabolic Syndrome: What Should Every Pediatrician Know? J Clin Res Pediatr Endocrinol 2017; 9:49-57. [PMID: 29280741 PMCID: PMC5790325 DOI: 10.4274/jcrpe.2017.s005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The Metabolic syndrome describes a clustering of typical cardiovascular risk factors. The syndrome is also known as "Insulin Resistance syndrome" as a substantial part of the pathophysiology is driven by resistance to the metabolic effects of insulin. The major cause of insulin resistance in childhood is a typical lipid partitioning pattern characterized by increased deposition of lipids within insulin responsive tissues, such as the liver and skeletal muscle and within the viscera. This lipid deposition pattern is also associated with infiltration of intra-abdominal tissues with cells of the immune system, inducing systemic, low-grade inflammation typically observed in insulin resistant obese children and adolescents. Several clues derived from a careful history and physical examination, along with a basic laboratory workup, provide clues in regards to risk stratification in obese children.
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Affiliation(s)
- Ahmad Ighbariya
- Ruth Rappaport Children’s Hospital, Clinic of Pediatrics, Haifa, Israel
,* Address for Correspondence: Ruth Rappaport Children’s Hospital, Clinic of Pediatrics, Haifa, Israel E-mail:
| | - Ram Weiss
- Ruth Rappaport Children’s Hospital, Clinic of Pediatrics, Haifa, Israel
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133
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Bouhenni H, Daoudi H, Djemai H, Noirez P, Rouabah A, Vitiello D, Rouabah L. Relationships between metabolic profile, hypertension and uric acid with cardiometabolic risk in adolescents with abdominal obesity: impact of geodemographic factors on the prevalence of abdominal obesity. Int J Adolesc Med Health 2017; 32:/j/ijamh.ahead-of-print/ijamh-2017-0107/ijamh-2017-0107.xml. [PMID: 29168965 DOI: 10.1515/ijamh-2017-0107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 08/25/2017] [Indexed: 12/18/2022]
Abstract
Background Association of hyperuricemia, dyslipidemia and high blood pressure (BP) among adolescents with high waist-to-height ratio (WHtR) remains not fully addressed and could represent a new way to diagnose adolescents early with cardiometabolic risk. Objective We aimed to determine abdominal obesity (AO) prevalence and investigate relations between AO, uric acid (UA), lipid profiles, BP and geographical patterns in adolescents. Subjects 577 and 204 Algerian students aged between 10 and 19 years were included in our epidemiological and biochemical studies, respectively. Methods Height, weight, waist circumference (Wc) and hip circumferences, body mass index (BMI) and BP were measured. Fasting blood sampling was performed to measure glycemia, lipid profile, uricemia, insulinemia and leptinemia. The WHtR ≥0.50 was applied for the diagnosis of AO and geodemographics was evaluated. Results The prevalence of AO was 12.13% among all students, 19.17% and 16.39% among students living in urban and plain areas, respectively. The risk of AO may be reduced in rural and mountainous areas. Lipid parameters, UA, insulin and leptin serum concentrations were significantly increased in adolescents with WHtR ≥0.50 compared to those with WHtR <0.50. Cardiometabolic risk was increased with WHtR ≥0.50 and BMI >26. Means of BMI, Wc, BP, and lipid parameters were significantly increased in the fourth quartiles compared to the first quartile of UA. Conclusion Urban areas and plains represent factors contributing to AO and WHtR ≥0.50 may be used as a cut-off point to define risks of high BP, lipid abnormalities and UA serum level in Algerian adolescents.
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Affiliation(s)
- Hamida Bouhenni
- Laboratory of Molecular and Cellular Biology, Faculty of Natural Sciences and Life Sciences, Mentouri Brothers University, Constantine, Algeria
| | - Hadjer Daoudi
- Laboratory of Molecular and Cellular Biology, Faculty of Natural Sciences and Life Sciences, Mentouri Brothers University, Constantine, Algeria
| | - Haidar Djemai
- IRMES - Institute for Research in Biomedecine and Epidemiology of Sport, Paris, France.,EA 7329, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,National Institute of Sport, Expertise and Performance - INSEP, Paris, France
| | - Philippe Noirez
- IRMES - Institute for Research in Biomedecine and Epidemiology of Sport, Paris, France.,EA 7329, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,National Institute of Sport, Expertise and Performance - INSEP, Paris, France
| | - Abdelkader Rouabah
- Laboratory of Molecular and Cellular Biology, Faculty of Natural Sciences and Life Sciences, Mentouri Brothers University, Constantine, Algeria
| | - Damien Vitiello
- IRMES - Institute for Research in Biomedecine and Epidemiology of Sport, Paris, France.,National Institute of Sport, Expertise and Performance - INSEP, Paris, France.,EA 7329, Paris Descartes University, School of Sport Sciences, 1 Lacretelle street, 75015, Paris, France, Phone: +331176533402
| | - Leila Rouabah
- Laboratory of Molecular and Cellular Biology, Faculty of Natural Sciences and Life Sciences, Mentouri Brothers University, 1 Ain El bey street, 25000, Constantine, Algeria, Phone: +213777065109
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134
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Thota RN, Abbott KA, Ferguson JJA, Veysey M, Lucock M, Niblett S, King K, Garg ML. InsuTAG: A novel physiologically relevant predictor for insulin resistance and metabolic syndrome. Sci Rep 2017; 7:15204. [PMID: 29123160 PMCID: PMC5680177 DOI: 10.1038/s41598-017-15460-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 10/25/2017] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to investigate whether a novel physiologically relevant marker, InsuTAG (fasting insulin × fasting triglycerides) can predict insulin resistance (IR) and metabolic syndrome (MetS). Data of 618 participants from the Retirement Health and Lifestyle Study (RHLS) were evaluated for the current study. IR was defined by homeostatic model assessment (HOMA-IR) scores. Pearson correlations were used to examine the associations of InsuTAG with HOMA-IR and other markers. Predictions of IR from InsuTAG were evaluated using multiple regression models. Receiver operating characteristic curves (ROC) were constructed to measure the sensitivity and specificity of InsuTAG values and to determine the optimum cut-off point for prediction of IR. InsuTAG was positively correlated with HOMA-IR (r = 0.86; p < 0.0001). InsuTAG is a strong predictor of IR accounting for 65.0% of the variation in HOMA-IR values after adjusting for potential confounders. Areas under the ROC curve showed that InsuTAG (0.93) has higher value than other known lipid markers for predicting IR, with a sensitivity and specificity of 84.15% and 86.88%. Prevalence of MetS was significantly (p < 0.0001) higher in subjects with InsuTAG values greater than optimal cut-off value of 11.2. Thus, InsuTAG appears to be a potential feasible marker of IR and metabolic syndrome.
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Affiliation(s)
- Rohith N Thota
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Kylie A Abbott
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Jessica J A Ferguson
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Martin Veysey
- School of Medicine & Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Mark Lucock
- School of Environmental & Life Sciences, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Suzanne Niblett
- School of Medicine & Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Katrina King
- School of Medicine & Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Manohar L Garg
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia.
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135
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Jayanthi R, Srinivasan AR, Hanifah M, Maran AL. Associations among Insulin Resistance, Triacylglycerol/High Density Lipoprotein (TAG/HDL ratio) and Thyroid hormone levels-A study on Type 2 diabetes mellitus in obese and overweight subjects. Diabetes Metab Syndr 2017; 11 Suppl 1:S121-S126. [PMID: 28043815 DOI: 10.1016/j.dsx.2016.12.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 12/12/2016] [Indexed: 12/01/2022]
Abstract
AIM Triacylglycerol/High density lipoprotein (TAG/HDL) ratio, a surrogate marker of LDL particle size (small dense) was included in our study to observe the link with insulin resistance and thyroid co-morbidity. METHODS Ninety three patients with T2DM of both genders were enrolled from a tertiary health care unit in Puducherry, during the latter half of 2015. The cardio-metabolic risk factors were assessed through body mass index (BMI), blood pressure, fasting blood glucose and lipid profile, glycated haemoglobin and homeostasis model assessment of insulin resistance (HOMA-IR). Serum free T4, T3 and TSH were also measured to evaluate the thyroid co-morbidity as a function of insulin resistance. RESULTS In addition to insulin resistance, results of our study were focussed on thyroid comorbidity. In overweight diabetic patients, the ROC curve analyses demonstrated that the best marker for insulin resistance was Triacylglycerol/High density lipoprotein (TAG/HDL), with the area under the ROC curve being 0.902. Thyroxine (T4) was less significant when compared to TAG/HDL with area under the ROC curve of 0.583. Triiodothyronine (T3) and T4 were more significant in obese group with areas under the curve being 0.842 and 0.816 respectively when compared against insulin resistance (cut-off value for HOMA-IR 2.69). The optimal cut-off points for overweight were: TAG≥101mg/dl; T4≥1.16ng/dl; TAG/HDL≥2.26 whereas for obese: TC≥163.5mg/dl; TAG≥141.5mg/dl; T3≥2.42pg/ml; T4≥0.96ng/ml. CONCLUSIONS In overweight type 2 diabetics, TAG/HDL ratio could be used as a reliable marker for insulin resistance with thyroid co-morbidity and T3, T4 were better objective markers in obese type 2 diabetics.
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Affiliation(s)
- Rajendran Jayanthi
- Department of Biochemistry, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth, Pondicherry 607403, India
| | - Abu Raghavan Srinivasan
- Department of Biochemistry, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth, Pondicherry 607403, India.
| | - Mohammed Hanifah
- Department of General Medicine, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth, India
| | - Anandraj Lokesh Maran
- Department of Community Medicine, Mahatma Gandhi Medical College & Research, Institute Sri Balaji Vidyapeeth, India
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136
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Gaya AR, Brand C, Dias AF, Gaya ACA, Lemes VB, Mota J. Obesity anthropometric indicators associated with cardiometabolic risk in Portuguese children and adolescents. Prev Med Rep 2017; 8:158-162. [PMID: 29057209 PMCID: PMC5643080 DOI: 10.1016/j.pmedr.2017.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 09/26/2017] [Accepted: 10/02/2017] [Indexed: 12/11/2022] Open
Abstract
The purpose of this study was to determine the association between cardiometabolic risk with body mass index and skinfold independently or in combination in youth. This cross-sectional study comprised a convenience sample of 450 children and adolescents (255 girls), aged 10 to 18 years old. Indicators of body composition were measured, and hemodynamic assessment completed. The association between body mass index and/or sum of skinfolds and cardiometabolic risk (z score of the sum of triglycerides/high density lipoprotein cholesterol, waist circumference, and mean blood pressure), was calculated using Generalized Linear Models Regression. The results showed that youngsters classified as overweight or obese with the highest skinfold measurements had the strongest association with cardiometabolic risk (< beta >: 2.60; IC 95%: 2.25–3.0) when compared with those exhibiting normal skinfold thickness (< beta >: 1.78; IC 95%: 1.30–2.20). Body mass index was most strongly associated with cardiometabolic risk (< beta >: 1.78; IC 95%: 1.3–2.2), in comparison to skinfold thickness, which was associated to a lesser extent (< beta >: 0.41; IC 95%: 0.34–0.49). Results of this cross-sectional study indicate that body mass index is more strongly associated with cardiometabolic risk than skinfold thickness. However when these two measures of overweight/obesity are combined, prediction of cardiometabolic risk is further improved. It is therefore important that public health professionals consider both body mass index and sum of skinfolds to better predict cardiometabolic risk in overweight and obese youth. Implications for future research include the use of longitudinal designs and inclusion of children from other racial/ethnic groups. Body mass index and skinfold improved the prediction of cardiometabolic risk. Body mass index seems to be the best indicator of cardiometabolic risk factors. Anthropometric indicators are cost-effective screening of overweight/obesity.
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Key Words
- BMI, body mass index
- Body mass index
- CM, cardiometabolic
- DBP, diastolic blood pressure
- ESKF, average of skinfolds
- HDL-C, high density lipoprotein cholesterol
- Health
- LDL-C, low density lipoprotein cholesterol
- MAP, mean arterial pressure
- OW/OB, overweight/obese
- SBP, systolic blood pressure
- SKF, skinfolds
- Skinfold
- TG, triglycerides
- WC, waist circumference
- WHtR, waist-to-height ratio
- Youngsters
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Affiliation(s)
- Anelise Reis Gaya
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Caroline Brand
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Arieli Fernandes Dias
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Adroaldo Cezar Araujo Gaya
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Vanilson Batista Lemes
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Dr. Plácido da Costa, 91, 4200-450 Porto, Portugal
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137
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Yoo DY, Kang YS, Kwon EB, Yoo EG. The triglyceride-to-high density lipoprotein cholesterol ratio in overweight Korean children and adolescents. Ann Pediatr Endocrinol Metab 2017; 22:158-163. [PMID: 29025201 PMCID: PMC5642079 DOI: 10.6065/apem.2017.22.3.158] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 01/04/2017] [Accepted: 02/21/2017] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio has recently been reported as a biomarker of cardiometabolic risk in obese children and adolescents. The purpose of this study is to describe the TG/HDL-C ratio and related factors in overweight and normal weight Korean children and to evaluate whether the high TG/HDL-C ratio is associated with insulin resistance in overweight children and adolescents. METHODS Data from 255 overweight (aged 8.7±2.0 years) and 514 normal weight (aged 8.9±1.8 years) children and adolescents were evaluated. Glucose, insulin, total cholesterol (TC), HDL-C and TG levels were measured after overnight fasting, and the TG/HDL-C ratio, non-HDL-C and the homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. RESULTS The TG/HDL-C ratio was higher in overweight group compared to normal weight group (P<0.001). Among overweight children and adolescents, alanine aminotransferase (P=0.018), non-HDL-C (P<0.001), and HOMA-IR (P=0.004) were different between the TG/HDL-C ratio tertile groups. The prevalence of elevated HOMA-IR was increased with increasing TG/HDL-C ratio tertiles (P for trend=0.003). On regression analysis adjusted for age and sex, the BMI (β=0.402, P=0.001) and TG/HDL-C ratio (β=0.251, P=0.014) were independently associated with HOMA-IR (adjusted R2=0.324). The TG/HDL-C ratio of 2.0 or more showed higher sensitivity (55.6%) and specificity (72.9%), when compared to TC (≥200 mg/dL), non-HDL-C (≥145 mg/dL), and LDL-C (≥130 mg/dL) for identifying overweight children with elevated HOMA-IR. CONCLUSIONS The TG/HDL-C ratio is independently associated with insulin resistance in overweight children and adolescents, and it can be useful in identifying those at higher cardiometabolic risk.
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Affiliation(s)
- Dong-Yoon Yoo
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Yu Sun Kang
- Department of Pediatrics, CHA Gumi Medical Center, Gumi, Korea
| | - Eun Byul Kwon
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Eun-Gyong Yoo
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea,Address for correspondence: Eun-Gyong Yoo, MD, PhD https://orcid.org/0000-0002-6452-655X Department of Pediatrics, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea Tel: +82-31-780-1999 Fax: +82-31-780-5239 E-mail:
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138
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Nogay NH. Assessment of the correlation between the atherogenic index of plasma and cardiometabolic risk factors in children and adolescents: might it be superior to the TG/HDL-C ratio? J Pediatr Endocrinol Metab 2017; 30:947-955. [PMID: 28787273 DOI: 10.1515/jpem-2016-0479] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 07/20/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Most of the studies investigating the correlation between the atherogenic index of plasma (AIP) and cardiometabolic risk factors have been conducted with adults, while only a limited number of related studies that involved children and adolescents has been conducted. The purpose of this study is to assess the correlation between the AIP and other cardiometabolic risk factors in adolescents. METHODS This study was conducted with 310 girls and 90 boys who were between the ages of 6 and 18 years. After a 10-h fasting period, the biochemical values of the participants were measured in the morning. The anthropometric measurements of the participants were also taken. The AIP was calculated as Log10 (triglycerides/high density lipoprotein-cholesterol; TG/HDL-C). RESULTS In adolescents between the ages of 12 and 18, the mean AIP of the group with TG ≥130 mg/dL was significantly higher than that of the groups with TG of 90-129 mg/dL and <90 mg/dL. There was a strong correlation between TG and AIP for both boys and girls among the children and adolescents, while there was a strong correlation between the TG/HDL-C ratio and TG only in the boys who were within the 6-11-year-old age group. CONCLUSIONS An increase in AIP is associated with cardiovascular risk factors in children and adolescents other than those seen in adults. Based on the TG/HDL-C ratio, the AIP may be superior as a complementary index in the assessment of cardiometabolic risks in children and adolescents.
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139
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Hartmann B, Lanzinger S, Bramlage P, Groß F, Danne T, Wagner S, Krakow D, Zimmermann A, Malcharzik C, Holl RW. Lean diabetes in middle-aged adults: A joint analysis of the German DIVE and DPV registries. PLoS One 2017; 12:e0183235. [PMID: 28827839 PMCID: PMC5565180 DOI: 10.1371/journal.pone.0183235] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 08/01/2017] [Indexed: 12/29/2022] Open
Abstract
AIMS To assess differences in demographics, treatment and outcome of lean (LD) compared to overweight and obese people with diabetes clinically classified as type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS We combined data from the German DIVE (Diabetes Versorgungs-Evaluation) and DPV (Diabetes-Patienten-Verlaufsdokumentation) databases to produce a large cohort of people with T2DM. The characteristics of people with Body Mass Index (BMI) <25 kg/m2, ≥25-30 kg/m2 and ≥30 kg/m2 aged 30 to 50 years were compared, including demographics, cardiovascular (CV) risk factors, comorbidities and outcomes. RESULTS A total of 37,870 people were included in the analysis, 3,191 of these (8.4%) had a BMI < 25 kg/m2. LD reported more nicotine (41.6% of 2,070 vs. 38.1% of 6,070 and 33.4% of 16,823; P<0.001)and alcohol consumption (12.0% of 1,282, 10.3% of 3,594 and 6.6% of 9,418; P<0.001)compared to overweight and obese people. More LD were treated with insulin in comparison to the other subgroups (short acting insulin 33.1% of 3,191 vs. 28.4% of 9,234 and 28.0% of 25,445; P <0.001; long acting insulin 31.3% of 3,191 vs. 28.9% of 9,234 and 29.3% of 25,445; P = 0.043). Regression models adjusted for age, gender and diabetes duration showed a 2.50 times higher odds ratio (OR) for hypoglycemia and a 2.52 higher OR for mortality in LD compared to the BMI subgroup ≥30 kg/m2. CONCLUSIONS LD is associated with an increased risk of hypoglycaemia and death. Patients are characterized by male gender, lifestyle habits as smoking and alcohol consumption while cardiovascular comorbidities are less important. In comparison to patients of the other weight groups they are treated with insulin more often and considerably less with metformin.
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Affiliation(s)
- Bettina Hartmann
- Department of Gastroenterology and Diabetology, Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - Stefanie Lanzinger
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Peter Bramlage
- Institute for Pharmacology and Preventive Medicine, Mahlow, Germany
| | | | - Thomas Danne
- Diabeteszentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover, Germany
| | - Siegfried Wagner
- Department of Internal Medicine II, DONAUISAR Klinikum, Deggendorf, Germany
| | | | - Artur Zimmermann
- Praxis Dr. Zimmermann- Diabeteszentrum Bad Aibling, Bad Aibling, Germany
| | | | - Reinhard W. Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
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Ortiz Segura MDC, Del Río Navarro BE, Rodríguez Espino BA, Marchat LA, Sánchez Muñoz F, Villafaña S, Hong E, Meza-Cuenca F, Mailloux Salinas P, Bolaños-Jiménez F, Zambrano E, Arredondo-López AA, Bravo G, Huang F. Abnormality of adipokines and endothelial dysfunction in Mexican obese adolescents with insulin resistance. Endocr Res 2017; 42:252-259. [PMID: 28318332 DOI: 10.1080/07435800.2017.1294601] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was to investigate the possible relationship among insulin resistance (IR), endothelial dysfunction, and alteration of adipokines in Mexican obese adolescents and their association with metabolic syndrome (MetS). MATERIALS AND METHODS Two hundred and twenty-seven adolescents were classified according to the body mass index (BMI) (control: N=104; obese: N=123) and homeostasis model of the assessment-insulin resistance index (HOMA-IR) (obese with IR: N=65). The circulating concentrations of leptin, adiponectin, soluble intercellular adhesion molecule-1 (sICAM-1), and IR were determined by standard methods. RESULTS The obese adolescents with IR presented increased presence of MetS and higher circulating concentrations in sICAM-1 in comparison with the obese subjects without IR. The lowest concentrations of adiponectin were observed in the obese with IR. In multivariate linear regression models, sICAM-1 along with triglycerides, total cholesterol, and waist circumference was strongly associated with HOMA-IR (R2=0.457, P=0.008). Similarly, after adjustment for age, BMI-SDS, lipids, and adipokines, HOMA-IR remained associated with sICAM-1 (R2=0.372, P=0.008). BMI-SDS was mildly associated with leptin (R2=0.176, P=0.002) and the waist circumference was mild and independent determinant of adiponectin (R2=0.136, P=0.007). CONCLUSIONS Our findings demonstrated that the obese adolescents, particularly the obese subjects with IR exhibited increased presence of MetS, abnormality of adipokines, and endothelial dysfunction. The significant interaction between IR and endothelial dysfunction may suggest a novel therapeutic approach to prevent or delay systemic IR and the genesis of cardiovascular diseases in obese patients.
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Affiliation(s)
- Maria Del Carmen Ortiz Segura
- a Department of Pharmacobiology , Centro de Investigacion de Estudio Avanzados del Instituto Politecnico Nacional , Mexico City , Mexico
| | | | | | - Laurence A Marchat
- d Sección de Estudios de Posgrado e Investigación, Escuela Nacional de Medicina y Homeopatía del Instituto Politécnico Nacional , Mexico City , Mexico
| | - Fausto Sánchez Muñoz
- e Department of Inmunology , Instituto Nacional de Cardiología Ignacio Chávez , Mexico City , Mexico
| | - Santiago Villafaña
- f Sección de Postgrado, Escuela Superior de Medicina-Instituto Politécnico Nacional , Mexico City , Mexico
| | - Enrique Hong
- a Department of Pharmacobiology , Centro de Investigacion de Estudio Avanzados del Instituto Politecnico Nacional , Mexico City , Mexico
| | - Fabián Meza-Cuenca
- a Department of Pharmacobiology , Centro de Investigacion de Estudio Avanzados del Instituto Politecnico Nacional , Mexico City , Mexico
| | - Patrick Mailloux Salinas
- a Department of Pharmacobiology , Centro de Investigacion de Estudio Avanzados del Instituto Politecnico Nacional , Mexico City , Mexico
| | - Francisco Bolaños-Jiménez
- g INRA, UMR1280 Physiologie des Adaptations Nutritionnelles , Université de Nantes, Nantes Atlantique Université , Nantes , France
| | - Elena Zambrano
- h Departamento de Biología de la Reproducción , Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran , Mexico City , Mexico
| | | | - Guadalupe Bravo
- a Department of Pharmacobiology , Centro de Investigacion de Estudio Avanzados del Instituto Politecnico Nacional , Mexico City , Mexico
| | - Fengyang Huang
- j Laboratory of Pharmacology and Toxicology, HIMFG , Mexico City , Mexico
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Type 2 Diabetes Mellitus and Simple Glucose Metabolism Parameters may Reliably Predict Nonalcoholic Fatty Liver Disease Features. Obes Surg 2017; 28:187-194. [DOI: 10.1007/s11695-017-2829-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Lin D, Qi Y, Huang C, Wu M, Wang C, Li F, Yang C, Yan L, Ren M, Sun K. Associations of lipid parameters with insulin resistance and diabetes: A population-based study. Clin Nutr 2017; 37:1423-1429. [PMID: 28673690 DOI: 10.1016/j.clnu.2017.06.018] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 11/23/2016] [Accepted: 06/15/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE A dramatic gap exists between the clinical practice and guidelines for the dyslipidemia control in patients with diabetes. It is still uncertain which routinely available lipid measure is more applicable in estimation of insulin sensitivity and blood glucose control. The present study aims to investigate associations of routine lipid profiles with insulin resistance and diabetes, respectively. METHODS We conducted a population-based study in 9764 Chinese participants. The homeostasis model assessment of insulin resistance was calculated to estimate insulin sensitivity. Diabetes was diagnosed according to the 1999 World Health Organization diagnostic criteria. RESULTS Participants with insulin resistance or diabetes presented with significantly higher triglycerides (TG), Non-high-density lipoprotein cholesterol (Non-HDL-C), Non-HDL-C/HDL-C, TG/HDL-C and lower HDL-C when compared with control subjects (all P < 0.0001). Such lipid measures were significantly correlated with fasting insulin, fasting plasma glucose (FPG), oral glucose tolerance test (OGTT) 2 h glucose and Hemoglobin A1c (HbA1c) in Pearson's correlation analysis and multivariate linear regression analysis (all P < 0.0001). In logistic regression analysis, subjects were more likely to have prevalent insulin resistance and diabetes with the elevated quartiles of TG, Non-HDL-C, Non-HDL-C/HDL-C and TG/HDL-C (all P < 0.05). TG/HDL-C ratio, compare with other lipid parameters, have shown the strongest correlation with increased odds of insulin resistance and diabetes. CONCLUSION Our study suggests a discordant association of lipid parameters with blood glucose level and TG/HDL-C is a better marker for evaluating insulin resistance and diabetes in Chinese population when compared with other routine lipid measures.
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Affiliation(s)
- Diaozhu Lin
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou 510120, People's Republic of China
| | - Yiqin Qi
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou 510120, People's Republic of China
| | - Chulin Huang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou 510120, People's Republic of China
| | - Muchao Wu
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou 510120, People's Republic of China
| | - Chuan Wang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou 510120, People's Republic of China
| | - Feng Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou 510120, People's Republic of China
| | - Chuan Yang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou 510120, People's Republic of China
| | - Li Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou 510120, People's Republic of China
| | - Meng Ren
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou 510120, People's Republic of China.
| | - Kan Sun
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou 510120, People's Republic of China.
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Cho H, Kim JH. Prevalence of microalbuminuria and its associated cardiometabolic risk factors in Korean youth: Data from the Korea National Health and Nutrition Examination Survey. PLoS One 2017; 12:e0178716. [PMID: 28575100 PMCID: PMC5456094 DOI: 10.1371/journal.pone.0178716] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/17/2017] [Indexed: 12/18/2022] Open
Abstract
Background Microalbuminuria is a known early predictive factor for renal and cardiovascular diseases, not only for patients with diabetes mellitus or hypertension but also in the general population. However, the prevalence and risk factors associated with microalbuminuria in Korean youth are unknown. Objectives The aims of this study are to evaluate the prevalence of microalbuminuria and the association between microalbuminuria and obesity or cardiometabolic risk factors in Korean children and adolescents without diabetes. Methods This study examines data obtained from the Korea National Health and Nutrition Examination Survey (between 2011 and 2014). It includes a total of 1,976 participants aged between 10 and 19 years (boys 1,128 and girls 848). Microalbuminuria was defined as a urine albumin-to-creatinine ratio (UACR) of ≥ 30 mg/g and < 300 mg/g. Association between microalbuminuria and the risk factors for cardiometabolic diseases including insulin resistance was evaluated. Results The prevalence of microalbuminuria was found to be 3.0% in Korean children and adolescents over this time period. The mean UACR for non-obese youth was significantly greater than that found in obese youth (3.2 ± 0.1 mg/g in the non-obese group vs. 2.1 ± 0.2 mg/g in the obese group; P < 0.001). In multiple logistic regression analysis, microalbuminuria was associated with hyperglycemia (OR 2.62, 95% CI 1.09–6.30) and hemoglobin A1c (OR 3.34, 95% CI 1.09–10.17) in the non-obese group and hypertension (OR 14.10, 95% CI 1.12–177.98) and HbA1c (OR 6.68, 95% CI 1.87–23.95) in the obese group. Conclusions The prevalence of microalbuminuria is not prominent in obese children and adolescents. Our findings demonstrated that the presence of hypertension and hyperglycemia was associated with microalbuminuria. Especially Hemoglobin A1c was associated with microalbuminuria in youths regardless of weight status. Microalbuminuria in pediatric population can be a helpful marker for the risk of cardiovascular disease.
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Affiliation(s)
- Heeyeon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae Hyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- * E-mail:
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Bentley AR, Rotimi CN. Interethnic Differences in Serum Lipids and Implications for Cardiometabolic Disease Risk in African Ancestry Populations. Glob Heart 2017; 12:141-150. [PMID: 28528248 PMCID: PMC5582986 DOI: 10.1016/j.gheart.2017.01.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 01/13/2017] [Indexed: 12/12/2022] Open
Abstract
African Americans generally have a healthier lipid profile (lower triglycerides and higher high-density lipoprotein cholesterol concentration) compared with those of other ethnicities. Paradoxically, African Americans do not experience a decreased risk of the cardiometabolic diseases that serum lipids are expected to predict. This review explores this mismatch between biomarker and disease among African ancestry individuals by investigating the presence of interethnic differences in the biological relationships underlying the serum lipids-disease association. This review also discusses the physiologic and genomic factors underlying these interethnic differences. Additionally, because of the importance of serum lipids in assessing disease risk, interethnic differences in serum lipids have implications for identifying African ancestry individuals at risk of cardiometabolic disease. Where possible, data from Africa is included, to further elucidate these ancestral differences in the context of a different environmental background.
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Affiliation(s)
- Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Charles N Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
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Yang SH, Du Y, Li XL, Zhang Y, Li S, Xu RX, Zhu CG, Guo YL, Wu NQ, Qing P, Gao Y, Cui CJ, Dong Q, Sun J, Li JJ. Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Cardiovascular Events in Diabetics With Coronary Artery Disease. Am J Med Sci 2017; 354:117-124. [PMID: 28864368 DOI: 10.1016/j.amjms.2017.03.032] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 03/07/2017] [Accepted: 03/20/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND It has been demonstrated that an elevated ratio of triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) is a risk factor of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM) and is also found to be associated with cardiovascular events (CVEs) in the general population. However, its prognostic value in patients with T2DM along with CAD remains to be determined. MATERIALS AND METHODS A total of 1,447 consecutive patients with T2DM with angiographic-proven stable CAD were enrolled in the present study and followed-up for an average of 20.3 months. The characteristics of all patients including fasting lipid profile were obtained at baseline and multivariate Cox proportional hazards models were constructed using log TG/HDL-C as a predictor variable. The relationships between CVEs and total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, TC/HDL-C, LDL-C/HDL-C and apolipoprotein B/ apolipoprotein AI (apoB/apoAI) were also explored. RESULTS Compared with patients without CVEs, the ones who experienced CVEs had a higher TG/HDL-C ratio. Univariable regression revealed a significant association of log TG/HDL-C with CVEs (hazard ratio = 2.5, P = 0.015). After adjusting for multiple traditional risk factors of cardiovascular disease, the association was still found (hazard ratio = 2.47, P = 0.047). Moreover, results suggested that the ratios of non-HDL-C, TC/HDL-C, LDL-C/HDL-C and apoB/apoAI were not predictors for CVEs in T2DM. CONCLUSIONS In our primary study, data suggested that elevated TG/HDL-C value might be a useful predictor for future CVEs in Chinese patients with T2DM with stable CAD. Further study is needed to confirm our findings.
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Affiliation(s)
- Sheng-Hua Yang
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ying Du
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Xiao-Lin Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yan Zhang
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Sha Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Rui-Xia Xu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Cheng-Gang Zhu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yuan-Lin Guo
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Na-Qiong Wu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ping Qing
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ying Gao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Chuan-Jue Cui
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Qian Dong
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jing Sun
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jian-Jun Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
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Liu X, Hill AM, West SG, Gabauer RM, McCrea CE, Fleming JA, Kris-Etherton PM. Acute Peanut Consumption Alters Postprandial Lipids and Vascular Responses in Healthy Overweight or Obese Men. J Nutr 2017; 147:835-840. [PMID: 28356431 PMCID: PMC5404215 DOI: 10.3945/jn.116.246785] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 01/09/2017] [Accepted: 03/02/2017] [Indexed: 12/25/2022] Open
Abstract
Background: Postprandial hyperlipidemia is associated with impaired endothelial function. Peanut consumption favorably affects the lipid and lipoprotein profile; however, the effects on endothelial function remain unclear.Objective: The purpose of the study was to evaluate the effects of acute peanut consumption as part of a high-fat meal on postprandial endothelial function.Methods: We conducted a randomized, controlled, crossover postprandial study to evaluate the effect of acute peanut consumption on postprandial lipids and endothelial function as assessed by flow-mediated dilatation (FMD) of the brachial artery in 15 healthy overweight or obese men [mean age: 26.7 y; mean body mass index (in kg/m2): 31.4]. Participants consumed, in a randomized order, a peanut meal containing 3 ounces (85 g) ground peanuts (1198 kcal; 40.0% carbohydrate, 47.7% fat, 19.4% saturated fat, 13.2% protein) and a control meal matched for energy and macronutrient content. Meals were in the form of a shake, scheduled ≥1 wk apart. Lipids, lipoproteins, glucose, and insulin were measured at baseline (0 min) and at 30, 60, 120, and 240 min after shake consumption. FMD was measured at baseline and at 240 min.Results: Acute peanut consumption blunted the serum triglyceride (TG) response 120 and 240 min after consumption compared with the control meal (means ± SEMs-120 min: 188.9 ± 19.4 compared with 197.5 ± 20.7 mg/dL; 240 min: 189.9 ± 24.3 compared with 197.3 ± 18.4 mg/dL; P < 0.05 for both). Total, LDL, and HDL cholesterol and glucose and insulin responses were similar between the test meals. Compared with baseline, only the control meal significantly decreased FMD at 240 min (control: -1.2% ± 0.5%; P = 0.029; peanut: -0.6% ± 0.5%; P = 0.3). Participants with higher baseline total (>150 mg/dL) and LDL (>100 mg/dL)-cholesterol concentrations showed a significant decrease in FMD after the control meal (-1.8%, P = 0.017; -2.0%, P = 0.038), whereas the peanut meal maintained endothelial function in all participants irrespective of total- and LDL-cholesterol concentrations.Conclusion: The inclusion of 85 g peanuts (3 ounces) as part of a high-fat meal improved the postprandial TG response and preserved endothelial function in healthy overweight or obese men. This trial was registered at clinicaltrials.gov as NCT01405300.
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Affiliation(s)
| | - Alison M Hill
- Departments of Nutritional Sciences and.,School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Sheila G West
- Departments of Nutritional Sciences and.,School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | | | - Cindy E McCrea
- Departments of Nutritional Sciences and.,Biobehavioral Health, The Pennsylvania State University, State College, PA; and
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Associations of lipid profiles with insulin resistance and β cell function in adults with normal glucose tolerance and different categories of impaired glucose regulation. PLoS One 2017; 12:e0172221. [PMID: 28199386 PMCID: PMC5310856 DOI: 10.1371/journal.pone.0172221] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 02/01/2017] [Indexed: 12/17/2022] Open
Abstract
Aims To investigate the associations of dyslipidemia with insulin resistance and β cell function in individuals with normal glucose tolerance (NGT) and different categories of impaired glucose regulation (IGR). Methods 544 subjects (365 with dyslipidemia and/or IGR and 179 with normal lipid and glucose tolerance) were enrolled in the study. All subjects underwent oral glucose tolerance test (OGTT). HOMA-IR was used to evaluate insulin sensitivity. Disposition index (DI) was used to evaluate β cell function. Multiple linear regression analysis was performed to assess correlations among lipid profiles, insulin resistance and β cell function. Results Among subjects with NGT, those with dyslipidemia had higher level of HOMA-IR but lower level of DI. While among subjects with different categories of IGR, those with dyslipidemia and CGI had significantly decreased DI. No obvious differences of insulin resistance or β cell function were found in IFG or IGT subjects with or without dyslipidemia. TG and HDL-C were correlated with HOMA-IR (β = 0.79, p <0.001; β = -0.38, p = 0.027, respectively, compared with subjects in the low level groups). Moreover, TG and TC were negatively correlated with DI (β = -2.17, p = 0.013; β = -2.01, p = 0.034 respectively, compared with subjects in the low level groups) after adjusting for confounding parameters. Conclusions Dyslipidemia induces insulin resistance and impaired β cell response to insulin resistance in individuals with NGT. Furthermore, dyslipidemia diminishes β cell function in subjects with CGI. TG and HDL-C were correlated with insulin resistance, and TG, TC were negatively correlated with β cell response to insulin resistance in non-diabetic individuals.
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Ghomari-Boukhatem H, Bouchouicha A, Mekki K, Chenni K, Belhadj M, Bouchenak M. Blood pressure, dyslipidemia and inflammatory factors are related to body mass index in scholar adolescents. Arch Med Sci 2017; 13:46-52. [PMID: 28144254 PMCID: PMC5206370 DOI: 10.5114/aoms.2017.64713] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 06/18/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Obesity is associated with increased occurrence of numerous diseases, including hypertension, dyslipidemia, insulin resistance, diabetes, and atherosclerosis. Blood pressure (BP), dyslipidemia, and inflammation markers and their relationships with body mass index (BMI) were determined in scholar adolescents. MATERIAL AND METHODS Adolescents (n = 210) (sex ratio G/B = 106/104; 11 to 16 years) were recruited in three colleges of Oran city. Anthropometric parameters were measured to classify adolescents as thin (T), normal weight (NW), overweight (OW), or obese (O). Waist circumference (WC) and BP were measured, and serum glucose, uric acid, urea, lipid parameters, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), C-reactive protein (CRP), insulin, leptin, and adiponectin were analyzed. RESULTS Adolescents were classified according to their BMI as T (15%), NW (63%), OW (13%), and O (9%). Compared to NW, increased values of WC, BP (p < 0.001), and glucose (p < 0.01) were noted in OW and O groups. Total cholesterol (TC) level was elevated in O adolescents (p < 0.01). Increased low-density lipoprotein cholesterol (LDL-C) in OW (p < 0.05) and O (p < 0.01), and reduced high-density lipoprotein cholesterol (HDL-C) concentrations were noted in both OW and O groups (p < 0.05), compared to NW. Elevated triglyceride (TG) values and TG : HDL-C ratio were observed in OW (p < 0.05) and O (p < 0.01). High values of uric acid were noted in OW and O adolescents (p < 0.01). Compared to NW, there was no significant difference in IL-1β whereas IL-6 was elevated in T (p < 0.05), OW (p < 0.01) and O (p < 0.001). Leptin, TNF-α, and CRP concentrations were significantly increased (p < 0.001), whereas adiponectin values were decreased in both OW and O groups (p < 0.01), compared to NW. CONCLUSIONS Significant associations were noted between WC, BP, dyslipidemia, inflammation markers, and BMI, indicating that both OW and O adolescents have a tendency to present metabolic syndrome risk factors.
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Affiliation(s)
- Hanane Ghomari-Boukhatem
- Laboratoire de Nutrition Clinique et Métabolique, Faculté des Sciences de la Nature et de la vie, Université d’Oran 1 Ahmed Ben Bella, Oran, Algeria
| | - Assia Bouchouicha
- Laboratoire de Nutrition Clinique et Métabolique, Faculté des Sciences de la Nature et de la vie, Université d’Oran 1 Ahmed Ben Bella, Oran, Algeria
| | - Khedidja Mekki
- Laboratoire de Nutrition Clinique et Métabolique, Faculté des Sciences de la Nature et de la vie, Université d’Oran 1 Ahmed Ben Bella, Oran, Algeria
| | - Karima Chenni
- Laboratoire de Biostatistiques, Faculté de Médecine, Université d’Oran, Oran, Algeria
| | - Mohamed Belhadj
- Service de Médecine Interne, Etablissement Hospitalo-Universitaire EHU, Oran, Algeria
| | - Malika Bouchenak
- Laboratoire de Nutrition Clinique et Métabolique, Faculté des Sciences de la Nature et de la vie, Université d’Oran 1 Ahmed Ben Bella, Oran, Algeria
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Triglycerides/glucose index is a useful surrogate marker of insulin resistance among adolescents. Int J Obes (Lond) 2017; 41:789-792. [DOI: 10.1038/ijo.2017.14] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 12/15/2016] [Accepted: 12/30/2016] [Indexed: 01/08/2023]
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150
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Iwani NAKZ, Jalaludin MY, Zin RMWM, Fuziah MZ, Hong JYH, Abqariyah Y, Mokhtar AH, Wan Nazaimoon WM. Triglyceride to HDL-C Ratio is Associated with Insulin Resistance in Overweight and Obese Children. Sci Rep 2017; 7:40055. [PMID: 28059134 PMCID: PMC5216403 DOI: 10.1038/srep40055] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/30/2016] [Indexed: 01/19/2023] Open
Abstract
The purpose of this study was to investigate the usefulness of triglyceride to hdl-c ratio (TG:HDL-C) as an insulin resistance (IR) marker for overweight and obese children. A total of 271 blood samples of obese and overweight children aged 9-16 years were analysed for fasting glucose, lipids and insulin. Children were divided into IR and non-insulin resistance, using homeostasis model assessment (HOMA). The children were then stratified by tertiles of TG: HDL-C ratio. The strength between TG:HDL-C ratio and other parameters of IR were quantified using Pearson correlation coefficient (r). Odds ratio was estimated using multiple logistic regression adjusted for age, gender, pubertal stages and IR potential risk factors. Children with IR had significantly higher TG:HDL-C ratio (2.48) (p = 0.01). TG:HDL-C ratio was significantly correlated with HOMA-IR (r = 0.104, p < 0.005) and waist circumference (r = 0.134, p < 0.001). Increasing tertiles of TG:HDL-C ratio showed significant increase in mean insulin level (p = 0.03), HOMA-IR (p = 0.04) and significantly higher number of children with acanthosis nigricans and metabolic syndrome. The odds of having IR was about 2.5 times higher (OR = 2.47; 95% CI 1.23, 4.95; p = 0.01) for those in the highest tertiles of TG:HDL-C ratio. Hence, TG:HDL-C may be a useful tool to identify high risk individuals.
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Affiliation(s)
- Nur Ahmad Kamil Zati Iwani
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Diabetes and Endocrine Unit, Institute For Medical Research, Kuala Lumpur, Malaysia
| | | | - Ruziana Mona Wan Mohd Zin
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Diabetes and Endocrine Unit, Institute For Medical Research, Kuala Lumpur, Malaysia
| | - Md Zain Fuziah
- Department of Paediatrics, Putrajaya Hospital, Putrajaya, Malaysia
| | | | - Yahya Abqariyah
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Abdul Halim Mokhtar
- Department of Sports Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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