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杨 会, 袁 璐, 吴 结, 李 星, 龙 璐, 滕 屹, 冯 琬, 吕 良, 许 彬, 马 天, 肖 金, 周 丁, 李 佳. [Construction of a Predictive Model for Diabetes Mellitus Type 2 in Middle-Aged and Elderly Populations Based on the Medical Checkup Data of National Basic Public Health Service]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2024; 55:662-670. [PMID: 38948267 PMCID: PMC11211768 DOI: 10.12182/20240560502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Indexed: 07/02/2024]
Abstract
Objective To establish a universally applicable logistic risk prediction model for diabetes mellitus type 2 (T2DM) in the middle-aged and elderly populations based on the results of a Meta-analysis, and to validate and confirm the efficacy of the model using the follow-up data of medical check-ups of National Basic Public Health Service. Methods Cohort studies evaluating T2DM risks were identified in Chinese and English databases. The logistic model utilized Meta-combined effect values such as the odds ratio (OR) to derive β, the partial regression coefficient, of the logistic model. The Meta-combined incidence rate of T2DM was used to obtain the parameter α of the logistic model. Validation of the predictive performance of the model was conducted with the follow-up data of medical checkups of National Basic Public Health Service. The follow-up data came from a community health center in Chengdu and were collected between 2017 and 2022 from 7602 individuals who did not have T2DM at their baseline medical checkups done at the community health center. This community health center was located in an urban-rural fringe area with a large population of middle-aged and elderly people. Results A total of 40 cohort studies were included and 10 items covered in the medical checkups of National Basic Public Health Service were identified in the Meta-analysis as statistically significant risk factors for T2DM, including age, central obesity, smoking, physical inactivity, impaired fasting glucose, a reduced level of high-density lipoprotein cholesterol (HDL-C), hypertension, body mass index (BMI), triglyceride glucose (TYG) index, and a family history of diabetes, with the OR values and 95% confidence interval (CI) being 1.04 (1.03, 1.05), 1.55 (1.29, 1.88), 1.36 (1.11, 1.66), 1.26 (1.07, 1.49), 3.93 (2.94, 5.24), 1.14 (1.06, 1.23), 1.47 (1.34, 1.61), 1.11 (1.05, 1.18), 2.15 (1.75, 2.62), and 1.66 (1.55, 1.78), respectively, and the combined β values being 0.039, 0.438, 0.307, 0.231, 1.369, 0.131, 0.385, 0.104, 0.765, and 0.507, respectively. A total of 37 studies reported the incidence rate, with the combined incidence being 0.08 (0.07, 0.09) and the parameter α being -2.442 for the logistic model. The logistic risk prediction model constructed based on Meta-analysis was externally validated with the data of 7602 individuals who had medical checkups and were followed up for at least once. External validation results showed that the predictive model had an area under curve (AUC) of 0.794 (0.771, 0.816), accuracy of 74.5%, sensitivity of 71.0%, and specificity of 74.7% in the 7602 individuals. Conclusion The T2DM risk prediction model based on Meta-analysis has good predictive performance and can be used as a practical tool for T2DM risk prediction in middle-aged and elderly populations.
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Affiliation(s)
- 会芳 杨
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China
| | - 璐 袁
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China
| | - 结凤 吴
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China
| | - 星月 李
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China
| | - 璐 龙
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China
| | - 屹霖 滕
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China
| | - 琬婷 冯
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China
| | - 良 吕
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China
| | - 彬 许
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China
| | - 天佩 马
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China
| | - 金雨 肖
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China
| | - 丁子 周
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China
| | - 佳圆 李
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu 610041, China
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Jing J, Li J, Yan N, Li N, Liu X, Li X, Zhang J, Wang Q, Yang C, Qiu J, Liu X, Wang F, Zhao Y, Zhang Y. Increased TG Levels and HOMA-IR Score Are Associated With a High Risk of Prediabetes: A Prospective Study. Asia Pac J Public Health 2023; 35:413-419. [PMID: 37551032 DOI: 10.1177/10105395231191688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
This study aimed to determine the association of blood lipid and insulin levels with the development of prediabetes. In this prospective cohort study, we collected and analyzed data related to demographic characteristics, lipid profiles, and insulin parameters at baseline (2008-2012) and at follow-up (2019-2020). A total of 1205 participants were included. The study found that maintained or elevated Homeostatic Model Assessment for Insulin Resistance (HOMO-IR) score and elevated triglyceride (TG) levels from baseline to follow-up were associated with an increased risk of prediabetes. However, the interaction between blood lipids and insulin had no significant effect on the risk of prediabetes. Our findings indicate that elevated TG or HOMA-IR levels are associated with an increased risk of prediabetes. These findings emphasize the need to formulate initiatives that can help reduce dyslipidemia to prevent the onset of prediabetes and diabetes.
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Affiliation(s)
- Jinyun Jing
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Juan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Ni Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Nan Li
- Ningxia Center for Disease Control and Prevention, Yinchuan, China
| | - Xiaowei Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Xiaoxia Li
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia China
| | - Jiaxing Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Qingan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Chan Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
- Department of Community Nursing, School of Nursing, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Jiangwei Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Xiuying Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia China
| | - Faxuan Wang
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia China
- Department of Occupational and Environmental Hygiene, School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Yi Zhao
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia China
- Department of Nutrition and Food Hygiene, School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Yuhong Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia China
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Peng H, Wang M, Wang S, Wang X, Fan M, Qin X, Wu Y, Chen D, Li J, Hu Y, Wu T. KCNQ1 rs2237892 polymorphism modify the association between short-term ambient particulate matter exposure and fasting blood glucose: A family-based study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 876:162820. [PMID: 36921852 DOI: 10.1016/j.scitotenv.2023.162820] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND The association between particulate matter and fasting blood glucose (FBG) has shown conflicting results. Genome-wide association studies have shown that KCNQ1 rs2237892 polymorphism is associated with the risk of diabetes. Whether KCNQ1 rs2237892 polymorphism might modify the association between particulate matter and FBG is still uncertain. METHODS Data collected from a family-based cohort study in Northern China, were used to perform the analysis. A generalized additive Gaussian model was used to examine the short-term effects of air pollutants on FBG. We further conducted interaction analyses by including a cross-product term of air pollutants by rs2237892 within KCNQ1 gene. RESULTS A total of 4418 participants were included in the study. In the single pollutant model, the FBG level increased 0.0031 mmol/L with per 10 μg/m3 elevation in fine particular matter (PM2.5) for lag 0 day. After additional adjustments for nitrogen dioxide (NO2) and sulfur dioxide (SO2), similar results were observed for lag 0-2 days. As for particulate matter with particle size below 10 μm (PM10), the significant association between the daily average concentration of the pollutant and FBG level was observed for lag 0-3 days. Additionally, rs2237892 in KCNQ1 gene modified the association between PM and FBG level. The higher risk of FBG levels associated with elevations in PM10 and PM2.5 were more evident as the number of risk allele C increased. Individuals with a CC genotype had the highest risk of elevation in FBG levels. CONCLUSION Short-term exposures to PM2.5 and PM10 were associated with higher FBG levels. Additionally, rs2237892 in KCNQ1 gene might modify the association between the air pollutants and FBG levels.
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Affiliation(s)
- Hexiang Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Xueheng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Meng Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Xueying Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Dafang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
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Wang Y, Wang J, Liu L, Yang P, Deng S, Liu X, Zhao L, Wang C, Li Y. Baseline level and change trajectory of the triglyceride-glucose index in relation to the development of NAFLD: a large population-based cohort study. Front Endocrinol (Lausanne) 2023; 14:1137098. [PMID: 37223043 PMCID: PMC10200880 DOI: 10.3389/fendo.2023.1137098] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/20/2023] [Indexed: 05/25/2023] Open
Abstract
Background Insulin resistance (IR) and nonalcoholic fatty liver disease (NAFLD) are closely related. The triglyceride-glucose index (TyG index) has been proposed as a new indicator of IR. It remains unclear whether the triglyceride-glucose (TyG) index is prospectively associated with incident nonalcoholic fatty liver disease (NAFLD). Methods This large-scale study comprised 1 prospective cohort totaling 22,758 subjects without NAFLD at baseline who underwent repeated health examinations and 1 subcohort totaling 7,722 subjects with more than three visits. The TyG index was ascertained mathematically by ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2). NAFLD was diagnosed by ultrasound without other concomitant liver diseases. A combinatorial Cox proportional hazard model and latent class growth mixture modeling method were used to identify the association of the TyG index and its transition trajectories with NAFLD risk. Results During 53,481 person-years of follow-up, there were 5319 incident cases with NAFLD. Compared with those in the lowest quartile of the baseline TyG index, participants in the highest quartile had 2.52-fold (95% confidence interval, 2.21-2.86) higher odds of incident NAFLD. Similarly, restricted cubic spline analysis showed a dose-response relationship (p nonlinearity<0.001). Subgroup analyses showed a more significant association in the female and normal body size populations (p for interaction<0.001). Three distinct trajectories of changes in the TyG index were identified. Compared with the continued low group, the moderately increasing and highly increasing groups conferred 1.91-fold (1.65-2.21) and 2.19-fold (1.73-2.77) higher NAFLD risk, respectively. Conclusions Participants with a higher baseline TyG index or a higher excessive TyG exposure were associated with an increased NAFLD risk. The findings imply that lifestyle interventions and modulation of IR might be considered to both reduce TyG index levels and prevent NAFLD development.
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Affiliation(s)
- Yaqin Wang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiangang Wang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lei Liu
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Pingting Yang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shuwen Deng
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xuelian Liu
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Linlin Zhao
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Changfa Wang
- General Surgery Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ying Li
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
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Zhang J, Wang R, Liu Q, Song G, Tang X. Association of triglyceride-glucose index with incident hypertension among non-overweight healthy adults: A cohort study in China. Nutr Metab Cardiovasc Dis 2023; 33:1057-1065. [PMID: 36948935 DOI: 10.1016/j.numecd.2023.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 02/06/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND AND AIMS Overweight and obesity are well recognized as important and traditional risk factors for hypertension (HTN), but the prevalence of HTN tends to increase in non-overweight people. Triglyceride-glucose (TyG) index has been observed to be associated with HTN. However, whether such association still persists in non-overweight people remains unclear. The aim of our cohort study was to explore the link between TyG index and incident HTN in non-overweight Chinese population. METHODS AND RESULTS As many as 4678 individuals without HTN at baseline were involved, who underwent at least two years of health check-ups in the eight-year study period and maintained non-overweight at follow-up. According to baseline TyG index quintiles, participants were classified into five groups. Compared with the 1st quantile, those in the 5th quantile of TyG index had a 1.73-fold (HR 95% CI 1.13-2.65) risk of incident HTN. The results remained consistent when analyses were restricted to participants without abnormal TG or FPG level at baseline (HR 1.62, 95% CI 1.17-2.26). Furthermore, the subgroup analyses were conducted, the risk of incident HTN was still significantly increased with increasing TyG index for subgroups of older participants (age≥ 40 years), males, females and higher BMI group (BMI≥ 21 kg/m2). CONCLUSIONS The risk of incident HTN increased with increasing TyG index among Chinese non-overweight adults, so TyG index might be a reliable predictor of incident HTN among adults maintaining non-overweight.
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Affiliation(s)
- Jiwei Zhang
- The Department of Health Statistics, School of Public Health, Dalian Medical University, No. 9 South Road, Lvshun District, Dalian City, Liaoning Province, 116044, PR China; Department of Hospital Infection Control, First Affiliated Hospital of Nanchang University, Nanchang University, No. 17 Yong wai zheng street, Nanchang City, Jiangxi Province, 330006, PR China
| | - Runnan Wang
- The Department of Health Statistics, School of Public Health, Dalian Medical University, No. 9 South Road, Lvshun District, Dalian City, Liaoning Province, 116044, PR China
| | - Qigui Liu
- The Department of Health Statistics, School of Public Health, Dalian Medical University, No. 9 South Road, Lvshun District, Dalian City, Liaoning Province, 116044, PR China
| | - Guirong Song
- The Department of Health Statistics, School of Public Health, Dalian Medical University, No. 9 South Road, Lvshun District, Dalian City, Liaoning Province, 116044, PR China.
| | - Xiao Tang
- The Department of Health Statistics, School of Public Health, Dalian Medical University, No. 9 South Road, Lvshun District, Dalian City, Liaoning Province, 116044, PR China.
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Genetic Markers of Insulin Resistance and Atherosclerosis in Type 2 Diabetes Mellitus Patients with Coronary Artery Disease. Metabolites 2023; 13:metabo13030427. [PMID: 36984867 PMCID: PMC10054456 DOI: 10.3390/metabo13030427] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 03/17/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is characterized by impaired insulin secretion on a background of insulin resistance (IR). IR and T2DM are associated with atherosclerotic coronary artery disease (CAD). The mechanisms of IR and atherosclerosis are known to share similar genetic and environmental roots. Endothelial dysfunction (ED) detected at the earliest stages of IR might be the origin of atherosclerosis progression. ED influences the secretion of pro-inflammatory cytokines and their encoding genes. The genes and their single nucleotide polymorphisms (SNPs) act as potential genetic markers of IR and atherosclerosis. This review focuses on the link between IR, T2DM, atherosclerosis, CAD, and the potential genetic markers CHI3L1, CD36, LEPR, RETN, IL-18, RBP-4, and RARRES2 genes.
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Tohidi M, Asgari S, Chary A, Safiee S, Azizi F, Hadaegh F. Association of triglycerides to high-density lipoprotein cholesterol ratio to identify future prediabetes and type 2 diabetes mellitus: over one-decade follow-up in the Iranian population. Diabetol Metab Syndr 2023; 15:13. [PMID: 36732786 PMCID: PMC9893691 DOI: 10.1186/s13098-023-00988-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND To determine the association between triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) for identifying subjects at risk of incident prediabetes and type 2 diabetes mellitus (T2DM). METHODS In 5064 subjects (men = 2247) aged ≥ 20 years, using Cox proportional hazards regression analyses, the associations of TG/HDL-C with incident prediabetes and T2DM were examined among normoglycemic men and women. Furthermore, the association of this lipid ratio with incident T2DM was also assessed among prediabetic subjects (n = 1414). The multivariable analyses were adjusted for age, body mass index, waist-to-height ratio, wrist circumference, systolic blood pressure, family history of T2DM, education level, history of cardiovascular diseases, and fasting plasma glucose (FPG). RESULTS During a median follow-up of 11.2 years, 2140 new cases of prediabetes (men = 1070) and 360 incident T2DM (men = 152) were identified among normoglycemic individuals. In the prediabetic population, 574 new cases of T2DM (men = 252) were developed. Among the whole population, compared to the first quartile (reference), higher quartiles of TG/HDL-C were significantly associated with higher risks of incident prediabetes and T2DM among normoglycemic individuals and incident T2DM in the prediabetic population (all P for trend < 0.001). The corresponding hazard ratios (HRs) and 95% confidence intervals (CIs) for the fourth quartiles were 1.37(1.20-1.58), 1.92(1.34-2.75), and 1.57(1.22-2.01), respectively. The sex-stratified analyses demonstrated similar significant associations in both sexes; however, TG/HDL-C lost its association with incident T2DM among prediabetic men. Among the normoglycemic population, 1 unit increase in TG/HDL-C was significantly associated with incident prediabetes and T2DM [1.02(1.00-1.03) and 1.06(1.03-1.08), respectively]. The corresponding value for incident T2DM in prediabetic individuals was 1.01(1.00-1.03). In a subgroup population having insulin data (n = 2897), the associations between TG/HDL-C and incident prediabetes and T2DM among normoglycemic individuals generally persisted even after replacing FPG with an index of insulin resistance (IR), i.e., homeostasis model assessment of IR (HOMA-IR) in the adjusted model. CONCLUSIONS In conclusion, in the normoglycemic population, the increasing value of TG/HDL-C was unfavorably associated with incident prediabetes and T2DM, especially among women. Similarly, TG/HDL-C was associated with incident T2DM in prediabetic individuals. Generally, we found that the correlation between TG/HDL-C and different states of dysglycemia is independent of HOMA-IR.
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Affiliation(s)
- Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box 19395-4763, Tehran, Islamic Republic of Iran
| | - Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box 19395-4763, Tehran, Islamic Republic of Iran
| | - Abdolreza Chary
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box 19395-4763, Tehran, Islamic Republic of Iran
| | - Siavash Safiee
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box 19395-4763, Tehran, Islamic Republic of Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box 19395-4763, Tehran, Islamic Republic of Iran.
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Yin Q, Yan X, Cao Y, Zheng J. Evaluation of novel obesity- and lipid-related indices as predictors of abnormal glucose tolerance in Chinese women with polycystic ovary syndrome. BMC Endocr Disord 2022; 22:272. [PMID: 36348340 PMCID: PMC9644461 DOI: 10.1186/s12902-022-01179-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 10/16/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE We aimed to evaluate the performance of Chinese visceral adiposity index (CVAI), visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride glucose (TyG) as indices in screening abnormal glucose tolerance (AGT) in Chinese women with polycystic ovary syndrome (PCOS), using the oral glucose tolerance test (OGTT) as a reference test. In addition, we essentially compared the abilities of these indices with body mass index (BMI), waist circumference (WC), fasting plasma glucose (FPG). MATERIALS AND METHODS All 1113 PCOS patients evaluated in this study underwent OGTTs. The 2-h post-oral glucose load (2 h-PG) level was used to categorize subjects into two groups: those having AGT or normal glucose tolerance (NGT) levels. RESULTS A statistically significant positive correlation between levels of 2 h-PG and FPG, BMI, WC, LAP, VAI, CVAI, TyG, (P < 0.05), was observed. The strongest correlation was found between the levels of 2 h-PG and CVAI (r = 0.47). The CVAI provided the highest area under the receiver-operating characteristic curve (AUC) for AGT, followed by LAP, BMI, TyG, VAI, WC, and FPG. The CVAI of 32.61 (with AUC: 0.76, sensitivity: 73%, specificity: 70%, positive preductive value (PPV): 0.41, negative predictive value (NPV): 0.90) was found to be the cut-off point for AGT in Chinese women with PCOS. CONCLUSIONS CVAI may not reliably detect AGT in Chinese women with PCOS. However, it is suitable as a first screening indicator to guide physicians to ordering OGTT.
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Affiliation(s)
- Qianqian Yin
- Center for Reproductive Medicine, XuZhou Central Hospital, No. 199, Jiefang Road, Xuzhou, 221009, Jiangsu, China
| | - Xiaonan Yan
- Center for Reproductive Medicine, XuZhou Central Hospital, No. 199, Jiefang Road, Xuzhou, 221009, Jiangsu, China
| | - Yijuan Cao
- Center for Reproductive Medicine, XuZhou Central Hospital, No. 199, Jiefang Road, Xuzhou, 221009, Jiangsu, China.
| | - Jianhua Zheng
- Department of Obstetrics and Gynecology, XuZhou Central Hospital, No. 199, Jiefang Road, Xuzhou, 221009, Jiangsu, China.
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9
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Dietrich JW, Dasgupta R, Anoop S, Jebasingh F, Kurian ME, Inbakumari M, Boehm BO, Thomas N. SPINA Carb: a simple mathematical model supporting fast in-vivo estimation of insulin sensitivity and beta cell function. Sci Rep 2022; 12:17659. [PMID: 36271244 PMCID: PMC9587026 DOI: 10.1038/s41598-022-22531-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 10/17/2022] [Indexed: 01/18/2023] Open
Abstract
Modelling insulin-glucose homeostasis may provide novel functional insights. In particular, simple models are clinically useful if they yield diagnostic methods. Examples include the homeostasis model assessment (HOMA) and the quantitative insulin sensitivity check index (QUICKI). However, limitations of these approaches have been criticised. Moreover, recent advances in physiological and biochemical research prompt further refinement in this area. We have developed a nonlinear model based on fundamental physiological motifs, including saturation kinetics, non-competitive inhibition, and pharmacokinetics. This model explains the evolution of insulin and glucose concentrations from perturbation to steady-state. Additionally, it lays the foundation of a structure parameter inference approach (SPINA), providing novel biomarkers of carbohydrate homeostasis, namely the secretory capacity of beta-cells (SPINA-GBeta) and insulin receptor gain (SPINA-GR). These markers correlate with central parameters of glucose metabolism, including average glucose infusion rate in hyperinsulinemic glucose clamp studies, response to oral glucose tolerance testing and HbA1c. Moreover, they mirror multiple measures of body composition. Compared to normal controls, SPINA-GR is significantly reduced in subjects with diabetes and prediabetes. The new model explains important physiological phenomena of insulin-glucose homeostasis. Clinical validation suggests that it may provide an efficient biomarker panel for screening purposes and clinical research.
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Affiliation(s)
- Johannes W. Dietrich
- grid.5570.70000 0004 0490 981XDiabetes, Endocrinology and Metabolism Section, Department of Internal Medicine I, St. Josef Hospital, Ruhr University Bochum, NRW, Gudrunstr. 56, 44791 Bochum, Germany ,Diabetes Centre Bochum-Hattingen, St. Elisabeth-Hospital Blankenstein, Im Vogelsang 5-11, 45527 Hattingen, NRW Germany ,grid.5570.70000 0004 0490 981XCentre for Rare Endocrine Diseases, Ruhr Centre for Rare Diseases (CeSER), Ruhr University Bochum and Witten/Herdecke University, Alexandrinenstr. 5, 44791 Bochum, NRW Germany ,Centre for Diabetes Technology, Catholic Hospitals Bochum, Gudrunstr. 56, 44791 Bochum, NRW, Germany
| | - Riddhi Dasgupta
- grid.11586.3b0000 0004 1767 8969Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, 632004 India
| | - Shajith Anoop
- grid.11586.3b0000 0004 1767 8969Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, 632004 India
| | - Felix Jebasingh
- grid.11586.3b0000 0004 1767 8969Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, 632004 India
| | - Mathews E. Kurian
- grid.11586.3b0000 0004 1767 8969Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, 632004 India
| | - Mercy Inbakumari
- grid.11586.3b0000 0004 1767 8969Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, 632004 India
| | - Bernhard O. Boehm
- grid.59025.3b0000 0001 2224 0361Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore, 308232 Singapore ,grid.6582.90000 0004 1936 9748Department of Internal Medicine I, Ulm University Medical Centre, Ulm University, 89070 Ulm, Germany ,grid.240988.f0000 0001 0298 8161Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Nihal Thomas
- grid.11586.3b0000 0004 1767 8969Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, 632004 India
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10
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González-González JG, Violante-Cumpa JR, Zambrano-Lucio M, Burciaga-Jimenez E, Castillo-Morales PL, Garcia-Campa M, Solis RC, González-Colmenero AD, Rodríguez-Gutiérrez R. HOMA-IR as a predictor of Health Outcomes in Patients with Metabolic Risk Factors: A Systematic Review and Meta-analysis. High Blood Press Cardiovasc Prev 2022; 29:547-564. [PMID: 36181637 DOI: 10.1007/s40292-022-00542-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/14/2022] [Indexed: 10/07/2022] Open
Abstract
INTRODUCTION There exists clinical interest in the following question: Is there an association between HOMA-IR and the risk of developing metabolic diseases? AIMS Assessing the association between high values of HOMA-IR with the incidence of T2DM, MACE, essential hypertension, dyslipidemia, NASH, and cancer in healthy participants and participants with a component of metabolic syndrome. METHODS Databases were searched by an experienced librarian to find eligible studies. Observational cohort studies enrolling healthy adults and adults with metabolic syndrome components that evaluated HOMA as a marker of IR were considered for inclusion. Eligibility assessment, data extraction and risk of bias assessment were performed independently and in duplicate. Baseline characteristics of patients, cutoff values of HOMA-IR to predict metabolic events were extracted independently and in duplicate. RESULTS 38 studies (215,878 participants) proved eligible. A higher HOMA-IR value had a significant effect on the risk of developing T2DM (HR 1.87; CI 1.40-2.49), presenting non-fatal MACE (HR 1.46; CI 1.08-1.97) and hypertension (HR 1.35; CI 1.15-1.59). No association was found regarding cancer mortality and fatal MACE with higher HOMA-IR values, there was not enough information to carry out a meta-analysis to establish an association between higher values of HOMA with cancer incidence, dyslipidemia, and NASH. CONCLUSIONS High values of HOMA were associated with an increased risk of diabetes, hypertension, and non-fatal MACE; yet, not for cardiovascular or cancer mortality. More research is needed to determine the value of the HOMA index in metabolic and cardiovascular outcomes. PROSPERO REGISTRATION NUMBER CRD42020187645.
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Affiliation(s)
- José G González-González
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Knowledge and Evaluation Research Unit, Mayo Clinic, 201 W. Center St, Rochester, MN, 55902, USA.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Jorge R Violante-Cumpa
- Division of Endocrinology, Internal Medicine Department, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Ave. Gonzalitos y Madero s/n 64460, Monterrey, Nuevo León, México.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Miguel Zambrano-Lucio
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Erick Burciaga-Jimenez
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Patricia L Castillo-Morales
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Mariano Garcia-Campa
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Ricardo César Solis
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Alejandro D González-Colmenero
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - René Rodríguez-Gutiérrez
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico. .,Knowledge and Evaluation Research Unit, Mayo Clinic, 201 W. Center St, Rochester, MN, 55902, USA. .,Division of Endocrinology, Internal Medicine Department, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Ave. Gonzalitos y Madero s/n 64460, Monterrey, Nuevo León, México. .,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.
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11
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Martínez-Hervás S, Morales-Suarez-Varela MM, Andrés-Blasco I, Lara-Hernández F, Peraita-Costa I, Real JT, García-García AB, Chaves FJ. Developing a simple and practical decision model to predict the risk of incident type 2 diabetes among the general population: The Di@bet.es Study. Eur J Intern Med 2022; 102:80-87. [PMID: 35570127 DOI: 10.1016/j.ejim.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/08/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022]
Abstract
AIMS To develop a simple multivariate predictor model of incident type 2 diabetes in general population. METHODS Participants were recruited from the Spanish Di@bet.es cohort study with 2570 subjects meeting all criteria to be included in the at-risk sample studied here. Information was collected using an interviewer-administered structured questionnaire, followed by physical and clinical examination. CHAID algorithm, which collects the information of individuals with and without type 2 diabetes, was used to develop a decision tree based type 2 diabetes prediction model. RESULTS 156 individuals were identified as having developed type 2 diabetes (6.5% incidence). Fasting plasma glucose (FPG) at the beginning of the study was the main predictive variable for incident type 2 diabetes: FPG ≤ 92 mg/dL (ref.), 92-106 mg/dL (OR = 3.76, 95%CI = 2.36-6.00), > 106 mg/dL (OR = 13.21; 8.26-21.12). More than 25% of subjects starting follow-up with FPG levels > 106 mg/dL developed type 2 diabetes. When FPG <106 mg/dL, other variables (fasting triglycerides (FTGs), BMI or age) were needed. For levels ≤ 92 mg/dL, higher FTGs levels increased risk of incident type 2 diabetes (FTGs > 180 mg/dL, OR = 14.57; 4.89-43.40) compared with the group of FTGs ≤ 97 mg/dL (FTGs = 97-180 mg/dL, OR = 3.12; 1.05-9.24). This model correctly classified 93.5% of individuals. CONCLUSIONS The type 2 diabetes prediction model is based on FTGs, FPG, age, gender, and BMI values. Utilizing commonly available clinical data and a simple blood test, a simple tree diagram helps identify subjects at risk of developing type 2 diabetes, even in apparently low risk subjects with normal FPG.
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Affiliation(s)
- Sergio Martínez-Hervás
- Department of Medicine, University of Valencia, Avenida Blasco Ibañez 15, Valencia 46010, Spain; Service of Endocrinology and Nutrition, Valencia University Clinical Hospital, Avenida Blasco Ibañez 17, Valencia 46010, Spain; INCLIVA Biomedical Research Institute, Menendez Pelayo 4acc, Valencia 46010, Spain; CIBER of Diabetes and Associated Metabolic Diseases CIBERDEM, Monforte de Lemos 3-5, Madrid 28029, Spain
| | - María M Morales-Suarez-Varela
- Department of Preventive Medicine, Unit of Public Health and Environmental Care, University of Valencia, Vicente Andres Estelles Avenue, Burjassot, Valencia 46100, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Monforte de Lemos 3-5, Madrid 28029, Spain
| | - Irene Andrés-Blasco
- Genomic and Diabetes Unit, INCLIVA Biomedical Research Institute, Menendez Pelayo 4acc, Valencia 46010, Spain
| | - Francisco Lara-Hernández
- Genomic and Diabetes Unit, INCLIVA Biomedical Research Institute, Menendez Pelayo 4acc, Valencia 46010, Spain
| | - Isabel Peraita-Costa
- Department of Preventive Medicine, Unit of Public Health and Environmental Care, University of Valencia, Vicente Andres Estelles Avenue, Burjassot, Valencia 46100, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Monforte de Lemos 3-5, Madrid 28029, Spain
| | - José T Real
- Department of Medicine, University of Valencia, Avenida Blasco Ibañez 15, Valencia 46010, Spain; Service of Endocrinology and Nutrition, Valencia University Clinical Hospital, Avenida Blasco Ibañez 17, Valencia 46010, Spain; INCLIVA Biomedical Research Institute, Menendez Pelayo 4acc, Valencia 46010, Spain; CIBER of Diabetes and Associated Metabolic Diseases CIBERDEM, Monforte de Lemos 3-5, Madrid 28029, Spain.
| | - Ana-Bárbara García-García
- CIBER of Diabetes and Associated Metabolic Diseases CIBERDEM, Monforte de Lemos 3-5, Madrid 28029, Spain; Genomic and Diabetes Unit, INCLIVA Biomedical Research Institute, Menendez Pelayo 4acc, Valencia 46010, Spain.
| | - F Javier Chaves
- CIBER of Diabetes and Associated Metabolic Diseases CIBERDEM, Monforte de Lemos 3-5, Madrid 28029, Spain; Genomic and Diabetes Unit, INCLIVA Biomedical Research Institute, Menendez Pelayo 4acc, Valencia 46010, Spain
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12
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Zeng X, Han D, Zhou H, Xue Y, Wang X, Zhan Q, Bai Y, Huang X, Zeng Q, Zhang H, Ma Z, Ren H, Xu D. Triglyceride-Glucose Index and Homeostasis Model Assessment-Insulin Resistance in Young Adulthood and Risk of Incident Congestive Heart Failure in Midlife: The Coronary Artery Risk Development in Young Adults Study. Front Cardiovasc Med 2022; 9:944258. [PMID: 35845059 PMCID: PMC9279654 DOI: 10.3389/fcvm.2022.944258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 06/06/2022] [Indexed: 11/25/2022] Open
Abstract
Objective This study aimed to assess the association between triglyceride-glucose (TyG) index/homeostasis model assessment-insulin resistance (HOMA-IR) within young adults and congestive heart failure (CHF), and to explore whether TyG index can replace HOMA-IR as a surrogate marker for IR in predicting the risk of CHF. Methods A total of 4,992 participants between the ages of 18 and 30 years were enrolled from the Coronary Artery Risk Development in Young Adults (CARDIA) investigation [from 1985 to 1986 (year 0)]. A Cox proportional hazard regression analysis was conducted for assessing correlations between baseline TyG index/HOMA-IR and CHF events, together with the receiver operating characteristic (ROC) curve employed for scrutinizing TyG index/HOMA-IR and the risk of CHF. Results During the 31-year follow-up period, 64 (1.3%) of the 4,992 participants developed CHF. In multivariable Cox proportional hazards models, adjusted for confounding factors for CHF, an increased risk of CHF was associated with a per-unit increase in the TyG index [hazard ratio (HR) 2.8; 95% confidence interval (CI), 1.7–4.7] and HOMA-IR (HR 1.2; 95% CI, 1.1–1.3). A Kaplan–Meier curve analysis showed that participants in the TyG index and HOMA-IR index Q4 group had a higher risk of CHF than those in the Q1 group. The area under curve (AUC) for the TyG index and HOMA-IR consisted of 0.67 (95% CI, 0.6–0.742) and 0.675 (95% CI, 0.604–0.746), respectively. There were no significant differences between the TyG index and HOMA-IR for AUC (p = 0.986). Conclusion The higher TyG index and HOMA-IR are independent risk factors for CHF. The TyG index can replace HOMA-IR in young adulthood as a surrogate marker for IR to predict the risk of CHF.
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Affiliation(s)
- Xianghui Zeng
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Dunzheng Han
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Haobin Zhou
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuting Xue
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiao Wang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qiong Zhan
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yujia Bai
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xingfu Huang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qingchun Zeng
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hao Zhang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhuang Ma
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hao Ren
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Hao Ren,
| | - Dingli Xu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Dingli Xu,
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13
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Fu X, Liu H, Liu J, Li N, Li L, Ke D, Liu M, Lu Y, Duan L, Ma L, Huo Y, Lei Q, Yan S. Association Between Triglyceride-Glucose Index and the Risk of Type 2 Diabetes Mellitus in an Older Chinese Population Aged Over 75 Years. Front Public Health 2022; 9:796663. [PMID: 35399348 PMCID: PMC8989963 DOI: 10.3389/fpubh.2021.796663] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/14/2021] [Indexed: 01/19/2023] Open
Abstract
Background The association between the triglyceride–glucose (TyG) index and type 2 diabetes mellitus (T2DM) in older adults has not been fully understood. This research aims to explore the association between the TyG index and the incidence of T2DM in an older Chinese population aged over 75 years. Methods This longitudinal analysis study was performed based on a database from a health check screening program in China. The participants were stratified based on the quintile ranges of the TyG index (Q1 to Q5 groups). T2DM was defined as fasting plasma glucose (FPG) ≥ 7.00 mmol/L and/or self-reported T2DM. The cumulative incidences of T2DM in various quintile groups were estimated by the Kaplan–Meier method. The Cox proportional hazard model was used to examine the independent impact of the TyG index on the risk of T2DM during the follow-up period. Subgroup analysis was performed by gender and BMI to further validate the credibility of the results. Results During the follow-up period, a total of 231 new-onset T2DM cases were recorded among the 2,571 individuals aged over 75 years. After adjusting confounding factors, elevated TyG index independently indicated a higher risk of T2DM (HR = 1.89; 95% CI, 1.47–2.44; p < 0.01). Higher TyG index quintile groups (Q3 to Q5) also presented with a higher risk of T2DM (hazard ratio (HR) = 1.36, 1.44, and 2.12, respectively) as compared with the lowest quintile group (Q1). Subgroup analysis showed that increased TyG index led to a higher risk of T2DM with HR = 2.35 (95% CI, 1.73–3.19), 1.90 (95% CI, 1.27–2.83), 2.95 (95% CI, 1.94–4.50), and 1.72 (95% CI, 1.25–2.35) in male subgroup, female subgroup, BMI < 24 kg/m2 subgroup, and BMI ≥ 24 kg/m2 subgroup, respectively. Conclusions Triglyceride–glucose index independently correlated with the risk of incident T2DM in Chinese adults aged over 75 years. The TyG index might be useful in monitoring T2DM in the older populations.
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Affiliation(s)
- Xiaomin Fu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hongzhou Liu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.,Department of Endocrinology, First Hospital of Handan City, Handan, China
| | - Jing Liu
- Clinics of Cadre, Department of Outpatient, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Nan Li
- Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Lele Li
- Department of Endocrinology, Genetics, Metabolism and Adolescent Medicine, National Center for Children's Health, Beijing Children's Hospital, The Capital Medical University, Beijing, China
| | - Dianshan Ke
- Department of Orthopedics, Fujian Provincial Hospital, Fuzhou, China
| | - Minyan Liu
- Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yanhui Lu
- Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Lihua Duan
- Department of Ultrasound Medicine, Handan Central Hospital, Handan, China
| | - Linlin Ma
- General Surgery Department 5, Handan Central Hospital, Handan, China
| | - Yanfei Huo
- Physical Examination Center, Handan Central Hospital, Handan, China
| | - Qinghua Lei
- Physical Examination Center, Handan Central Hospital, Handan, China
| | - Shuangtong Yan
- Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
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14
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Yang X, Wang G, Jing J, Wang A, Zhang X, Jia Q, Meng X, Zhao X, Liu L, Li H, Wang Y, Wang Y. Association of triglyceride-glucose index and stroke recurrence among nondiabetic patients with acute ischemic stroke. BMC Neurol 2022; 22:79. [PMID: 35260102 PMCID: PMC8902785 DOI: 10.1186/s12883-022-02588-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 01/31/2022] [Indexed: 11/28/2022] Open
Abstract
Backgroud and purpose Triglyceride-glucose (TyG) index has been considered a surrogate marker of insulin resistance. We investigated the association between TyG index and stroke recurrence and compared the effectiveness of TyG index with homeostasis model assessment of insulin resistance (HOMA-IR) in predicting stroke recurrence and death in nondiabetic acute ischemic stroke patients. Methods Nondiabetic acute ischemic stroke patients from the ACROSS-China (Abnormal Glucose Regulation in Patients with Acute Stroke across China) registry were included. TyG index was performed and classified into four groups by quartiles. The outcomes were stroke recurrence and death within 1 year. The association between TyG index and the risk of stroke recurrence and death were analyzed by Cox regression models. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the prediction of TyG index and HOMA-IR for stroke recurrence and death. Delong test was used for comparing the differences between area under the curve (AUC) of TyG index and HOMA-IR. Results Among the 1226 patients included, the median (interquartile range) of TyG index was 5.8 (5.5–6.2). Both the third and fourth quartiles of TyG index were associated with an increased risk of stroke recurrence (adjusted hazard ratio 2.04, 95% confidence interval 1.26–3.31; adjusted hazard ratio 1.86, 95% confidence interval 1.13–3.06). Patients with fourth quartiles of TyG index were associated with a higher mortality risk (adjusted hazard ratio, 2.91; 95% confidence interval, 1.62–2.53). Regarding stroke recurrence within 1 year, the AUC (95% confidence interval) of the ROC curve for the TyG index was similar to that of the HOMA-IR[0.56 (0.52–0.61) vs 0.57 (0.52–0.61); P = 0.93]. Regarding death within 1 year, the AUCs (95% confidence interval) of the ROC curve for the TyG index and HOMA-IR were 0.55 (0.50–0.61) and 0.59 (0.53–0.64), respectively (P = 0.32). Conclusions Elevated TyG index was associated with an increased risk of stroke recurrence and death. However, neither of TyG nor HOMA-IR can be a qualified predictor of stroke recurrence and death in nondiabetic acute ischemic stroke patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02588-3.
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Affiliation(s)
- Xiaomeng Yang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Guangyao Wang
- Department of Neurology, Beijing Jishuitan Hospital, Beijing, China
| | - Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xiaoli Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Qian Jia
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Liping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China. .,China National Clinical Research Center for Neurological Diseases, Beijing, China. .,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China. .,China National Clinical Research Center for Neurological Diseases, Beijing, China.
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15
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Hirschler V, Molinari C, Edit S, Miorin C, Bocco P, Guntsche Z, Lapertosa S, Gonzalez CD. Ability of TyG Index as a Marker of Insulin Resistance in Argentinean School Children. Front Pediatr 2022; 10:885242. [PMID: 35586828 PMCID: PMC9110001 DOI: 10.3389/fped.2022.885242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine if the triglycerides and glucose index (TyG) can be used as a marker for insulin resistance (IR) in Argentinean schoolchildren according to age and sex. METHODS Anthropometric data, blood glucose levels, lipid profiles, and insulin levels were measured. The TyG index was defined by Ln [fasting triglyceride (mg/dL)* fasting glucose (mg/dL)/2]. A comparison of the ability of TyG to identify children with IR was performed using receiver operating characteristic (ROC) curves and the area under the ROC (AUROC) curve. IR was defined as HOMA-IR > III quartile. RESULTS A total of 915 (528, 57.7% males) apparently healthy schoolchildren, aged 9.3 ± 2.2, were evaluated. The AUROC using the HOMA-IR > III quartile as the dichotomous variable showed that TyG was a fair marker to identify IR (0.65, 95% CI, 0.61-0.69; p < 0.01). There was a significantly higher TyG AUROC in males (0.69, 95% CI, 0.63-0.75; p < 001) than in females (0.60, 95% CI, 0.54-0.66; p < 0.01). When children were divided according to age into two groups (5.0-9.9 and 10.0-14.9-year-olds); younger children (0.64, 95% CI, 0.58-0.69; p < 0.011) and older children (0.62, 95% CI, 0.55-0.68; p = 0.01) had a similar and fair AUROC. However, when children were divided by age and sex, females older than ten had a non-significant AUROC (0.53, 95% CI, 0.42-0.63; p = 0.61). The TyG index compared with HOMA-IR had low sensitivity and specificity, ranging from 0.62 to 0.56. CONCLUSION The TyG index had a fair AUROC with low sensitivity and specificity, indicating poor discrimination in identifying IR in apparently healthy Argentinean children. The ability to use TyG for screening purposes seems limited in Argentinean schoolchildren.
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Affiliation(s)
- Valeria Hirschler
- Argentine Society of Diabetes, Epidemiology Committee, Buenos Aires, Argentina
| | - Claudia Molinari
- Argentine Society of Diabetes, Epidemiology Committee, Buenos Aires, Argentina.,UBA School of Pharmacy and Biochemistry, Mathematics, Buenos Aires, Argentina
| | - Scaiola Edit
- Argentine Society of Diabetes, Epidemiology Committee, Buenos Aires, Argentina
| | - Cecilia Miorin
- Pediatrica Endocrinology and Diabetes, Hospital of Notti, Mendoza, Argentina
| | - Patricia Bocco
- Argentine Society of Diabetes, Epidemiology Committee, Buenos Aires, Argentina
| | - Zelmira Guntsche
- Pediatrica Endocrinology and Diabetes, Hospital of Notti, Mendoza, Argentina
| | - Silvia Lapertosa
- Argentine Society of Diabetes, Epidemiology Committee, Buenos Aires, Argentina
| | - Claudio D Gonzalez
- Argentine Society of Diabetes, Epidemiology Committee, Buenos Aires, Argentina
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16
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Yao H, Sun Z, Yuan W, Shao C, Cai H, Li L, Qian Y, Wang Z. Relationship Between the Triglyceride-Glucose Index and Type 2 Diabetic Macroangiopathy: A Single-Center Retrospective Analysis. Diabetes Metab Syndr Obes 2022; 15:3483-3497. [PMID: 36388062 PMCID: PMC9656493 DOI: 10.2147/dmso.s387040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/02/2022] [Indexed: 11/11/2022] Open
Abstract
PURPOSE The research explores the relationship between the triglyceride-glucose index (TyG index) and the macroangiopathy risk in single-center hospitalized type 2 diabetes mellitus (T2DM) patients and develops a risk prediction nomogram model. PATIENTS AND METHODS A total of 858 patients with T2DM were studied retrospectively. Lasso regression was used to eliminate unimportant factors, and multivariate logistic regression analysis was used to investigate the association between the TyG index and macrovascular disease in T2DM. A nomogram model was constructed to predict macrovascular disease in T2DM and tested using the bootstrap technique, and the efficacy of the nomogram model was investigated using ROC curves. The multivariate Cox proportional hazards model estimated the association between the TyG index and all-cause mortality. RESULTS TyG index, high-density lipoprotein, red blood cell count, hypertension, history of taking ACEI/ARB drugs, and aortic calcification were closely related to macrovascular complications. In Cox proportional hazard model, the HRs of TyG index were 1.89 (95% confidence interval (CI) 1.29-2.76, p < 0.001) after adjusting for covariates. The risk of all-cause mortality in T2DM with macrovascular complications was significantly higher than in diabetic patients without vascular disease. In the ROC curve analysis, the cut-off value of the TyG index for macrovascular complications of T2DM was 9.31 (AUC: 0.702, 95% CI 0.67-0.74, p < 0.001). CONCLUSION TyG index predicts future macrovascular disease in diabetic patients independently of known cardiovascular risk factors, suggesting that TyG index may be a useful marker for prognosis in diabetic patients.
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Affiliation(s)
- Haipeng Yao
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Zhen Sun
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Wei Yuan
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Chen Shao
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Honghua Cai
- Department of Burns and Plastic Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Lihua Li
- Department of Pathology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Yongjiang Qian
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Zhongqun Wang
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
- Correspondence: Zhongqun Wang, Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, People’s Republic of China, Email
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17
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Mompeo O, Berry SE, Spector TD, Menni C, Mangino M, Gibson R. Differential associations between a priori diet quality scores and markers of cardiovascular health in women: cross-sectional analyses from TwinsUK. Br J Nutr 2021; 126:1017-1027. [PMID: 33298202 DOI: 10.1017/s000711452000495x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
CVD is the leading cause of death worldwide and, after dementia, is the second biggest cause of death for women. In England, it accounts for one in four of all deaths. Lifestyle modifications represent the primary route both to reduce CVD risk factors and prevent CVD outcomes. Diet constitutes one of the key modifiable risk factors in the aetiology of CVD. We investigated the relationship between nine main dietary indices and a comprehensive range of CVD risk factors in 2590 women from TwinsUK. After adjustment for multiple testing, we found that the Dietary Approaches to Stop Hypertension (DASH) diet was inversely correlated with some of the most common CVD risk factors (BMI, visceral fat (VF), TAG, insulin, homoeostasis model assessment of insulin resistance (HOMA2-IR) and atherosclerotic CVD (ASCVD) risk) with PFDR ranging from 6·28 × 10-7 to 5·63 × 10-4. Similar association patterns were detected across most of the dietary indices analysed. In our post hoc investigation, to determine if any specific food groups were driving associations between the DASH score and markers of cardiometabolic risk, we found that increased BMI, VF, HOMA2-IR, ASCVD risk, insulin and TAG levels were directly correlated with red meat consumption (PFDR ranging from 4·65 × 10-9 to 7·98 × 10-3) and inversely correlated with whole-grain cereal consumption (PFDR ranging from 1·26 × 10-6 to 8·28 × 10-3). Our findings revealed that the DASH diet is associated with a more favourable CVD risk profile, suggesting that this diet may be a candidate dietary pattern to supplement current UK dietary recommendations for CVD prevention.
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Affiliation(s)
- Olatz Mompeo
- Department of Twin Research and Genetic Epidemiology, King's College London, LondonSE1 7EH, UK
| | - Sarah E Berry
- Department of Nutritional Sciences, King's College London, LondonSE1 9NH, UK
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, LondonSE1 7EH, UK
| | - Cristina Menni
- Department of Twin Research and Genetic Epidemiology, King's College London, LondonSE1 7EH, UK
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King's College London, LondonSE1 7EH, UK
- NIHR Biomedical Research Centre, Guy's and St Thomas' Foundation Trust, LondonSE1 9RT, UK
| | - Rachel Gibson
- Department of Nutritional Sciences, King's College London, LondonSE1 9NH, UK
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18
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Tarantino G, Crocetto F, Di Vito C, Creta M, Martino R, Pandolfo SD, Pesce S, Napolitano L, Capone D, Imbimbo C. Association of NAFLD and Insulin Resistance with Non Metastatic Bladder Cancer Patients: A Cross-Sectional Retrospective Study. J Clin Med 2021; 10:jcm10020346. [PMID: 33477579 PMCID: PMC7831331 DOI: 10.3390/jcm10020346] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/09/2021] [Accepted: 01/13/2021] [Indexed: 01/28/2023] Open
Abstract
Among risk factors (apart from smoking) likely involved in bladder cancer (BCa), metabolic syndrome (MS), obesity and type 2 diabetes mellitus (T2DM) have been explored with contrasting results. In spite of these studies, there is little data on the association between nonalcoholic fatty liver disease (NAFLD), its main driver, i.e., insulin resistance (IR), and BCa. Implanting a cross-sectional retrospective study we tried to investigate both NAFLD and IR prevalence in a hospital based population of BCa patients. We studied laboratory data from 204 patients with histologically confirmed non metastatic BCa and 50 subjects with no BCa, but with bladder diseases (no Ca BD). We evaluated the presence of NAFLD by the triglycerides/glucose Index (TyG Index), using a cut-off of 0.59 and by the Aspartate Aminotransferase/Alanine Aminotransferase AST/ALT ratio. IR was assessed by the same TyG Index (cut-off 4.68) and the triglycerides/High-Density Lipoprotein HDL ratio (cut-off 2.197). The diagnosis of impaired fasting glucose (IFG), condition of prediabetes, as well as that of T2DM was assessed according to canonical guidelines. The TyG Index predicted NAFLD presence in both groups (p = 0.000), but the BCa group showed a major percentage of NAFLD cases with respect to no Ca BD group (59% versus 40%). A greater proportion of IR (47%) in BCa group than in no Ca BD one (37%) was evidenced by the TyG Index with its median value significantly different (p = 0.0092). This high rate of IR in the BCa group was confirmed by the triglycerides/HDL ratio (p = 0.02). Prediabetes and T2DM were more prevalent in the BCa group than no Ca BD group (p = 0.024). In this study a consistent NAFLD presence was found in BCa patients. This is an important comorbidity factor that deserves further consideration in prospective studies. The higher prevalence of NAFLD, IR, prediabetes and T2DM in the BCa group evidences the need that these disorders should be reckoned as adjunct factors that could impact on this cancerous disease.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II Medical School, Via S. Pansini 5, 80131 Naples, Italy
- Correspondence:
| | - Felice Crocetto
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Concetta Di Vito
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Massimiliano Creta
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Raffaele Martino
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Savio Domenico Pandolfo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Salvatore Pesce
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Luigi Napolitano
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Domenico Capone
- Clinical Pharmacology Consultant, Via Volturno 27, 80026 Naples, Italy;
| | - Ciro Imbimbo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
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19
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Yang Y, Zhang Y, Wang J, Ning X, Zhang Y, Zhao T, Zhong Y, Liu Z, Xia L, Li W, Yao X, Zhang K, Liu H. Sex Differences in the Association of HOMA-IR Index and BDNF in Han Chinese Patients With Chronic Schizophrenia. Front Psychiatry 2021; 12:656230. [PMID: 34234699 PMCID: PMC8255609 DOI: 10.3389/fpsyt.2021.656230] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/21/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Previous research has indicated that there are significant sex differences in serum BDNF levels and metabolic indicators in patients with schizophrenia. Studies have found that BDNF is involved in blood sugar regulation. Homeostasis model assessment of insulin resistance (HOMA-IR) is currently a sensitive indicator for measuring insulin resistance. Our study aims to explore the sex differences in the relationship between serum BDNF levels and HOMA-IR in patients with chronic schizophrenia (CS). Methods: A total of 332 patients with CS were enrolled in this study. General information of all participants was collected. Haematological indicators were collected, and the Positive and Negative Syndrome Scale (PANSS) was used to evaluate psychiatric symptoms. Sex differences in serum BDNF levels, HOMA-IR index and other metabolic indexes were investigated. Then, linear regression analysis was used to analyse the relationship between the HOMA-IR index and BDNF levels in male and female patients. Results: The HOMA-IR index of female patients was significantly higher than that of males, but there was no significant difference in serum BDNF levels between male patients and female patients. There was a positive correlation between BDNF level and HOMA-IR index, and this relationship only existed in female patients. Conclusion: The results show that there are significant sex differences in HOMA-IR in patients with CS. In addition, only in female patients was there a positive correlation between the HOMA-IR index and BDNF level, which suggests that sex factors should be taken into account in evaluating the relationship between BDNF and blood glucose in patients with CS.
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Affiliation(s)
- Yating Yang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China.,Anhui Psychiatric Center, Anhui Medical University, Chaohu, China
| | - Yulong Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China.,Anhui Psychiatric Center, Anhui Medical University, Chaohu, China
| | - Juan Wang
- Chengdu Fourth People's Hospital, Chengdu, China
| | - Xiaoshuai Ning
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China.,Anhui Psychiatric Center, Anhui Medical University, Chaohu, China
| | - Yelei Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China.,Anhui Psychiatric Center, Anhui Medical University, Chaohu, China
| | - Tongtong Zhao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China.,Anhui Psychiatric Center, Anhui Medical University, Chaohu, China
| | - Yi Zhong
- Hangzhou Seventh People's Hospital, Hangzhou, China
| | - Zhiwei Liu
- Fuyang Third People's Hospital, Fuyang, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China.,Anhui Psychiatric Center, Anhui Medical University, Chaohu, China
| | - Wenzheng Li
- Hefei Fourth People's Hospital, Hefei, China
| | - Xianhu Yao
- Ma'anshan Fourth People's Hospital, Ma'anshan, China
| | - Kai Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China.,Anhui Psychiatric Center, Anhui Medical University, Chaohu, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China.,Anhui Psychiatric Center, Anhui Medical University, Chaohu, China
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20
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Association between Triglyceride-Glucose Index and Type 2 Diabetes Mellitus in the Japanese Population: A Secondary Analysis of a Retrospective Cohort Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2947067. [PMID: 33490240 PMCID: PMC7787715 DOI: 10.1155/2020/2947067] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/23/2022]
Abstract
Triglyceride-glucose index (TyG index) is associated with type 2 diabetes mellitus (T2DM), but research on this relationship is limited in Japan. The purpose of this study was to evaluate the correlation between TyG index and the risk of T2DM in the Japanese population. Here, 12732 participants were selected from the NAGALA study (NAfld in the Gifu Area, Longitudinal Analysis) conducted between 2004 and 2015 for a retrospective cohort analysis. The association between TyG index and T2DM was assessed using the Cox proportional-hazard model. Subgroup analyses were conducted according to age, sex, smoking status, alcohol consumption, waist circumference, BMI, and follow-up duration. The formula for TyG index was expressed as ln [fasting triglyceride level (mg/dL) × fasting plasma glucose level (mg/dL)/2]. After follow-up, 150 (1.18%) patients developed T2DM. After adjusting for potential confounders, a linear relationship was observed between TyG and the risk of T2DM. After adjusting for age, sex, BMI, waist circumference, HDL-cholesterol, total cholesterol, systolic blood pressure, regular exercise, smoking status, and alcohol consumption, TyG index, as a continuous variable, was associated with an increased risk of T2DM (adjusted hazard ratio (aHR), 1.79; 95% confidence interval (95% CI), 1.25-2.57). Compared with the first quartile of TyG index, subjects in the fourth quartile were 2.33-fold more likely to develop T2DM (aHR 2.33, 95% CI 1.09-4.96; P for trend 0.0224). Subgroup analyses showed that the association between TyG index and incident T2DM stably existed in different subgroups according to the variables tested. Therefore, TyG index was linearly related to the risk of incident T2DM in the Japanese population and may be used as a monitoring tool.
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21
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da Silva A, Caldas APS, Rocha DMUP, Bressan J. Triglyceride-glucose index predicts independently type 2 diabetes mellitus risk: A systematic review and meta-analysis of cohort studies. Prim Care Diabetes 2020; 14:584-593. [PMID: 32928692 DOI: 10.1016/j.pcd.2020.09.001] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 08/26/2020] [Accepted: 09/02/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Our objective was to perform a systematic review and meta-analysis of cohort studies evaluating the triglyceride-glucose (TyG) index as a tool for type 2 diabetes (T2D) prediction in adults and older adults. METHODS Studies were identified in PubMed, Cochrane, Scopus, and Lilacs. Studies with cohort design, which evaluated the T2D incidence through the hazard ratio (HR) or relative risk (RR) or odds ratio values were included. Were included both studies that evaluated the incidence of T2D from tertiles, quartiles, quintiles, or single TyG index values. First, a meta-analysis only for studies that reported data in HR values was performed. Additionally, given the different association measurements used, the number of T2D cases, non-T2D cases, and the total number of participants were extracted from exposed and non-exposed groups when available. Then the risk ratio was calculated. A meta-analysis using the inverse variance method and the random-effects model was performed. Heterogeneity was assessed by I2 statistics and by inspecting funnel plots. RESULTS Thirteen cohort studies with a total of 70,380 subjects, both sexes, adults, and older adults were included in the meta-analysis. Ten studies showed a significant association of the TyG index with T2D risk through HR estimative (overall HR: 2.44, 95% CI: 2.17-2.76). After estimating RR for nine studies, we also observed a significant association of the TyG index with T2D risk (RR: 3.12, 95 CI: 2.31-4.21). For all analyses, high heterogeneity was verified by I2 and visual inspection of funnel plots. CONCLUSIONS TyG index has a positive and significant association with T2D risk, suggesting that the TyG index may become an applicable tool to identify subjects with T2D risk. However, due to the high heterogeneity observed in overall HR and RR analysis, more studies could be necessary to confirm these results.
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Affiliation(s)
- Alessandra da Silva
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil.
| | - Ana Paula Silva Caldas
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | | | - Josefina Bressan
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
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Chen CL, Liu L, Lo K, Huang JY, Yu YL, Huang YQ, Feng YQ. Association Between Triglyceride Glucose Index and Risk of New-Onset Diabetes Among Chinese Adults: Findings From the China Health and Retirement Longitudinal Study. Front Cardiovasc Med 2020; 7:610322. [PMID: 33330672 PMCID: PMC7728664 DOI: 10.3389/fcvm.2020.610322] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 11/02/2020] [Indexed: 12/14/2022] Open
Abstract
The triglyceride glucose (TyG) index has been proposed to be a surrogate of insulin resistance. In the present study, we aimed to examine the relationship between TyG index and the risk of incident diabetes in middle-age and older adults in China using nationally representative data from the China Health and Retirement Longitudinal Study 2011-2015. Information on socio-demographics, medical background, anthropometric measurement, and laboratory information were collected. The association between TyG index and diabetes was examined by Cox proportional hazards models and restricted cubic spline regression, and the results were presented in hazard ratio (HR) with 95% confidence interval (CI). Subgroup analyses were also conducted to examine potential interactions between demographics and TyG index. Among 7,428 participants, 791 (10.6%) of them developed diabetes over 3.4 years of follow-up. The multivariate HR for every SD increment in TyG index was 1.22 (95% CI, 1.14-1.31). When comparing to the lowest quartile of TyG index, the multivariate HRs for new-onset diabetes were 1.22 (0.96-1.54) for Q2, 1.61 (1.28-2.01) for Q3, and 1.73 (1.38-2.16) for Q4 (P for trend <0.001). The restricted cubic spline regression also showed a linear association. No interaction was found between subgroup variables and the association between TyG index and the risk of diabetes. In conclusion, higher TyG index associated with the elevated risk of new-onset diabetes in middle-aged and older adults.
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Affiliation(s)
- Chao-lei Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lin Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Kenneth Lo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Epidemiology, Centre for Global Cardiometabolic Health, Brown University, Providence, RI, United States
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, China
| | - Jia-yi Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yu-ling Yu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yu-qing Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ying-qing Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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23
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Zhang Y, Qin P, Lou Y, Zhao P, Li X, Qie R, Wu X, Han M, Huang S, Zhao Y, Liu D, Wu Y, Li Y, Yang X, Zhao Y, Feng Y, Wang C, Ma J, Peng X, Chen H, Zhao D, Xu S, Wang L, Luo X, Zhang M, Hu D, Hu F. Association of TG/HDLC ratio trajectory and risk of type 2 diabetes: A retrospective cohort study in China. J Diabetes 2020; 13:402-412. [PMID: 33074586 DOI: 10.1111/1753-0407.13123] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/20/2020] [Accepted: 10/15/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The association of ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDL-C ratio) change trajectory with risk of type 2 diabetes mellitus (T2DM) remains unknown. The aim of this study was to evaluate the association between risk of T2DM and TG/HDL-C ratio change trajectory. METHODS A total of 18 444 participants aged 18-80 years old were included in this cohort study. Linear regression and quadratic regression models were used to determine the TG/HDL-C ratio change trajectory. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between TG/HDL-C ratio change trajectory and probability of T2DM. RESULTS T2DM developed in 714 participants during a median follow-up of 5.74 years (92 076.23 person-years of follow-up). After adjusting for baseline potential confounders, odds of T2DM were greater for participants with the increasing, U-shape, bell-shape, and other shape change vs decreasing change (adjusted OR [aOR] 2.01, 95% CI 1.42-2.81; 1.56, 1.15-2.13; 1.60, 1.17-2.20; and 1.49, 1.13-2.00, respectively). The results were robust in the sensitivity analyses on excluding baseline participants with T2DM. Moreover, the associations remained significant with male sex, age <60 years and body mass index <24 kg/m2 . CONCLUSIONS This retrospective study revealed increased probability of T2DM with increasing, U-shape, bell-shape, and other-shape TG/HDL-C ratio change trajectories, especially with male sex, age <60 years and body mass index <24 kg/m2 .
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Affiliation(s)
- Yanyan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Pei Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Yanmei Lou
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, People's Republic of China
| | - Ping Zhao
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, People's Republic of China
| | - Xue Li
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, People's Republic of China
| | - Ranran Qie
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Xiaoyan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Minghui Han
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Shengbing Huang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Dechen Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yuying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Yang Li
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Xingjin Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yifei Feng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Changyi Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Jianping Ma
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Xiaolin Peng
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Hongen Chen
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Dan Zhao
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Shan Xu
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Li Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Xinping Luo
- School of Basic Medicine, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Ming Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Fulan Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
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Barzegar N, Tohidi M, Hasheminia M, Azizi F, Hadaegh F. The impact of triglyceride-glucose index on incident cardiovascular events during 16 years of follow-up: Tehran Lipid and Glucose Study. Cardiovasc Diabetol 2020; 19:155. [PMID: 32993633 PMCID: PMC7526412 DOI: 10.1186/s12933-020-01121-5] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/12/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND To investigate whether the Triglyceride-Glucose index (TyG-index) is associated with increased risk of cardiovascular diseases (CVD)/coronary heart disease (CHD). METHODS A total of 7521 Iranians aged ≥ 30 years (male = 3367) were included in the study. Multivariate Cox regression analyses (adjusted for age, gender, waist circumference, body mass index, educational level, smoking status, physical activity, family history of CVD, type 2 diabetes, hypertension, low and high density lipoprotein cholesterol, and lipid lowering drugs) were used to assess the risk of incident CVD/CHD across quintiles and for 1-standard deviation (SD) increase in the TyG-index. The cut off point for TyG-index was assessed by the minimum value of [Formula: see text]. We also examined the added value of the TyG-index in addition to the Framingham risk score when predicting CVD. RESULTS During follow-up, 1084 cases of CVD (male = 634) were recorded. We found a significant trend of TyG-index for incident CVD/CHD in multivariate analysis (both Ps for tend ≤ 0.002). Moreover, a 1-SD increase in TyG-index was associated with significant risk of CVD/CHD in multivariate analysis [1.16 (1.07-1.25) and 1.19 (1.10-1.29), respectively]. The cut-off value of TyG-index for incident CVD was 9.03 (59.2% sensitivity and 63.2% specificity); the corresponding value of TyG-index for incident CHD was 9.03 (60.0% sensitivity and 62.8% specificity), respectively. Although no interaction was found between gender and TyG-index for CVD/CHD in multivariate analysis (both Ps for interaction > 0.085), the significant trend of TyG-index was observed only among females for incident CVD (P = 0.035). A significant interaction was found between age groups (i.e. ≥ 60 vs < 60 years) and TyG-index for CVD outcomes in the multivariate model (P-value for interaction = 0.046). Accordingly, a significant association between the TyG-index and outcomes was found only among the younger age group. Among the population aged < 60 the addition of TyG-index to the Framingham risk score (FRS) did not show improvement in the predictive ability of the FRS, using integrated discrimination improvement. CONCLUSION The TyG-index is significantly associated with increased risk of CVD/CHD incidence; this issue was more prominent among the younger population. However, adding TyG-index to FRS does not provide better risk prediction for CVD.
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Affiliation(s)
- Niloofar Barzegar
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24 Aarabi St. Velenjak, P.O. Box: 19395-4763, Tehran, Iran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24 Aarabi St. Velenjak, P.O. Box: 19395-4763, Tehran, Iran.
| | - Mitra Hasheminia
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24 Aarabi St. Velenjak, P.O. Box: 19395-4763, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24 Aarabi St. Velenjak, P.O. Box: 19395-4763, Tehran, Iran
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Aslan Çin NN, Yardımcı H, Koç N, Uçaktürk SA, Akçil Ok M. Triglycerides/high-density lipoprotein cholesterol is a predictor similar to the triglyceride-glucose index for the diagnosis of metabolic syndrome using International Diabetes Federation criteria of insulin resistance in obese adolescents: a cross-sectional study. J Pediatr Endocrinol Metab 2020; 33:777-784. [PMID: 32447329 DOI: 10.1515/jpem-2019-0310] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 03/16/2020] [Indexed: 01/11/2023]
Abstract
Objectives Metabolic syndrome (MS) is a fatal endocrinopathy that begins with insulin resistance (IR) and causes abdominal obesity, glucose intolerance, or systemic disorders. This study was aimed to determine the cut-off values for the triglyceride (TG)/high-density lipoprotein cholesterol (TG/HDL-C) ratio, the TG glucose (TyG) index and homeostasis model assessment (HOMA-IR) for the diagnosis of MS in obese adolescents, and to compare which of the three indexes would offer a more accurate approach to diagnosis. Methods The study population comprised 1,171 obese adolescents (639 females and 532 males aged 10-16 years, Body Mass Index (BMI)>=95th percentile). Indirect measures of IR screening for MS were the TG/HDL ratio, TyG index, and HOMA-IR. The cut-off values of the TG/HDL ratio, TyG index, and HOMA-IR were obtained from receiver operation characteristic (ROC) curves. Results HOMA-IR had a significant positive correlation with the TyG index (r=0.352, p<0.001) and TG/HDL-C (r=0.291, p<.001). The TyG index and TG/HDL-C showed a strong positive correlation (r=0.901, p<0.001). The TG/HDL-C ratio showed a larger ROC Area under Curve (AUC=0.849) than HOMA-IR index (AUC=0.689), but as a predictor similar to TyG index (AUC=0.833) when screening for MS. The cut-off values for MS were as follows: TG/HDL-C ratio>2.16 (sensitivity: 88.8%; specificity: 49.7%), TyG index>8.50 (sensitivity: 85.6%; specificity: 57.0%) and HOMA-IR>2.52 (sensitivity: 83.2%; specificity: 40.4%). Conclusions Both the TyG index and TG/HDL-C ratio are better markers than HOMA-IR to determine the risk of metabolic syndrome according to IDF criteria. Besides, the TyG index and TG/HDL-C ratio have similar differentiating powers to determine this risk in obese Turkish adolescents.
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Affiliation(s)
- Nazlı Nur Aslan Çin
- Ankara University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Fatih Cad. Tepebaşı Mah, No:197/A, 06300, Ankara, Kecioren, Turkey
| | - Hülya Yardımcı
- Ankara University Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara, Turkey
| | - Nevra Koç
- Health Sciences University, Ministry of Health Ankara City Hospital, Department of Child Nutrition and Metabolism, Ankara, Turkey
| | - Seyit Ahmet Uçaktürk
- Health Sciences University, Ministry of Health Ankara City Hospital, Department of Child Nutrition and Metabolism, Ankara, Turkey
| | - Mehtap Akçil Ok
- Baskent University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Baglica Campus, Ankara,Turkey
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Chamroonkiadtikun P, Ananchaisarp T, Wanichanon W. The triglyceride-glucose index, a predictor of type 2 diabetes development: A retrospective cohort study. Prim Care Diabetes 2020; 14:161-167. [PMID: 31466834 DOI: 10.1016/j.pcd.2019.08.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 08/08/2019] [Indexed: 01/28/2023]
Abstract
AIMS The triglycerides-glucose (TyG) index, the product of fasting plasma glucose (FPG) and triglycerides (TG) is a novel index. Many previous studies have reported that the TyG index might be a strong predictor of incident type 2 diabetes. We determined whether the TyG index could be a useful predictor for diabetes diagnosis and compared it to the FPG and TG as predictors of type 2 diabetes. METHODS A total of 617 subjects without baseline diabetes were examined and followed up for a median period of 9.2 years. We performed a mixed effect cox regression analysis to evaluate the risk of developing diabetes across the quartiles of the TyG index, calculated as ln[triglyceride (mg/dl)×FPG (mg/dl)/2], and plotted a receiver operating characteristic (ROC) curve to assess discrimination among TyG, FPG and TG. RESULTS During 4,871.56 person-years of follow-up, there were 163 incident cases of diabetes. The risk of diabetes increased across the quartiles of the TyG index. Those in the highest quartile of TyG had a higher risk of developing diabetes (adjusted HR 3.38 95% CI 2.38-4.8, ptrend<0.001) than those in the lowest quartile. The area under the curve (AUC) of the ROC plots were 0.79 (95% CI 0.74-0.83) for FPG, 0.64 (95% CI 0.60-0.69) for TyG and 0.59 (95% CI 0.54-0.64) for TG. CONCLUSION The TyG index was significantly associated with risk of incident diabetes and could be a valuable biomarker of developing diabetes. However, FPG appeared to be a more robust predictor of diabetes.
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Affiliation(s)
- Panya Chamroonkiadtikun
- Department of Family and Preventive Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
| | - Thareerat Ananchaisarp
- Department of Family and Preventive Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
| | - Worawit Wanichanon
- Department of Family and Preventive Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
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Alkhaldy AA, Rizq NK, Del Jaylan SA, Alkendi EA, Alghamdi WM, Alfaraidi SM. Dietary Intake and Physical Activity in Relation to Insulin Resistance in Young Overweight Saudi Females: An Exploratory Pilot Study. Prev Nutr Food Sci 2020; 24:373-380. [PMID: 31915631 PMCID: PMC6941727 DOI: 10.3746/pnf.2019.24.4.373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022] Open
Abstract
Insulin resistance is a major contributor to the development of several chronic metabolic diseases, including type 2 diabetes mellitus, and is an increasing health concern in Saudi Arabia. Diet and physical activity have been postulated to affect insulin resistance; however, their effects on development of insulin resistance in young overweight Saudi females have not been explored. Therefore, the aim of the study is to investigate whether diet and physical inactivity increases the risk of insulin resistance in young overweight Saudi females. In a cross-sectional study, 42 overweight female Saudi students, aged between 20 and 30 years, were recruited from King Abdul-Aziz University. A questionnaire was used to collect demographics, anthropometric measurements, physical activity, and food frequency data. Blood biomarkers (lipid profile, fasting glucose, and fasting insulin) were measured. Insulin resistance was assessed using homeostasis model assessment 2 (HOMA2)-insulin resistance (IR) scores. A significant difference in median body mass index (BMI) was observed between the HOMA2-IR normal and HOMA2-IR raised index groups (P=0.04). In terms of dietary habits, the insulin resistant group had a higher intake of canned beverages compared with the normal group (P=0.03). No significant differences were found between the groups in terms of waist circumference, hip circumference, waist-to-hip ratio, or body fat percentage. The lipid profile also did not significantly differ between the two groups. This study demonstrates significant differences in HOMA2-IR-defined insulin resistance according to subjects’ BMI and canned beverage intake. A larger study is needed to confirm these associations.
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Affiliation(s)
- Areej Ali Alkhaldy
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdul-Aziz University, Jeddah 21589, the Kingdom of Saudi Arabia
| | - Nour Kamal Rizq
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdul-Aziz University, Jeddah 21589, the Kingdom of Saudi Arabia
| | - Sarah A Del Jaylan
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdul-Aziz University, Jeddah 21589, the Kingdom of Saudi Arabia
| | - Eman Ali Alkendi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdul-Aziz University, Jeddah 21589, the Kingdom of Saudi Arabia
| | - Wijdan Mohammed Alghamdi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdul-Aziz University, Jeddah 21589, the Kingdom of Saudi Arabia
| | - Sara Mohammed Alfaraidi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdul-Aziz University, Jeddah 21589, the Kingdom of Saudi Arabia
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Qin L, Huang CC, Yan XM, Wang Y, Li ZY, Wei XC. Long non-coding RNA H19 is associated with polycystic ovary syndrome in Chinese women: a preliminary study. Endocr J 2019; 66:587-595. [PMID: 30982795 DOI: 10.1507/endocrj.ej19-0004] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) represents a serious reproductive and endocrine condition and is associated with high incidence rates. H19 is a compelling long noncoding RNA (lncRNA) which carries out a range of biological functions. However, prior to this study, little was known as to whether there was an association between lncRNA H19 and PCOS. In the current study, we used quantitative real-time polymerase chain reaction (qRT-PCR) to determine lncRNA H19 expression levels in peripheral blood leukocytes from patients with PCOS and compared this data with that derived from normal controls. We also screened data for potential relationships between lncRNA H19 and a range of endocrine variables in PCOS. The expression of lncRNA H19 was significantly higher in cases of PCOS than in controls. Individuals exhibiting higher expression levels of lncRNA H19 were associated with a significantly higher risk of PCOS than those with lower expression levels. Moreover, lncRNA H19 expression was positively correlated with fasting plasma glucose levels; this was the case with both raw data, and after adjustment for age and BMI in the PCOS group. However, lncRNA H19 expression showed no significant correlation with total testosterone or insulin resistance in either PCOS cases or the controls. In conclusion, we demonstrate the first evidence to indicate that lncRNA H19 is associated with PCOS, suggesting that elevated lncRNA H19 levels are a risk factor for PCOS. For susceptible individuals, lncRNA H19 may represent a useful biomarker of the early stages of endocrine and metabolic disorders in PCOS.
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Affiliation(s)
- Li Qin
- Department of Obstetrics and Gynecology, the First Clinical Medical College of Jinan University, Guangzhou, Guangdong 510632, China
- Center for Reproductive Medicine, the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi 533000, China
| | - Chui-Can Huang
- Department of Obstetrics and Gynecology, the First Clinical Medical College of Jinan University, Guangzhou, Guangdong 510632, China
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong 510632, China
| | - Xiu-Min Yan
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong 510632, China
| | - Yao Wang
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong 510632, China
| | - Zhong-Yi Li
- Department of Obstetrics and Gynecology, the First Clinical Medical College of Jinan University, Guangzhou, Guangdong 510632, China
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong 510632, China
| | - Xiang-Cai Wei
- Department of Obstetrics and Gynecology, the First Clinical Medical College of Jinan University, Guangzhou, Guangdong 510632, China
- Guangdong Women and Children Hospital, Guangzhou, Guangdong 510000, China
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Priya E, Jayashree K, Senthilkumar GP, Yasir M, Babu K R, Devi TD. Role of Fetuin-A and vascular endothelial growth factor In type 2 diabetes mellitus patients without and with retinopathy. Diabetes Metab Syndr 2019; 13:2699-2703. [PMID: 31405696 DOI: 10.1016/j.dsx.2019.07.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 07/10/2019] [Indexed: 01/29/2023]
Affiliation(s)
- Ezhumalai Priya
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India
| | - Kuppuswami Jayashree
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India
| | | | - Md Yasir
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India
| | - Ramesh Babu K
- Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India
| | - Thiyagarajan Durga Devi
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India
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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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