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Li X, Wang J, Zhang M, Li X, Fan Y, Zhou X, Sun Y, Qiu Z. Biological aging mediates the associations of metabolic score for insulin resistance with all-cause and cardiovascular disease mortality among US adults: A nationwide cohort study. Diabetes Obes Metab 2024. [PMID: 38853301 DOI: 10.1111/dom.15694] [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: 03/25/2024] [Revised: 05/11/2024] [Accepted: 05/20/2024] [Indexed: 06/11/2024]
Abstract
AIM To investigate the associations of metabolic score for insulin resistance (METS-IR) with all-cause and cardiovascular disease (CVD)-specific mortality and the potential mediating role of biological ageing. METHODS A cohort of 19 204 participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 was recruited for this study. Cox regression models, restricted cubic splines, and Kaplan-Meier survival curves were used to determine the relationships of METS-IR with all-cause and CVD-specific mortality. Mediation analyses were performed to explore the possible intermediary role of biological ageing markers, including phenotypic age (PhenoAge) and biological age (BioAge). RESULTS During a median follow-up of 9.17 years, we observed 2818 deaths, of which 875 were CVD-specific. Multivariable Cox regression showed that the highest METS-IR level (Q4) was associated with increased all-cause (hazard ratio [HR] 1.38, 95% confidence interval [CI] 1.14-1.67) and CVD mortality (HR 1.52, 95% CI 1.10-2.12) compared with the Q1 level. Restricted cubic splines showed a nonlinear relationship between METS-IR and all-cause mortality. Only METS-IR above the threshold (41.02 μg/L) was positively correlated with all-cause death. METS-IR had a linear positive relationship with CVD mortality. In mediation analyses, we found that PhenoAge mediated 51.32% (p < 0.001) and 41.77% (p < 0.001) of the association between METS-IR and all-cause and CVD-specific mortality, respectively. For BioAge, the mediating proportions of PhenoAge were 21.33% (p < 0.001) and 15.88% (p < 0.001), respectively. CONCLUSIONS This study highlights the detrimental effects of insulin resistance, as measured by METS-IR, on all-cause and CVD mortality. Moreover, it underscores the role of biological ageing in mediating these associations, emphasizing the need for interventions targeting both insulin resistance and ageing processes to mitigate mortality risks in metabolic disorders.
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Affiliation(s)
- Xiaoxuan Li
- Department of Oncology, Key Laboratory of Cancer Molecular and Translational Research, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jia Wang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mengqi Zhang
- Department of Oncology, Key Laboratory of Cancer Molecular and Translational Research, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiangjun Li
- Breast Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuchen Fan
- Department of Medicine, Qingdao University, Qingdao, China
| | - Xinbei Zhou
- Department of Critical Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuxin Sun
- Department of Oncology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenkang Qiu
- Interventional Medical Center, The Affiliated Hospital of Qingdao University, Qingdao, China
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Chen Y, Du J, Zhou N, Song Y, Wang W, Hong X. Correlation between triglyceride glucose-body mass index and hypertension risk: evidence from a cross-sectional study with 60,283 adults in eastern China. BMC Cardiovasc Disord 2024; 24:270. [PMID: 38783200 PMCID: PMC11112881 DOI: 10.1186/s12872-024-03934-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Insulin resistance (IR) and obesity are established risk factors for hypertension, with triglyceride-glucose (TyG) serving as a recognized surrogate marker for IR. The aim of this study was to investigate the association between TyG-BMI and hypertension in the general population. METHODS A total of 60,283 adults aged ≥18 years who underwent face-to-face questionnaires, anthropometric measurements, and laboratory examination were included in this study. Multivariable logistic regression models and receiver operating characteristic curve (ROC) were used to determine the association between TyG-BMI and hypertension. The restricted cubic spline model was used for the dose-response analysis. RESULTS After fully adjusting for confounding variables, multivariate logistic regression model showed a stable positive association between TyG-BMI and hypertension (OR: 1.61 per SD increase; 95% CI: 1.55-1.67; P-trend < 0.001). The multivariate adjusted OR and 95% CI for the highest TyG-BMI quartile compared with the lowest quartile were 2.52 (95% CI 2.28-2.78). Dose-response analysis using restricted cubic spline confirmed that the association between TyG-BMI index and hypertension was linear. Subgroup analyses showed that stronger associations between TyG-BMI index and hypertension were detected in young and middle-aged individuals (P for interaction < 0.05). ROC analysis showed that TyG-BMI index could better predict the risk of hypertension than other parameters (TyG-BMI cut-off value: 207.105, AUC: 0.719, sensitivity 65.5%, specificity 66.8%), particularly among young and middle-aged people. CONCLUSION The TyG-BMI index was independently associated with hypertension in the study population. Further studies are required to confirm this relationship.
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Affiliation(s)
- Yijia Chen
- Department of Chronic and Noncommunicable Disease Prevention, Nanjing Medical University Affiliated Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Jinling Du
- Guangzhou Liwan Center for Disease Control and Prevention, Guangzhou, 510176, China
| | - Nan Zhou
- Department of Chronic and Noncommunicable Disease Prevention, Nanjing Medical University Affiliated Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Yingqian Song
- Nanjing Gulou Center for Disease Control and Prevention, Nanjing, 210015, China
| | - Weiwei Wang
- Department of Chronic and Noncommunicable Disease Prevention, Nanjing Medical University Affiliated Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Xin Hong
- Department of Chronic and Noncommunicable Disease Prevention, Nanjing Medical University Affiliated Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
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Tsai KZ, Chu CC, Huang WC, Sui X, Lavie CJ, Lin GM. Prediction of various insulin resistance indices for the risk of hypertension among military young adults: the CHIEF cohort study, 2014-2020. Cardiovasc Diabetol 2024; 23:141. [PMID: 38664804 PMCID: PMC11046748 DOI: 10.1186/s12933-024-02229-8] [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: 12/03/2023] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Non-insulin-based insulin resistance (NI-IR) indices have been reported to have an association with prevalent hypertension, however, no cohort studies to date have compared their prediction of hypertension among young adults. METHODS A total of 2,448 military men and women, aged 18-39 years, without baseline hypertension in Taiwan were followed for incident hypertension events from 2014 until the end of 2020. All subjects underwent annual health examinations including measurements of blood pressure (BP) in mmHg. Systolic BP (SBP) 130-139/diastolic BP (DBP) < 80, SBP < 130/DBP 80-89, and SBP 130-139/DBP 80-89 were respectively defined as stage I isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH) and combined hypertension (CH). The cut-off levels of stage II hypertension for SBP and DBP were 140-159 and 90-99, respectively. Four NI-IR indices included the ratio of serum triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C), TyG index defined as ln[TG* fasting glucose (FG)/2], Metabolic Score for IR (METS-IR) defined as ln[(2* FG) + TG)* body mass index (BMI)/(ln(HDL-C))], and ZJU index defined as BMI + FG + TG + 3* alanine transaminase/aspartate transaminase (+ 2 if female). Multivariable Cox regression analysis was performed with adjustments for baseline age, sex, body mass index, BP, substance use, family history for early onset cardiovascular diseases or hypertension, low-density lipoprotein cholesterol, kidney function, serum uric acid and physical activity to determine the associations. RESULTS During a median follow-up of 6.0 years, there were 920 hypertension events (37.6%). Greater TyG, TG/HDL-C and METS-IR indices were associated with a higher risk of stage I IDH (hazard ratios (HRs) and 95% confidence intervals: 1.376 (1.123-1.687), 1.082 (1.039-1.127) and 3.455 (1.921-6.214), respectively), whereas only greater ZJU index was associated with a higher risk of stage II IDH [HRs: 1.011 (1.001-1.021)]. In addition, greater ZJU index was associated with a higher risk of stage II ISH [HR: 1.013 (1.003-1.023)], and greater TyG index was associated with a higher risk of stage II CH [HR: 2.821 (1.244-6.395)]. CONCLUSION Insulin resistance assessed by various NI-IR indices was associated with a higher risk of hypertension in young adults, while the assessment ability for specific hypertension category may differ by NI-IR indices.
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Affiliation(s)
- Kun-Zhe Tsai
- Department of Medicine, Hualien Armed Forces General Hospital, No. 100, Jinfeng St, Hualien City, 970, Taiwan
- Department of Stomatology of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan
| | - Chen-Chih Chu
- Department of Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Wei-Chun Huang
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Carl J Lavie
- Ochsner Clinical School, John Ochsner Heart and Vascular Institute, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Gen-Min Lin
- Department of Medicine, Hualien Armed Forces General Hospital, No. 100, Jinfeng St, Hualien City, 970, Taiwan.
- Department of Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
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Zeng J, Zhang T, Yang Y, Wang J, Zheng D, Hou Y, Tong Y, Fan X, Wang X, Fang Y. Association between a metabolic score for insulin resistance and hypertension: results from National Health and Nutrition Examination Survey 2007-2016 analyses. Front Endocrinol (Lausanne) 2024; 15:1369600. [PMID: 38711979 PMCID: PMC11070536 DOI: 10.3389/fendo.2024.1369600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/08/2024] [Indexed: 05/08/2024] Open
Abstract
Background The Metabolic Score for Insulin Resistance (METS-IR) offers a promising and reliable non-insulin-based approach to assess insulin resistance and evaluate cardiometabolic risk. However, evidence for the association between METS-IR and hypertension was still limited. Methods Participants from the National Health and Nutrition Examination Survey (NHANES) database from 2007-2016 were selected for weighted multivariable regression analyses, subgroup analyses and restricted cubic spline (RCS) modeling to assess the association between the METS-IR and hypertension, as well as systolic blood pressure (SBP) and diastolic blood pressure (DBP). Results This study enrolled 7,721 adults aged ≥20 years, 2,926 (34.03%) of whom was diagnosed as hypertension. After adjusting for all potential covariates, an increased METS-IR (log2 conversion, denoted as log2METS-IR) was independently associated with a higher prevalence of hypertension (odd ratio [OR] 3.99, 95% confidence interval [CI] 3.19~5.01). The OR for hypertension in subjects with the highest quartile of METS-IR was 3.89-fold (OR 3.89, 95% CI 3.06~4.94) higher than that in those with the lowest quartile of METS-IR. This positive correlation became more significant as METS-IR increased (p for trend < 0.001). Log2METS-IR was significantly correlated with increase in SBP (β 6.75, 95% CI 5.65~7.85) and DBP (β 5.59, 95% CI 4.75~6.43) in a fully adjusted model. Consistent results were obtained in subgroup analyses. Hypertension, SBP and DBP all exhibited a non-linear increase with the rise in METS-IR. The minimal threshold for the beneficial association of METS-IR with hypertension, SBP and DBP were all identified to be 46.88. Conclusion The findings of this study revealed a significant positive association between METS-IR and hypertension among US adults, suggesting METS-IR as a potential tool for assessing hypertension risk.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Xuan Wang
- Department of Endocrinology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yi Fang
- Department of Endocrinology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
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Huang WC, Tsai KZ, Yang KT, Chen HH, Kwon Y, Lin GM. A comparison of various insulin resistance indices and the possibility of hypertension in military adults: CHIEF study. Diabetol Metab Syndr 2024; 16:78. [PMID: 38566188 PMCID: PMC10986110 DOI: 10.1186/s13098-024-01323-x] [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: 01/29/2024] [Accepted: 03/28/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Insulin resistance is associated with the development of hypertension, whereas there were rare studies comparing various non-insulin based insulin resistance (NI-IR) indices for the possibility of hypertension among young and middle-aged adults. METHODS This cross-sectional study included a total of 4,080 military personnel, aged 18-50 years, without antihypertensive medications therapy in 2014. All subjects received annual health examinations for blood pressure (BP) measurements. Stage I isolated diastolic hypertension (IDH) and isolated systolic hypertension (ISH) and combined hypertension were respectively defined as systolic BP (SBP) < 130 mmHg/diastolic BP (DBP) 80-89 mmHg, SBP 130-139 mmHg/DBP < 80 mmHg, and SBP 130-139 mmHg/DBP 80-89 mmHg. The cut-off values of stage II hypertension for SBP and DBP were 140-159 mmHg and 90-99 mmHg, respectively. Four NI-IR indices included the serum triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio, TyG index, Metabolic Score for IR (METS-IR) and ZJU index which were defined according to their specific formula. Multiple logistic regression analysis with adjustments for age, sex, anthropometrics, substance use, kidney function, serum uric acid, atherogenic cholesterols and physical activity was performed to determine the associations. RESULTS There were 1,024 subjects with hypertension (25.1%) in which 739 were stage I hypertension, and 285 were stage II hypertension. For total hypertension, there were an association with TyG and METS-IR indices [odds ratios (ORs) and 95% confidence intervals: 1.432 (1.215-1.688) and 1.553 (1.040-2.321), respectively]. For hypertension subtypes, TyG index was positively associated with overall, stage I, and stage II ISH [ORs: 1.447 (1.149-1.823), 1.317 (1.029-1.687), and 2.011 (1.351-2.994), respectively], while TG/HDL-C, METS-IR and ZJU indices were merely associated with stage II ISH [ORs: 1.053 (1.006-1.103), 3.001 (1.171-7.696) and 1.009 (1.000-1.017), respectively]. In addition, TyG and METS-IR indices were positively associated with stage II IDH [ORs: 1.813 (1.207-2.721) and 2.85 (1.080-7.520), respectively], and TyG index was also associated with combined hypertension [OR: 1.425 (1.007-1.833)]. CONCLUSION Among young and middle-aged adults, insulin resistance assessed by the four NI-IR indices was positively associated with stage II ISH, while only TyG index had a significant association for both stage II IDH and combined hypertension.
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Affiliation(s)
- Wei-Che Huang
- Department of Internal Medicine, Hualien-Armed Forces General Hospital, No. 100, Jinfeng St., 970, Hualien City, Taiwan
- Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kun-Zhe Tsai
- Department of Internal Medicine, Hualien-Armed Forces General Hospital, No. 100, Jinfeng St., 970, Hualien City, Taiwan
- Department of Stomatology of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Periodontology, School of Dentistry, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Kai-Ti Yang
- Department of Surgery, Mennonite Christian Hospital, Hualien, Taiwan
| | - Han-Hsing Chen
- Department of Internal Medicine, Mennonite Christian Hospital, Hualien, Taiwan
| | - Younghoon Kwon
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Gen-Min Lin
- Department of Internal Medicine, Hualien-Armed Forces General Hospital, No. 100, Jinfeng St., 970, Hualien City, Taiwan.
- Departments of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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Zhang F, Yu Z. Mendelian randomization study on insulin resistance and risk of hypertension and cardiovascular disease. Sci Rep 2024; 14:6191. [PMID: 38485964 PMCID: PMC10940700 DOI: 10.1038/s41598-023-46983-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 01/07/2022] [Indexed: 03/18/2024] Open
Abstract
Observational studies have suggested that insulin resistance (IR) is associated with hypertension and various cardiovascular diseases. However, the presence of a causal relationship between IR and cardiovascular disease remains unclear. Here, we applied Mendelian randomization (MR) approaches to address the causal association between genetically determined IR and the risk of cardiovascular diseases. Our primary genetic instruments comprised 53 SNPs associated with IR phenotype from a GWAS of up to 188,577 participants. Genetic association estimates for hypertension and venous thromboembolism (VTE) were extracted from UK Biobank, estimates for atrial fibrillation (AF) were extracted from the hitherto largest GWAS meta-analysis on AF, estimates for heart failure were extracted from HERMES Consortium, estimates for peripheral artery disease (PAD) and aortic aneurysm were extracted from the FinnGen Study. The main analyses were performed using the random-effects inverse-variance weighted approach, and complemented by sensitivity analyses and multivariable MR analyses. Corresponding to 55% higher fasting insulin adjusted for body mass index, 0.46 mmol/L lower high-density lipoprotein cholesterol and 0.89 mmol/L higher triglyceride, one standard deviation change in genetically predicted IR was associated with increased risk of hypertension (odds ratio (OR) 1.06, 95% CI 1.04-1.08; P = 1.91 × 10-11) and PAD (OR 1.90, 95% CI 1.43-2.54; P = 1.19 × 10-5). Suggestive evidence was obtained for an association between IR and heart failure (OR per SD change in IR: 1.19, 95% CI 1.01-1.41, P = 0.041). There was no MR evidence for an association between genetically predicted IR and atrial fibrillation, VTE, and aortic aneurysm. Results were widely consistent across all sensitivity analyses. In multivariable MR, the association between IR and PAD was attenuated after adjustment for lipids (P = 0.347) or BMI (P = 0.163). Our findings support that genetically determined IR increases the risk of hypertension and PAD.
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Affiliation(s)
- Fangfang Zhang
- Department of Outpatient, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, China
| | - Zhimin Yu
- Department of Geriatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China.
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Tang AS, Rankin KP, Cerono G, Miramontes S, Mills H, Roger J, Zeng B, Nelson C, Soman K, Woldemariam S, Li Y, Lee A, Bove R, Glymour M, Aghaeepour N, Oskotsky TT, Miller Z, Allen IE, Sanders SJ, Baranzini S, Sirota M. Leveraging electronic health records and knowledge networks for Alzheimer's disease prediction and sex-specific biological insights. NATURE AGING 2024; 4:379-395. [PMID: 38383858 PMCID: PMC10950787 DOI: 10.1038/s43587-024-00573-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 01/19/2024] [Indexed: 02/23/2024]
Abstract
Identification of Alzheimer's disease (AD) onset risk can facilitate interventions before irreversible disease progression. We demonstrate that electronic health records from the University of California, San Francisco, followed by knowledge networks (for example, SPOKE) allow for (1) prediction of AD onset and (2) prioritization of biological hypotheses, and (3) contextualization of sex dimorphism. We trained random forest models and predicted AD onset on a cohort of 749 individuals with AD and 250,545 controls with a mean area under the receiver operating characteristic of 0.72 (7 years prior) to 0.81 (1 day prior). We further harnessed matched cohort models to identify conditions with predictive power before AD onset. Knowledge networks highlight shared genes between multiple top predictors and AD (for example, APOE, ACTB, IL6 and INS). Genetic colocalization analysis supports AD association with hyperlipidemia at the APOE locus, as well as a stronger female AD association with osteoporosis at a locus near MS4A6A. We therefore show how clinical data can be utilized for early AD prediction and identification of personalized biological hypotheses.
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Affiliation(s)
- Alice S Tang
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA.
- Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, San Francisco and Berkeley, CA, USA.
| | - Katherine P Rankin
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Gabriel Cerono
- Weill Institute for Neuroscience. Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Silvia Miramontes
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Hunter Mills
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Jacquelyn Roger
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Billy Zeng
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Charlotte Nelson
- Weill Institute for Neuroscience. Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Karthik Soman
- Weill Institute for Neuroscience. Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Sarah Woldemariam
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Yaqiao Li
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Albert Lee
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Riley Bove
- Weill Institute for Neuroscience. Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Maria Glymour
- Department of Anesthesiology, Pain, and Perioperative Medicine, Stanford University, Palo Alto, CA, USA
| | - Nima Aghaeepour
- Department of Anesthesiology, Pain, and Perioperative Medicine, Stanford University, Palo Alto, CA, USA
- Department of Pediatrics, Stanford University, Palo Alto, CA, USA
- Department of Biomedical Data Science, Stanford University, Palo Alto, CA, USA
| | - Tomiko T Oskotsky
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Zachary Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Isabel E Allen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Stephan J Sanders
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA
- Institute of Developmental and Regenerative Medicine, Department of Paediatrics, University of Oxford, Oxford, UK
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Sergio Baranzini
- Weill Institute for Neuroscience. Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Marina Sirota
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA.
- Department of Pediatrics, University of California, San Francisco, CA, USA.
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Liu J, Li X, Zhu P. Effects of Various Heavy Metal Exposures on Insulin Resistance in Non-diabetic Populations: Interpretability Analysis from Machine Learning Modeling Perspective. Biol Trace Elem Res 2024:10.1007/s12011-024-04126-3. [PMID: 38409445 DOI: 10.1007/s12011-024-04126-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/22/2024] [Indexed: 02/28/2024]
Abstract
Increasing and compelling evidence has been proved that heavy metal exposure is involved in the development of insulin resistance (IR). We trained an interpretable predictive machine learning (ML) model for IR in the non-diabetic populations based on levels of heavy metal exposure. A total of 4354 participants from the NHANES (2003-2020) with complete information were randomly divided into a training set and a test set. Twelve ML algorithms, including random forest (RF), XGBoost (XGB), logistic regression (LR), GaussianNB (GNB), ridge regression (RR), support vector machine (SVM), multilayer perceptron (MLP), decision tree (DT), AdaBoost (AB), Gradient Boosting Decision Tree (GBDT), Voting Classifier (VC), and K-Nearest Neighbour (KNN), were constructed for IR prediction using the training set. Among these models, the RF algorithm had the best predictive performance, showing an accuracy of 80.14%, an AUC of 0.856, and an F1 score of 0.74 in the test set. We embedded three interpretable methods, the permutation feature importance analysis, partial dependence plot (PDP), and Shapley additive explanations (SHAP) in RF model for model interpretation. Urinary Ba, urinary Mo, blood Pb, and blood Cd levels were identified as the main influencers of IR. Within a specific range, urinary Ba (0.56-3.56 µg/L) and urinary Mo (1.06-20.25 µg/L) levels exhibited the most pronounced upwards trend with the risk of IR, while blood Pb (0.05-2.81 µg/dL) and blood Cd (0.24-0.65 µg/L) levels showed a declining trend with IR. The findings on the synergistic effects demonstrated that controlling urinary Ba levels might be more crucial for the management of IR. The SHAP decision plot offered personalized care for IR based on heavy metal control. In conclusion, by utilizing interpretable ML approaches, we emphasize the predictive value of heavy metals for IR, especially Ba, Mo, Pb, and Cd.
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Affiliation(s)
- Jun Liu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Xingyu Li
- Cardiovascular Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peng Zhu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China.
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Wang H, Iwama N, Yuwaki K, Nakamichi Y, Hamada H, Tomita H, Tagami K, Kudo R, Kumagai N, Metoki H, Nakaya N, Hozawa A, Kuriyama S, Yaegashi N, Saito M. Association of parity with the prevalence of hypertension in Japan: The Tohoku Medical Megabank Community-based cohort study. J Clin Hypertens (Greenwich) 2024; 26:102-121. [PMID: 38192049 PMCID: PMC10857469 DOI: 10.1111/jch.14756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 11/18/2023] [Accepted: 11/22/2023] [Indexed: 01/10/2024]
Abstract
This study investigated the association of parity with hypertension prevalence in Japanese women while considering a clinical history of hypertensive disorders of pregnancy (HDP) and menopausal status. This cross-sectional study included 30,530 Japanese women (6700 premenopausal; 23 830 postmenopausal). The association between parity and the prevalence of hypertension was evaluated using a multiple logistic regression model with possible confounders. In premenopausal women, no statistically significant association between parity and hypertension prevalence was found. When not adjusted for current body mass index (BMI), a linear graded association was observed between parity and the prevalence of hypertension in postmenopausal women. However, the association between parity and hypertension prevalence in postmenopausal women was attenuated after adjustment for current BMI. Both current BMI and a clinical history of HDP were significantly associated with a high risk of hypertension in both premenopausal and postmenopausal women. Our results also suggest that continuous surveillance and preventive measures for hypertension should be provided for women with HDP and high parity.
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Affiliation(s)
- Hongxin Wang
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Noriyuki Iwama
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Women's Health Care Medical ScienceTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiMiyagiJapan
| | - Keiichi Yuwaki
- Underwriting and Medical DepartmentThe Dai‐ichi Life Insurance Company, LimitedKoto‐kuTokyoJapan
| | - You Nakamichi
- Underwriting and Medical DepartmentThe Dai‐ichi Life Insurance Company, LimitedKoto‐kuTokyoJapan
| | - Hirotaka Hamada
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Hasumi Tomita
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Kazuma Tagami
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Rie Kudo
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Natsumi Kumagai
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Hirohito Metoki
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiMiyagiJapan
- Division of Public Health, Hygiene and EpidemiologyTohoku Medical Pharmaceutical UniversitySendaiMiyagiJapan
| | - Naoki Nakaya
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiMiyagiJapan
| | - Atsushi Hozawa
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiMiyagiJapan
| | - Shinichi Kuriyama
- Division of Molecular EpidemiologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
- International Research Institute of Disaster ScienceTohoku UniversitySendaiMiyagiJapan
- Environment and Genome Research CenterTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Nobuo Yaegashi
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Women's Health Care Medical ScienceTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiMiyagiJapan
- Environment and Genome Research CenterTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Masatoshi Saito
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Women's Health Care Medical ScienceTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Department of Maternal and Fetal TherapeuticsTohoku University Graduate School of MedicineSendaiMiyagiJapan
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10
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Ning Z, Ai G, Chen B, Yao H, Cao H, Pan D, Lu X. Impact of chiglitazar on glycemic control in type 2 diabetic patients with metabolic syndrome and insulin resistance: A pooled data analysis from two phase III trials. J Diabetes 2024; 16:e13484. [PMID: 37853916 PMCID: PMC10859313 DOI: 10.1111/1753-0407.13484] [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: 04/18/2023] [Revised: 08/24/2023] [Accepted: 09/23/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND To evaluate the glycemic control effects of vhiglitazar (carfloglitazar), a novel peroxisome proliferator-activated receptor pan-agonist, in patients with type 2 diabetes mellitus (T2DM) with metabolic syndrome (MetS) or insulin resistance (IR) using pooled data analysis of two phase III clinical trials. METHODS Data were collected from two randomized phase III clinical trials in China, comparing chiglitazar to placebo or sitagliptin in T2DM patients. The MetS was defined by the Adult Treatment Panel III MetS criteria, and IR was defined by homeostatic model assessment for insulin resistance (HOMA-IR) ≥4.31 (male) or 4.51 (female). The main end point of this analysis was glycemic control in the different arms within each subgroup. RESULTS In the MetS subgroup, changes in glycated hemoglobin (HbA1c) from baseline at week 24 in the chiglitazar 32 mg, chiglitazar 48 mg, and sitagliptin 100 mg arms were -1.44%, -1.68%, and -1.37%, respectively; p < .05 was obtained when chiglitazar 48 mg was compared with sitagliptin. In the IR subgroup, the changes in HbA1c were -1.58%, -1.56%, and -1.26% in chiglitazar 32 mg, chiglitazar 48 mg, and sitagliptin 100 mg arms, respectively; p < .05 was obtained when chiglitazar 32 mg was compared with sitaligptin. The two doses of chiglitazar demonstrated a greater reduction in fasting plasma glucose and 2 h postprandial plasma glucose than sitagliptin in the pooled population and in the MetS and IR subgroups. CONCLUSIONS Chiglitazar shows promising efficacy for glycemic control in patients with T2DM associated with MetS or IR. Further prospective trials are required to validate these findings.
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Affiliation(s)
- Zhiqiang Ning
- Shenzhen Chipscreen Biosciences Co., Ltd.ShenzhenChina
| | - Guoqiang Ai
- Shenzhen Chipscreen Biosciences Co., Ltd.ShenzhenChina
| | - Bo Chen
- Shenzhen Chipscreen Biosciences Co., Ltd.ShenzhenChina
| | - He Yao
- Shenzhen Chipscreen Biosciences Co., Ltd.ShenzhenChina
| | - Haixiang Cao
- Shenzhen Chipscreen Biosciences Co., Ltd.ShenzhenChina
| | - Desi Pan
- Shenzhen Chipscreen Biosciences Co., Ltd.ShenzhenChina
| | - Xianping Lu
- Shenzhen Chipscreen Biosciences Co., Ltd.ShenzhenChina
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11
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Wang G, Zhu Z, Wang Y, Zhang Q, Sun Y, Pang G, Ge W, Ma Z, Ma H, Gong L, Ma H, Shao F, Zhu M. The association between METS-IR, an indirect index for insulin resistance, and lung cancer risk. Eur J Public Health 2024:ckad234. [PMID: 38300233 DOI: 10.1093/eurpub/ckad234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Insulin resistance has been reported to increase the risk of breast, prostate and colorectal cancer. However, the role of insulin resistance and its interaction with genetic risk in the development of lung cancer remains controversial. Therefore, we aimed to explore the association between a novel metabolic score for insulin resistance (METS-IR) and lung cancer risk. METHODS A total of 395 304 participants without previous cancer at baseline were included. The Cox proportional hazards regression model was performed to investigate the association between METS-IR and lung cancer risk. In addition, a Mendelian randomization analysis was also performed to explore the causal relationship. The joint effects and additive interactions between METS-IR and polygenetic risk score (PRS) of lung cancer were also investigated. RESULTS During a median follow-up of 11.03 years (Inter-quartile range (IQR): 10.30-11.73), a total of 3161 incident lung cancer cases were diagnosed in 395 304 participants. There was a significant association between METS-IR and lung cancer risk, with an HR of 1.28 (95% CI: 1.17-1.41). Based on the Mendelian randomization analysis, however, no causal associations were observed. We observed a joint effect but no interaction between METS-IR and genetic risk. The lung cancer incidence was estimated to be 100.42 (95% CI: 91.45-109.38) per 100 000 person-year for participants with a high METS-IR and PRS, while only 42.76 (95% CI: 36.94-48.59) with low METS-IR and PRS. CONCLUSIONS High METS-IR was significantly associated with an increased risk of lung cancer. Keeping a low level of METS-IR might help reduce the long-term incident risk of lung cancer.
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Affiliation(s)
- Guoqing Wang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhaopeng Zhu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yi Wang
- Department of Respiratory Disease, Nanjing Chest Hospital, Nanjing Medical University, Nanjing, China
| | - Qiang Zhang
- Department of Thoracic Surgery, Nanjing Chest Hospital, Nanjing Medical University, Nanjing, China
| | - Yungang Sun
- Department of Thoracic Surgery, Nanjing Chest Hospital, Nanjing Medical University, Nanjing, China
| | - Guanlian Pang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Wenjing Ge
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhimin Ma
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Huimin Ma
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Linnan Gong
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hongxia Ma
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Feng Shao
- Department of Thoracic Surgery, Nanjing Chest Hospital, Nanjing Medical University, Nanjing, China
| | - Meng Zhu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Epidemiology, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
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12
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Zyoud SH. Mapping the landscape of research on insulin resistance: a visualization analysis of randomized clinical trials. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:6. [PMID: 38195616 PMCID: PMC10777523 DOI: 10.1186/s41043-024-00497-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/05/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Insulin resistance, a condition in which cells do not respond adequately to insulin, plays a crucial role in diabetes and related metabolic disorders. Randomized clinical trials (RCTs) explore interventions to manage insulin resistance, contributing to evidence-based medical progress. The current study aimed to analyze the global research landscape and trends in RCTs targeting insulin resistance. METHODS This study used bibliometric analysis and data visualization to examine RCT publications on insulin resistance from 2003 to 2022. The Scopus database was used due to its comprehensive coverage. The search strategy involved combining terms related to insulin resistance with RCT-related terms. The search query was validated, and core bibliometric indicators were used to analyze publication growth, origin, productivity, quality, and citations. RESULTS Between 2003 and 2022, 1077 RCT-focused publications on insulin resistance were identified from a pool of 24,932 related articles. The growth followed two phases, with a significant increase after 2008. The USA (n = 308; 28.60%), Iran (n = 165; 15.32%), China (n = 110; 10.21%), and the UK (n = 92; 8.54%) were the main contributors. The active institutions included Tehran University of Medical Sciences (n = 38; 3.53%) and Harvard Medical School (n = 31; 2.88%). Prominent funding agencies include the National Institutes of Health (n = 88; 8.17%) and the National Institute of Diabetes and Digestive and Kidney Diseases (n = 86; 7.99%). The top journals included the American Journal of Clinical Nutrition (n = 44; 4.09%) and Diabetes Care (n = 35; 3.25%). Co-occurrence analysis revealed three clusters addressing "utilizing lipid panels as indicators of insulin resistance," "analyzing the impact of diet composition and physical activity on insulin sensitivity among obese individuals," and "exploring insulin resistance in cases of polycystic ovary syndrome." CONCLUSIONS This comprehensive bibliometric analysis highlights the global research landscape and trends in RCTs targeting insulin resistance. Research on lipid panels, diet impact, and insulin resistance in patients with polycystic ovary syndrome will continue to be a hotspot. The findings offer valuable information on research priorities, international collaborations, and impactful publications. This study provides a foundation for future directorial investigations in this critical area of metabolic health.
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Affiliation(s)
- Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Centre, An-Najah National University Hospital, Nablus, 44839, Palestine.
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13
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Ning P, Zeng J, Feng Q, Chen M, Cao H. Triglyceride-Glucose Index as a Predictor of Lower Extremity Arterial Disease in Patients with Diabetes: A Hospitalized Population Retrospective Study. Ann Vasc Surg 2024; 98:173-181. [PMID: 37802143 DOI: 10.1016/j.avsg.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 06/28/2023] [Accepted: 08/04/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND The triglyceride-glucose (TyG) index is a new, simple, and inexpensive marker of insulin resistance that is becoming increasingly important as a promising predictor of diseases such as atherosclerosis. Atherosclerosis is the main cause of lower extremity arterial disease (LEAD). In this study, we investigated the relationship between TyG index values and LEAD risk in patients with diabetes. METHODS Patients with diabetes hospitalized at the Endocrinology Department of our hospital from June 1, 2021, to May 31, 2022, were retrospectively included. Baseline data, biochemical indicators, and ankle-brachial index values were collected. Statistical methods were used to assess the relationship between TyG index values and the risk of LEAD. RESULTS A total of 1,040 hospitalized patients with diabetes were included, they were divided into the LEAD group with 168 patients and the no LEAD group with 872 patients. TyG index values in the LEAD group were higher than those in the no LEAD group (9.94 ± 0.78 vs. 9.36 ± 0.70, P < 0.001). TyG index values were independently correlated with LEAD risk in patients with diabetes (odds ratio = 3.92, 95% confidence interval (CI): 2.92-5.26, P < 0.001) in multivariate logistic regression analysis after adjusting for different risk factors (all P < 0.05). The area under the receiver operating characteristic curve was 0.72 (95% CI: 0.68-0.76) when TyG index values were used to diagnose LEAD in patients with diabetes. When Youden's index reached the maximum value of 0.34, the optimal TyG index threshold for predicting the onset of diabetic LEAD was 9.56, sensitivity was 71.1%, and specificity was 63.0%. CONCLUSIONS Increases in TyG index values were associated with the risk of LEAD in patients with diabetes and, thus, may be used as a predictor of LEAD in this patient population, especially in primary care institutions with relatively few resources.
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Affiliation(s)
- Peng Ning
- Department of Endocrine and Metabolism, Geriatric Diseases Institute of Chengdu, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, China
| | - Jing Zeng
- Department of Endocrine and Metabolism, Geriatric Diseases Institute of Chengdu, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, China
| | - Qiu Feng
- Department of Endocrine and Metabolism, Geriatric Diseases Institute of Chengdu, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, China
| | - Min Chen
- Department of Endocrine and Metabolism, Geriatric Diseases Institute of Chengdu, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, China
| | - Hongyi Cao
- Department of Endocrine and Metabolism, Geriatric Diseases Institute of Chengdu, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, China.
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14
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Zhou X, Zhang L, Lin X, Chen X, Liu H, Yuan X, Zhao Q, Wang W, Lei X, Jose PA, Deng C, Yang J. Thrombospondin 2 is a novel biomarker of essential hypertension and associated with nocturnal Na + excretion and insulin resistance. Clin Exp Hypertens 2023; 45:2276029. [PMID: 37943619 DOI: 10.1080/10641963.2023.2276029] [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] [Received: 06/19/2023] [Accepted: 10/17/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Thrombospondins (TSPs) play important roles in several cardiovascular diseases. However, the association between circulating (plasma) thrombospondin 2 (TSP2) and essential hypertension remains unclear. The present study was aimed to investigate the association of circulating TSP2 with blood pressure and nocturnal urine Na+ excretion and evaluate the predictive value of circulating TSP2 in subjects with hypertension. METHODS AND RESULTS 603 newly diagnosed essential hypertensive subjects and 508 healthy subjects were preliminarily screened, 47 healthy subjects and 40 newly diagnosed essential hypertensive subjects without any chronic diseases were recruited. The results showed that the levels of circulating TSP2 were elevated in essential hypertensive subjects. The levels of TSP2 positively associated with systolic blood pressure (SBP), diastolic blood pressure (DBP), and other clinical parameters, including homeostasis model assessment of insulin resistance (HOMA-IR), brachial-ankle pulse wave velocity, and serum triglycerides, but negatively associated with nocturnal urine Na+ concentration and excretion and high-density lipoprotein cholesterol. Results of multiple linear regressions showed that HOMA-IR and nocturnal Na+ excretion were independent factors related to circulating TSP2. Mantel-Haenszel chi-square test displayed linear relationships between TSP2 and SBP (χ2 = 35.737) and DBP (χ2 = 26.652). The area under receiver operating characteristic curve (AUROC) of hypertension prediction was 0.901. CONCLUSION Our study suggests for the first time that the circulating levels of TSP2 may be a novel potential biomarker for essential hypertension. The association between TSP2 and blood pressure may be, at least in part, related to the regulation of renal Na+ excretion, insulin resistance, and/or endothelial function.
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Affiliation(s)
- Xiaoxin Zhou
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Longlong Zhang
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Endocrinology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoqian Lin
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xi Chen
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hong Liu
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoli Yuan
- Health Management Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiuxia Zhao
- Health Management Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Weiwei Wang
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Cardiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xun Lei
- Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Pedro A Jose
- Division of Renal Diseases & Hypertension, Department of Medicine and Department of Physiology and Pharmacology, The George Washington University School of Medicine & Health Sciences, New York, WA, USA
| | - Chunyan Deng
- Department of Neurology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Yang
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
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15
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Li X, Chang X, Dang Y, Xue Y, Wang Q, Liu W, Yin T, Zhao Y, Zhang Y. Additive interactions between obesity and insulin resistance on hypertension in a Chinese rural population. BMC Public Health 2023; 23:2519. [PMID: 38102585 PMCID: PMC10724980 DOI: 10.1186/s12889-023-17454-1] [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] [Received: 09/13/2022] [Accepted: 12/11/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Adiposity and insulin resistance (IR) are closely associated with hypertension; however, the role of interactions between obesity phenotypes and IR in hypertension is unclear. This study aimed to evaluate the interactions of body mass index (BMI), waist circumference (WC), and body fat percentage (BF%) with IR on hypertension risk. METHODS We analyzed data from 4888 participants (mean age 57 years, 41.2% men) in the China Northwest Natural Population Cohort, Ningxia Project. BMI, WC, and BF% were determined using bioelectrical impedance analysis devices. IR was estimated using a homeostasis model assessment index (HOMA-IR). Multivariable-adjusted logistic regression was used to evaluate the association between HOMA-IR and hypertension risk. We calculated the relative excess risk and attributable proportion with their 95% confidence intervals (CIs) to assess whether adiposity phenotypes modified the effect of HOMA-IR on hypertension risk. RESULTS The crude prevalence of hypertension was 52.2%. The multivariable-adjusted odds ratio of HOMA-IR was 1.80 (95% CI: 1.23-2.65) for the risk of hypertension in the highest versus the lowest quartiles, but this association became marginal in models further adjusting for BMI, WC, and BF% (P for trend = 0.056). Relative excess risk and attributable proportion for interaction between high HOMA-IR and high BF% were 0.32 (0.04-0.59) and 0.33 (0.06-0.60), respectively. Additionally, high truncal and leg BF% and high HOMA-IR accounted for the hypertension risk in women, but not in men. We did not observe any significant interactions between BMI or WC and HOMA-IR on hypertension. CONCLUSION BF% modified the association between IR and increased risk of hypertension in women with high truncal and leg BF%, but not in men.
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Affiliation(s)
- Xiaoxia Li
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health of Ningxia Medical University, Yinchuan, 750004, China
| | - Xiaoyu Chang
- Editorial Board of Journal of Ningxia Medical University, Yinchuan, 750004, China
| | - Yuanyuan Dang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Yixuan Xue
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Qingan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health of Ningxia Medical University, Yinchuan, 750004, China
| | - Wanlu Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Ting Yin
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Yi Zhao
- Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health of Ningxia Medical University, Yinchuan, 750004, China
- Department of Nutrition and Food Hygiene, School of Public Health of Ningxia Medical University, Yinchuan, 750004, China
| | - Yuhong Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China.
- Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health of Ningxia Medical University, Yinchuan, 750004, China.
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Güven AT. Evaluation of the Relationship between Inflammatory, Metabolic, and Liver-Related Indexes and Blood Pressure Dipping Ratios: A Retrospective Study. Niger J Clin Pract 2023; 26:1886-1894. [PMID: 38158357 DOI: 10.4103/njcp.njcp_510_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/10/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Nighttime blood pressure dipping is a normal physiologic phenomenon. Lack of dipping is associated with increased cardiovascular disease; thus, non-dipping patients are candidates for more strict risk reduction strategies. Dipping presence can be identified using ambulatory blood pressure measurement (ABPM). Recent findings indicate that inflammatory, metabolic, and liver-related indices may have a role in predicting dipping presence dichotomously. AIM To investigate whether dipping ratios correlate with that inflammatory, metabolic, and liver-related indices. MATERIALS AND METHODS Hypertensive patients with ABPM recordings were retrospectively collected. Patient characteristics, co-morbidities, medications, laboratory results, and ABPM results were analyzed. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), triglyceride-glucose index (TyG), triglyceride-to-HDL ratio (TG/HDL), total cholesterol-to-HDL ratio (TC/HDL), AST-to-ALT ratio (AST/ALT), fibrosis-4 (FIB-4), and AST-to-platelet ratio index (APRI) were calculated. Differences and correlations were analyzed between indices, dipping patterns, and ratios. RESULTS Ninety-three patients were included in the study. Forty-five had either a systolic or diastolic dipping pattern. NLR, PLR, TG/HDL, and TC/HDL indices correlated negatively with dipping ratios. AST/ALT was higher in systolic dippers (1.04 vs 0.88, P = 0.03). However, no difference was observed between NLR, PLR, TyG, TG/HDL, TC/HDL, FIB-4, and APRI among different dipping presences. CONCLUSION This study showed for the first time that there was a negative correlation between inflammatory and metabolic indices and dipping ratios.
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Affiliation(s)
- A T Güven
- Department of Internal Medicine, Division of General Internal Medicine, Faculty of Medicine, Başkent University, Ankara, Turkey
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Tan L, Liu Y, Liu J, Zhang G, Liu Z, Shi R. Association between insulin resistance and uncontrolled hypertension and arterial stiffness among US adults: a population-based study. Cardiovasc Diabetol 2023; 22:311. [PMID: 37946205 PMCID: PMC10637002 DOI: 10.1186/s12933-023-02038-5] [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: 09/13/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Prior research has established the correlation between insulin resistance (IR) and hypertension. While the association between triglyceride-glucose (TyG) index, a reliable surrogate marker of IR, and uncontrolled hypertension as well as arterial stiffness among individuals with hypertension remains undisclosed. METHODS In this study, a total of 8513 adults diagnosed with hypertension from the National Health and Nutrition Examination Survey 1999-2018 were included. The primary outcome of the study are arterial stiffness (represented with estimated pulse wave velocity, ePWV) and uncontrolled hypertension. Logistic regression model, subgroup analysis, restricted cubic spine, and smooth curve fitting curve were conducted to evaluate the association between the IR indicators and uncontrolled hypertension and arterial stiffness in individuals with hypertension. RESULTS Among included participants, the overall prevalence of uncontrolled hypertension was 54.3%. After adjusting for all potential covariates, compared with the first quartile of TyG index, the risk of uncontrolled hypertension increased about 28% and 49% for participants in the third quartile (OR, 1.28; 95% CI 1.06-1.52) and the fourth quartile (OR, 1.49; 95% CI 1.21-1.89) of TyG index, respectively. The higher OR of TyG index was observed in participants taking antihypertensive medication [fourth quartile versus first quartile (OR, 2.03; 95% CI 1.37-3.11)]. Meanwhile, we explored the potential association between TyG index and arterial stiffness and found that TyG index was significantly associated with increased arterial stiffness (β for ePWV, 0.04; 95% CI 0.00-0.08; P = 0.039). However, traditional IR indicator HOMA-IR showed no significant positive correlation to uncontrolled hypertension as well as arterial stiffness in US adults with hypertension. CONCLUSION Elevated levels of the TyG index were positive associated with prevalence of uncontrolled hypertension and arterial stiffness among US adults with hypertension.
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Affiliation(s)
- Liao Tan
- Department of Cardiology, Third Xiangya Hospital, Central South University, Hunan, China
| | - Yubo Liu
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Liu
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guogang Zhang
- Department of Cardiology, Third Xiangya Hospital, Central South University, Hunan, China
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhaoya Liu
- Department of the Geriatrics, Third Xiangya Hospital, Central South University, Hunan, China.
| | - Ruizheng Shi
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Yang H, Gong R, Liu M, Deng Y, Zheng X, Hu T. HOMA-IR is positively correlated with biological age and advanced aging in the US adult population. Eur J Med Res 2023; 28:470. [PMID: 37898776 PMCID: PMC10612177 DOI: 10.1186/s40001-023-01448-1] [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] [Received: 05/03/2023] [Accepted: 10/15/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Insulin resistance (IR) had been reported to be associated with age; however, few studies have explored the association between IR and biological age (BA). The HOMA-IR value is a useful indicator of the extent of IR. This cross-sectional study is to explore the relationship between HOMA-IR and BA/advanced aging in the US population. METHODS This study is a cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data. The survey comprised 12,266 people from the NHANES, and their full HOMA-IR data as well as BA data were extracted. Four multiple linear regressions were performed to analyze the association between HOMA-IR and BA, and four multiple logistic regression models were performed to analyze the association between HOMA-IR and advanced aging. In addition, trend tests and stratified analysis were performed and smoothed fitted curves were plotted to test the robustness of the results. RESULTS HOMA-IR was positively correlated with BA [β: 0.51 (0.39, 0.63)], and it was the same to advanced aging [OR: 1.05 (1.02, 1.07)], and both showed a monotonically increasing trend. The trend tests showed that the results were stable (all P for trend < 0.0001). The smoothed fitted curves showed that there were non-linear relationships between HOMA-IR and BA/advanced aging. And the stratified analysis indicated that the relationship between HOMA-IR and BA/advanced aging remained robust in all subgroups. CONCLUSION The study suggested that HOMA-IR is positively correlated with BA and advanced aging in the US adult population, with a monotonic upward trend. This is a new finding to reveal the relationship between HOMA-IR and age from new standpoint of BA rather than chronological age (CA). And it may contribute to a better understanding of human health aging and may aid future research in this field.
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Affiliation(s)
- Haifang Yang
- Medical College of Qinghai University, Xining, China
| | - Rongpeng Gong
- Medical College of Qinghai University, Xining, China
| | - Moli Liu
- Medical College of Qinghai University, Xining, China
| | - Ying Deng
- Department of Cardiology, The First Branch, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoyu Zheng
- School of Clinical Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, China.
| | - Tianyang Hu
- Precision Medicine Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Xu J, Xu W, Chen G, Hu Q, Jiang J. Association of TyG index with prehypertension or hypertension: a retrospective study in Japanese normoglycemia subjects. Front Endocrinol (Lausanne) 2023; 14:1288693. [PMID: 37964964 PMCID: PMC10642169 DOI: 10.3389/fendo.2023.1288693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/16/2023] [Indexed: 11/16/2023] Open
Abstract
Aim The objective of our study was to investigate the potential association between the triglyceride and glucose (TyG) index and the occurrence of prehypertension or hypertension in a cohort of normoglycemic Japanese subjects. Methods The NAGALA physical examination program was conducted in 1994 at Murakami Memorial Hospital in Gifu City, Japan. For our retrospective study, we selected 15,450 participants who had taken part in this program. Our aim was to explore the potential link between the TyG index, a surrogate marker for insulin resistance, and the presence of prehypertension (pre-HTN) or hypertension (HTN). Our analysis included adjustments for clinical demographic attributes and serum biomarkers. Logistic regression was employed to assess the relationship between the TyG index and the likelihood of pre-HTN or HTN. Results A total of 15,450 study subjects were included in our analysis. Notably, the prevalence of both pre-HTN and HTN displayed an ascending trend with increasing quartiles of the TyG index. In our comprehensive multivariable logistic regression analysis, when evaluating TyG as a continuous variable, the adjusted odds ratio (OR) for pre-HTN was OR 1.31 [95% CI 1.11-1.56], while for HTN, it was OR 1.76 [95% CI 1.24-2.5] within the fully adjusted model (model 3). When TyG was stratified into quartiles within model 3, the adjusted ORs for pre-HTN were OR 1.16 [95% CI 1.02-1.31], OR 1.22 [95% CI 1.06-1.41], and OR 1.31 [95% CI 1.08-1.59], respectively, using quartile 1 as the reference. The adjusted ORs for HTN in quartiles 2, 3, and 4 were OR 1.22 [95% CI 0.89-1.66], OR 1.4 [95% CI 1.02-1.91], and OR 1.48 [95% CI 1.02-2.15], respectively, within the same model and analysis, with quartile 1 as the reference. Subgroup analysis indicated that the TyG index exhibited a significant positive correlation with the risk of hypertension or prehypertension, except in the subgroup aged ≥65 years. Conclusion Our study highlights a robust correlation between the TyG index and the likelihood of pre-HTN or HTN in normoglycemic Japanese subjects. This underscores the potential clinical relevance of the TyG index in refining early hypertension management strategies. Nonetheless, the validation of these findings necessitates larger studies with extended follow-up periods.
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Affiliation(s)
- Jingtao Xu
- Department of Emergency, First People’s Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People’s Hospital of Foshan, Foshan, China
| | - Weigan Xu
- Department of Emergency, First People’s Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People’s Hospital of Foshan, Foshan, China
| | - Guojun Chen
- Department of Emergency, First People’s Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People’s Hospital of Foshan, Foshan, China
| | - Qiaohua Hu
- Department of Emergency, First People’s Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People’s Hospital of Foshan, Foshan, China
| | - Jun Jiang
- The Poison Treatment Centre of Foshan, First People’s Hospital of Foshan, Foshan, China
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20
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Nie Z, Xu J, Cheng Y, Li Z, Zhang R, Zhang W, Zhao L. Effects of time-restricted eating with different eating windows on human metabolic health: pooled analysis of existing cohorts. Diabetol Metab Syndr 2023; 15:209. [PMID: 37875984 PMCID: PMC10594936 DOI: 10.1186/s13098-023-01190-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 10/12/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Time-restricted eating (TRE), a feasible form of intermittent fasting, has been proven to benefit metabolic health in animal models and humans. To our knowledge, specific guidance on the appropriate period for eating during TRE has not yet been promoted. Therefore, to compare and assess the relative effectiveness estimates and rankings of TRE with different eating windows on human metabolic health, we conducted a systematic review and network meta-analysis (NMA). METHOD PubMed, EMBASE and the Cochrane Library were searched for randomized controlled trials that compared different eating windows on human metabolic health for adults. A Bayesian NMA was used to compare direct and indirect effects to determine the best different eating windows, and scientific evidence using GRADE. RESULTS Twenty-seven RCTs comparing TRE with different eating windows on human metabolic health were reviewed, and all were included in the NMA. Compared with the normal diet group (non-TRE), the TRE group has certain benefits in reducing weight and fasting insulin. In terms of reducing fasting insulin, the 18:6 group (eating time = 6 h) was better than the 14:10 group (eating time = 10 h) and 16:8 group (eating time = 8 h) (P < 0.05); The < 6 group (eating time < 6 h) was better than the 14:10 group (P < 0.05). In terms of reducing fasting glucose, the < 6 group was better than the 14:10 group (P < 0.05). There were no statistical variations in weight, HDL, TG, and LDL across the different modes of TRE (P > 0.05). CONCLUSIONS Our research showed that no particular metabolic advantages of various eating windows were found. Therefore, our results suggested that different eating windows could promote similar benefits for metabolic parameters.
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Affiliation(s)
- Zhongbiao Nie
- Department of Pharmacy, Peking University Third Hospital, Beijing, 100191, China
- Department of Pharmacy, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
| | - Jiaming Xu
- Department of Pharmacy, Peking University Third Hospital, Beijing, 100191, China
| | - Yinchu Cheng
- Department of Pharmacy, Peking University Third Hospital, Beijing, 100191, China
| | - Zhihong Li
- Department of Pharmacy, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
| | - Ran Zhang
- Nephrology Department, Affiliated Hospital of Shanxi University of Chinese Medicine, Taiyuan, 030036, China
| | - Wentao Zhang
- Pharmacy Department, Beijing hospital of Integrated traditional Chinese and Western Medicine, Beijing, 100039, China
| | - Libo Zhao
- Department of Pharmacy, Peking University Third Hospital, Beijing, 100191, China.
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21
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Hijazin K, Smith B, Garrett C, Knox A, Kelly LA. Relationship between adiponectin and blood pressure in obese Latino adolescent boys with a family history of type 2 diabetes. BMC Pediatr 2023; 23:523. [PMID: 37864156 PMCID: PMC10588243 DOI: 10.1186/s12887-023-04337-y] [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: 06/23/2023] [Accepted: 09/30/2023] [Indexed: 10/22/2023] Open
Abstract
INTRODUCTION Adipokines are associated with several pathological states including, metabolic syndrome, obesity, insulin resistance and type 2 diabetes. One of these adipokines, adiponectin is of particular interest as it has been shown to have numerous anti-inflammatory effects, However, the association between adiponectin and blood pressure remains inconclusive especially in the Latino adolescent with obesity. PURPOSE To investigate the relationship between plasma adiponectin and blood pressure in Latino adolescents' boys with obesity and a with a family history of Type 2 diabetes. METHODS Thirty two Latino adolescent males with obesity aged 14-17 years with a family history of type 2 diabetes underwent a frequently sampled glucose tolerance test (FSIVGTT) to measure insulin sensitivity. Body composition was assessed using dual energy x-ray absorptiometry. Obesity was defined as having a BMI percentile ≥95. Blood pressure was assessed using the Dinamap automated blood pressure monitor, and the average of three readings was used in the analysis. Fasting plasma adiponectin was determined using radioimmunoassay. RESULTS There were moderate positive significant correlations for adiponectin and Systolic blood pressure(SBP) (rho = 0.436, p < 0.027) and Diastolic blood pressure(DBP) (rho = 0.41,p < 0.028). A multivariate liner regression showed that plasma adiponectin could significantly detect 19% of the variance in SBP (p = 0.017, and 33% for DBP (p = 0.017). In a simple linear regression adiponectin was not related to any of our variables (p < 0.05). CONCLUSION In conclusion, adiponectin was positively and significantly correlated to blood pressure in Latino adolescent with obesity. Future studies should investigate this relationship in a large sample of Latino adolescent youth.
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Affiliation(s)
- Kristin Hijazin
- Department of Exercise Science, California Lutheran University, 60 W. Olsen Road, #3400, Thousand Oaks, CA, 91360, USA
| | - Brandon Smith
- Department of Exercise Science, California Lutheran University, 60 W. Olsen Road, #3400, Thousand Oaks, CA, 91360, USA
| | - Coleby Garrett
- Department of Exercise Science, California Lutheran University, 60 W. Olsen Road, #3400, Thousand Oaks, CA, 91360, USA
| | - Allan Knox
- Department of Exercise Science, California Lutheran University, 60 W. Olsen Road, #3400, Thousand Oaks, CA, 91360, USA
| | - Louise A Kelly
- Department of Exercise Science, California Lutheran University, 60 W. Olsen Road, #3400, Thousand Oaks, CA, 91360, USA.
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22
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Kolb H, Kempf K, Martin S. Insulin and aging - a disappointing relationship. Front Endocrinol (Lausanne) 2023; 14:1261298. [PMID: 37854186 PMCID: PMC10579801 DOI: 10.3389/fendo.2023.1261298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/25/2023] [Indexed: 10/20/2023] Open
Abstract
Experimental studies in animal models of aging such as nematodes, fruit flies or mice have observed that decreased levels of insulin or insulin signaling promotes longevity. In humans, hyperinsulinemia and concomitant insulin resistance are associated with an elevated risk of age-related diseases suggestive of a shortened healthspan. Age-related disorders include neurodegenerative diseases, hypertension, cardiovascular disease, and type 2 diabetes. High ambient insulin concentrations promote increased lipogenesis and fat storage, heightened protein synthesis and accumulation of non-functional polypeptides due to limited turnover capacity. Moreover, there is impaired autophagy activity, and less endothelial NO synthase activity. These changes are associated with mitochondrial dysfunction and oxidative stress. The cellular stress induced by anabolic activity of insulin initiates an adaptive response aiming at maintaining homeostasis, characterized by activation of the transcription factor Nrf2, of AMP activated kinase, and an unfolded protein response. This protective response is more potent in the long-lived human species than in short-lived models of aging research resulting in a stronger pro-aging impact of insulin in nematodes and fruit flies. In humans, resistance to insulin-induced cell stress decreases with age, because of an increase of insulin and insulin resistance levels but less Nrf2 activation. These detrimental changes might be contained by adopting a lifestyle that promotes low insulin/insulin resistance levels and enhances an adaptive response to cellular stress, as observed with dietary restriction or exercise.
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Affiliation(s)
- Hubert Kolb
- Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, Düsseldorf, Germany
| | - Kerstin Kempf
- West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, Düsseldorf, Germany
| | - Stephan Martin
- Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, Düsseldorf, Germany
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23
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Yang Y, Piao W, Cai S, Huang K, Yuan C, Cheng X, Zhang L, Li Y, Zhao L, Yu D. Comparison of data-driven identified hypertension-protective dietary patterns among Chinese adults: based on a nationwide study. Eur J Nutr 2023; 62:2805-2825. [PMID: 37335360 DOI: 10.1007/s00394-023-03195-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/09/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE Diet pattern (DP) is a key modifiable and cost-effective factor in hypertension (HTN) management. The current study aimed to identify and compare the hypertension-protective DPs among Chinese adults. METHODS 52,648 participants aged over 18 years were included from China Nutrition and Health Surveillance (CNHS) 2015-2017. Reduced rank regression (RRR) and partial least square regression (PLS) was applied to identify the DPs. Multivariable-adjusted logistic regression was used to assess the association between the DPs and HTN. RESULTS DPs derived by RRR and PLS were both featured by higher consumption of fresh vegetables and fruits, mushrooms and edible fungi, seaweeds, soybeans and related products, mixed legumes, dairy products, fresh eggs, and lower of refined grain consumption. Compared to the lowest quintile, participants in the highest quintile had lower odds of HTN (RRR-DP: OR = 0.77, 95% CI = 0.72-0.83; PLS-DP: OR = 0.76, 95% CI = 0.71-0.82; all p < 0.0001). Simplified DP scores were observed the same protective tendencies (Simplified RRR-DP: OR = 0.81, 95% CI = 0.75-0.87; Simplified PLS-DP: OR = 0.79, 95% CI = 0.74-0.85; all p < 0.0001) and showed effective extrapolation in subgroups defined by gender, age, location, lifestyle, and different metabolic conditions. CONCLUSIONS The identified DPs had high conformity with East Asian dietary habits, and significantly negative associations with HTN among Chinese adults. The simplified DP technique also indicated the potential for improving the extrapolation of the results of DP analysis related to HTN.
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Affiliation(s)
- Yuxiang Yang
- Department of Nutrition Surveillance, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing, 100050, China
| | - Wei Piao
- Department of Nutrition Surveillance, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing, 100050, China
- NHC Key Laboratory of Trace Element Nutrition, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing, 100050, China
| | - Shuya Cai
- Department of Nutrition Surveillance, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing, 100050, China
| | - Kun Huang
- Department of Nutrition Surveillance, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing, 100050, China
| | - Changzheng Yuan
- School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, China
| | - Xue Cheng
- Department of Nutrition Surveillance, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing, 100050, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai, Beijing, 100069, China
| | - Yuge Li
- Department of Nutrition Surveillance, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing, 100050, China
| | - Liyun Zhao
- Department of Nutrition Surveillance, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing, 100050, China.
- NHC Key Laboratory of Trace Element Nutrition, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing, 100050, China.
| | - Dongmei Yu
- Department of Nutrition Surveillance, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing, 100050, China.
- NHC Key Laboratory of Trace Element Nutrition, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing, 100050, China.
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24
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Argoty-Pantoja AD, Velázquez-Cruz R, Meneses-León J, Salmerón J, Rivera-Paredez B. Triglyceride-glucose index is associated with hypertension incidence up to 13 years of follow-up in mexican adults. Lipids Health Dis 2023; 22:162. [PMID: 37759253 PMCID: PMC10523648 DOI: 10.1186/s12944-023-01925-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
The triglyceride-glucose index (TyG index) is an indicator of insulin resistance that has been studied recently. The relationship between insulin resistance and the risk of hypertension has been documented previously. However, there is limited knowledge regarding the association of the TyG index with hypertension incidence. This study aimed to evaluate the association of the TyG index with changes in blood pressure (BP) and hypertension incidence in Mexican adults. This analysis was performed using the Health Workers Cohort Study data. The TyG index was estimated as Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2] and divided into categories defined by tertiles. The analysis was conducted using fixed-effects linear regression models (n = 1,545) and Cox proportional hazards regression models (n = 1,113), adjusting for potential confounding variables. The incidence rates (95% CI) for the low, medium, and high categories of the TyG index were 22.1 (17.8, 27.5), 35.8 (30.1, 42.7), and 49.4 (42.1, 57.9), respectively. An increase in the levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) was observed when changing from a low to a medium (DBP: β 2.55 mmHg, 95% CI 0.81, 4.29) and from a low to a high category of the TyG index (SBP: β 3.10 mmHg, 95% CI 1.16, 5.04; DBP: β 4.91 mmHg, 95% CI 2.88, 6.94). Furthermore, participants within the top category of the TyG index had a 56% higher risk of hypertension than those in the bottom category (HR = 1.56; 95% CI 1.18, 2.08). These results support the hypothesis that the TyG index is associated with high blood pressure in Mexican adults.
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Grants
- 7876, 87783, 262233, 26267M, SALUD-2010-01-139796, SALUD-2011-01-161930, and CB-2013-01-221628 Consejo Nacional de Ciencia y Tecnología
- 7876, 87783, 262233, 26267M, SALUD-2010-01-139796, SALUD-2011-01-161930, and CB-2013-01-221628 Consejo Nacional de Ciencia y Tecnología
- 7876, 87783, 262233, 26267M, SALUD-2010-01-139796, SALUD-2011-01-161930, and CB-2013-01-221628 Consejo Nacional de Ciencia y Tecnología
- 7876, 87783, 262233, 26267M, SALUD-2010-01-139796, SALUD-2011-01-161930, and CB-2013-01-221628 Consejo Nacional de Ciencia y Tecnología
- 7876, 87783, 262233, 26267M, SALUD-2010-01-139796, SALUD-2011-01-161930, and CB-2013-01-221628 Consejo Nacional de Ciencia y Tecnología
- IA201523 Programa de Apoyo a Proyectos de Investigación e Innovación Tecnológica PAPIIT-DGAPA-UNAM
- IA201523 Programa de Apoyo a Proyectos de Investigación e Innovación Tecnológica PAPIIT-DGAPA-UNAM
- IA201523 Programa de Apoyo a Proyectos de Investigación e Innovación Tecnológica PAPIIT-DGAPA-UNAM
- IA201523 Programa de Apoyo a Proyectos de Investigación e Innovación Tecnológica PAPIIT-DGAPA-UNAM
- IA201523 Programa de Apoyo a Proyectos de Investigación e Innovación Tecnológica PAPIIT-DGAPA-UNAM
- Programa de Apoyo a Proyectos de Investigación e Innovación Tecnológica PAPIIT–DGAPA–UNAM
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Affiliation(s)
- Anna D. Argoty-Pantoja
- Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud. Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, 04510 México
| | - Rafael Velázquez-Cruz
- Laboratorio de Genómica del Metabolismo Óseo, Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de México, 14610 México
| | - Joacim Meneses-León
- Centro de Investigación en Políticas, Población y Salud (CIPPS), Universidad Nacional Autónoma de México (UNAM), Ciudad de México, 04510 México
| | - Jorge Salmerón
- Centro de Investigación en Políticas, Población y Salud (CIPPS), Universidad Nacional Autónoma de México (UNAM), Ciudad de México, 04510 México
| | - Berenice Rivera-Paredez
- Centro de Investigación en Políticas, Población y Salud (CIPPS), Universidad Nacional Autónoma de México (UNAM), Ciudad de México, 04510 México
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Manning A, Sevilla-González M, Smith K, Wang N, Jensen A, Litkowski E, Kim H, DiCorpo D, Westerman K, Cui J, Liu CT, Yu C, McNeil J, Lacaze P, Chang KM, Tsao P, Phillips L, Goodarzi M, Sladek R, Rotter J, Dupuis J, Florez J, Merino J, Meigs J, Zhou J, Raghavan S, Udler M. Heterogeneous effects on type 2 diabetes and cardiovascular outcomes of genetic variants and traits associated with fasting insulin. RESEARCH SQUARE 2023:rs.3.rs-3317661. [PMID: 37790568 PMCID: PMC10543499 DOI: 10.21203/rs.3.rs-3317661/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Hyperinsulinemia is a complex and heterogeneous phenotype that characterizes molecular alterations that precede the development of type 2 diabetes (T2D). It results from a complex combination of molecular processes, including insulin secretion and insulin sensitivity, that differ between individuals. To better understand the physiology of hyperinsulinemia and ultimately T2D, we implemented a genetic approach grouping fasting insulin (FI)-associated genetic variants based on their molecular and phenotypic similarities. We identified seven distinctive genetic clusters representing different physiologic mechanisms leading to rising FI levels, ranging from clusters of variants with effects on increased FI, but without increased risk of T2D (non-diabetogenic hyperinsulinemia), to clusters of variants that increase FI and T2D risk with demonstrated strong effects on body fat distribution, liver, lipid, and inflammatory processes (diabetogenic hyperinsulinemia). We generated cluster-specific polygenic scores in 1,104,258 individuals from five multi-ancestry cohorts to show that the clusters differed in associations with cardiometabolic traits. Among clusters characterized by non-diabetogenic hyperinsulinemia, there was both increased and decreased risk of coronary artery disease despite the non-increased risk of T2D. Similarly, the clusters characterized by diabetogenic hyperinsulinemia were associated with an increased risk of T2D, yet had differing risks of cardiovascular conditions, including coronary artery disease, myocardial infarction, and stroke. The strongest cluster-T2D associations were observed with the same direction of effect in non-Hispanic Black, Hispanic, non-Hispanic White, and non-Hispanic East Asian populations. These genetic clusters provide important insights into granular metabolic processes underlying the physiology of hyperinsulinemia, notably highlighting specific processes that decouple increasing FI levels from T2D and cardiovascular risk. Our findings suggest that increasing FI levels are not invariably associated with adverse cardiometabolic outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Kyong-Mi Chang
- The Corporal Michael J. Crescenz Veterans Affairs Medical Center and University of Pennsylvania Perelman School of Medicine
| | - Phil Tsao
- Stanford University School of Medicine
| | | | | | | | - Jerome Rotter
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
| | | | | | | | - James Meigs
- Department of Medicine, Harvard Medical School
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Shao Y, Li L, Zhong H, Wang X, Hua Y, Zhou X. Anticipated correlation between lean body mass to visceral fat mass ratio and insulin resistance: NHANES 2011-2018. Front Endocrinol (Lausanne) 2023; 14:1232896. [PMID: 37772076 PMCID: PMC10526824 DOI: 10.3389/fendo.2023.1232896] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
Objective The relationship between body composition and insulin resistance (IR) is controversial. This study aimed to thoroughly examine the correlation between adipose tissue, lean body mass, and IR as evaluated by the Homeostatic Model Assessment (HOMA-IR). Methods In this cross-sectional study, we utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2018. Our study included 4981 subjects, and we employed multiple linear regression, smoothed curve fitting, threshold, and saturation effect analysis to investigate the relationship between lean body mass, visceral fat mass, and IR. Also, we used the lean body mass to visceral fat ratio (Log LM/VFM) as a proxy variable to analyze its association with IR alone. Results The study discovered a negative link between lean body mass and IR, but the visceral fat mass was positively correlated after correcting for covariates. A negative correlation was observed when the alternative variable Log LM/VFM was analyzed separately for its association with IR. This association was present regardless of whether the exposure variables were analyzed as continuous or categorical. The data analysis revealed a nonlinear relationship between Log LM/VFM and IR, as evidenced by the generalized additive model. In addition, a threshold effect with a critical value of 1.80 and a saturation effect with a critical point of 2.5 were also observed. Further subgroup analysis for sex, age, BMI, active levels, hypertension, and diabetes showed considerable robustness between the relationship of Log LM/VFM and IR. Conclusion Maintaining a proper ratio of lean body mass and visceral fat is beneficial for decreasing IR.
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Affiliation(s)
- Ya Shao
- Department of Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Longti Li
- Department of Nursing, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Huiqin Zhong
- Department of Gastroenterology, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Xiaojun Wang
- Department of Gastroenterology, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Yu Hua
- Department of Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Xu Zhou
- Department of Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
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Mi Z, Wang X, Ma L, Liu H, Zhang Y, Ding Z, Wang L, Sun M, Li B. The dietary inflammatory index is positively associated with insulin resistance in underweight and healthy weight adults. Appl Physiol Nutr Metab 2023; 48:692-699. [PMID: 37262928 DOI: 10.1139/apnm-2022-0475] [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: 06/03/2023]
Abstract
The aim of this study was to explore the relationship between dietary inflammatory index (DII) and insulin resistance (IR) in underweight and healthy weight adults. This cross-sectional study involved 3205 participants from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. All dietary data used to calculate the DII were obtained based on the average of two 24-h dietary recall interviews. Participants were divided into an anti-inflammatory diet group and a pro-inflammatory diet group based on DII < 0 and DII ≥ 0, respectively. Fasting blood glucose and fasting insulin data used to calculate IR index (HOMA-IR) were from laboratory data in the NHANES database. According to the linear regression analysis results of DII and HOMA-IR, we found that there was a positive relationship between DII and IR. A positive association between DII and HOMA-IR was seen in the following groups after stratification: by age in 20-39-year olds, by sex in males, by race in Non-Hispanic Whites, by family history of diabetes in those without a family history of diabetes, by education level in those with high school education, by smoking status in current smokers and non-smokers, by hypertension in those with hypertension, by BMI in those with a BMI of 18.5-24.99, by hypertriglyceridemia (HTG) in those without HTG, by poverty impact ratio (PIR) in those with PIR ≤ 1.3 and >1.3, and by physical activity in those with moderate recreational activities. In conclusion, in underweight and healthy weight adults, DII was positively correlated with the risk of IR.
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Affiliation(s)
- Zhendong Mi
- Department of Preventive Medicine, School of Public Health, Jilin University, Changchun 130021, P.R. China
| | - Xuhan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, P.R. China
| | - Liying Ma
- Department of Preventive Medicine, School of Public Health, Jilin University, Changchun 130021, P.R. China
| | - Honglin Liu
- Department of Preventive Medicine, School of Public Health, Jilin University, Changchun 130021, P.R. China
| | - Yidan Zhang
- Department of Radiation Medicine, School of Public Health, Jilin University, Changchun 130021, P.R. China
| | - Ziji Ding
- Department of Preventive Medicine, School of Public Health, Jilin University, Changchun 130021, P.R. China
| | - Ling Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, P.R. China
| | - Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, P.R. China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, P.R. China
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Cai Y, Liu P, Xu Y, Xia Y, Peng X, Zhao H, Chen Q. Biomarkers of obesity-mediated insulin resistance: focus on microRNAs. Diabetol Metab Syndr 2023; 15:167. [PMID: 37537674 PMCID: PMC10401761 DOI: 10.1186/s13098-023-01137-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/09/2023] [Indexed: 08/05/2023] Open
Abstract
Obesity and metabolic syndromes are becoming increasingly prevalent worldwide. Insulin resistance (IR) is a common complication of obesity. However, IR occurrence varies across individuals with obesity and may involve epigenetic factors. To rationalize the allocation of healthcare resources, biomarkers for the early risk stratification of individuals with obesity should be identified. MicroRNAs (miRNAs) are closely associated with metabolic diseases and involved in epigenetic regulation. In this review, we have summarized the changes in miRNA expression in the peripheral circulation and tissues of patients and animals with obesity-associated IR over the last 5 years and identified several candidate biomarkers that predict obesity-related IR. There are areas for improvement in existing studies. First, more than the predictive validity of a single biomarker is required, and a biomarker panel needs to be formed. Second, miRNAs are often studied in isolation and do not form a network of signaling pathways. We believe that early biomarkers can help clinicians accurately predict individuals prone to obesity-related IR at an early stage. Epigenetic regulation may be one of the underlying causes of different clinical outcomes in individuals with obesity. Future studies should focus on objectively reflecting the differences in miRNA profile expression in individuals with obesity-related IR, which may help identify more reliable biomarkers. Understanding the metabolic pathways of these miRNAs can help design new metabolic risk prevention and management strategies, and support the development of drugs to treat obesity and metabolic disorders.
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Affiliation(s)
- Yichen Cai
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Pan Liu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yumei Xu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuguo Xia
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Xiaowan Peng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Haiyan Zhao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qiu Chen
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China.
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Hijazin K, Smith B, Garrett C, Knox A, Kelly LA. Relationship between Adiponectin and Blood Pressure in Obese Latino Adolescent Boys with a Family History of Type 2 Diabetes. RESEARCH SQUARE 2023:rs.3.rs-3101635. [PMID: 37577670 PMCID: PMC10418567 DOI: 10.21203/rs.3.rs-3101635/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
INTRODUCTION Adipokines are associated with several pathological states including, metabolic syndrome, obesity, insulin resistance and type 2 diabetes. One of these adipokines, adiponectin is of particular interest as it has been shown to have numerous anti-inflammatory effects, However, the association between adiponectin and blood pressure remains inconclusive especially in the obese Hispanic adolescent. PURPOSE to investigate the relationship between plasma adiponectin and blood pressure in obese Latino adolescents' boys with a family history of Type 2 diabetes. METHODS Thirty two obese Latino male adolescents aged 14-17 years with a family history of type 2 diabetes underwent a frequently sampled glucose tolerance test (FSIVGTT) to measure insulin sensitivity. Body composition was assessed using dual energy x-ray absorptiometry. Obesity was defined as having a BMI percentile 395. Blood pressure was assessed using the Dinamap automated blood pressure monitor, and the average of three readings was used in the analysis. Fasting plasma adiponectin was determined using radioimmunoassay. RESULTS There was a strong positive significant correlation for adiponectin and Systolic blood pressure(SBP) (p< 0.027) and a moderate, positive significant correction for Diastolic blood pressure(DBP) (p< 0.028). A multivariate liner regression showed that plasma adiponectin could significantly predict 19% of the variance in SBP (p=0.017, and 33% for DBP (p=0.017). CONCLUSION In conclusion, adiponectin was positively and significantly correlated to blood pressure in obese Latino adolescent youth. Future studies should investigate this relationship in a large sample of Latino adolescent youth.
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Zhu Q, Zhang T, Cheang I, Lu X, Shi M, Zhu X, Liao S, Gao R, Li X, Yao W. Negative association between triglyceride glucose index and BMI-adjusted skeletal muscle mass index in hypertensive adults. BMC Musculoskelet Disord 2023; 24:571. [PMID: 37442968 DOI: 10.1186/s12891-023-06700-7] [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: 04/12/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The triglyceride glucose (TyG) index, an indicator of insulin resistance, is often associated with adverse outcomes in various cardiovascular diseases, while hypertension is associated with an increased risk of cardiovascular diseases. As the loss of muscle mass in people with hypertension is poorly understood, the current study aimed to explore the relationship between TyG index and muscle mass in hypertensive population. METHODS We analyzed data from hypertensive adult participants in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. The TyG index and body mass index (BMI)-adjusted skeletal muscle mass index (SMI) were calculated and the relationship between the two was evaluated using multivariable linear regression and restricted cubic spline (RCS) regression models. RESULTS A total of 1633 participants in the dataset were included for the final analysis. In the multivariable regression analysis, the adjusted β of SMI with a 95% confidence interval (CI) for the highest TyG index quartile was - 5.27 (- 9.79 to - 0.75), compared with the lowest quartile. A negative linear relationship between TyG index and SMI was plotted by RCS regression (nonlinear P = 0.128). Stratified models of non-smoking women of different ages also demonstrated that SMI decreased as TyG index increased (all P for trend < 0.05). CONCLUSION This linear and negative correlation between TyG index and SMI in hypertensive patients suggests that insulin resistance adversely affects muscle mass.
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Affiliation(s)
- Qingqing Zhu
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Ting Zhang
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Iokfai Cheang
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Xinyi Lu
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Mengsha Shi
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Xu Zhu
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Shengen Liao
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Rongrong Gao
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China
| | - Xinli Li
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China.
| | - Wenming Yao
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Guangzhou Road 300, Nanjing, 210029, China.
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Castro L, Brant L, Diniz MDF, Lotufo P, Bensenor IJ, Chor D, Griep R, Barreto SM, Ribeiro AL. Association of hypertension and insulin resistance in individuals free of diabetes in the ELSA-Brasil cohort. Sci Rep 2023; 13:9456. [PMID: 37301876 PMCID: PMC10257662 DOI: 10.1038/s41598-023-35298-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/16/2023] [Indexed: 06/12/2023] Open
Abstract
Insulin resistance (IR) is defined as the subnormal response to insulin action on its target tissues. Studies suggest that IR may increase the risk of hypertension, but the results are inconsistent and it is not known whether such an effect is independent of overweight/obesity. We aimed to evaluate the association between IR and the incidence of prehypertension and hypertension in the Brazilian population and whether this association is independent of overweight/obesity. In 4717 participants of the Brazilian Longitudinal Study of Adult's Health (ELSA-Brasil), free of diabetes and cardiovascular disease at baseline (2008-2010), we investigated the incidence of prehypertension and hypertension after a mean follow-up of 3.8 ± 0.5 years. Insulin resistance at baseline was assessed by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index, defined if above the 75th percentile. The risk of IR-associated prehypertension/hypertension was estimated by multinomial logistic regression after adjustment for confounding factors. Secondary analysis were stratified by body mass index. The mean (SD) age of participants was 48 (8) years, 67% were women. The 75th percentile of HOMA-IR at baseline was 2.85. The presence of IR increased the chance of developing prehypertension by 51% (95% CI 1.28-1.79) and hypertension by 150% (95% CI 1.48-4.23). In individuals with BMI < 25 kg/m2, the presence of IR remained associated with the incidence of prehypertension (OR 1.41; 95% CI 1.01-1.98) and hypertension (OR 3.15; 95% CI 1.27-7.81). In conclusion, our results suggest that IR is a risk factor for hypertension, regardless of the presence of overweight or obesity.
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Affiliation(s)
- Luísa Castro
- Longitudinal Study of Adult Health - ELSA Brasil, Federal University of Minas Gerais, Prof. Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil
| | - Luísa Brant
- Longitudinal Study of Adult Health - ELSA Brasil, Federal University of Minas Gerais, Prof. Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil
| | - Maria de Fátima Diniz
- Longitudinal Study of Adult Health - ELSA Brasil, Federal University of Minas Gerais, Prof. Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil
| | - Paulo Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - Isabela Judith Bensenor
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - Dora Chor
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Rosane Griep
- Laboratory of Education in Environment and Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Sandhi Maria Barreto
- Longitudinal Study of Adult Health - ELSA Brasil, Federal University of Minas Gerais, Prof. Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil
| | - Antonio Luiz Ribeiro
- Longitudinal Study of Adult Health - ELSA Brasil, Federal University of Minas Gerais, Prof. Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil.
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Xie SS, Luo XT, Dong MH, Wang Q, Li J, Wu QF. Association Between Hemoglobin Glycation Index and Metabolic Syndrome in Middle-Aged and Older People. Diabetes Metab Syndr Obes 2023; 16:1471-1479. [PMID: 37229354 PMCID: PMC10204862 DOI: 10.2147/dmso.s406660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/05/2023] [Indexed: 05/27/2023] Open
Abstract
Purpose Hemoglobin glycation index (HGI) is used to describe the difference between estimated and measured glycated hemoglobin A1c (HbA1c). The present study aimed to investigate the association between metabolic syndrome (MetS) and HGI in middle-aged and elderly Chinese. Patients and Methods In this cross-sectional study, a multi-stage random sampling method was used to select objects from the permanent residents aged 35 years and above living in Ganzhou, Jiangxi, China. The demographic information, history of illness, physical examination, and blood biochemistry data were obtained. HGI was calculated from fasting plasma glucose (FPG) and HbA1c (HGI = measured HbA1c value - predicted HbA1c value). All participants were divided into low HGI and high HGI groups using the median HGI as a cut-off value. Univariate analysis was used to detect the influencing factors of HGI, and Logistic regression analysis was adopted to analyze the relationship between significant variables found in univariate analysis, MetS, or MetS's components and HGI. Results A total of 1826 participants were enrolled in the study, and the prevalence of MetS was 27.4%. There were 908 in the low HGI group and 918 in the high HGI group, and the prevalence of MetS was 23.7% and 31.0%, respectively. Logistic regression analysis showed that the prevalence of MetS in the high HGI group was higher than that in the low HGI group (OR=1.384, 95% CI:1.110~1.725), further analysis showed that HGI was related with abdominal obesity (OR=1.287, 95% CI:1.061~1.561), hypertension (OR=1.349, 95% CI:1.115~1.632), and hypercholesterolemia (OR=1.376, 95% CI:1.124~1.684) (all P < 0.05). After adjusting for age, sex, and serum uric acid (UA), the relationship still existed. Conclusion This study found that HGI is directly associated with MetS.
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Affiliation(s)
- Si-si Xie
- School of Graduate, Gannan Medical University, Ganzhou, Jiangxi, People’s Republic of China
| | - Xiao-ting Luo
- School of General Medicine, Gannan Medical University, Ganzhou, Jiangxi, People’s Republic of China
| | - Ming-hua Dong
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, People’s Republic of China
| | - Qi Wang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, People’s Republic of China
| | - Jian Li
- School of Basic Medical, Gannan Medical University, Ganzhou, Jiangxi, People’s Republic of China
| | - Qing-feng Wu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, People’s Republic of China
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Yu X, Wen C, Xu R, Huang W. Dapagliflozin's effect on serum homocysteine in patients with hypertension complicated with insulin resistance. J Clin Hypertens (Greenwich) 2023; 25:489-496. [PMID: 37129210 PMCID: PMC10184483 DOI: 10.1111/jch.14662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/29/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023]
Abstract
Most patients with hypertension are complicated with insulin resistance (IR), which is one of the risk factors of hypertension and can increase the level of serum homocysteine (Hcy) by affecting Hcy's metabolic enzyme and insulin level. Investigations in recent years have shown that Hcy is an independent risk factor for cardiovascular diseases. At present, folic acid is the prominent medicine used to reduce Hcy, but its effection for Hcy has an obvious individual difference, which is closely related to individual genes. Moreover, folic acid is chiefly used in patients with Hcy ≥15 μmol/L, but Hcy ≥10 μmol/L has had an adverse effect on the cardiovascular system. Randomized clinical trials have shown that dapagliflozin can improve IR. Therefore, whether it can reduce Hcy has become a new direction. This study was a retrospective case-control study. Patients with high serum Hcy and hypertension complicated with IR were divided into two groups: the dapagliflozin group (n = 166) and the control group (n = 198). Before and after 12 weeks of treatment, the changes in serum Hcy and IR index were measured and compared. We found that dapagliflozin could reduce the serum Hcy level of patients with hypertension and IR to a certain extent. Dapagliflozin could be a viable option for hypertension complicated with IR and hyperhomocysteinemia. However, these findings need to be further confirmed in future randomized clinical trials with a large number of samples.
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Affiliation(s)
- Xiaoqian Yu
- Department of Cardiology, Jinan Central Hospital, Shandong University, Jinan, China
| | - Cong Wen
- Department of Cardiology, Jinan Central Hospital, Weifang Medical University, Weifang, China
| | - Rui Xu
- Department of Cardiology, Jinan Central Hospital, Shandong University, Jinan, China
- Department of Cardiology, Jinan Central Hospital, Weifang Medical University, Weifang, China
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Wen Huang
- Department of Medical Ultrasound, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, 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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Cunha WR, Gaspar IC, de Souza BC, Martins BDL, de Miranda JA, Lanna CMM, Tanus-Santos JE, Lacchini R, de Almeida Belo V. High molecular weight adiponectin as a biomarker of hypertension in children and adolescents with obesity. Eur J Pediatr 2023:10.1007/s00431-023-04962-w. [PMID: 37067603 DOI: 10.1007/s00431-023-04962-w] [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: 02/08/2023] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 04/18/2023]
Abstract
Lower HMW (high molecular weight) adiponectin levels are associated with obesity, insulin resistance, and metabolic syndrome in children and adolescents. However, data on HMW levels in pediatric population with hypertension are lacking. This study aimed to examine the association and predictive capacity of HMW levels, HMW/HOMA-IR, and HMW/APN ratio with hypertension in obese children and adolescents. The 299 pediatric subjects were grouped in obese hypertensive (OH), obese normotensive (ON), and normal weight normotensive (NN). Plasma concentrations of HMW were investigated by ELISA. ANOVA was used to compare study groups, and a binary logistic regression analysis was used to verify if HMW, HMW/HOMA-IR, HMW/APN, APN, APN/HOMA-IR, and HOMA-IR are associated to hypertension regardless obesity in children and adolescents. To compare the strength and performance of each biomarker to classify individuals with and without hypertension, the receiver-operating characteristic (ROC) curve, area under the curve (AUC), and Youden index (J) were evaluated. Both HMW plasma levels and the HMW/HOMA-IR ratio were significantly lower in the OH group when compared to the ON group (HMW: 2.00 ± 1.33 µg/mL vs 2.48 ± 1.48 µg/mL; HMW/HOMA-IR ratio: 0.87 ± 0.95 vs 1.27 ± 1.2; P < 0.05) and NN weight groups (HMW: 2.00 ± 1.33 µg/mL vs 4.02 ± 1.99 µg/mL; HMW/HOMA-IR ratio: 0.87 ± 0.95 vs 2.62 ± 1.86; P < 0.05). Hypertension was associated with lowest HMW (OR = 4.50; 95% CI = 1.41-15.84) and HMW/HOMA-IR (OR = 12.13; 95% CI = 2.51-92.93) regardless of obesity. However, HOMA-IR or the HMW/APN was not significant (P > 0.05). In the ROC curve analyses, the HMW and HMW/HOM-IR were more sensitive to detect hypertension in children and adolescents with obesity. Conclusion: Low levels of HMW oligomer and HMW/HOM-IR are associated with hypertension in childhood obesity. Thus, these biomarkers could be clinically useful in identifying hypertension in childhood obesity. What is Known: • HMW has previously been reported as the most biologically active isoform of adiponectin, and lower HMW concentrations are associated with obesity, insulin resistance, and metabolic syndrome in children and adolescents. • HMW/HOMA-IR ratio is a sensitive predictor for metabolic syndrome in adults. What is New: • HMW levels are associated with hypertension in children and adolescents, independently of presence of obesity. • HMW was more sensitive to detect hypertension in children and adolescents with obesity when compared to HMW/HOMA-IR, HMW/APN, APN, APN/HOMA-IR, or HOMA-IR.
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Affiliation(s)
- Warlley Rosa Cunha
- School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | | | | | | | | | | | - José Eduardo Tanus-Santos
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Riccardo Lacchini
- Department of Psychiatric Nursing and Human Sciences, Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirão Preto, Brazil
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Meneses MJ, Patarrão RS, Pinheiro T, Coelho I, Carriço N, Marques AC, Romão A, Nabais J, Fortunato E, Raposo JF, Macedo MP. Leveraging the future of diagnosis and management of diabetes: From old indexes to new technologies. Eur J Clin Invest 2023; 53:e13934. [PMID: 36479853 DOI: 10.1111/eci.13934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/15/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Diabetes is a heterogeneous and multifactorial disease. However, glycemia and glycated hemoglobin have been the focus of diabetes diagnosis and management for the last decades. As diabetes management goes far beyond glucose control, it has become clear that assessment of other biochemical parameters gives a much wider view of the metabolic state of each individual, enabling a precision medicine approach. METHODS In this review, we summarize and discuss indexes that have been used in epidemiological studies and in the clinical practice. RESULTS Indexes of insulin secretion, sensitivity/resistance and metabolism have been developed and validated over the years to account also with insulin, C-peptide, triglycerides or even anthropometric measures. Nevertheless, each one has their own objective and consequently, advantages and disadvantages for specific cases. Thus, we discuss how new technologies, namely new sensors but also new softwares/applications, can improve the diagnosis and management of diabetes, both for healthcare professionals but also for caretakers and, importantly, to promote the empowerment of people living with diabetes. CONCLUSIONS In long-term, the solution for a better diabetes management would be a platform that allows to integrate all sorts of relevant information for the person with diabetes and for the healthcare practitioners, namely glucose, insulin and C-peptide or, in case of need, other parameters/indexes at home, sometimes more than once a day. This solution would allow a better and simpler disease management, more adequate therapeutics thereby improving patients' quality of life and reducing associated costs.
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Affiliation(s)
- Maria João Meneses
- iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal.,DECSIS II Iberia, Évora, Portugal
| | - Rita Susana Patarrão
- iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Tomás Pinheiro
- CENIMAT i3N, Materials Science Department, Faculty of Science and Technology, Universidade NOVA de Lisboa and CEMOP/UNINOVA, Caparica, Portugal
| | - Inês Coelho
- iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal
| | | | - Ana Carolina Marques
- CENIMAT i3N, Materials Science Department, Faculty of Science and Technology, Universidade NOVA de Lisboa and CEMOP/UNINOVA, Caparica, Portugal
| | | | - João Nabais
- Comprehensive Health Research Centre (CHRC), Departamento de Ciências Médicas e da Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
| | - Elvira Fortunato
- CENIMAT i3N, Materials Science Department, Faculty of Science and Technology, Universidade NOVA de Lisboa and CEMOP/UNINOVA, Caparica, Portugal
| | - João Filipe Raposo
- iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal.,APDP - Diabetes Portugal - Education and Research Center, Lisbon, Portugal
| | - Maria Paula Macedo
- iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal.,APDP - Diabetes Portugal - Education and Research Center, Lisbon, Portugal
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Song Q, Ling Q, Fan L, Deng Y, Gao Q, Yang R, Chen S, Wu S, Cai J. Severity of non-alcoholic fatty liver disease is a risk factor for developing hypertension from prehypertension. Chin Med J (Engl) 2023:00029330-990000000-00475. [PMID: 37027402 DOI: 10.1097/cm9.0000000000002111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND There is little published evidence about the role of non-alcoholic fatty liver disease (NAFLD) in the progression from prehypertension to hypertension. This study was conducted to investigate the association of NAFLD and its severity with the risk of hypertension developing from prehypertension. METHODS The study cohort comprised 25, 433 participants from the Kailuan study with prehypertension at baseline; those with excessive alcohol consumption and other liver diseases were excluded. NAFLD was diagnosed by ultrasonography and stratified as mild, moderate, or severe. Univariable and multivariable Cox proportional hazard regression was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of incident hypertension according to the presence and 3 categories of severity of NAFLD. RESULTS During a median of 12.6 years of follow-up, 10,638 participants progressed to hypertension from prehypertension. After adjusting for multiple risk factors, patients with prehypertension and NAFLD had a 15% higher risk of incident hypertension than those without NAFLD (HR = 1.15, 95% CI 1.10-1.21). Moreover, the severity of NAFLD was associated with the incidence of hypertension, which was higher in patients with more severe NAFLD (HR = 1.15 [95% CI 1.10-1.21] in the mild NAFLD group; HR = 1.15 [95% CI 1.07-1.24] in the moderate NAFLD group; and HR = 1.20 [95% CI 1.03-1.41] in the severe NAFLD group). Subgroup analysis indicated that age and baseline systolic blood pressure may modify this association. CONCLUSIONS NAFLD is an independent risk factor for hypertension in patients with prehypertension. The risk of incident hypertension increases with the severity of NAFLD.
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Affiliation(s)
- Qirui Song
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Qianhui Ling
- State Key Laboratory of Cardiovascular Disease of China, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Luyun Fan
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yue Deng
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Qiannan Gao
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Ruixue Yang
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei 063000, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei 063000, China
| | - Jun Cai
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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Zhong H, Shao Y, Guo G, Zhan Y, Liu B, Shao M, Li L. Association between the triglyceride-glucose index and arterial stiffness: A meta-analysis. Medicine (Baltimore) 2023; 102:e33194. [PMID: 36897703 PMCID: PMC9997783 DOI: 10.1097/md.0000000000033194] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/14/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Studies have shown a strong association between the triglyceride-glucose (TyG) index, a simple marker of insulin resistance, and various metabolic diseases. We performed a systematic review of the interaction between the TyG index and arterial stiffness. METHODS Relevant observational studies assessing the association between the TyG index and arterial stiffness were thoroughly searched in PubMed, Embase, and Scopus, and a manual search of the preprint server was conducted. A random-effects model was utilized to analyze the data. The risk of bias for the included studies was assessed using the Newcastle-Ottawa Scale. A pooled effect size estimate with a random-effects model was used for the meta-analysis. RESULTS Thirteen observational studies comprising 48,332 subjects were included. Of these, 2 were prospective cohort studies, and the remaining 11 were cross-sectional studies. According to the results of the analysis, the risk of developing high arterial stiffness was 1.85 times greater for those in the highest TyG index subgroup versus the lowest group (risk ratio [RR]: 1.85, 95% confidence interval: 1.54-2.33, I2 = 70%, P < .001). Consistent results were observed when the index was analyzed as a continuous variable (RR: 1.46, 95% confidence interval: 1.32-1.61, I2 = 77%, P < .001). A sensitivity analysis excluding each of the studies one by one yielded similar results (RRs for categorical variables: 1.67-1.94, P all <.001; RRs for continuous variables: 1.37-1.48, P all <.001). A subgroup analysis showed that different characteristics of the study subjects, such as type of study design, age, population, disease status, (including hypertension and diabetes), and pulse wave velocity measurement methods had no substantial effect on the results (P for subgroup analysis, all >0.05). CONCLUSIONS A relatively high TyG index might be linked to an increased incidence of arterial stiffness.
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Affiliation(s)
- Huiqin Zhong
- Department of Gastroenterology, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Ya Shao
- Sino-Canada Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Guangling Guo
- Sino-Canada Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Yan Zhan
- Department of Nursing, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Bin Liu
- Department of Pharmacy, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Meiling Shao
- Department of Pharmacy, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Longti Li
- Department of Nursing, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
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Zhao Y, Yang X, Wu Y, Huang H, Hu F, Zhang M, Sun L, Hu D. Association of triglyceride-glucose index and its 6-year change with risk of hypertension: A prospective cohort study. Nutr Metab Cardiovasc Dis 2023; 33:568-576. [PMID: 36642606 DOI: 10.1016/j.numecd.2022.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM We aimed to investigate the association of triglyceride-glucose (TyG) index and its dynamic change with risk of hypertension in rural Chinese and, further, to explore whether the TyG index mediates the obesity-related hypertension. METHODS AND RESULTS A prospective cohort study, including 10,309 subjects without hypertension at baseline, was conducted in 2007-2008 and followed up in 2013-2014. TyG index was calculated as Ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Logistic regression model was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Mediation analysis was performed to examine the contribution of the TyG index to the association of obesity-hypertension incidence. During a median follow-up of 6 years, 2073 subjects developed hypertension. In multivariate logistic model adjusted for age, sex, alcohol drinking, smoking, physical activity and education, monthly income, family history of hypertension, TC, and HDL-C, the risk of hypertension was 1.14 (1.07-1.22) for per-SD increase in TyG. After additional controlling for obesity, this association was nonsignificant (1.06, 0.99-1.13) and (1.05, 0.99-1.13) for BMI and WC, respectively. Increasing trends were found for hypertension incidence as the TyG change increased, with or without adjustment for obesity (all Ptrend < 0.05). With per-SD increment in TyG change, the risks of hypertension incidence were 1.14 (1.07-1.22) for absolute TyG change, and 1.15 (1.08-1.22) for relative TyG change in multivariate logistic model; the results were significant after further adjustment for BMI or WC, respectively. The TyG index partially mediated the obesity-incident hypertension association: 6.84% for BMI and 6.68% for WC, respectively. CONCLUSIONS Elevated TyG index and its dynamic change were positively associated with risk of incident hypertension in rural Chinese population, and the TyG index may play a partially mediating role in obesity-related incident hypertension.
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Affiliation(s)
- Yang Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xingjin Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yuying Wu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Hao Huang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Liang Sun
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Dongsheng Hu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
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Zhang F, Kadierding R, Zhang S, Yang H, Ren L, Ren M, Ma Y, Wang L, Zhang R, Li W, Cong H, Zhang Y. Triglyceride Glucose Index for Predicting Major Adverse Cardiovascular Events in Chinese Patients with Hypertension. Angiology 2023; 74:259-267. [PMID: 35621187 DOI: 10.1177/00033197221104559] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We conducted a longitudinal study (from February 2017 to July 2017) to explore whether the triglyceride glucose index (TyG) index has a prognostic value for major adverse cardiovascular events (MACE) among high-risk Chinese hypertensives. The study population were from 6 districts of Tianjin, China. Finally, a total of 2250 patients were enrolled in this 3.5 year cohort study. The patients were divided into two groups according to the cut-off value of the TyG index: Low-TyG group (n = 901, TyG ≤ 8.87), High-TyG group (n = 1349, TyG > 8.87). Univariate and multivariate Cox regression analyses were used to estimate the relationship between the TyG and MACE. In multivariate cox regression analyses, the hazard ratio (HR) (95% confidence interval (CI)) of the high-TyG group was 1.313 (1.010, 1.708) compared with the low-TyG group. In those with an age ≤65 years and male subgroups, the prediction value of TyG was higher, and the risk of occurrence of MACE greater after adjusting other risk factors. The TyG index is an indicator to predict the development of MACE in hypertensive patients.
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Affiliation(s)
- Fomin Zhang
- Thoracic Clinical College, 12610Tianjin Medical University, Tianjin, China
| | - Rena Kadierding
- Thoracic Clinical College, 12610Tianjin Medical University, Tianjin, China
| | - Shihan Zhang
- Thoracic Clinical College, 12610Tianjin Medical University, Tianjin, China
| | - Hua Yang
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China
| | - Libin Ren
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China
| | - Min Ren
- Tianjin Cardiovascular Institute, 499773Tianjin Chest Hospital, Tianjin, China
| | - Yue Ma
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China
| | - Le Wang
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China
| | - Rui Zhang
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China
| | - Wenyu Li
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China
| | - Hongliang Cong
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China
| | - Yingyi Zhang
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China
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Aktas H, Gul M, Inci S, Yildirim O, Turgut M. The effect of insulin resistance on the heart rate recovery in healthy individuals with a low-to-moderate cardiovascular disease risk profile. J Investig Med 2023; 71:482-488. [PMID: 36825620 DOI: 10.1177/10815589231158040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
The association between insulin resistance (IR) and heart rate recovery index (HRRI) has been reported previously, but the cardiovascular disease (CVD) risk profile of the subjects was unclear in these studies. Therefore, we evaluated the association between IR and HRRI in apparently healthy individuals without metabolic syndrome who had a low-to-moderate CVD risk profile. A total of 182 eligible subjects were retrospectively included in the study. The subjects were divided into two groups according to the homeostasis model assessment of IR (HOMA-IR) value. HOMA-IR ≥2.5 was defined as IR (+) group (92 subjects), and <2.5 as IR (-) group (88 subjects). HRRI-2 was found by subtracting the heart rate at the second minute in the post-exercise recovery period from the maximum heart rate. Abnormal HRRI was defined as HRRI-2 that is ≤42 beats. The mean age of the patients was 41.91 ± 8.64 and 49.4% of them were female. Abnormal HRRI rates were significantly higher in the IR (+) group (37.2% vs 18.2%; p = 0.004). A negative correlation was detected between HRRI-2 and HOMA-IR (r = -0.416; p < 0.001). HOMA-IR (Odds Ratio (OR) = 1.57; confidence interval (CI) = 1.10-2.23; p = 0.013) and maximum heart rate during exercise (OR = 0.95; CI = 0.91-0.99; p = 0.013) as independent variables of abnormal HRRI. The HOMA-IR value of 2.82 was identified as an effective cutoff point for the prediction of abnormal HRRI (area under the curve: 0.658; CI: 0.570-0.746; p = 0.001). In this study, it was shown that IR without metabolic syndrome reduces HRRI in healthy individuals with a low-to-moderate CVD risk profile.
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Affiliation(s)
- Halil Aktas
- Department of Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Murat Gul
- Department of Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Sinan Inci
- Department of Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Oguz Yildirim
- Department of Cardiology, Aksaray Education and Research Hospital, Aksaray, Turkey
| | - Mustafa Turgut
- Department of Internal Medicine, Aksaray Education and Research Hospital, Aksaray, Turkey
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Miao M, Bi Y, Hao L, Bao A, Sun Y, Du H, Song L, You S, Zhong C. Triglyceride-glucose index and short-term functional outcome and in-hospital mortality in patients with ischemic stroke. Nutr Metab Cardiovasc Dis 2023; 33:399-407. [PMID: 36586773 DOI: 10.1016/j.numecd.2022.11.004] [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: 09/07/2022] [Revised: 10/12/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND AIMS The triglyceride-glucose (TyG) index has been demonstrated as an independent marker of ischemic stroke. Whether TyG index predicts short-term outcomes in patients with ischemic stroke remains uncertain. The aim of the study was to investigate the early prognosis value of TyG index in ischemic stroke patients. METHODS AND RESULTS A total of 3216 acute ischemic stroke patients from 22 hospitals were included in this analysis. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Logistic regression model was performed to estimate the relationship between TyG index and unfavorable functional outcome of death or disability (modified Rankin Scale score of 4-6) at discharge. Risk reclassification with TyG index to predict unfavorable functional outcome was analyzed. During hospitalization, 748 patients (23.3%) experienced poor functional outcome and 105 patients (3.3%) died from all causes. The multivariable adjusted odds ratios for the highest versus lowest quartile of TyG index was 1.62 (95% CI 1.15-2.29) for unfavorable functional outcome at discharge. The addition of TyG index to the conventional model improved the risk reclassification (net reclassification improvement 10.37%; integrated discrimination improvement 0.27%; both p < 0.05) for poor functional outcome. Moreover, TyG index was associated with an odds ratio (95% CI) of 1.26 (1.02-1.55) for an ordinal shift in mRS score and 2.49 (1.21-5.12) for in-hospital mortality. CONCLUSIONS Higher TyG index was associated with higher risk of unfavorable functional outcome at discharge and in-hospital mortality, implicating the significant short-term prognostic effect of TyG index in patients with ischemic stroke.
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Affiliation(s)
- Mengyuan Miao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yucong Bi
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Lijun Hao
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Anran Bao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Yaming Sun
- Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215600, China
| | - Huaping Du
- Department of Neurology, The Affiliated Wujiang Hospital of Nantong University, Suzhou 215200, China
| | - Liyan Song
- Department of Neurology, The First People's Hospital of Taicang, Suzhou 215400, China
| | - Shoujiang You
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
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Fatty liver index predicts the development of hypertension in a Japanese general population with and without dysglycemia. Hypertens Res 2023; 46:879-886. [PMID: 36631554 DOI: 10.1038/s41440-022-01161-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 01/13/2023]
Abstract
Fatty liver has been suggested to be associated with the development of hypertension. However, whether this association is related to glycemia has not been elucidated. Therefore, we investigated whether the fatty liver index (FLI) predicts the development of hypertension among individuals with and without dysglycemia in a general Japanese population. A total of 3114 participants (1036 males and 2078 females) without hypertension who underwent a Specific Health Checkup in the fiscal year 2013 were followed up until 2018. The participants were divided into six groups based on FLI tertiles (low, moderate, or high) and whether they had dysglycemia. We estimated the hazard ratios (HRs) of each group by sex using the Cox proportional hazard model. Models were adjusted for age, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, smoking, and alcohol consumption and further adjusted for systolic blood pressure (SBP). During the mean follow-up period of 2.8 years, 160 of the 3114 participants developed hypertension. Using the low FLI group with normoglycemia as a reference, the HR for incident hypertension was increased in the high FLI group with and without dysglycemia in both sexes after adjusting for confounders, except SBP (HR [95% confidence interval]: male: 1.52 (1.06-2.17) in normoglycemia and 2.05 (1.43-2.92) in dysglycemia, and female: 1.86 (1.43-2.42) in normoglycemia and 2.98 (2.19-4.07) in dysglycemia). Furthermore, in females, this association was observed after adjusting for SBP. We concluded that FLI was independently associated with an increased risk of incident hypertension in individuals with and without dysglycemia.
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Relationship between the triglyceride-glucose index and the SYNTAX score 2 in patients with non-ST elevation myocardial infarction. Cardiovasc Endocrinol Metab 2023; 12:e0277. [PMID: 36699193 PMCID: PMC9829247 DOI: 10.1097/xce.0000000000000277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/12/2022] [Indexed: 01/10/2023]
Abstract
We evaluated if admissiontriglyceride-glucose index (TyG index) correlated with the anatomical synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score 2 in non-ST elevation myocardial infarction (NSTEMI), nondiabetic patients. Methods SYNTAX score 2 (SSII) was retrospectively evaluated in 260 nondiabetic patients hospitalized with NSTEMI who underwent coronary angiography. The TyG index was calculated using the following equation: log [fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. We stratified patients according to tertiles of SSII (≤21.5, 21.5-30.6, and ≥30.6). These score ranges were defined as SSII low, SSII mid, and SSII high, respectively. Results The average age of the patients was 57.2 ± 10.9 years; 135 patients (52.2%) were males. The average TyG index was 8.68 ± 0.12, and SSII was 18.9 ± 9.9. A moderate correlation was found between TyG index and SSII (r = 0.347; P < 0.001) and TyG index was independent risk factors for SSII high [odds ratio (OR), 6.0; 95% CI, 2.7-17.0; P < 0.001]. Conclusion In nondiabetic patients with NSTEMI, TyG index correlated with the SSII.
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Tan L, Long LZ, Ma XC, Yang WW, Liao FF, Peng YX, Lu JM, Shen AL, An DQ, Qu H, Fu CG. Association of body mass index trajectory and hypertension risk: A systematic review of cohort studies and network meta-analysis of 89,094 participants. Front Cardiovasc Med 2023; 9:941341. [PMID: 36684600 PMCID: PMC9846820 DOI: 10.3389/fcvm.2022.941341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 12/02/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Body mass index (BMI) trajectories, such as non-linear time trends and nonlinear changes in BMI with age, can provide information on the underlying temporal health patterns. The relationship between BMI trajectories and the risk of hypertension remains controversial. Methods PubMed, Embase, Cochrane, Scopus, and Web of Science databases were searched from their inception to January 31, 2022. We categorized BMI trajectories as "Stable high," "table normal," "Stable low," "Fluctuated (sharp increase)," and "Fluctuated (elevated-decrease)." The main outcome was the relative risk for the prevalence of hypertension in the different BMI trajectories. Potential sources of heterogeneity were examined using meta-regression and subgroup analysis. A publication bias test and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach were also used. Results The 18 cohort studies included 89,094 participants. Compared with the "Stable normal" trajectory, "Stable high," "Fluctuated (sharp increase)," and "Fluctuated (elevated-decrease)" trajectories were associated with an increased relative risk of hypertension: [RR (95% CI)]: 1.80 (1.29 2.50), p < 0.001; 1.53 (1.27 1.83), p < 0.001; 1.30 (1.24 1.37), p = 0.001, respectively. The "Stable low" trajectory was associated with a reduced risk of hypertension [0.83 (0.79 0.83), p < 0.001]. The "Stable high" trajectory (surface under the cumulative ranking curve = 88.1%) had the highest probability of developing hypertension in the population. The certainty of the evidence for direct comparisons of the incidence of hypertension between various BMI trajectories was generally very low. Conclusion Our findings suggested that "Stable high," "Fluctuated (sharp increase)," and "Fluctuated (elevated-decrease)" trajectories were associated with an increased relative risk of hypertension, with the "Stable high" trajectory most likely associated with hypertension. Systematic review registration [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=308575], identifier [CRD42022308575].
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Affiliation(s)
- Ling Tan
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lin-zi Long
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiao-chang Ma
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Cardiovascular Clinical Medical Research Center of TCM, Beijing, China
| | - Wen-wen Yang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fei-fei Liao
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Yu-xuan Peng
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Jie-ming Lu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - A-ling Shen
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Dong-qing An
- Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University, Ürümqi, China
| | - Hua Qu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Cardiovascular Clinical Medical Research Center of TCM, Beijing, China,Hua Qu,
| | - Chang-geng Fu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Cardiovascular Clinical Medical Research Center of TCM, Beijing, China,*Correspondence: Chang-geng Fu,
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Wang Y, Ye C, Kong L, Zheng J, Xu M, Xu Y, Li M, Zhao Z, Lu J, Chen Y, Wang W, Ning G, Bi Y, Wang T. Independent Associations of Education, Intelligence, and Cognition With Hypertension and the Mediating Effects of Cardiometabolic Risk Factors: A Mendelian Randomization Study. Hypertension 2023; 80:192-203. [PMID: 36353998 PMCID: PMC9722390 DOI: 10.1161/hypertensionaha.122.20286] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Education, intelligence, and cognition are associated with hypertension, but which one plays the most prominent role in the pathogenesis of hypertension and which modifiable risk factors mediate the causal effects remains unknown. METHODS Using summary statistics of genome-wide association studies of predominantly European ancestry, we conducted 2-sample multivariable Mendelian randomization to estimate the independent effects of education, intelligence, or cognition on hypertension (FinnGen study, 70 651 cases/223 663 controls; UK Biobank, 77 723 cases/330 366 controls) and blood pressure (International Consortium of Blood Pressure, 757 601 participants), and used 2-step Mendelian randomization to evaluate 25 potential mediators of the association and calculate the mediated proportions. RESULTS Meta-analysis of inverse variance weighted Mendelian randomization results from FinnGen and UK Biobank showed that genetically predicted 1-SD (4.2 years) higher education was associated with 44% (95% CI: 0.40-0.79) decreased hypertension risk and 1.682 mm Hg lower systolic and 0.898 mm Hg lower diastolic blood pressure, independently of intelligence and cognition. While the causal effects of intelligence and cognition on hypertension were not independent of education; 6 out of 25 cardiometabolic risk factors were identified as mediators of the association between education and hypertension, ranked by mediated proportions, including body mass index (mediated proportion: 30.1%), waist-to-hip ratio (22.8%), body fat percentage (14.1%), major depression (7.0%), high-density lipoprotein cholesterol (4.7%), and triglycerides (3.4%). These results were robust to sensitivity analyses. CONCLUSIONS Our findings illustrated the causal, independent impact of education on hypertension and blood pressure and outlined cardiometabolic mediators as priority targets for prevention of hypertension attributable to low education.
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Affiliation(s)
- Yiying Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.)
| | - Chaojie Ye
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.)
| | - Lijie Kong
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.)
| | - Jie Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, United Kingdom (J.Z.)
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.)
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.)
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.)
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.)
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.)
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.)
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.)
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.)
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.)
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (Y.W., C.Y., L.K., J.Z., M.X., Y.X., M.L., Z.Z., J.L., Y.C., W.W., G.N., Y.B., T.W.)
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Wang Z, Zhu M, Huang Y, Cao J, Xiong Z. High blood pressure mediated the effect of fasting insulin level on nonalcoholic fatty liver disease risk: A Mendelian randomization study. Digit Health 2023; 9:20552076231216682. [PMID: 38025107 PMCID: PMC10666686 DOI: 10.1177/20552076231216682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 12/01/2023] Open
Abstract
Objective The interactions between fasting insulin levels, high blood pressure and nonalcoholic fatty liver disease (NAFLD) are still unclear. We examined the causal mechanisms between these three cardiometabolic traits using Mendelian randomization (MR) approach by utilizing genetic instruments. Methods Three different genome-wide association studies resources of European ancestry were utilized for the present study. Two-sample MRs were used to assess causal effects between fasting insulin levels, high blood pressure and NAFLD. Multivariate MR was used to calculate the mediating effect. The inverse variance-weighted method was used as the main analysis method. Results Our study confirmed a causal effect of fasting insulin levels (IVW-OR = 9.54, P = 0.001) and high blood pressure (IVW-OR = 3.926, P = 0.005) on NAFLD risk. And fasting insulin level was positively casually associated with high blood pressure risk (IVW-OR = 1.170, P < 0.001). However, the impact of high blood pressure on fasting insulin levels was still uncertain because of the presence of horizontal pleiotropy. Reverse MR showed NAFLD had a positive correlation with fasting insulin levels (IVW-OR = 1.010, P < 0.001) and a negative causal effect on high blood pressure risk (IVW-OR = 0.997, P = 0.037). Combined the multivariate MR result revealed high blood pressure partially mediated the contribution of fasting insulin level to NAFLD risk (proportion mediated: 9.091%). Conclusions Our study suggests there is a bidirectional causal relationship between fasting insulin levels and NAFLD. High blood pressure seems to play a mediating role in the development of NAFLD caused by changes in fasting insulin levels. However, it is uncertain whether high blood pressure is a mediator between NAFLD and the risk of fasting insulin level.
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Affiliation(s)
- Ziwen Wang
- Department of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengpei Zhu
- Department of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yumei Huang
- Department of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiali Cao
- Department of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhifan Xiong
- Department of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Shan S, Li S, Lu K, Cao J, Sun W, Zhou J, Ren Z, Zhu S, Hou L, Chen D, Song P. Associations of the Triglyceride and Glucose Index With Hypertension Stages, Phenotypes, and Their Progressions Among Middle-Aged and Older Chinese. Int J Public Health 2023; 68:1605648. [PMID: 37020526 PMCID: PMC10067654 DOI: 10.3389/ijph.2023.1605648] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/06/2023] [Indexed: 04/07/2023] Open
Abstract
Objectives: To assess the associations of the triglyceride and glucose (TyG) index with hypertension stages, phenotypes, and their progressions. Methods: The data originated from the China Health and Retirement Longitudinal Study. Multinomial logistic regression investigated the associations of the TyG index with hypertension stages (stage 1, stage 2), phenotypes (isolated systolic hypertension [ISH], isolated diastolic hypertension [IDH], systolic diastolic hypertension [SDH]), their progressions. Results: Compared with the lowest quartile of TyG index, the highest quartile was associated with increased risks of stage 1 hypertension (OR 1.71, 95% CI 1.38-2.13), stage 2 (1.74, 1.27-2.38), ISH (1.66, 1.31-2.11), IDH (2.52, 1.26-5.05), and SDH (1.65, 1.23-2.23). Similar results were found when TyG index was a continuous variable. From 2011 to 2015, a higher baseline TyG index was associated with normotension to stage 1 (per-unit: 1.39, 1.16-1.65), normotension to ISH (per-unit: 1.28, 1.04-1.56), and normotension to IDH (per-unit: 1.94, 1.27-2.97). Conclusion: The TyG index was associated with different hypertension stages, phenotypes, their progressions, and could be served as a surrogate indicator for early hypertension management.
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Affiliation(s)
- Shiyi Shan
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuting Li
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Keyao Lu
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jin Cao
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weidi Sun
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiali Zhou
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ziyang Ren
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Institute of Reproductive and Child Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Siyu Zhu
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Leying Hou
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dingwan Chen
- School of Public Health, Hangzhou Medical College, Hangzhou, China
- *Correspondence: Dingwan Chen, ; Peige Song,
| | - Peige Song
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Dingwan Chen, ; Peige Song,
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Gutiérrez-Lara EJ, Sánchez-López A, Murbartián J, Acosta-Cota SJ, Centurión D. Effect of chronic administration of 17β-estradiol on the vasopressor responses induced by the sympathetic nervous system in insulin resistance rats. Steroids 2022; 188:109132. [PMID: 36273542 DOI: 10.1016/j.steroids.2022.109132] [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: 07/23/2022] [Revised: 09/14/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
Several studies have demonstrated that the underlying mechanism of insulin resistance (IR) is linked with developing diseases like diabetes mellitus, hypertension, metabolic syndrome, and polycystic ovary syndrome. In turn, the dysfunction of female gonadal hormones (especially 17β-estradiol) may be related to the development of IR complications since different studies have shown that 17β-estradiol has a cardioprotector and vasorelaxant effect. This study aimed was to determine the effect of the 17β-estradiol administration in insulin-resistant rats and its effects on cardiovascular responses in pithed rats. Thus, the vasopressor responses are induced by sympathetic stimulation or i.v. bolus injections of noradrenaline (α1/2), methoxamine (α1), and UK 14,304 (α2) adrenergic agonist were determined in female pithed rats with fructose-induced insulin resistance or control rats treated with: 1) 17β-estradiol or 2) its vehicle (oil) for 5 weeks. Thus, 17β-estradiol decreased heart rate, prevented the increase of blood pressure induced by ovariectomy, but with the opposite effect on sham-operated rats; and decreased vasopressor responses induced by i.v. bolus injections of noradrenaline on sham-operated (control and fructose group) and ovariectomized (control) rats, and those induced by i.v. bolus injections of methoxamine (α1 adrenergic agonist). Overall, these results suggest 17β-estradiol has a cardioprotective effect, and its effect on vasopressor responses could be mediated mainly by the α1 adrenergic receptor. In contrast, IR with ovariectomy 17β-estradiol decreases or loses its cardioprotector effect, this could suggest a possible link between the adrenergic receptors and the insulin pathway.
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Affiliation(s)
- Erika J Gutiérrez-Lara
- Departamento de Farmacobiología, Cinvestav Unidad Coapa, Czda. de los Tenorios 235, Col. Granjas-Coapa, Deleg. Tlalpan, C.P. 14330 México City, México
| | - Araceli Sánchez-López
- Departamento de Farmacobiología, Cinvestav Unidad Coapa, Czda. de los Tenorios 235, Col. Granjas-Coapa, Deleg. Tlalpan, C.P. 14330 México City, México
| | - Janet Murbartián
- Departamento de Farmacobiología, Cinvestav Unidad Coapa, Czda. de los Tenorios 235, Col. Granjas-Coapa, Deleg. Tlalpan, C.P. 14330 México City, México
| | - Selene J Acosta-Cota
- Departamento de Ciencias de la Salud, Universidad Autónoma de Occidente, Blv. Lola Beltrán y Blv. Rolando Arjona. S/N, Col. 4 de marzo, C.P. 80020 Culiacán, Sinaloa, México
| | - David Centurión
- Departamento de Farmacobiología, Cinvestav Unidad Coapa, Czda. de los Tenorios 235, Col. Granjas-Coapa, Deleg. Tlalpan, C.P. 14330 México City, México.
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Emlek N, Aydin C. The relationship between nondipper hypertension and triglyceride glucose index. Blood Press Monit 2022; 27:384-390. [PMID: 36094366 DOI: 10.1097/mbp.0000000000000618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Nondipper hypertensive patients have an increased incidence of damage to end organs, including the brain, heart, and kidney, and a worse cardiovascular prognosis. The triglyceride glucose (TyG) index is a reliable indicator of insulin resistance (IR) and is closely related to the traditional risk factors of cardiovascular disease. To the best of our knowledge, whether there is a relationship between the TyG index and impaired diurnal blood pressure (BP) has not been investigated. This study aimed to compare the TyG index between normotensive, nondipper, and dipper hypertensive patients. A total of 1037 patients grouped according to the results of ambulatory BP monitoring were included, with group 1 including dipper hypertensive ( n = 368), group 2 including nondipper hypertensive ( n = 496), and group 3 including normotensive control ( n = 173) patients. In both the univariate and multivariate logistic regression analyses, TyG index [odds ratio (OR), 4.656; 95% confidence interval (CI), 3.014-7.193; P < 0.001], age (OR, 1.011; 95% CI, 1.002-1.021; P = 0.018), and glomerular filtration rate (GFR) (OR, 0.979; 95% CI, 0.971-0.987; P < 0.001) were independent predictors of nondipper hypertension (HT). In the ROC analysis, a TyG index cutoff value of at least 4.74 predicted nondipper hypertensive patients with a sensitivity of 59.7%, and a specificity of 59.9% [area under the curve = 0.647 (0.614-0.680); 95% CI; P < 0.001]. We showed that TyG index, age, and GFR are independent predictors in patients with nondipper HT. TyG index, a simple, cost-effective, and rapid tool can predict the nondipper pattern in essential HT.
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Affiliation(s)
- Nadir Emlek
- Department of Cardiology, Faculty of Medicine Recep Tayyip Erdoğan University, Rize
| | - Cihan Aydin
- Department of Cardiology, Faculty of Medicine, Namik Kemal University, Tekirdağ, Turkey
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