The association of plant-based dietary patterns with visceral adiposity, lipid accumulation product, and triglyceride-glucose index in Iranian adults

Association of triglyceride glucose-related parameters with all-cause mortality and cardiovascular disease in NAFLD patients: NHANES 1999-2018

BACKGROUND

The relationship between the triglyceride-glucose (TyG) index and its derived index, the triglyceride glucose-waist height ratio (TyG-WHtR), with mortality and cardiovascular diseases (CVDs) in patients with non-alcoholic fatty liver disease (NAFLD) remains unclear.

METHODS

This study enrolled 6627 adults aged 18 and above diagnosed NAFLD from the National Health and Nutrition Examination Survey (NHANES, 1999-2018). Binary weighted logistic regression analyses, cox proportional hazards model and restricted cubic spline (RCS) were used to analyze the relationship between TyG and TyG-WHtR with all-cause mortality, CVD mortality and CVDs. Mediation analysis explored the mediating role of glycohemoglobin, insulin and hypertension in the above relationships. Meanwhile, the incremental predictive value of the TyG index and TyG-WHtR was further assessed.

RESULTS

Except for no significant association between the TyG index and both all-cause mortality and chronic heart failure (CHF), both TyG and TyG-WHtR exhibited significant positive correlations or trends of positive correlation with all-cause mortality, CVD mortality, total-CVD, CHF, coronary heart disease (CHD) and angina pectoris. For all-cause mortality, CVD mortality and CHF, TyG-WHtR was a better predictor than TyG (TyG-WHtR: HR 1.31, 95%CI 1.03-1.66; HR 2.22, 95%CI 1.42-3.47; OR 3.99, 95%CI 1.79-8.93). In contrast, TyG index demonstrated a stronger association with total-CVD, CHD and angina pectoris (TyG index: OR 2.00, 95%CI 1.26-3.18; OR 1.85, 95%CI 1.19-2.91; OR 2.93, 95%CI 1.23-7.00). RCS analysis showed that after adjusting for covariates, most of the aforementioned relationships were linear(P overall < 0.0001, P-nonlinear > 0.05), while the associations of the TyG index and TyG-WHtR with all-cause mortality and CHF were non-linear(P overall < 0.0001, P nonlinear < 0.05). The addition of the TyG index and TyG-WHtR to the basic model for outcomes improved the C-statistics, net reclassification improvement value, and integrated discrimination improvement value.

CONCLUSIONS

The predictive value of TyG or TyG-WHtR for all-cause mortality and cardiovascular risk in NAFLD patients was significant. The TyG index and TyG-WHtR might be valid predictors of cardiovascular outcomes of patients with NAFLD.

The association between dietary inflammatory index with some cardio-metabolic risk indices among the patients with type 2 diabetes from Hoveyzeh cohort study: a cross-sectional study

BACKGROUND

The dietary inflammatory index (DII) serves as a tool to assess the inflammatory impact of an individual's diet. This study aimed to investigate the association between DII and some cardio-metabolic risk indices among patients with T2DM.

METHODS

Data from the Hoveyzeh Cohort Study, encompassing 2045 adults with T2DM, were analyzed. DII scores were calculated based on food frequency questionnaires. Anthropometric measurements and biochemical tests were performed to assess cardio-metabolic risk factors.

RESULTS

Higher DII scores were positively associated with elevated triglyceride levels, triglyceride-glucose (TyG) index, lipid accumulation product (LAP), anthropometric indices including a body shape index (ABSI), body roundness index (BRI), body mass index (BMI), hip, waist circumferences (WC), and waist-to-height ratio (all Ptrend < 0.05). Notably, no significant association was observed between DII and fasting blood sugar (FBS) levels (Ptrend > 0.05). Additionally, dietary intake analysis revealed a negative correlation between DII scores and intake of fiber, fruits, vegetables, legumes, fish, seafood, dairy products, magnesium, and vitamins A, C, D, and E (all Ptrend < 0.05). Conversely, higher DII scores were associated with increased consumption of red meat, processed meat, refined cereals, potatoes, and soft drinks (all Ptrend < 0.05).

CONCLUSION

This study underscores the critical link between dietary inflammation, assessed by the DII score, and a multitude of cardio-metabolic risk factors in patients with T2DM. Notably, while the study did not find a significant association between DII and fasting blood sugar levels, it identified robust associations with novel anthropometric and biochemical indices indicative of cardio-metabolic risk. These findings highlight the potential of dietary interventions as a cornerstone strategy for managing T2DM and mitigating its associated complications.

A plant-based diet index to study the relation between diet and disease risk among adults: a narrative review

Plant-based diets (PBD) may offer various health benefits and contribute to a sustainable way of life, but, if not planned correctly, may also confer risks, e.g., by focusing on plant foods with low nutrient density, such as foods primarily consisting of refined carbohydrates. A plant-based diet index (PDI) differentiating between a healthful, unhealthful, and overall PBD, offers a promising approach to standardize and compare studies and integrate results. In this review we (1) summarize current evidence on the PDI and disease risk of relevance to public health, (2) discuss the methodology of the PDI and how it can be sensibly applied in further studies and (3) indicate areas with a lack of knowledge, such as vulnerable populations. In summary, our amalgamation shows, that adherence to a healthier plant-based diet is associated with an 8-68% lower risk for metabolic risk factors, diabetes, and cardiovascular disease, while adherence to an unhealthier plant-based diet is associated with a 10-63% higher risk. Although differences in calculation methods and underlying diet patterns between populations should be accounted for, the PDI can be a useful tool to assess adherence to different plant-based diet patterns and their association with health outcomes in cohort studies across cultures.

The Effect of a Program to Improve Adherence to the Mediterranean Diet on Cardiometabolic Parameters in 7034 Spanish Workers

BACKGROUND

Cardiovascular and metabolic diseases include a large group of pathologies and constitute one of the most serious chronic health problems facing the 21st century, with high rates of morbidity and mortality worldwide. Unhealthy diets influence the development of these pathologies. The Mediterranean diet can be an important part in the treatment of these diseases. The objective of this study was to assess the effect of a program that aims to increase adherence to the Mediterranean diet on the improvement of different cardiometabolic risk parameters.

METHODS

A prospective intervention study was carried out on 7034 Spanish workers. Prior to the intervention, 22 cardiometabolic risk scales were evaluated. Participants in this study were informed both orally and in writing of the characteristics and benefits of the Mediterranean diet and were given the website of the Ministry of Health, Consumption and Social Welfare of Spain, which provides advice on nutrition. Adherence to the Mediterranean diet was reinforced by sending a monthly SMS to their mobile phones. After six months of follow-up, the 22 risk scales were re-evaluated to assess changes. Means and standard deviations were calculated using Student's t test to analyse quantitative variables. Prevalence was calculated using the Chi-square test when the variables were qualitative.

RESULTS

All the cardiometabolic risk scales studied decreased after implementing a program to improve and enhance adherence to the Mediterranean diet. The number of losses in the sample was very low, standing at 4.31%.

CONCLUSIONS

The Mediterranean diet is effective in reducing all cardiovascular risk scales evaluated. The mean values and prevalence of high values of the different cardiometabolic risk scales analysed led to lower values after the implementation of the program to increase adherence to the Mediterranean diet. We observed a significant positive difference in metabolic age in both sexes. We have obtained a significant improvement in the insulin resistance index, especially in the SPISE-IR index, data that we have not found in previous publications. Easy access to the Internet and new information and communication technologies facilitate adherence to a diet and can reduce the number of losses.

Dietary fat types consumption association with obesity and coronary indices

This article aims to study the different dietary fat types associated with obesity and coronary indices. A sample of 491 healthy adults was included in a cross-sectional manner. Dietary fats intake, obesity indices (conicity index (CI), body adiposity index (BAI), abdominal volume index (AVI), body roundness index (BRI), and weight-adjusted-waist index (WWI)), and cardiovascular indices (cardiometabolic index (CMI), lipid accumulation product (LAP), and atherogenic index of plasma (AIP)) were calculated and studied. Participants with an acceptable intake of omega-3 had a higher BRI score (1⋅90 ± 0⋅06 v. 1⋅70 ± 0⋅06). Participants with an unacceptable intake of cholesterol had a higher CI (1⋅31 ± 0⋅11 v. 1⋅28 ± 0⋅12; P = 0⋅011), AVI (20⋅24 ± 5⋅8 v. 18⋅33 ± 6⋅0; P < 0⋅001), BRI (2⋅00 ± 1⋅01 v. 1⋅70 ± 1⋅00; P = 0⋅003), WWI (11⋅00 ± 0⋅91 v. 10⋅80 ± 0⋅97; P = 0⋅032), and lower AIP (0⋅46 ± 0⋅33 v. 0⋅53 ± 0⋅33; P = 0⋅024). Total fat, saturated fat (SFA), and polyunsaturated fat (PUFA) intake had a significant moderate correlation with AVI and BRI. The monounsaturated fat (MUFA) intake had a significantly weak correlation with CI, AVI, BRI, WWI, and AIP. Cholesterol and omega-6 had weak correlations with all indices. Similar correlations were seen among male and female participants. The different types of fat intake significantly affected obesity and coronary indices, especially SFA and PUFA, as well as omega-3 and cholesterol. Gender and the dietary type of fat intake have a relationship to influence the indicators of both obesity and coronary indices.

The association between dietary pattern and visceral adiposity index, triglyceride-glucose index, inflammation, and body composition among Iranian overweight and obese women

The aim of the present study was to investigate the association between dietary patterns, derived through latent class analysis (LCA), with visceral adiposity index (VAI), Triglyceride-Glucose Index (TyG), inflammation biomarkers, and body composition in overweight and obese Iranian women. For this cross-sectional study, dietary exposure was assessed using a validated 147-item semi-quantitative food frequency questionnaire (FFQ). Dietary patterns were derived through LCA. Binary logistic was performed to test the associations of dietary patterns with VAI, TyG, inflammation biomarkers, and body composition. Health centers in Tehran, Iran. 376 obese and overweight women, aged > 18 years. Two dietary patterns were identified using LCA modeling: healthy and unhealthy. Women in the unhealthy class were characterized by higher consumption of fast food, sweetened beverages, grains, unhealthy oils, butter and margarine, and snacks. Compared with the healthy class, the unhealthy class was associated with an increased risk of higher fasting blood sugar (FBS) (OR = 6.07; 95% CI: 1.33-27.74, P value = 0.02), c-reactive protein (CRP) (OR = 1.72; 95% CI: 1.05-2.80; P value = 0.02), and lower fat free mass index (FFMI) (OR = 0.56; 95% CI: 0.35-0.88, P value = 0.01), after adjusting for confounders. We found that adherence to an unhealthy dietary pattern was associated with decreased FFMI and increased FBS and CRP using LCA, but not with the rest of the variables. Further studies should be conducted to confirm the veracity of these findings.

Scoping review of the association of plant-based diet quality with health outcomes

Introduction

The association of plant-based dietary patterns with health outcomes has traditionally been assessed without considering nutritional value. The plant-based dietary index (PDI), first published in 2016, overcomes this limitation with both a healthful PDI (hPDI) and an unhealthful PDI (uPDI), based on the quality of plant foods consumed plus the frequency of animal foods. We sought to summarize the breadth of research using the hPDI and uPDI to gain insight into how the quality of plant-based dietary patterns might be associated with health outcomes.

Methods

Scoping review of studies that used the PDI, hPDI, or uPDI to report associations with health outcomes. Multiple databases were searched from 2010 through April 2023 with 2 authors independently assessing eligibility and extracting data. In addition to assessing the association of the indices to health outcomes, we determined the frequency of concordant or discordant findings for hPDI versus PDI and for hPDI versus uPDI.

Results

We included 95 articles (54% longitudinal, 37% cross-sectional, and 9% case-control) with a median sample size of 3,646. Higher hPDI levels were associated with favorable health outcomes in 36% of comparisons (most often for obesity, mortality, diabetes, cardiovascular disease, and psychiatric disorders), compared to 25% for the PDI and only 2% for the uPDI. Conversely, higher levels of the uPDI were associated with unfavorable health outcomes in 33% of comparisons, in contrast to under 1% for the hPDI and 2% for the PDI. When the hPDI association to an outcome was discordant with the uPDI or PDI, the significance and directionality always favored the hPDI over the uPDI, and nearly always favored the hPDI over the PDI.

Discussion

Dietary indices that account for the quality of plant foods can show health benefits that might be missed by a generic plant-based index. A greater focus on the quality of plant foods could improve nutrition guidelines, raise awareness about the benefits of adding unrefined plant foods to the diet, and empower consumers to make incremental additions of such foods to displace unhealthy foods. We anticipate increasing use of indices that address food quality in future research.

Plant-Based Nutrition: Exploring Health Benefits for Atherosclerosis, Chronic Diseases, and Metabolic Syndrome-A Comprehensive Review

Atherosclerosis, chronic non-communicable diseases, and metabolic syndrome are highly interconnected and collectively contribute to global health concerns that reduce life expectancy and quality of life. These conditions arise from multiple risk factors, including inflammation, insulin resistance, impaired blood lipid profile, endothelial dysfunction, and increased cardiovascular risk. Adopting a plant-based diet has gained popularity as a viable alternative to promote health and mitigate the incidence of, and risk factors associated with, these three health conditions. Understanding the potential benefits of a plant-based diet for human health is crucial, particularly in the face of the rising prevalence of chronic diseases like diabetes, hypertension, dyslipidemia, atherosclerosis, and cancer. Thus, this review focused on the plausible advantages of consuming a type of food pattern for the prevention and/or treatment of chronic diseases, emphasizing the dietary aspects that contribute to these conditions and the evidence supporting the benefits of a plant-based diet for human health. To facilitate a more in-depth analysis, we present separate evidence for each of these three concepts, acknowledging their intrinsic connection while providing a specific focus on each one. This review underscores the potential of a plant-based diet to target the underlying causes of these chronic diseases and enhance health outcomes for individuals and populations.

Healthy plant-based diets improve dyslipidemias, insulin resistance, and inflammation in metabolic syndrome. A narrative review

Plant-based diets (PBDs) have become very popular in recent years and have been identified as a dietary strategy associated with protection against chronic disease. However, the classifications of PBDs vary depending on the type of diet. Some PBDs have been recognized as healthful for their high content of vitamins, minerals, antioxidants, and fiber, or unhealthful if they are high in simple sugars and saturated fat. Depending on this classification, the type of PBD impacts its protective effects against disease dramatically. Metabolic syndrome (MetS), characterized by the presence of high plasma triglycerides and low HDL cholesterol, impaired glucose metabolism, elevated blood pressure, and increased concentrations of inflammatory biomarkers, also increases the risk for heart disease and diabetes. Thus, healthful plant-based diets could be considered favorable for individuals having MetS. The different types of plant-based diets (vegan, lacto-vegetarian, lacto-ovo-vegetarian, or pescatarian) are discussed with a focus on specific effects of dietary components in maintaining a healthy weight, protecting against dyslipidemias, insulin resistance, hypertension, and low-grade inflammation.

Dietary insulin index and insulin load in relation to hypertriglyceridemic waist phenotype and low brain derived neurotrophic factor in adults

Background

The evidence about the relation of the insulinemic potential of food with visceral obesity and brain-derived neurotrophic factor (BDNF) was limited. We aimed to investigate the relation of dietary insulin index (DII) and dietary insulin load (DIL) with hypertriglyceridemic waist phenotype (HTGW) and serum BDNF in Iranian adults.

Methods

This cross-sectional study included 528 middle-aged adults (45.6% women), using a multistage cluster random-sampling method. Dietary intakes were assessed using a validated semi-quantitative 168-item food frequency questionnaire. Blood samples were collected after 12 h of fasting for assessing the serum BDNF and triglyceride concentrations. HTGW was defined as triacylglycerol ≥ 150 mg/dL plus enlarged waist circumference. The values less than the first decile of serum BDNF were considered as the low level.

Results

Individuals in the top tertile of DIL, in comparison to those in the bottom tertile, had higher odds of HTGW in both crude (OR = 1.96, 95% CI: 1.14–3.37) and fully adjusted model (OR = 6.10, 95% CI: 1.58–23.53). However, the relation between DII and odds of HTGW was statistically insignificant in crude (OR = 1.30, 95% CI: 0.78–2.16) and maximally adjusted model (OR = 1.25, 95% CI: 0.65–2.40). After considering confounders, participants in the top tertile of DIL had marginally higher odds of having low BDNF values (OR = 2.00, 95% CI: 0.95–4.21). Nevertheless, the association between DII and odds of low BDNF values was statistically insignificant.

Conclusion

This population-based study demonstrated that adults with higher DIL had significantly higher chance of HTGW phenotype and slightly higher chance for low BDNF level. DII was not associated with HTGW phenotype or BDNF values.

TyG index is positively associated with risk of CHD and coronary atherosclerosis severity among NAFLD patients

Background

Insulin resistance (IR), endothelial dysfunction, inflammation, glucose and lipid metabolism disorders, and thrombosis are believed involved in coronary heart disease (CHD) and non-alcoholic fatty liver disease (NAFLD). Triglyceride-glucose (TyG) index, a new IR indicator, is correlated with NAFLD occurrence and severity, but its relationship with CHD risk remains unclear. This study investigated the correlation between TyG index and CHD risk among NAFLD patients.

Methods

This cross-sectional study included 424 patients with NAFLD and chest pain in the Department of Cardiology, The Second Hospital of Shanxi Medical University, from January 2021 to December 2021. The TyG index was calculated and coronary angiography performed. All individuals were divided into NAFLD + CHD and NAFLD groups and then by TyG index level. The t-test, Mann–Whitney U-test, or one-way analysis of variance compared differences in continuous variables, while the chi-square test or Fisher’s exact test compared differences in categorical variables. Logistic regression analysis determined the independent protective or hazardous factors of NAFLD with CHD. The receiver operating characteristic curve evaluated the ability of different TyG index rule-in thresholds to predict CHD. The relationship between Gensini score and TyG index was evaluated using linear correlation and multiple linear regression.

Results

CHD was detected in 255 of 424 patients. Compared to NAFLD group, multivariate logistic regression showed that TyG index was a risk factor for CHD among NAFLD patients after adjustment for age, sex, hypertension, and diabetes mellitus with the highest odds ratio (OR, 2.519; 95% CI, 1.559–4.069; P < 0.001). TG, low-density lipoprotein cholesterol, FBG and TYG–body mass index were also risk factors for CHD among NAFLD patients. High-density lipoprotein cholesterol level was a protective factor for CHD events in patients with NAFLD. In an in-depth analysis, multivariate logistic regression analysis showed that each 1-unit increase in TyG index was associated with a 2.06-fold increased risk of CHD (OR, 2.06; 95% CI, 1.16–3.65; P = 0.013). The multifactor linear regression analysis showed each 0.1-unit increase in TyG in the NAFLD-CHD group was associated with a 2.44 increase in Gensini score (β = 2.44; 95% CI, 0.97–3.91; P = 0.002).

Conclusions

The TyG index was positively correlated with CHD risk in NAFLD patients and reflected coronary atherosclerosis severity.

Triglyceride-glucose index predicts the risk of gestational diabetes mellitus: a systematic review and meta-analysis

AIMS

We aimed to investigate the potential predictive efficacy of triglyceride-glucose (T/Gly) index for gestational diabetes mellitus (GDM) in a systematic review and meta-analysis.

MATERIALS AND METHODS

Cohort studies demonstrating the association between T/Gly index measured at the first trimester or before pregnancy and the subsequent incidence of GDM were identified by search of PubMed, Embase, China National Knowledge Infrastructure, and WanFang databases. A random-effect model incorporating the heterogeneity was applied to pool the results. Five cohort studies including 382,213 women were included in this meta-analysis.

RESULTS

Compared to those with the lowest category of T/Gly index, women with the highest category of T/Gly index were independently associated with higher risk of subsequent GDM (odds ratio [OR]: 2.52, 95% confidence interval [CI]: 1.33 ∼ 4.67, I²=65%, p=.004) after adjustment of potential confounding factors including age, body mass index, and family history of diabetes. The association was stronger in prospective cohort studies than retrospective cohort studies (p for subgroup difference=.007), and a significant association was detected in Asian women (OR: 3.30, 95% CI: 1.50-7.28, p =.003), but not in non-Asian women (OR: 0.96, 95% CI: 0.35-2.63, p=.94).

CONCLUSIONS

Higher T/Gly index may independently predict the risk of GDM in Asian women.

Association between triglyceride glucose index and risk of cancer: A meta-analysis

BACKGROUND

Triglyceride glucose (TyG) index as a more convenient and reliable predictor of insulin resistance (IR) is thought to be associated with many diseases, but its relationship with cancer remains unclear.

METHODS

The meta-analysis was conducted to evaluate the effects of TyG index on cancer risk utilizing the available evidence. PubMed, EMBASE, Medline, Cochrane Library and Web of Science were searched from their inception up to July 2022. A random-effects model was used to calculate the effect estimates and 95% confidence intervals (CIs).

RESULTS

A total of 6 observational studies met our inclusion criteria, which including 992292 participants. The meta-analysis indicated that the higher TyG index increased cancer risk compared to the lower TyG index group (total effect size =1.14, 95% CI [1.08, 1.20], P<0.001).

CONCLUSIONS

Our meta-analysis found that higher TyG index may increase the risk of cancer. More prospective cohort studies and basic research are warranted to verify the relationship.

The Safe and Effective Use of Plant-Based Diets with Guidelines for Health Professionals

Plant-based diets, defined here as including both vegan and lacto-ovo-vegetarian diets, are growing in popularity throughout the Western world for various reasons, including concerns for human health and the health of the planet. Plant-based diets are more environmentally sustainable than meat-based diets and have a reduced environmental impact, including producing lower levels of greenhouse gas emissions. Dietary guidelines are normally formulated to enhance the health of society, reduce the risk of chronic diseases, and prevent nutritional deficiencies. We reviewed the scientific data on plant-based diets to summarize their preventative and therapeutic role in cardiovascular disease, cancer, diabetes, obesity, and osteoporosis. Consuming plant-based diets is safe and effective for all stages of the life cycle, from pregnancy and lactation, to childhood, to old age. Plant-based diets, which are high in fiber and polyphenolics, are also associated with a diverse gut microbiota, producing metabolites that have anti-inflammatory functions that may help manage disease processes. Concerns about the adequate intake of a number of nutrients, including vitamin B12, calcium, vitamin D, iron, zinc, and omega-3 fats, are discussed. The use of fortified foods and/or supplements as well as appropriate food choices are outlined for each nutrient. Finally, guidelines are suggested for health professionals working with clients consuming plant-based diets.

Triglyceride-Glukose Index Predicts Adverse Events in Patients with Acute Coronary Syndrome: A Meta-Analysis of Cohort Studies

The triglyceride-glucose (TyG) index, a recently proposed indicator for insulin resistance, has been related with cardiovascular risks. We aimed to summarize the association between TyG index and incidence of major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS). Cohort studies demonstrating the association between TyG index and incidence of MACEs in ACS patients with multivariate adjusted analyses were identified by search of PubMed, Embase, and Web of Science databases. A random-effekt model incorporating the heterogeneity was applied to pool the results. Eight cohort studies with 19 611 participants were included. Results showed that compared to those with the lowest category of TyG index, ACS patients with the highest category of TyG index were independently associated with higher risk of MACEs [risk ratio (RR): 1.94, 95% confidence interval (CI): 1.47-2.56, I²=85%, p <0.001). Subgroup analyses showed consistent results in patients with ST-segment elevated myocardial infarction or non-ST segment elevated ACS, in patients with or without diabetes, and in patients after percutaneous coronary intervention. Results were consistent in studies with TyG index analyzed as continuous variable (RR for per standard deviation increment of TyG index: 1.59, 95% CI: 1.38-1.83, I²=24%, p <0.001). In conclusion, higher TyG index may be independently associated with higher incidence of MACEs in patients with ACS.

The Role of Exercise, Diet, and Cytokines in Preventing Obesity and Improving Adipose Tissue

The prevalence of obesity continues to rise worldwide despite evidence-based public health recommendations. The promise to adopt a healthy lifestyle is increasingly important for tackling this global epidemic. Calorie restriction or regular exercise or a combination of the two is accepted as an effective strategy in preventing or treating obesity. Furthermore, the benefits conferred by regular exercise to overcome obesity are attributed not only to reduced adiposity or reduced levels of circulating lipids but also to the proteins, peptides, enzymes, and metabolites that are released from contracting skeletal muscle or other organs. The secretion of these molecules called cytokines in response to exercise induces browning of white adipose tissue by increasing the expression of brown adipocyte-specific genes within the white adipose tissue, suggesting that exercise-induced cytokines may play a significant role in preventing obesity. In this review, we present research-based evidence supporting the effects of exercise and various diet interventions on preventing obesity and adipose tissue health. We also discuss the interplay between adipose tissue and the cytokines secreted from skeletal muscle and other organs that are known to affect adipose tissue and metabolism.

Triglyceride-glucose index and the incidence of atherosclerotic cardiovascular diseases: a meta-analysis of cohort studies

Background

Insulin resistance has been demonstrated to be involved in the pathogenesis of atherosclerotic cardiovascular diseases (ASCVDs). This study evaluated the association between the triglyceride–glucose (TyG) index, a novel surrogate indicator of insulin resistance, and the incidence of ASCVDs in people without ASCVDs at baseline by performing a meta-analysis.

Methods

Cohort studies reporting the multivariate-adjusted association between the TyG index and the incidence of ASCVDs were obtained by searching the PubMed and Embase databases. A random-effects model incorporating intra-study heterogeneity was applied to combine the results.

Results

Eight cohort studies comprising 5,731,294 participants were included in this meta-analysis. The results showed that compared to those with the lowest TyG index category, participants with the highest TyG index category were independently associated with a higher risk of ASCVDs [hazard ratio (HR): 1.61, 95% confidence interval (CI) 1.29–2.01, I² = 80%, P < 0.001]. This finding was consistent with the meta-analysis results with the TyG index analyzed as a continuous variable (HR per 1-unit increment of the TyG index: 1.39, 95% CI 1.18–1.64, I² = 89%, P < 0.001). Subgroup analyses suggested that the age, sex, and diabetic status did not significantly affect the association (for subgroup analyses, all P > 0.05). Moreover, participants with the highest TyG index category were independently associated with a higher risk of coronary artery disease [(CAD), HR: 1.95, 95% CI 1.47–2.58, I² = 92%, P < 0.001] and stroke (HR: 1.26, 95% CI 1.23–1.29, I² = 0%, P < 0.001).

Conclusions

A higher TyG index may be independently associated with a higher incidence of ASCVDs, CAD, and stroke in people without ASCVDs at baseline.

The association between dietary antioxidant quality score with metabolic syndrome and its components in Iranian adults: A cross-sectional study

We aimed to investigate whether adherence to dietary antioxidant quality score (DAQS) is associated with metabolic syndrome (MetS) among the Tehranian population. This cross-sectional study was conducted on 270 apparently healthy adults aged between 18 and 45 years old who lived in Tehran, Iran, between February 2017 and December 2018. Participants were categorized based on tertile cut-off points of DAQs. To examine the association between DAQS and MetS and its components, we used multivariable logistic regression analysis in different models. Adherence to DAQS was associated with a significant increase for intake of vitamin B6 (P-value = 0.02), riboflavin (P-value < 0.001), folate (P-value = 0.03), selenium (P-value = 0.03), vitamin D (P-value < 0.001), and calcium (P-value < 0.001). Adherence to DAQS showed a significant decrease for odds of systolic blood pressure (SBP) (OR: 0.17, 95% CI: 0.04, 0.65, P-value = 0.03). We also found that the overall adherence to DAQS was not significantly related to MetS and its other components. In conclusion, although we observed an improvement in SBP with a greater adherence to dietary antioxidant quality score, there was no association between DAQS and metabolic syndrome and its other components.