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Li Z, He Y, Wang S, Li L, Yang R, Liu Y, Cheng Q, Yu L, Zheng Y, Zheng H, Gao S, Yu C. Association between triglyceride glucose index and carotid artery plaque in different glucose metabolic states in patients with coronary heart disease: a RCSCD-TCM study in China. Cardiovasc Diabetol 2022; 21:38. [PMID: 35277186 PMCID: PMC8917731 DOI: 10.1186/s12933-022-01470-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/28/2022] [Indexed: 01/14/2023] Open
Abstract
Background The triglyceride glucose (TyG) index serves as a surrogate indicator of insulin resistance. However, there is limited evidence on the association between the TyG index and carotid artery plaque (CAP) in patients with coronary heart disease (CHD). Methods The 10,535 CHD patients were divided according to TyG index quartiles (Q1: TyG index < 8.52; Q2: 8.52 ≤ TyG index < 8.93; Q3: 8.93 ≤ TyG index ≤ 9.40; Q4: TyG index > 9.40). The presence or absence of CAP was determined by carotid ultrasonography. Logistic regression was used to analyze the relationship between the TyG index and CAP in CHD patients. The relationship between the TyG index and CAP in according to sex, age groups, and glucose metabolism states were also assessed. Results The baseline analysis showed that there were significant differences in related parameters among CHD patients divided into four groups according to the quartile of the TyG index. In the multi-adjusted modles, compared to Q1 of the TyG index, the odds ratios (OR) for Q4 of the TyG index for CAP were 1.37 (95% confidence interval [CI] 1.28–1.47) in CHD patients. The association between the TyG index and CAP in female (OR: 1.35; 95% CI 1.29–1.43) was higher than that in male (OR: 1.20; 95% CI 1.13–1.27). The OR value of middle-aged (≤ 60 years old) patients (OR: 1.34; 95% CI 1.26–1.42) was higher than that in elderly (> 60 years old) patients (OR: 1.16; 95% CI 1.11–1.22). In different glucose metabolism states, the TyG index of CHD patients was significantly related to the risk of CAP, with the highest OR value observed for diabetes (OR: 1.36; 95% CI 1.26–1.46). Conclusions The TyG index and CAP showed a significant association in CHD patients. This association between TyG index and CAP in CHD patients is higher in female than in male, and the association in middle-aged and elderly patients is higher than that in elderly patients. In the condition of DM, the association between TyG index and carotid artery plaque in CHD patients is higher. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01470-3.
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The Active Compounds of Yixin Ningshen Tablet and Their Potential Action Mechanism in Treating Coronary Heart Disease- A Network Pharmacology and Proteomics Approach. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:4912395. [PMID: 32419806 PMCID: PMC7204378 DOI: 10.1155/2020/4912395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 09/15/2019] [Accepted: 10/10/2019] [Indexed: 12/22/2022]
Abstract
Yixin Ningshen tablet is a CFDA-approved TCM formula for treating coronary heart disease (CHD) clinically. However, its active compounds and mechanism of action in treating CHD are unknown. In this study, a novel strategy with the combination of network pharmacology and proteomics was proposed to identify the active components of Yixin Ningshen tablet and the mechanism by which they treat CHD. With the application of network pharmacology, 62 active compounds in Yixin Ningshen tablet were screened out by text mining, and their 313 potential target proteins were identified by a tool in SwissTargetPrediction. These data were integrated with known CHD-related proteomics results to predict the most possible targets, which reduced the 313 potential target proteins to 218. The STRING database was retrieved to find the enriched pathways and related diseases of these target proteins, which indicated that the Calcium, MAPK, PI3K-Akt, cAMP, Rap1, AGE-RAGE, Relaxin, HIF-1, Prolactin, Sphingolipid, Estrogen, IL-17, Jak-STAT signaling pathway, necroptosis, arachidonic acid metabolism, insulin resistance, endocrine resistance, and steroid hormone biosynthesis might be the main pathways regulated by Yixin Ningshen tablet for the treatment of CHD. Through further enrichment analysis and literature study, EGFR, ERBB2, VGFR2, FGF1, ESR1, LOX15, PGH2, HMDH, ADRB1, and ADRB2 were selected and then validated to be the target proteins of Yixin Ningshen tablet by molecular docking, which indicated that Yixin Ningshen tablet might treat CHD mainly through promoting heart regeneration, new vessels' formation, and the blood supply of the myocardial region and reducing cardiac output, oxygen demand, and inflammation as well as arteriosclerosis (promoting vasodilation and intraplaque neoangiogenesis, lowering blood lipid). This study is expected to benefit the clinical application of Yixin Ningshen tablet for the treatment of CHD.
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Marcelino Rodríguez I, Oliva García J, Alemán Sánchez JJ, Almeida González D, Domínguez Coello S, Brito Díaz B, Gannar F, Rodríguez Pérez MDC, Elosua R, Cabrera de León A. Lipid and inflammatory biomarker profiles in early insulin resistance. Acta Diabetol 2016; 53:905-913. [PMID: 27432443 DOI: 10.1007/s00592-016-0885-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 07/02/2016] [Indexed: 12/25/2022]
Abstract
AIMS To analyze the serum lipid and inflammatory biomarker profile in the early insulin resistance (e-IR). METHODS Cross-sectional study of 5943 adults without diabetes, stratified into no IR group (C-peptide <third tertile and glucose <100 mg/dL), e-IR group (C-peptide ≥third tertile and glucose <100 mg/dL) and advanced IR group (glucose ≥100 mg/dL). RESULTS E-IR showed significant differences with no IR in the serum concentration of triglycerides (P < 0.001), HDL cholesterol (P < 0.001), LDL cholesterol (P < 0.001), sCD40L (P < 0.001), C-reactive protein (P < 0.004), leptin (P < 0.001) and adiponectin (P < 0.001). Adjusting for age, gender and abdominal obesity, corroborated the association of e-IR with highest quintile of triglycerides (OR 3.88 [3.07-4.89]), HDL cholesterol (OR 0.35 [0.28-0.44]), sCD40L (OR 0.47 [0.24-0.94]), C-reactive protein (OR 2.31 [1.29-4.12]), adiponectin (OR 0.11 [0.04-0.32]), PAI-1 (OR 3.29 [1.29-8.40]) and resistin (OR 1.25 [1.01-1.54]); the same biomarkers were associated with advanced IR although resistin was a protective factor (OR 0.73 [0.58-0.93]). CONCLUSIONS Euglycemic patients with e-IR present an unfavorable serum lipid and inflammatory biomarker profile. Measuring C-peptide in euglycemic patients with elevated triglycerides identifies e-IR.
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Affiliation(s)
- Itahisa Marcelino Rodríguez
- Research Unit, University Hospital Nuestra Señora de la Candelaria, Carretera de El Rosario 145, 38010, Santa Cruz de Tenerife, Canary Islands, Spain
- Cardiovascular Research Network of the Carlos III Institute of Health, Santa Cruz de Tenerife, Spain
| | - José Oliva García
- Research Unit, University Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | - José Juan Alemán Sánchez
- Research Unit, University Hospital Nuestra Señora de la Candelaria, Carretera de El Rosario 145, 38010, Santa Cruz de Tenerife, Canary Islands, Spain
- Cardiovascular Research Network of the Carlos III Institute of Health, Santa Cruz de Tenerife, Spain
- Primary Care Authority, Santa Cruz de Tenerife, Spain
| | - Delia Almeida González
- Cardiovascular Research Network of the Carlos III Institute of Health, Santa Cruz de Tenerife, Spain
- Immunology Unit, University Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | - Santiago Domínguez Coello
- Cardiovascular Research Network of the Carlos III Institute of Health, Santa Cruz de Tenerife, Spain
- Primary Care Authority, Santa Cruz de Tenerife, Spain
| | - Buenaventura Brito Díaz
- Research Unit, University Hospital Nuestra Señora de la Candelaria, Carretera de El Rosario 145, 38010, Santa Cruz de Tenerife, Canary Islands, Spain
- Primary Care Authority, Santa Cruz de Tenerife, Spain
| | - Fadoua Gannar
- Faculty of Sciences of Bizerte, Carthage University, Tunis, Tunisia
| | - María Del Cristo Rodríguez Pérez
- Research Unit, University Hospital Nuestra Señora de la Candelaria, Carretera de El Rosario 145, 38010, Santa Cruz de Tenerife, Canary Islands, Spain
- Primary Care Authority, Santa Cruz de Tenerife, Spain
| | - Roberto Elosua
- Cardiovascular Research Network of the Carlos III Institute of Health, Santa Cruz de Tenerife, Spain
- Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain
| | - Antonio Cabrera de León
- Research Unit, University Hospital Nuestra Señora de la Candelaria, Carretera de El Rosario 145, 38010, Santa Cruz de Tenerife, Canary Islands, Spain.
- Área de medicina preventiva y salud pública, Universidad de La Laguna, La Laguna, Spain.
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Abbasi F, Kohli P, Reaven GM, Knowles JW. Hypertriglyceridemia: A simple approach to identify insulin resistance and enhanced cardio-metabolic risk in patients with prediabetes. Diabetes Res Clin Pract 2016; 120:156-61. [PMID: 27565692 DOI: 10.1016/j.diabres.2016.07.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 05/03/2016] [Accepted: 07/30/2016] [Indexed: 10/21/2022]
Abstract
AIMS Prediabetes (PreDM) is a metabolically heterogeneous condition, differing in degree of insulin resistance and risk of type 2 diabetes mellitus and coronary heart disease (CHD). This study was initiated to evaluate the hypothesis that a fasting plasma triglyceride (TG) concentration ⩾1.7mmol/L can aid in identifying the subset of individuals with PreDM who are most insulin resistant and at greatest risk to develop CHD as well as type 2 diabetes mellitus. METHODS In this cross-sectional study, measurements were made of: (1) steady-state plasma glucose (SSPG) concentration during the insulin suppression test to ascertain degree of insulin resistance and (2) conventional CHD risk factors in 587 apparently healthy individuals with normal fasting plasma glucose (NFG, n=370) or PreDM (n=217). RESULTS Subjects with PreDM were significantly (P<0.001) more insulin resistant (higher SSPG concentrations) and had a more adverse CHD risk profile than those with NFG. A TG concentration ⩾1.7mmol/L identified a subset of individuals with PreDM (38%) who had a higher mean SSPG concentration (11.3±3.5mmol/L vs. 9.3±3.9mmol/L, P<0.001), were more likely to be insulin resistant (66% vs. 39%, P<0.001), and had a more adverse CHD risk factor profile. CONCLUSIONS Measurement of fasting TG concentration in individuals with PreDM may provide a simple clinical approach to identify those who are insulin resistant, at enhanced risk of CHD, and more likely to develop type 2 diabetes mellitus.
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Affiliation(s)
- Fahim Abbasi
- Division of Cardiovascular Medicine and Cardiovascular Institute, Stanford University School of Medicine, Falk CVRC, 300 Pasteur Drive, Stanford, CA 94305-5406, USA.
| | - Payal Kohli
- Kaiser Permanente, 2045 Franklin Street, Denver, CO 80205, USA.
| | - Gerald M Reaven
- Division of Cardiovascular Medicine and Cardiovascular Institute, Stanford University School of Medicine, Falk CVRC, 300 Pasteur Drive, Stanford, CA 94305-5406, USA.
| | - Joshua W Knowles
- Division of Cardiovascular Medicine and Cardiovascular Institute, Stanford University School of Medicine, Falk CVRC, 300 Pasteur Drive, Stanford, CA 94305-5406, USA.
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Salazar MR, Carbajal HA, Espeche WG, Aizpurúa M, Leiva Sisnieguez CE, Leiva Sisnieguez BC, Stavile RN, March CE, Reaven GM. Insulin resistance: The linchpin between prediabetes and cardiovascular disease. Diab Vasc Dis Res 2016; 13:157-63. [PMID: 26802220 DOI: 10.1177/1479164115610057] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to test the hypothesis that cardiovascular disease occurs to the greatest extent in persons with prediabetes mellitus who are also insulin resistant. In 2003, 664 non-diabetic women (n = 457) and men (n = 207), aged 52 ± 16 and 53 ± 15 years, were surveyed during a programme for cardiovascular disease prevention. Fasting plasma glucose concentrations defined participants as having normal fasting plasma glucose (fasting plasma glucose <5.6 mmol/L) or prediabetes mellitus (fasting plasma glucose ⩾ 5.6 and <7.0 mmol/L). The tertile of prediabetes mellitus subjects with the highest fasting plasma insulin concentration was classified as insulin resistant. Baseline cardiovascular disease risk factors were accentuated in prediabetes mellitus versus normal fasting glucose, particularly in prediabetes mellitus/insulin resistant. In 2012, 86% of the sample were surveyed again, and the crude incidence for cardiovascular disease was higher in subjects with prediabetes mellitus versus normal fasting glucose (13.7 vs 6.0/100 persons/10 years; age- and sex-adjusted hazard ratio = 1.88, p = 0.052). In prediabetes mellitus, the crude incidences were 22.9 versus 9.6/100 persons/10 years in insulin resistant versus non-insulin resistant persons (age- and sex-adjusted hazard ratio = 2.36, p = 0.040). In conclusion, cardiovascular disease risk was accentuated in prediabetes mellitus/insulin resistant individuals, with a relative risk approximately twice as high compared to prediabetes mellitus/non-insulin resistant subjects.
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Affiliation(s)
- Martin R Salazar
- Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
| | - Horacio A Carbajal
- Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
| | - Walter G Espeche
- Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
| | | | - Carlos E Leiva Sisnieguez
- Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
| | - Betty C Leiva Sisnieguez
- Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
| | - Rodolfo N Stavile
- Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
| | - Carlos E March
- Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
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Priest JR, Yang W, Reaven G, Knowles JW, Shaw GM. Maternal Midpregnancy Glucose Levels and Risk of Congenital Heart Disease in Offspring. JAMA Pediatr 2015; 169:1112-6. [PMID: 26457543 PMCID: PMC4996656 DOI: 10.1001/jamapediatrics.2015.2831] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE There is a well-described association between maternal diabetes mellitus and risk of congenital heart disease (CHD) in offspring. Although the clinical diagnoses of type 2 diabetes or gestational diabetes are strong risk factors for CHD, subclinical abnormalities of glucose and insulin metabolism are common within the general population and could also confer risk for CHD. We hypothesize that continuous measures of blood analytes related to maternal diabetes are related to odds of cardiac malformations. OBJECTIVE To explore the potential association of 2 different CHD phenotypes in offspring with maternal midpregnancy measures of glucose and insulin. DESIGN, SETTING, AND PARTICIPANTS Case-control study from a population-based cohort of 277 pregnant women in southern and central California carrying infants with tetralogy of Fallot (TOF) (n = 55), dextrotransposition of the great arteries (dTGA) (n = 42), or healthy infants without CHD (n = 180). Serum samples were collected from 2003 through 2007. The analysis was conducted from March through June 2015. MAIN OUTCOMES AND MEASURES Blood analytes related to maternal glucose metabolism were measured from random nonfasting second-trimester blood samples. We measured serum insulin levels by a validated radioimmunoassay, and we measured glucose levels. Multivariable logistic regression models estimated the association between these levels and case status. RESULTS Serum glucose values were elevated in the maternal samples for offspring with TOF (median, 97.0 mg/dL [to convert to millimoles per liter, multiply by 0.0555]) relative to controls (median, 91.5 mg/dL) (P = .01, Wilcoxon rank sum test), a phenomenon not observed in the maternal samples for offspring with dTGA (median, 90.0 mg/dL) relative to controls (P = .18, Wilcoxon rank sum test). Serum insulin levels were significantly different between controls (median, 18.8 μIU/mL [to convert to picomoles per liter, multiply by 6.945]) and maternal samples for offspring with dTGA (median, 13.1 μIU/mL; P = .048, Wilcoxon rank sum test) but not with TOF (median, 14.3 μIU/mL; P = .35, Wilcoxon rank sum test). Relative to maternal blood glucose levels of infants without cardiac malformations, we observed that maternal blood glucose levels in models including insulin were strongly associated with odds of TOF (adjusted odds ratio = 7.54; 95% CI, 2.30-24.69) but not with dTGA (adjusted odds ratio = 1.16; 95% CI, 0.28-4.79). CONCLUSIONS AND RELEVANCE These results represent a direct correlation of glucose as a continuous variable to odds of specific cardiac malformations. The association between serum glucose and odds of TOF indicates the need for additional epidemiological and mechanistic investigations into the risk conferred by insulin signaling and glucose metabolism during early pregnancy.
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Affiliation(s)
- James R Priest
- Division of Pediatric Cardiology and Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California USA
- Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Wei Yang
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Gerald Reaven
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Joshua W. Knowles
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Gary M. Shaw
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
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