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Li C, Zhang Y, Wu X, Liu K, Wang W, Qin Y, Ma W, Zhang H, Wang J, Zou Y, Song L. Prognostic value of the triglyceride-glucose index for adverse cardiovascular outcomes in young adult hypertension. Clin Hypertens 2024; 30:25. [PMID: 39217344 PMCID: PMC11366158 DOI: 10.1186/s40885-024-00274-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 05/22/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index is a reliable marker of insulin resistance that is involved in the progression of hypertension. This study aimed to evaluate the association of the TyG index with the risk for major cardiovascular events (MACE) in young adult hypertension. METHODS A total of 2,651 hypertensive patients aged 18-40 years were consecutively enrolled in this study. The TyG index was calculated as Ln [triglycerides × fasting plasma glucose/2]. The cutoff value for an elevated TyG index was determined to be 8.43 by receiver-operating characteristic curve analysis. The primary endpoint was MACE, which was a composite of all-cause death, non-fatal myocardial infarction, coronary revascularization, non-fatal stroke, and end-stage renal dysfunction. The secondary endpoints were individual MACE components. RESULTS During the median follow-up time of 2.6 years, an elevated TyG index was associated with markedly increased risk of MACE (adjusted hazard ratio [HR] 3.440, P < 0.001) in young hypertensive adults. In subgroup analysis, the elevated TyG index predicted an even higher risk of MACE in women than men (adjusted HR 6.329 in women vs. adjusted HR 2.762 in men, P for interaction, 0.001); and in patients with grade 2 (adjusted HR 3.385) or grade 3 (adjusted HR 4.168) of hypertension than those with grade 1 (P for interaction, 0.024). Moreover, adding the elevated TyG index into a recalibrated Systematic COronary Risk Evaluation 2 model improved its ability to predict MACE. CONCLUSIONS An elevated TyG index is associated with a higher risk of MACE in young adult hypertension, particularly in women and those with advanced hypertension. Regular evaluation of the TyG index facilitates the identification of high-risk patients.
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Affiliation(s)
- Chen Li
- Department of Cardiomyopathy, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China
| | - Yu Zhang
- Department of Cardiomyopathy, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China
| | - Xueyi Wu
- Department of Cardiomyopathy, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China
| | - Kai Liu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China
| | - Wei Wang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China
| | - Ying Qin
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China
| | - Wenjun Ma
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China
| | - Huimin Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China
| | - Jizheng Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China
| | - Yubao Zou
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China.
| | - Lei Song
- Department of Cardiomyopathy, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China.
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, People's Republic of China.
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Nuryunarsih D, Herawati L, Badi'ah A, Donsu JDT, Okatiranti. Predicting Changes in Systolic and Diastolic Blood Pressure of Hypertensive Patients in Indonesia Using Machine Learning. Curr Hypertens Rep 2023; 25:377-383. [PMID: 37642805 PMCID: PMC10598158 DOI: 10.1007/s11906-023-01261-5] [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] [Accepted: 08/04/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE OF REVIEW This retrospective study investigated factors that influence the occurrence of decreased systolic and diastolic blood pressure including sociodemographic and economic factors, hypertension duration, cigarette consumption, alcohol consumption, duration of smoking, type of cigarettes, exercise, salt consumption, sleeping pills consumption, insomnia, and diabetes. These factors were applied to predict the reality of systolic and diastolic decrease using the machine learning algorithm Naïve Bayes, artificial neural network, logistic regression, and decision tree. RECENT FINDINGS The increase in blood pressure, both systolic and diastolic, is very harmful to the health because uncontrolled high systolic and diastolic blood pressure can cause various diseases such as congestive heart failure, kidney failure, and cardiovascular disease. There have been many studies examining the factors that influence the occurrence of hypertension, but few studies have used machine learning to predict hypertension. The machine learning models performed well and can be used for predicting whether a person with hypertension with certain characteristics will experience a decrease in their systolic or diastolic blood pressure after treatment with antihypertensive drugs.
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Affiliation(s)
- Desy Nuryunarsih
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Rd, Glasgow, G4 0BA, UK.
| | - Lucky Herawati
- Environmental Health Department, Health Polytechnic, Ministry of Health, Yogyakarta, Indonesia
| | - Atik Badi'ah
- Nursing Department, Health Polytechnic, Ministry of Health, Yogyakarta, Indonesia
| | | | - Okatiranti
- Nursing Department, University of Nottingham, Nottingham, UK
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Pan L, Zou H, Meng X, Li D, Li W, Chen X, Yang Y, Yu X. Predictive values of metabolic score for insulin resistance on risk of major adverse cardiovascular events and comparison with other insulin resistance indices among Chinese with and without diabetes mellitus: Results from the 4C cohort study. J Diabetes Investig 2023; 14:961-972. [PMID: 37132055 PMCID: PMC10360377 DOI: 10.1111/jdi.14024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/06/2023] [Accepted: 04/14/2023] [Indexed: 05/04/2023] Open
Abstract
AIMS/INTRODUCTION To investigate the relationship between the metabolic score for insulin resistance (METS-IR) index and major adverse cardiac events (MACEs) and to compare its ability to predict MACEs with other IR indices including homeostatic model assessment for IR (HOMA-IR) and triglyceride glucose (TyG) index-related parameters. MATERIALS AND METHODS We conducted a cohort study enrolling 7,291 participants aged ≥40 years. Binary logistic regression and restricted cubic splines were performed to determine the association between METS-IR and MACEs, and the receiver operating curve (ROC) was utilized to compare the predictive abilities of IR indices and to determine the optimal cut-off points. RESULTS There were 348 (4.8%) cases of MACEs during a median follow-up of 3.8 years. Compared with participants with a METS-IR in the lowest quartile, the multivariate-adjusted RRs and 95% CIs for participants with a METS-IR in the highest quartile were 1.47 (1.05-2.77) in all participants, 1.42 (1.18-2.54) for individuals without diabetes, and 1.75 (1.11-6.46) for individuals with diabetes. Significant interactions were found between the METS-IR and the risk of MACEs by sex in all participants and by age and sex in individuals without diabetes (all P values for interaction < 0.05). In the ROC analysis, the METS-IR had a higher AUC value than other indices for predicting MACEs in individuals with diabetes and had a comparable or higher AUC than other indices for individuals without diabetes. CONCLUSIONS The METS-IR can be an effective clinical indicator for identifying MACEs, as it had superior predictive power when compared with other IR indices in individuals with diabetes.
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Affiliation(s)
- Limeng Pan
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Huajie Zou
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Division of Endocrinology, Department of Internal MedicineThe Affiliated Hospital of Qinghai UniversityXiningChina
| | - Xiaoyu Meng
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Danpei Li
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Wenjun Li
- Computer Center, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Xi Chen
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Yan Yang
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Xuefeng Yu
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
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Rao K, Yang J, Wu M, Zhang H, Zhao X, Dong Y. Association Between the Metabolic Score for Insulin Resistance and Hypertension in Adults: A Meta-Analysis. Horm Metab Res 2023; 55:256-265. [PMID: 36796411 DOI: 10.1055/a-2010-2452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The metabolic score for insulin resistance (METS-IR) is a recently developed parameter for screening of metabolic disorder. However, the association between METS-IR and risk of hypertension in general adult population remains not fully determined. A meta-analysis was therefore performed. Observational studies evaluating the association between METS-IR and hypertension in adults were retrieved by searching PubMed, Embase, and Web of Science databases from inception to October 10, 2022. A random-effects model, which incorporates the potential influence of heterogeneity, was used to pool the results. Eight studies with 305 341 adults were included in the meta-analysis, and 47 887 (15.7%) of them had hypertension. Pooled results showed that a higher METS-IR was associated with hypertension after adjusting for multiple conventional risk factors [relative risk (RR) for highest versus lowest category of METS-IR: 1.67, 95% confidence interval (CI): 1.53 to 1.83, p<0.001, I2=8%]. The results were consistent in subgroup analyses according to study design, source of the cohort, age, sex, body mass index of the participants, and quality scores of the study (p for subgroup difference all>0.05). Results of meta-analysis with METS-IR analyzed in continuous variables also showed that METS-IR was associated with the risk of hypertension (RR for 1-unit increment of METS-IR: 1.15, 95% CI: 1.08 to 1.23, p<0.001, I2=79%). In conclusion, a high METS-IR is associated with hypertension in general adult population. Measuring METS-IR may be useful for screening participants at high risk of hypertension.
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Affiliation(s)
- Kunrui Rao
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, China
| | - Jun Yang
- Department of Cardiovascular Medicine, Nanchang First Hospital, Nanchang, China
| | - Mengbo Wu
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, China
| | - Huang Zhang
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, China
| | - Xiangtao Zhao
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, China
| | - Yifei Dong
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, China
- Key Laboratory of Molecular Biology in Jiangxi Province, Nanchang University Second Affiliated Hospital, Nanchang, China
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Cao C, Wang H, Gao H, Wu W. Insulin resistance is associated with an unfavorable outcome among non-diabetic patients with isolated moderate-to-severe traumatic brain injury – A propensity score-matched study. Front Neurol 2022; 13:949091. [PMID: 35968315 PMCID: PMC9366396 DOI: 10.3389/fneur.2022.949091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/04/2022] [Indexed: 12/27/2022] Open
Abstract
BackgroundHyperglycemia is an independent risk factor for the poor prognosis in patients with traumatic brain injury (TBI), and stress-induced impaired insulin function is the major factor of hyperglycemia in non-diabetic patients with TBI. Several types of research suggested that insulin resistance (IR) is related to the poor prognosis of neurocritical ill patients; here we focused on the role of IR in non-diabetic patients after TBI.MethodsWe performed a prospective observational study with the approval of the Ethics Committee of our institute. IR was accessed via the update Homeostasis Model Assessment (HOMA2) of IR, a computer-calculated index by glucose and insulin level. HOMA2 ≥ 1.4 was considered as the threshold of IR according to the previous studies. The glycemic variability (GV) indices were calculated by fingertip blood glucose concentration at an interval of 2 h within 24 h to explore the relationship between IR and GV. The outcome was the 6-month neurological outcome evaluated with the Glasgow outcome scale.ResultsA total of 85 patients with isolated moderate-to-severe TBI (admission GCS ≤ 12) were finally included in our study, 34 (40%) were diagnosed with IR with HOMA2 ≥ 1.4. After propensity score matching (PSM), 22 patients in IR group were matched to 34 patients in non-IR group. Patients with IR suffered increased systemic glycemic variation after isolated moderate-to-severe TBI. IR was a significant factor for the poor prognosis after TBI (OR = 3.25, 95% CI 1.03–10.31, p = 0.041).ConclusionsThe IR estimated by HOMA2 was associated with greater GV and an unfavorable outcome after isolated moderate-to-severe TBI. Ameliorating impaired insulin sensitivity may be a potential therapeutic strategy for the management of TBI patients.
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