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Wurtzel JGT, Lazar S, Askari S, Zhao X, Severa J, Ayombil F, Michael JV, Camire RM, McKenzie SE, Stalker TJ, Ma P, Goldfinger LE. Plasma growth factors maintain constitutive translation in platelets to regulate reactivity and thrombotic potential. Blood Adv 2024; 8:1550-1566. [PMID: 38163324 PMCID: PMC10982986 DOI: 10.1182/bloodadvances.2023011734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/14/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
ABSTRACT Mechanisms of proteostasis in anucleate circulating platelets are unknown and may regulate platelet function. We investigated the hypothesis that plasma-borne growth factors/hormones (GFHs) maintain constitutive translation in circulating platelets to facilitate reactivity. Bio-orthogonal noncanonical amino acid tagging (BONCAT) coupled with liquid chromatography-tandem mass spectrometry analysis revealed constitutive translation of a broad-spectrum translatome in human platelets dependent upon plasma or GFH exposure, and in murine circulation. Freshly isolated platelets from plasma showed homeostatic activation of translation-initiation signaling pathways: phosphorylation of p38/ERK upstream kinases, essential intermediate MNK1/2, and effectors eIF4E/4E-BP1. Plasma starvation led to loss of pathway phosphorylation, but it was fully restored with 5-minute stimulation by plasma or GFHs. Cycloheximide or puromycin infusion suppressed ex vivo platelet GpIIb/IIIa activation and P-selectin exposure with low thrombin concentrations and low-to-saturating concentrations of adenosine 5'-diphosphate (ADP) or thromboxane analog but not convulxin. ADP-induced thromboxane generation was blunted by translation inhibition, and secondary-wave aggregation was inhibited in a thromboxane-dependent manner. Intravenously administered puromycin reduced injury-induced clot size in cremaster muscle arterioles, and delayed primary hemostasis after tail tip amputation but did not delay neither final hemostasis after subsequent rebleeds, nor final hemostasis after jugular vein puncture. In contrast, these mice were protected from injury-induced arterial thrombosis and thrombin-induced pulmonary thromboembolism (PE), and adoptive transfer of translation-inhibited platelets into untreated mice inhibited arterial thrombosis and PE. Thus, constitutive plasma GFH-driven translation regulates platelet G protein-coupled receptor reactivity to balance hemostasis and thrombotic potential.
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Affiliation(s)
- Jeremy G. T. Wurtzel
- Division of Hematology, Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Sophia Lazar
- Division of Hematology, Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Shayan Askari
- Division of Hematology, Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Xuefei Zhao
- Division of Hematology, Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Jenna Severa
- Division of Hematology, Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Francis Ayombil
- Division of Hematology and the Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - James V. Michael
- Division of Hematology, Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Rodney M. Camire
- Division of Hematology and the Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Steven E. McKenzie
- Division of Hematology, Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Timothy J. Stalker
- Division of Hematology, Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Peisong Ma
- Division of Hematology, Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Lawrence E. Goldfinger
- Division of Hematology, Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
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Choi JW, Kim TH, Park JS, Lee CH. Association between Relative Thrombocytosis and Microalbuminuria in Adults with Mild Fasting Hyperglycemia. J Pers Med 2024; 14:89. [PMID: 38248790 PMCID: PMC10817638 DOI: 10.3390/jpm14010089] [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: 12/01/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
An elevated platelet count may contribute to significant thrombotic events and pose a risk for diabetic microvascular complications. Albuminuria, one of the hallmarks of diabetes, is thought to be a risk factor for endothelial dysfunction. In this study, we investigated the association between relative thrombocytosis and an increased urine albumin-to-creatinine ratio in healthy adult participants. Using multivariate analyses on data from the Korea National Health and Nutrition Examination Survey V-VI, 12,525 eligible native Koreans aged ≥ 20 were categorized into platelet count quintiles by sex. The highest platelet count quintile included younger, more obese participants with elevated white blood cell counts, poor lipid profiles, and a better estimated glomerular filtration rate. Restricted cubic spline regression analysis revealed significant associations between platelet count and fasting blood glucose, glycated hemoglobin, and urine albumin-to-creatinine ratio. Adjusted logistic regression models indicated that heightened fasting blood glucose and platelet count were linked to risk of microalbuminuria (fasting blood glucose, odds ratio = 1.026, 95%CI = 1.011-1.042; platelet count, odds ratio = 1.004, 95%CI = 1.002-1.006). Particularly, an increased platelet count was notably associated with microalbuminuria progression in subjects with impaired fasting glucose. These findings suggest that an elevated platelet count, even below diagnostic thrombocytosis levels, independently correlates with an increased risk of vascular endothelial dysfunction in patients with impaired fasting glucose.
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Affiliation(s)
- Jong Wook Choi
- Research Institute of Medical Science, Konkuk University School of Medicine, Chungju 27478, Republic of Korea;
| | - Tae Hoon Kim
- Department of Internal Medicine, CHA Bundang Medical Center, Seongnam 13495, Republic of Korea;
| | - Joon-Sung Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Republic of Korea;
| | - Chang Hwa Lee
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Republic of Korea;
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Zhang N, Chi X, Zhou Z, Song Y, Li S, Xu J, Li J. Triglyceride-glucose index is associated with a higher risk of stroke in a hypertensive population. Cardiovasc Diabetol 2023; 22:346. [PMID: 38093283 PMCID: PMC10720217 DOI: 10.1186/s12933-023-02082-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the association of triglyceride-glucose (TyG) index, an insulin resistance surrogate biomarker, with first stroke in a hypertensive population and to explore potential influencing factors. METHODS This study, a cohort study among a rural Chinese hypertensive population, utilized data from the China Stroke Primary Prevention Trial (CSPPT). The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Multivariate analysis using Cox proportional hazards models was conducted. RESULTS A total of 7569 hypertensive patients were included in this study. When TyG index was assessed as quartiles, compared with the reference group (Quartile 1), the hazard ratio of stroke was 1.04 in Quartile 2, 1.43 in Quartile 3, and 1.45 in Quartile 4, with a significant trend test (P = 0.013). When Quartiles 3 and 4 were combined (≥ 8.8), the hazard ratio was 1.41 compared with combined Quartiles 1 and 2 (< 8.8). Similar findings were observed for the association of TyG index with ischemic stroke. Further, a joint effect of baseline TyG index and age on first stroke was found. Using the group with TyG < 8.8 and age < 60 years as a reference, the highest hazard ratio of stroke was found in the group with a higher TyG index and aged 60 or greater (HR: 2.15, 95% CI 1.50, 3.07, P < 0.001). CONCLUSIONS In a hypertensive population, baseline TyG index was associated with a significantly higher risk of first stroke. In addition, age was a significant effect modifier for this association.
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Affiliation(s)
- Nan Zhang
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Xiying Chi
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Ziyi Zhou
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, China
| | - Yun Song
- Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Shuqun Li
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Jiafeng Xu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China.
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Wan Y, Zhang Z, Ling Y, Cui H, Tao Z, Pei J, Maimaiti A, Bai H, Wu Y, Li J, Zhao G, Zaid M. Association of triglyceride-glucose index with cardiovascular disease among a general population: a prospective cohort study. Diabetol Metab Syndr 2023; 15:204. [PMID: 37845738 PMCID: PMC10580532 DOI: 10.1186/s13098-023-01181-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND The impact of triglyceride-glucose (TyG) index, a surrogate marker for insulin resistance, on the risk of cardiovascular disease (CVD) in general populations remains controversial. We aimed to comprehensively study the relationship between TyG index with the risk of incident CVD events in the general population in Shanghai. METHODS A total of 42,651 participants without previous history of CVD events from Shanghai Suburban Adult Cohort and Biobank (SSACB) were included. SSACB was a community-based natural population cohort study using multistage cluster sampling method. TyG index was calculated as Ln [fasting serum triglyceride (mg/dL) * fasting blood glucose (mg/dL)/2]. Kaplan-Meier curves, log-rank test and cox proportional hazards model were used to calculate the association between TyG index and incident CVD, including stroke and coronary heart disease (CHD). Restricted cubic spline analyses were used to determine whether there was a non-linear relationship between TyG index and CVD events. RESULTS During a median follow-up of 4.7 years, 1,422 (3.3%) individuals developed CVD, including 674 (1.6%) cases of stroke and 732 (1.7%) cases of CHD. A one unit increment higher TyG index was associated with [HR(95%CI)] 1.16(1.04-1.29) in CVD and with 1.39(1.19-1.61) in stroke. Only linear relationships between TyG and CVD/stroke were observed, while no relationship was observed with CHD after adjustments for confounders. In subgroup analyses, younger (< 50y) and diabetic participants had higher risk of CVD than their counterpart groups, while hypertensive and dyslipidemic participants depicted lower risks than their counterparts. CONCLUSION Elevated TyG index was associated with a higher risk of incident CVD and stroke. TyG index may help in the early stage of identifying people at high risk of CVD.
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Affiliation(s)
- Yiming Wan
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Ziliang Zhang
- Shanghai Depeac Biotechnology Co., Ltd, Shanghai, China
| | - Yong Ling
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Hui Cui
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Zihan Tao
- Department of Plastic Surgery, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Jianfeng Pei
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Aikedan Maimaiti
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Haifan Bai
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Yiling Wu
- Songjiang Center for Disease Control and Prevention, Shanghai, China
| | - Jing Li
- Songjiang District Zhongshan Street Community Healthcare Center, Shanghai, China
| | - Genming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Maryam Zaid
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
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Yu Y, Meng Y, Liu J. Association between the triglyceride-glucose index and stroke in middle-aged and older non-diabetic population: A prospective cohort study. Nutr Metab Cardiovasc Dis 2023; 33:1684-1692. [PMID: 37574222 DOI: 10.1016/j.numecd.2023.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 01/20/2023] [Accepted: 02/04/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND AND AIMS Data regarding the association between insulin resistance (IR) and stroke among the non-diabetic population is still limited and inconsistent. This study aimed to investigate the association between IR measured by the triglyceride-glucose (TyG) index and the risk of stroke among the middle-aged and elderly Chinese without diabetes. METHODS AND RESULTS A total of 17,708 middle-aged and elderly (main respondents≥45 years) individuals without diabetes were enrolled from the China Health and Retirement Longitudinal Study. Participants were divided into 4 categories according to quartiles of the TyG index. During a median follow-up of 7.00 years, a total of 305 (3.93%) incident strokes occurred. With the increase in the TyG index quartiles, stroke incidence increased substantially, compared with the Q1 group, the fully adjusted hazard ratios (HRs) were 1.64 (95% confidence interval [CI], 1.13-2.38), 1.65 (95% CI, 1.10-2.46), and 1.76 (95% CI, 1.21-2.57) for Q2, Q3, and Q4 groups, respectively. The cutoff value we determined for the TyG index was 8.28. Furthermore, the addition of the TyG index to a conventional risk model had an incremental effect on the predictive value for stroke (integrated discrimination improvement 0.17%, P = 0.0025; category-free net reclassification improvement 17.91%, P = 0.0025). CONCLUSION TyG index was significantly associated with a higher risk of stroke among the middle-aged and elderly non-diabetic population. Our findings indicated that the TyG index may be a good tool in the prediction of stroke risk for clinical and public health fields.
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Affiliation(s)
- Yanbo Yu
- Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
| | - Ying Meng
- Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
| | - Jing Liu
- Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
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Chen T, Qian Y, Deng X. Triglyceride glucose index is a significant predictor of severe disturbance of consciousness and all-cause mortality in critical cerebrovascular disease patients. Cardiovasc Diabetol 2023; 22:156. [PMID: 37386419 PMCID: PMC10311865 DOI: 10.1186/s12933-023-01893-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/17/2023] [Indexed: 07/01/2023] Open
Abstract
OBJECTIVE The association of the triglyceride-glucose (TyG) index with severe consciousness disturbance and in-hospital mortality in patients with cerebrovascular disease in the intensive care unit (ICU) is unclear. This study aimed to investigate the TyG index's predictive ability on the severity of impaired consciousness and in-hospital mortality in patients with cerebrovascular disease in the ICU. METHOD Patients diagnosed with non-traumatic cerebral hemorrhage and cerebral infarction were extracted from the MIMIC-IV database and analyzed as two cohorts. The association between the TyG index and the severity of patients' impairment of consciousness and in-hospital mortality was analyzed using logistic regression models. Using restricted cubic spline curves, we analyzed potential nonlinear relationships between TyG indices and outcome indicators. receiver operating characteristic (ROC) curves were utilized to evaluate the predictive ability of the TyG index for outcome indicators. RESULT The study's last two cohorts comprised 537 patients with traumatic cerebral hemorrhage and 872 patients with cerebral infarction. TyG index was a significant predictor of the severity of impaired consciousness and in-hospital mortality in patients with cerebrovascular disease, as determined by logistic regression. The risk of severe consciousness impairment and in-hospital mortality increased roughly linearly with increasing TyG index. CONCLUSION The TyG index was found to be a significant predictor for severe impairment of consciousness and in-hospital death in patients with cerebrovascular disease in the ICU, and it provides some predictive value for the severity of consciousness disturbances and in-hospital mortality in cerebrovascular disease patients.
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Affiliation(s)
- Ting Chen
- Department of Neurosurgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032 China
| | - Yuan Qian
- Clinical Medical Research Center for Obstetrics and Gynecology (Yunnan Joint Key Laboratory), Kunming city of Maternal and Child Health Hospital,Kunming city of Women and Children Hospital, Kunming, Yunnan 650032 China
| | - Xingli Deng
- Department of Neurosurgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032 China
- Puer People’s Hospital, Puer, Yunnan 665099, China
- Yunnan Provincial Clinical Research Center for Neurological Disease, Kunming, Yunnan, 650032 China
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Wu Y, Yang Y, Zhang J, Liu S, Zhuang W. The change of triglyceride-glucose index may predict incidence of stroke in the general population over 45 years old. Cardiovasc Diabetol 2023; 22:132. [PMID: 37296457 PMCID: PMC10257314 DOI: 10.1186/s12933-023-01870-z] [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: 04/15/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Stroke has been found to be highly correlated with the triglyceride-glucose (TyG) index. The relation between the TyG index changes and stroke, however, has seldom been reported, and current researches mentioning the TyG index concentrate on individual values. We aimed to investigate whether the level and the change of TyG index was associated with the incidence of stroke. METHODS Sociodemographic, medical background, anthropometric and laboratory information were retrospectively collected. Classification was conducted using k-means clustering analysis. Logistic regressions were to determine the relationship between different classes with changes in the TyG index and incidence of stroke, taking the class with the smallest change as a reference. Meanwhile, restricted cubic spline regression was applied to examine the links of cumulative TyG index and stroke. RESULTS 369 (7.8%) of 4710 participants had a stroke during 3 years. Compared to class 1 with the best control of the TyG Index, the OR for class 2 with good control was 1.427 (95% CI, 1.051-1.938), the OR for class 3 with moderate control was 1.714 (95% CI, 1.245-2.359), the OR for class 4 with worse control was 1.814 (95% CI, 1.257-2.617), and the OR for class 5 with consistently high levels was 2.161 (95% CI, 1.446-3.228). However, after adjusting for multiple factors, only class 3 still had an association with stroke (OR 1.430, 95%CI, 1.022-2.000). The relation between the cumulative TyG index and stroke was linear in restricted cubic spline regression. In subgroup analysis, similar results were shown in participants without diabetes or dyslipidemia. There is neither additive nor multiplicative interaction between TyG index class and covariates. CONCLUSION A constant higher level with worst control in TyG index indicated a higher risk of stroke.
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Affiliation(s)
- Yaoling Wu
- Shantou University Medical College, Shantou, Guangdong China
- Neurology Department, First Affiliated Hospital of Shantou University Medical College, No.57, ChangPing Road, JinPing District, ShanTou City, 515041 Guangdong Province China
| | - Yongbiao Yang
- Shantou University Medical College, Shantou, Guangdong China
- Neurology Department, First Affiliated Hospital of Shantou University Medical College, No.57, ChangPing Road, JinPing District, ShanTou City, 515041 Guangdong Province China
| | - Jinsheng Zhang
- Shantou University Medical College, Shantou, Guangdong China
- Neurology Department, First Affiliated Hospital of Shantou University Medical College, No.57, ChangPing Road, JinPing District, ShanTou City, 515041 Guangdong Province China
| | - Shuo Liu
- Neurology Department, First Affiliated Hospital of Shantou University Medical College, No.57, ChangPing Road, JinPing District, ShanTou City, 515041 Guangdong Province China
| | - Weiduan Zhuang
- Neurology Department, First Affiliated Hospital of Shantou University Medical College, No.57, ChangPing Road, JinPing District, ShanTou City, 515041 Guangdong Province China
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Yang Y, Huang X, Wang Y, Leng L, Xu J, Feng L, Jiang S, Wang J, Yang Y, Pan G, Jiang B, Wang Y, Chen L. The impact of triglyceride-glucose index on ischemic stroke: a systematic review and meta-analysis. Cardiovasc Diabetol 2023; 22:2. [PMID: 36609319 PMCID: PMC9825038 DOI: 10.1186/s12933-022-01732-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/28/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Strokes significantly impair quality of life and incur high economic and societal burdens. The triglyceride and glucose (TyG) index is a biochemical marker of insulin resistance (IR) and may have important value in the prediction of strokes, especially ischemic stroke (IS). Our study aims to investigate the relationship between TyG index and IS and ascertain whether TyG index is independently associated with IS adverse outcomes. METHODS The Cochrane, Embase, Medline, Web of Science, PubMed, and other relevant English databases and related websites were systematically searched for articles on ''TyG index'' and "stroke" published from inception to April 4, 2022. We reviewed the available literature on the TyG index and its relation to predicting IS occurrence in the general population and adverse clinical outcomes. We calculated odds ratios (OR) of TyG index and its predictability of IS occurrence and adverse outcomes. Statistical analyses were performed using the Meta Package in STATA, version 12.0. RESULTS A total of 18 studies and 592,635 patients were included in our analysis. The pooled effect values of all stroke types showed that higher TyG index was associated with increased the risk of IS in the general population (OR 1.37; 95% CI 1.22-1.54) in a total sample of 554,334 cases with a high level of heterogeneity (P = 0.000, I2 = 74.10%). In addition, compared to IS patients with a lower TyG index, IS patients with a higher TyG index was associated with higher risk of stroke recurrence (OR: 1.50; 95% CI 1.19-1.89) and increased risk of mortality (OR 1.40 95% CI 1.14-1.71). No correlation was found in the effect value combinations of poor functional outcomes (OR 1.12; 95% CI 0.88-1.43) and neurological worsening (OR: 1.76; 95% CI 0.79-3.95) in a total sample of 38,301 cases with a high level of heterogeneity (P = 0.000; I2 = 77.20%). CONCLUSIONS TyG index has potential value in optimizing risk stratification for IS in the general population. Furthermore, there is a significant association between high TyG index and many adverse outcomes of stroke, especially stroke recurrence and high mortality. Future studies should focus on multi-center and multi-regional designs in order to further explore the relationship between IS and TyG index.
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Affiliation(s)
- Ying Yang
- grid.415440.0Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People’s Hospital, (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China ,grid.411587.e0000 0001 0381 4112School of Computer Science and Technology, Chongqing University of Posts and Telecommunications, Chongqing, China
| | - Xiangting Huang
- grid.440809.10000 0001 0317 5955Department of Medicine, Jinggangshan University, Ji’an, Jiangxi China ,grid.13291.380000 0001 0807 1581The Centre of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yuge Wang
- grid.440809.10000 0001 0317 5955Department of Medicine, Jinggangshan University, Ji’an, Jiangxi China
| | - Lin Leng
- grid.459428.6Department of Nephrology, Fifth People’s Hospital of Chengdu, Chengdu, China
| | - Jiapei Xu
- grid.415440.0Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People’s Hospital, (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Lei Feng
- grid.415440.0Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People’s Hospital, (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Shixie Jiang
- grid.168010.e0000000419368956Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA USA
| | - Jiang Wang
- grid.440809.10000 0001 0317 5955Department of Medicine, Jinggangshan University, Ji’an, Jiangxi China
| | - Yanrong Yang
- grid.415440.0Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People’s Hospital, (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Gaofeng Pan
- grid.415440.0Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People’s Hospital, (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Bing Jiang
- grid.415440.0Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People’s Hospital, (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Yan Wang
- Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People's Hospital, (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China.
| | - Lan Chen
- Department of Neurology, Affiliated Hospital of Jinggangshan University, JingGangshan University, Ji'an, Jiangxi province, 343000, China, .
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9
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Yan F, Yan S, Wang J, Cui Y, Chen F, Fang F, Cui W. Association between triglyceride glucose index and risk of cerebrovascular disease: systematic review and meta-analysis. Cardiovasc Diabetol 2022; 21:226. [PMID: 36324146 PMCID: PMC9632026 DOI: 10.1186/s12933-022-01664-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/12/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The triglyceride glucose (TyG) index, which is a new surrogate indicator of insulin resistance (IR), is thought to be associated with many diseases, such as cardiovascular disease, but its relationship with cerebrovascular disease is still controversial. METHODS The PubMed, EMBASE, Cochrane Library, Web of Science and Medline databases were searched until March 2022 to evaluate the association between the TyG index and cerebrovascular disease risk. A random‒effects model was used to calculate the effect estimates and 95% confidence intervals (CIs). RESULTS A total of 19 cohort studies and 10 case‒control/cross‒sectional studies were included in our study, which included 11,944,688 participants. Compared with a low TyG index, a higher TyG index increased the risk of cerebrovascular disease (RR/HR = 1.22, 95% CI [1.14, 1.30], P< 0.001; OR = 1.15, 95% CI [1.07, 1.23], P< 0.001). Furthermore, the results of the dose-response analysis of the cohort study demonstrated that the risk of cerebrovascular disease increased by 1.19 times per 1 mg/dl increment of the TyG index (relative risk = 1.19, 95% CI [1.13,1.25], P< 0.001). CONCLUSION TyG index is related to cerebrovascular disease. More data and basic research are needed to confirm the association.
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Affiliation(s)
- Feifei Yan
- grid.64924.3d0000 0004 1760 5735Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021 Changchun, P. R. China
| | - Shoumeng Yan
- grid.64924.3d0000 0004 1760 5735School of Nursing, Jilin University, 130021 Changchun, P. R. China
| | - Jing Wang
- grid.64924.3d0000 0004 1760 5735Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021 Changchun, P. R. China
| | - Yani Cui
- grid.64924.3d0000 0004 1760 5735Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021 Changchun, P. R. China
| | - Feinan Chen
- grid.64924.3d0000 0004 1760 5735Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021 Changchun, P. R. China
| | - Fang Fang
- grid.64924.3d0000 0004 1760 5735Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021 Changchun, P. R. China
| | - Weiwei Cui
- grid.64924.3d0000 0004 1760 5735Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021 Changchun, P. R. China
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Prognostic Significance of Plasma Insulin Level for Deep Venous Thrombosis in Patients with Severe Traumatic Brain Injury in Critical Care. Neurocrit Care 2022; 38:263-278. [PMID: 36114315 DOI: 10.1007/s12028-022-01588-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/10/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Whether insulin resistance underlies deep venous thrombosis (DVT) development in patients with severe traumatic brain injury (TBI) is unclear. In this study, the association between plasma insulin levels and DVT was analyzed in patients with severe TBI. METHODS A prospective observational study of 73 patients measured insulin, glucose, glucagon-like peptide 1 (GLP-1), inflammatory factors, and hematological profiles within four preset times during the first 14 days after TBI. Ultrasonic surveillance of DVT was tracked. Two-way analysis of variance was used to determine the factors that discriminated between patients with and without DVT or with and without insulin therapy. Partial correlations of insulin level with all the variables were conducted separately in patients with DVT or patients without DVT. Factors associated with DVT were analyzed by multivariable logistic regression. Neurological outcomes 6 months after TBI were assessed. RESULTS Among patients with a mean (± standard deviation) age of 53 (± 16 years), DVT developed in 20 patients (27%) on median 10.4 days (range 4-22), with higher Acute Physiology and Chronic Health Evaluation II scores but similar Sequential Organ Failure Assessment scores and TBI severity. Patients with DVT were more likely to receive insulin therapy than patients without DVT (60% vs. 28%; P = 0.012); hence, they had higher 14-day insulin levels. However, insulin levels were comparable between patients with DVT and patients without DVT in the subgroups of patients with insulin therapy (n = 27) and patients without insulin therapy (n = 46). The platelet profile significantly discriminated between patients with and without DVT. Surprisingly, none of the coagulation profiles, blood cell counts, or inflammatory mediators differed between the two groups. Patients with insulin therapy had significantly higher insulin (P = 0.006), glucose (P < 0.001), and GLP-1 (P = 0.01) levels and were more likely to develop DVT (60% vs. 15%; P < 0.001) along with concomitant platelet depletion. Insulin levels correlated with glucose, GLP-1 levels, and platelet count exclusively in patients without DVT. Conversely, in patients with DVT, insulin correlated negatively with GLP-1 levels (P = 0.016). Age (P = 0.01) and elevated insulin levels at days 4-7 (P = 0.04) were independently associated with DVT. Patients with insulin therapy also showed worse Glasgow Outcome Scale scores (P = 0.001). CONCLUSIONS Elevated insulin levels in the first 14 days after TBI may indicate insulin resistance, which is associated with platelet hyperactivity, and thus increasing the risk of DVT.
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Dai S, Zhang H, Yang F, Shang W, Zeng S. Effects of IGF-1 on the Three-Dimensional Culture of Ovarian Preantral Follicles and Superovulation Rates in Mice. BIOLOGY 2022; 11:biology11060833. [PMID: 35741354 PMCID: PMC9219699 DOI: 10.3390/biology11060833] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/22/2022] [Accepted: 05/25/2022] [Indexed: 12/25/2022]
Abstract
Insulin-like growth factor-1 (IGF-1) plays a crucial role during folliculogenesis, which has been demonstrated by previous research. However, the optimal IGF-1 dosage in the three-dimensional (3D) culture system is unknown. Mouse secondary follicles (140−150 µm) were cultured for 6 days within an alginate bead in a medium supplemented with 0 (G0), 5 ng/mL (G5), 10 ng/mL (G10), or 50 ng/mL IGF-1 (G50). Secretions of 17β-estradiol and progesterone were significantly increased in G10 and G50 (p < 0.05). However, G50 significantly inhibited follicular growth (p < 0.05), while G10 showed a higher oocyte maturation rate. Thus, the 10 ng/mL IGF-1 was used in subsequent experiments. IGF-1 enhanced the function of granulosa cells (GCs) by upregulating expressions of Star, Cyp19a1, Hsd3b1, Fshr, and Lhcgr. Oocyte secretory function was promoted by upregulating expressions of Bmp-15, Gdf-9, and Fgf-8. Addition of IGF-1 showed anti-apoptotic effect. However, G10 did not improve fertilization rate of MII oocytes compared to G0. In an intraperitoneal injection experiment in mice, IGF-1 significantly increased the number of ovulated oocytes (p < 0.05). In conclusion, 10 ng/mL IGF-1 can promote the production of mature oocytes in the 3D culture medium and injection of IGF-1 before superovulation increases the number of ovulated oocytes.
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Affiliation(s)
- Shizhen Dai
- National Engineering Laboratory for Animal Breeding, Key Laboratory of Animal Genetics and Breeding of the Ministry of Agriculture, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China; (S.D.); (H.Z.); (F.Y.)
| | - Hanxue Zhang
- National Engineering Laboratory for Animal Breeding, Key Laboratory of Animal Genetics and Breeding of the Ministry of Agriculture, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China; (S.D.); (H.Z.); (F.Y.)
| | - Feng Yang
- National Engineering Laboratory for Animal Breeding, Key Laboratory of Animal Genetics and Breeding of the Ministry of Agriculture, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China; (S.D.); (H.Z.); (F.Y.)
| | - Wei Shang
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Center for Reproductive Medicine, The Sixth Medical Center, Beijing 100037, China
- Correspondence: (W.S.); (S.Z.)
| | - Shenming Zeng
- National Engineering Laboratory for Animal Breeding, Key Laboratory of Animal Genetics and Breeding of the Ministry of Agriculture, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China; (S.D.); (H.Z.); (F.Y.)
- Correspondence: (W.S.); (S.Z.)
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12
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Peters LJF, Baaten CCFMJ, Maas SL, Lu C, Nagy M, Jooss NJ, Bidzhekov K, Santovito D, Moreno-Andrés D, Jankowski J, Biessen EAL, Döring Y, Heemskerk JWM, Weber C, Kuijpers MJE, van der Vorst EPC. MicroRNA-26b Attenuates Platelet Adhesion and Aggregation in Mice. Biomedicines 2022; 10:biomedicines10050983. [PMID: 35625720 PMCID: PMC9138361 DOI: 10.3390/biomedicines10050983] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 02/05/2023] Open
Abstract
Platelets are key regulators of haemostasis, making platelet dysfunction a major driver of thrombosis. Numerous processes that determine platelet function are influenced by microRNAs (miRs). MiR-26b is one of the highest-expressed miRs in healthy platelets, and its expression in platelets is changed in a diseased state. However, the exact effect of this miR on platelet function has not been studied yet. In this study, we made use of a whole-body knockout of miR-26b in ApoE-deficient mice in order to determine its impact on platelet function, thrombus formation and platelet signalling both ex vivo and in vivo. We show that a whole-body deficiency of miR-26b exacerbated platelet adhesion and aggregation ex vivo. Additionally, in vivo, platelets adhered faster, and larger thrombi were formed in mice lacking miR-26b. Moreover, isolated platelets from miR-26b-deficient mice showed a hyperactivated Src and EGFR signalling. Taken together, we show here for the first time that miR-26b attenuates platelet adhesion and aggregation, possibly through Src and EGFR signalling.
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Affiliation(s)
- Linsey J. F. Peters
- Institute for Molecular Cardiovascular Research (IMCAR), RWTH Aachen University, 52056 Aachen, Germany; (L.J.F.P.); (C.C.F.M.J.B.); (S.L.M.); (J.J.); (E.A.L.B.)
- Interdisciplinary Center for Clinical Research (IZKF), RWTH Aachen University, 52056 Aachen, Germany
- Department of Pathology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 Maastricht, The Netherlands;
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität München, 80337 Munich, Germany; (K.B.); (D.S.); (Y.D.); (C.W.)
| | - Constance C. F. M. J. Baaten
- Institute for Molecular Cardiovascular Research (IMCAR), RWTH Aachen University, 52056 Aachen, Germany; (L.J.F.P.); (C.C.F.M.J.B.); (S.L.M.); (J.J.); (E.A.L.B.)
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 Maastricht, The Netherlands; (M.N.); (N.J.J.); (J.W.M.H.); (M.J.E.K.)
| | - Sanne L. Maas
- Institute for Molecular Cardiovascular Research (IMCAR), RWTH Aachen University, 52056 Aachen, Germany; (L.J.F.P.); (C.C.F.M.J.B.); (S.L.M.); (J.J.); (E.A.L.B.)
- Interdisciplinary Center for Clinical Research (IZKF), RWTH Aachen University, 52056 Aachen, Germany
| | - Chang Lu
- Department of Pathology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 Maastricht, The Netherlands;
| | - Magdolna Nagy
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 Maastricht, The Netherlands; (M.N.); (N.J.J.); (J.W.M.H.); (M.J.E.K.)
| | - Natalie J. Jooss
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 Maastricht, The Netherlands; (M.N.); (N.J.J.); (J.W.M.H.); (M.J.E.K.)
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Kiril Bidzhekov
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität München, 80337 Munich, Germany; (K.B.); (D.S.); (Y.D.); (C.W.)
| | - Donato Santovito
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität München, 80337 Munich, Germany; (K.B.); (D.S.); (Y.D.); (C.W.)
- DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, 80337 Munich, Germany
- Institute for Genetic and Biomedical Research (IRGB), Unit of Milan, National Research Council, 20090 Milan, Italy
| | - Daniel Moreno-Andrés
- Department of Biochemistry and Molecular Cell Biology, Medical School, RWTH Aachen University, 52056 Aachen, Germany;
| | - Joachim Jankowski
- Institute for Molecular Cardiovascular Research (IMCAR), RWTH Aachen University, 52056 Aachen, Germany; (L.J.F.P.); (C.C.F.M.J.B.); (S.L.M.); (J.J.); (E.A.L.B.)
- Department of Pathology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 Maastricht, The Netherlands;
| | - Erik A. L. Biessen
- Institute for Molecular Cardiovascular Research (IMCAR), RWTH Aachen University, 52056 Aachen, Germany; (L.J.F.P.); (C.C.F.M.J.B.); (S.L.M.); (J.J.); (E.A.L.B.)
- Department of Pathology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 Maastricht, The Netherlands;
| | - Yvonne Döring
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität München, 80337 Munich, Germany; (K.B.); (D.S.); (Y.D.); (C.W.)
- Institute for Genetic and Biomedical Research (IRGB), Unit of Milan, National Research Council, 20090 Milan, Italy
- Swiss Cardiovascular Center, Division of Angiology, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland
| | - Johan W. M. Heemskerk
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 Maastricht, The Netherlands; (M.N.); (N.J.J.); (J.W.M.H.); (M.J.E.K.)
- Synapse Research Institute, Kon. Emmaplein 7, 6217 Maastricht, The Netherlands
| | - Christian Weber
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität München, 80337 Munich, Germany; (K.B.); (D.S.); (Y.D.); (C.W.)
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 Maastricht, The Netherlands; (M.N.); (N.J.J.); (J.W.M.H.); (M.J.E.K.)
- Institute for Genetic and Biomedical Research (IRGB), Unit of Milan, National Research Council, 20090 Milan, Italy
- Munich Cluster for Systems Neurology (SyNergy), 81377 Munich, Germany
| | - Marijke J. E. Kuijpers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 Maastricht, The Netherlands; (M.N.); (N.J.J.); (J.W.M.H.); (M.J.E.K.)
- Thrombosis Expertise Center, Heart and Vascular Center, Maastricht University Medical Center, 6229 Maastricht, The Netherlands
| | - Emiel P. C. van der Vorst
- Institute for Molecular Cardiovascular Research (IMCAR), RWTH Aachen University, 52056 Aachen, Germany; (L.J.F.P.); (C.C.F.M.J.B.); (S.L.M.); (J.J.); (E.A.L.B.)
- Interdisciplinary Center for Clinical Research (IZKF), RWTH Aachen University, 52056 Aachen, Germany
- Department of Pathology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 Maastricht, The Netherlands;
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität München, 80337 Munich, Germany; (K.B.); (D.S.); (Y.D.); (C.W.)
- Correspondence: ; Tel.: +49-(0)241-80-36914
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13
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Feng X, Yao Y, Wu L, Cheng C, Tang Q, Xu S. Triglyceride-Glucose Index and the Risk of Stroke: A Systematic Review and Dose-Response Meta-Analysis. Horm Metab Res 2022; 54:175-186. [PMID: 35276743 DOI: 10.1055/a-1766-0202] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Insulin resistance (IR) is an independent risk factor of cardiovascular disease. Recent research has proposed a new inexpensive and reliable indicator of IR: triglyceride glucose index (TyG index). We aim to evaluate the dose-response association between the TyG index and stroke through meta-analysis. Literature published from inception until October 2021 were searched in PubMed, Embase, Cochrane Library and Web of science. Cohort studies published in English and focusing on the association between the TyG index and stroke were included in our meta-analysis. I2 statistic and Chi-square were used to assess the heterogeneity. When I2≥30% or p≤0.10, the random-effect model was used to pool the effect; otherwise, we chose the fixed-effect model. Eleven cohort studies, including 5 721 077 subjects and 95 490 stroke patients, were included in our study. After pooling the effect adjusted by multiple confounders, we found that compared with the lowest baseline TyG index group, the highest one was independently associated with increased stroke risk (RR: 1.27; 95% CI, 1.24 to 1.29; I2=6%). Dose-response meta-analysis showed that the association between the two variables had a non-linear trend (p-nonlinearity<0.0001; p-heterogeneity=0.28). Subgroup analysis showed that the risk of ischemic stroke was positively correlated with TyG index (RR: 1.48; 95% CI, 1.34 to 1.62; I2=15%), while we did not observe this correlation in hemorrhagic stroke patients. In patients with type 2 diabetes and acute coronary syndrome, the TyG index was linearly correlated with incident strokes. In conclusion, elevated TyG index is the independent risk factor for incident strokes (especially ischemic stroke).
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Affiliation(s)
- Xiao Feng
- Department of Neurology, Huazhong University of Science and Technology, Wuhan, China
| | - Yao Yao
- Department of Neurology, Huazhong University of Science and Technology, Wuhan, China
| | - Lingshan Wu
- Department of Neurology, Huazhong University of Science and Technology, Wuhan, China
| | - Chang Cheng
- Department of Neurology, Huazhong University of Science and Technology, Wuhan, China
| | - Qiaoqiao Tang
- Department of Neurology, Huazhong University of Science and Technology, Wuhan, China
| | - Shabei Xu
- Department of Neurology, Huazhong University of Science and Technology, Wuhan, China
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14
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Tang X, Zhang L, Li Y, Zhou Y, Cai X, Yao Y, Fang Q. Relationship between triglyceride-glucose index and carotid plaques in a high-stroke-risk population in southeast china: A population-based cross-sectional survey. Front Endocrinol (Lausanne) 2022; 13:1023867. [PMID: 36313776 PMCID: PMC9596760 DOI: 10.3389/fendo.2022.1023867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cervical arterial atherosclerosis (CAA) is an important risk factor of stroke in China. The triglyceride-glucose (TyG) index is a simple and low-cost marker for ischemic stroke. Whether the TyG index predicts cervical arterial atherosclerosis remains uncertain. This study aimed to investigate the relationship between the TyG index and cervical arterial atherosclerosis. METHODS This cross-sectional study was conducted in residents aged ≥40 years in the general population of southeast China. All participants completed a detailed questionnaire and provided blood samples. The high-stroke-risk groups further completed cervical artery ultrasonography. The TyG index was calculated using a well-established formula and analyzed in quartiles (Q1-Q4). Multivariate logistic regression was used to investigate the relationship between the TyG index and cervical arterial atherosclerosis. RESULTS A total of 4,499 participants aged ≥40 years were finally included, with 23.47% comprising the high-stroke-risk population. The prevalence rates of increased intima-media thickness (IMT), carotid plaque, and cervical artery stenosis (CAS) in the high-stroke-risk population were 21.97%, 39.3%, and 6.1%, respectively. Subjects with higher TyG were still more likely to have carotid plaque. After adjusting for several established risk factors, compared with the TyG-Q1 group, the TyG-Q2, TyG-Q3, and TyG-Q4 groups were more likely to have carotid plaque (OR = 1.85, 95%CI = 1.28-2.67; OR = 1.51, 95%CI = 1.05-2.18; and OR = 1.29, 95%CI = 0.90-1.84). TyG was an independent predictor of the presence of plaque in the carotid artery of the high-stroke-risk population. CONCLUSIONS An elevated TyG index is a potential predictor of carotid plaques in the high-stroke-risk population older than 40 years.
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Affiliation(s)
- Xiang Tang
- Department of Neurology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lulu Zhang
- Department of Neurology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yidan Li
- Department of Neurology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yun Zhou
- Department of Neurology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiuying Cai
- Department of Neurology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ye Yao
- Department of Biostatistics, School of Public Health, Fudan University, China and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Ye Yao, ; Qi Fang,
| | - Qi Fang
- Department of Neurology, First Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Ye Yao, ; Qi Fang,
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15
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Wang F, Wang J, Han Y, Shi X, Xu X, Hou C, Gao J, Zhu S, Liu X. Triglyceride-glucose index and stroke recurrence in elderly patients with ischemic stroke. Front Endocrinol (Lausanne) 2022; 13:1005614. [PMID: 36105408 PMCID: PMC9467280 DOI: 10.3389/fendo.2022.1005614] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND PURPOSE This study aimed to explore the association between triglyceride-glucose (TyG) index and stroke recurrence in elderly patients with ischemic stroke in China. METHODS We enrolled ischemic stroke patients aged ≥ 65 years from the Nanjing Stroke Registry Program. The primary endpoint was defined as recurrent stroke within one year after the index stroke. We used multivariable Cox proportional hazards regression models to investigate the association between TyG index and stroke recurrence. We assessed the discriminative ability of TyG index with the receiver operative characteristic and the area under the curve. RESULTS A total of 955 patients (median age, 70.0 [67.0, 75.0]; male sex, 67.2%) from the Nanjing Stroke Registry Program were enrolled. During one year follow-up, 97 (10.2%) elderly patients experienced stroke recurrence. In multivariable analyses, the association between TyG index and stroke recurrence remained significant after adjusting for confounders (quartile 4 versus quartile 1; hazard ratio, 2.073, 95% confidence interval, 1.158-3.711; P = 0.014). The restricted cubic spline showed an increasing trend for TyG index and stroke recurrence (P for non-linearity = 0.072). The area under the curve to predict stroke recurrence with TyG index was 0.719 (95% confidence interval, 0.666-0.772). Besides, TyG index slightly improved the prediction for stroke recurrence. CONCLUSION Elevated TyG index was associated with stroke recurrence in elderly patients with ischemic stroke. Further studies are warranted to assess the role of TyG index in the development of stroke recurrence in the elderly.
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Affiliation(s)
- Fang Wang
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jinjing Wang
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yunfei Han
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xuan Shi
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xiaohui Xu
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Chao Hou
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jie Gao
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Shuanggen Zhu
- Department of Neurology, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, China
- Department of Neurology, People’s Hospital of Longhua, Shenzhen, China
- *Correspondence: Shuanggen Zhu, ; Xinfeng Liu,
| | - Xinfeng Liu
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
- *Correspondence: Shuanggen Zhu, ; Xinfeng Liu,
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16
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Cai X, Hu J, Zhu Q, Wang M, Liu S, Dang Y, Hong J, Li N. Relationship of the metabolic score for insulin resistance and the risk of stroke in patients with hypertension: A cohort study. Front Endocrinol (Lausanne) 2022; 13:1049211. [PMID: 36545329 PMCID: PMC9760826 DOI: 10.3389/fendo.2022.1049211] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/17/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND The current status of the dose-response relationship between the metabolic score for insulin resistance (METS-IR) and new-onset stroke in hypertensive patients and its subtypes is unclear. This study aimed to determine the association between METS-IR and incident stroke and its subtypes within a cohort of Chinese hypertensive patients. METHODS A total of 14032 hospitalized patients with hypertension from January 1, 2010, to December 31, 2021, were included in this retrospective cohort study. Cox models and restricted cubic splines were applied to determine the association between METS-IR and the risk of stroke. RESULTS During a median follow-up of 4.80 years, 1067 incident stroke cases occurred. Patients in the highest quartile group of METS-IR levels exhibited a higher risk of stroke (HR, 1.80; 95% CI, 1.50-2.17) and ischemic stroke (HR, 1.96; 95% CI, 1.60-2.42) than those in the lowest quartile group. However, no significant associations were observed between METS-IR and the risk of hemorrhagic stroke. Restricted cubic spline analysis suggested a nearly J-shaped association between METS-IR and risk of stroke and ischemic stroke (P for nonlinearity < 0.001). METS-IR did produce a significant improvement in the C statistic when added to the basic model (from 0.637 to 0.664, P < 0.001). Notably, the addition of METS-IR to the basic model resulted in a significant improvement in predicting incident total stroke and ischemic stroke. CONCLUSIONS This cohort study suggests a relationship between METS-IR and the risk of stroke and ischemic stroke. Further studies are required to elucidate the underlying mechanisms.
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Guo Y, Zhao J, Zhang Y, Wu L, Yu Z, He D, Huang H, Qu W, Luo X. Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients. BMC Neurol 2021; 21:409. [PMID: 34702218 PMCID: PMC8549262 DOI: 10.1186/s12883-021-02443-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/18/2021] [Indexed: 12/23/2022] Open
Abstract
Aim Insulin resistance was reported to increase the risk of ischemic stroke, which can be assessed by the triglyceride glucose (TyG) index. However, it remains unclear whether the TyG index influences the platelet reactivity during the treatment of ischemic patients. Methods Ischemic stroke patients receiving dual antiplatelet therapy (DAPT) within 48 h onset were consecutively included. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The top quartile of TyG index was defined as insulin resistance. The platelet reactivity was assessed by thromboelastography. The platelet inhibition rate induced by arachidonic acid (AA) or adenosine diphosphate (ADP) was used to confirm the high residual on-treatment platelet reactivity (HRPR) to aspirin or clopidogrel, respectively. The association between TyG index and platelet reactivity was assessed by Kruskal–Wallis test. The independent risk factors of HRPR were determined by multivariate logistic regression analysis. Results A total of 1002 patients were included and divided into 4 groups by quartiles of the TyG index (< 2.02; 2.02–2.27; 2.27–2.52; ≥2.52). The findings demonstrated that the maximum intensity of the clot increased, but the AA-induced platelet inhibition rate decreased, depending on the TyG index quartiles. No significant difference was found in the ADP-induced platelet inhibition rate among groups. The prevalence of aspirin HRPR increased depending on the TyG index quartile. Unlike the non-insulin resistance group, the insulin resistance group was independently associated with aspirin HRPR (OR = 1.689, 95% CI 1.14 to 2.51, P = 0.009). Conclusions In acute ischemic stroke patients taking DAPT, the elevation of the TyG index is associated with enhanced platelet reactivity and higher prevalence of aspirin HRPR. Insulin resistance assessed by the TyG index could be an independent risk factor for aspirin HRPR.
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Affiliation(s)
- Yinping Guo
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Jing Zhao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Yi Zhang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Lingshan Wu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Zhiyuan Yu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Dan He
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, Guangdong, China
| | - Hao Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Wensheng Qu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
| | - Xiang Luo
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
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18
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Wang A, Wang G, Liu Q, Zuo Y, Chen S, Tao B, Tian X, Wang P, Meng X, Wu S, Wang Y, Wang Y. Triglyceride-glucose index and the risk of stroke and its subtypes in the general population: an 11-year follow-up. Cardiovasc Diabetol 2021; 20:46. [PMID: 33602208 PMCID: PMC7893902 DOI: 10.1186/s12933-021-01238-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/01/2021] [Indexed: 12/27/2022] Open
Abstract
Background Triglyceride-glucose (TyG) index was recently suggested to be a reliable surrogate marker of insulin resistance. We aim to investigate the associations between baseline and long-term TyG index with subsequent stroke and its subtypes in a community-based cohort. Methods A total of 97,653 participants free of history of stroke in the Kailuan Study were included. TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Baseline TyG index was measured during 2006–2007. Updated cumulative average TyG index used all available TyG index from baseline to the outcome events of interest or the end of follow up. The outcome was the first occurrence of stroke, including ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage. The associations of TyG index with outcomes were explored with Cox regression. Results During a median of 11.02 years of follow-up, 5122 participants developed stroke of whom 4277 were ischemic stroke, 880 intracerebral hemorrhage, and 144 subarachnoid hemorrhage. After adjusting for confounding variables, compared with participants in the lowest quartile of baseline TyG index, those in the third and fourth quartile were associated with an increased risk of stroke (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.12–1.33, and adjusted HR 1.32, 95% CI 1.21–1.44, respectively, P for trend < 0.001). We also found a linear association between baseline TyG index with stroke. Similar results were found for ischemic stroke. However, no significant associations were observed between baseline TyG index and risk of intracranial hemorrhage. Parallel results were observed for the associations of updated cumulative average TyG index with outcomes. Conclusions Elevated levels of both baseline and long-term updated cumulative average TyG index can independently predict stroke and ischemic stroke but not intracerebral hemorrhage in the general population during an 11-year follow-up.
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Affiliation(s)
- Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guangyao Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qian Liu
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Yingting Zuo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, No.57 Xinhua East Street, Lubei District, Tangshan, 063000, China
| | - Boni Tao
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Penglian Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, No.57 Xinhua East Street, Lubei District, Tangshan, 063000, China.
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China. .,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China. .,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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19
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van Niekerk G, Dalgleish AG, Joubert F, Joubert A, Engelbrecht AM. The immuno-oncological implications of insulin. Life Sci 2020; 264:118716. [PMID: 33159956 DOI: 10.1016/j.lfs.2020.118716] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/27/2020] [Accepted: 11/02/2020] [Indexed: 11/29/2022]
Abstract
Emerging evidence has implicated insulin in regulating the phenotypes of various immune cells through canonical downstream signalling effectors of insulin, namely, the PI3K/Akt/mTOR pathway. Notably, these signalling components also exhibit crosstalk with other immune signalling pathways, such as the JAK/STAT pathway (activated by cytokines and growth factors), and, importantly, are also negatively regulated by the immune checkpoint blockers (ICBs), PD-1 and CTLA-4. Here, we point out recent findings, suggesting that insulin may promote a pro-inflammatory phenotype with potential implications on ICB therapy. As an example, the contemporary paradigm holds that, while T cell receptor recognition of distinct MHC-expressed epitopes ensures specificity, co-activation of CD28 along with signal inputs form various cytokines and insulin operates to 'fine-tune' the immune response via PI3K and other downstream signalling molecules. These considerations highlight the urgent need for focused investigations into the role of insulin in regulating immune cell function in the context of ICB therapies.
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Affiliation(s)
- Gustav van Niekerk
- Department of Physiological Sciences, Stellenbosch University, Stellenbosch, South Africa.
| | - Angus G Dalgleish
- Department of Cellular and Molecular Medicine, St George's University of London, London, UK
| | - Fourie Joubert
- Department of Biochemistry, Genetics and Microbiology, Centre for Bioinformatics and Computational Biology, University of Pretoria, Pretoria, South Africa
| | - Annie Joubert
- Department of Physiology, University of Pretoria, Pretoria, South Africa
| | - Anna-Mart Engelbrecht
- Department of Physiological Sciences, Stellenbosch University, Stellenbosch, South Africa
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20
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Zhou Y, Pan Y, Yan H, Wang Y, Li Z, Zhao X, Li H, Meng X, Wang C, Liu L, Wang Y. Triglyceride Glucose Index and Prognosis of Patients With Ischemic Stroke. Front Neurol 2020; 11:456. [PMID: 32587566 PMCID: PMC7297915 DOI: 10.3389/fneur.2020.00456] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 04/28/2020] [Indexed: 12/17/2022] Open
Abstract
Background: The triglyceride glucose index (TyG index) has been proposed as a simple and credible surrogate marker of insulin resistance. However, it is unclear whether TyG index correlates with adverse clinical outcomes in patients with ischemic stroke. Accordingly, this study aimed to explore the relationship between baseline TyG index and clinical outcomes of ischemic stroke individuals. Methods: We included eligible subjects with ischemic stroke from the China National Stroke Registry II for the current analysis. TyG index was calculated and divided into quartiles to explore the relationship with the outcomes of ischemic stroke. Outcomes included stroke recurrence, all-cause mortality, poor functional outcome at 12 months, and neurologic worsening at discharge. Multivariable Cox regression and logistic regression models were performed to explore the correlation of baseline TyG index with the outcomes. Results: Among the 16,310 patients enrolled in the study, the average age was 64.83 ± 11.9 years, and 63.48% were men. The median TyG index was 8.73 (interquartile range, 8.33-9.21). After adjustment for multiple potential covariates, the fourth quartile of TyG index was associated with an increased risk of stroke recurrence (adjusted HR, 1.32; 95% CI, 1.11-1.57; P = 0.002), all-cause mortality (adjusted HR, 1.25; 95%CI, 1.06-1.47; P = 0.01) at 12-month follow-up, and neurological worsening (adjusted OR, 1.26; 95% CI, 1.02-1.55; P = 0.03) at discharge, but not poor functional outcome compared with the first quartile. Conclusion: TyG index representing insulin resistance was associated with an increased risk of stroke recurrence, all-cause mortality, and neurologic worsening in patients with ischemic stroke.
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Affiliation(s)
- Yimo Zhou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Hongyi Yan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Zixiao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Chunxue Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Liping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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21
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Shi W, Xing L, Jing L, Tian Y, Yan H, Sun Q, Dai D, Shi L, Liu S. Value of triglyceride-glucose index for the estimation of ischemic stroke risk: Insights from a general population. Nutr Metab Cardiovasc Dis 2020; 30:245-253. [PMID: 31744716 DOI: 10.1016/j.numecd.2019.09.015] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 08/26/2019] [Accepted: 09/16/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND AIMS Recent studies have recognized triglyceride-glucose index (TyG) as a practical surrogate of insulin resistance. Previous studies have demonstrated that insulin resistance contributes to ischemic stroke via multiple mechanisms. Our study aimed to investigate the association between TyG and prevalent ischemic stroke, exploring the value of TyG to optimize the risk stratification of ischemic stroke. METHODS AND RESULTS This cross-sectional study included 10,900 subjects (mean age: 59.95 years, 59.8% females) from rural areas of northeast China between September 2017 to May 2018. TyG was calculated as ln[fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2]. The prevalence of ischemic stroke was 5.49%. After adjusting for all covariates, each SD increment of TyG caused 22.8% additional risk for ischemic stroke. When dividing TyG into quartiles, the top quartile had a 1.776 times risk for ischemic stroke against the bottom category. Furthermore, smoothing curve fitting demonstrated this association was linear in the whole range of TyG. Finally, AUC revealed an improvement when introducing TyG into clinical risk factors (0.746 vs 0.751, p = 0.029). Consistently, category-free net reclassification index (0.195, 95% CI: 0.112-0.277, P < 0.001) and integrated discrimination index (0.003, 95% CI: 0.001-0.004, P < 0.001) confirmed the improvement by TyG to stratify ischemic stroke risk. CONCLUSION The prevent ischemic stroke correlated proportionally with the increment of TyG, implicating the linearity of TyG as an indicator of ischemic stroke. Our findings suggest the potential value of TyG to optimize the risk stratification of ischemic stroke in a general population.
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Affiliation(s)
- Wenrui Shi
- Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Liying Xing
- Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China; Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, People's Republic of China
| | - Li Jing
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, People's Republic of China
| | - Yuanmeng Tian
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, People's Republic of China
| | - Han Yan
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, People's Republic of China
| | - Qun Sun
- Disease Control and Prevention of Chao Yang City, Chaoyang, Liaoning, People's Republic of China
| | - Dong Dai
- Disease Control and Prevention of Dan Dong City, Dandong, Liaoning, People's Republic of China
| | - Lei Shi
- Disease Control and Prevention of Liao Yang City, Liaoyang, Liaoning, People's Republic of China
| | - Shuang Liu
- Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang, 110005, Liaoning, People's Republic of China.
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22
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Gligorijevic N, Robajac D, Nedic O. Enhanced Platelet Sensitivity to IGF-1 in Patients with Type 2 Diabetes Mellitus. BIOCHEMISTRY (MOSCOW) 2019; 84:1213-1219. [PMID: 31694517 DOI: 10.1134/s0006297919100109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Diabetes mellitus is characterized by increased platelet activation which is determined by many factors including changes in the expression of membrane proteins. The aim of this study was to investigate the sensitivity of human platelets to the insulin-like growth factor (IGF) system in patients with poorly controlled type 2 diabetes mellitus (DM2). Ligand binding was analyzed using 125I-labelled IGF-1 and insulin, and relative expression of insulin-like growth factor 1 receptor (IGF-1R) and insulin receptor (IR) was evaluated by Western blotting. Platelet aggregation in the presence of IGF-1 was studied by the plate aggregometry assay. We found that platelets from DM2 patients exhibited significantly higher IGF-1 binding and upregulation of IGF-1R expression in comparison with healthy individuals. Both insulin binding and IR expression were lower in the DM2 group, but the differences with the healthy control were statistically insignificant. The potentiating effect of IGF-1 on the thrombin-induced activation of platelets was detected in both groups but was significantly more pronounced in the DM2 patients. The initial rate of platelet activation in the presence of IGF-1 positively correlated with the concentration of glycated hemoglobin. Platelets isolated from DM2 patients displayed elevated expression of the IGF-1R subunits, which might have contributed to the higher sensitivity of these cells to IGF-1 in thrombin-initiated aggregation by increasing the rate of platelet activation. However, further experiments are needed to investigate the role of IGF-1 in thrombotic complications that usually accompany diabetes.
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Affiliation(s)
- N Gligorijevic
- Institute for the Application of Nuclear Energy (INEP), University of Belgrade, Belgrade, 11080, Serbia.
| | - D Robajac
- Institute for the Application of Nuclear Energy (INEP), University of Belgrade, Belgrade, 11080, Serbia.
| | - O Nedic
- Institute for the Application of Nuclear Energy (INEP), University of Belgrade, Belgrade, 11080, Serbia.
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23
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IGF-1 facilitates thrombopoiesis primarily through Akt activation. Blood 2018; 132:210-222. [DOI: 10.1182/blood-2018-01-825927] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/22/2018] [Indexed: 12/21/2022] Open
Abstract
Key Points
IGF-1 has the ability to promote megakaryocyte differentiation, PPF, and platelet release. The effect of IGF-1 on thrombopoiesis is mediated primarily by AKT activation with the assistance of SRC-3.
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24
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Wersäll A, Williams CM, Brown E, Iannitti T, Williams N, Poole AW. Mouse Platelet Ral GTPases Control P-Selectin Surface Expression, Regulating Platelet-Leukocyte Interaction. Arterioscler Thromb Vasc Biol 2018; 38:787-800. [PMID: 29437579 DOI: 10.1161/atvbaha.117.310294] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 01/25/2018] [Indexed: 01/28/2023]
Abstract
OBJECTIVE RalA and RalB GTPases are important regulators of cell growth, cancer metastasis, and granule secretion. The purpose of this study was to determine the role of Ral GTPases in platelets with the use of platelet-specific gene-knockout mouse models. APPROACH AND RESULTS This study shows that platelets from double knockout mice, in which both GTPases have been deleted, show markedly diminished (≈85% reduction) P-selectin translocation to the surface membrane, suggesting a critical role in α-granule secretion. Surprisingly, however, there were only minor effects on stimulated release of soluble α- and δ-granule content, with no alteration in granule count, morphology, or content. In addition, their expression was not essential for platelet aggregation or thrombus formation. However, absence of surface P-selectin caused a marked reduction (≈70%) in platelet-leukocyte interactions in blood from RalAB double knockout mice, suggesting a role for platelet Rals in platelet-mediated inflammation. CONCLUSIONS Platelet Ral GTPases primarily control P-selectin surface expression, in turn regulating platelet-leukocyte interaction. Ral GTPases could therefore be important novel targets for the selective control of platelet-mediated immune cell recruitment and inflammatory disease.
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Affiliation(s)
- Andreas Wersäll
- From the School of Physiology, Pharmacology and Neuroscience, University of Bristol, United Kingdom (A.W., C.M.W., E.B., A.W.P.); and KWS Biotest, Portishead, Bristol, United Kingdom (T.I., N.W.).
| | - Chris M Williams
- From the School of Physiology, Pharmacology and Neuroscience, University of Bristol, United Kingdom (A.W., C.M.W., E.B., A.W.P.); and KWS Biotest, Portishead, Bristol, United Kingdom (T.I., N.W.)
| | - Edward Brown
- From the School of Physiology, Pharmacology and Neuroscience, University of Bristol, United Kingdom (A.W., C.M.W., E.B., A.W.P.); and KWS Biotest, Portishead, Bristol, United Kingdom (T.I., N.W.)
| | - Tommaso Iannitti
- From the School of Physiology, Pharmacology and Neuroscience, University of Bristol, United Kingdom (A.W., C.M.W., E.B., A.W.P.); and KWS Biotest, Portishead, Bristol, United Kingdom (T.I., N.W.)
| | - Neil Williams
- From the School of Physiology, Pharmacology and Neuroscience, University of Bristol, United Kingdom (A.W., C.M.W., E.B., A.W.P.); and KWS Biotest, Portishead, Bristol, United Kingdom (T.I., N.W.)
| | - Alastair W Poole
- From the School of Physiology, Pharmacology and Neuroscience, University of Bristol, United Kingdom (A.W., C.M.W., E.B., A.W.P.); and KWS Biotest, Portishead, Bristol, United Kingdom (T.I., N.W.)
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Abstract
Insulin resistance often refers to a pathological condition in which cells fail to respond to the normal actions of insulin. Increasing literature has noted a critical role of insulin resistance in the pathogenesis of ischemic stroke. Insulin resistance plays an important role in the pathogenesis of ischemic stroke via enhancing advanced changes of atherosclerosis. A variety of literature indicates that insulin resistance enhances platelet adhesion, activation and aggregation which are conducive to the occurrence of ischemic stroke. Insulin resistance also induces hemodynamic disturbances and contributes to the onset of ischemic stroke. In addition, insulin resistance may augment the role of the modifiable risk factors in ischemic stroke and induce the occurrence of ischemic stroke. Preclinical and clinical studies have supported that improving insulin resistance may be an effective measure to prevent or delay ischemic stroke.
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Affiliation(s)
- Xiao-Ling Deng
- Department of Neurology, Renmin Hospital, Hubei University of Medicine, Shiyan Renmin Hospital, Shiyan, 442000, Hubei Province, People's Republic of China
| | - Zhou Liu
- Department of Neurology, The Affiliated Hospital of Guangdong Medical University, and Institute of Neurology, Guangdong Medical University, Zhanjiang, Guangdong Province, People's Republic of China
| | - Chuanling Wang
- Department of Pathology, Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Yanfeng Li
- Department of Neurology, Peking Union Medical College Hospital, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China.
| | - Zhiyou Cai
- Department of Neurology, Chongqing General Hospital, No. 312 Zhongshan First Road, Yuzhong District, Chongqing, 400013, People's Republic of China.
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26
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Przygodzki T, Talar M, Kassassir H, Mateuszuk L, Musial J, Watala C. Enhanced adhesion of blood platelets to intact endothelium of mesenteric vascular bed in mice with streptozotocin-induced diabetes is mediated by an up-regulated endothelial surface deposition of VWF - In vivo study. Platelets 2017; 29:476-485. [PMID: 28745543 DOI: 10.1080/09537104.2017.1332365] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Numerous in vitro experiments have confirmed that a dysfunctional endothelium is characterized by, inter alia, a higher affinity for binding of platelets and leukocytes. However, there is still no direct evidence for greater interaction between platelets and intact endothelium in in vivo animal models of diabetes. Therefore, the present study examines the pro-adhesive properties of endothelium change in vivo as an effect of streptozotocin (STZ)-induced diabetes and the role of two key platelet receptors: GPIb-IX-V and GPIIb/IIIa. Mice of C57BL strain with streptozotocin-induced diabetes were used in the study. Flow cytometry was used to assess basal activation and reactivity of platelets. Adhesion of platelets to the vascular wall was visualized with the use of intravital microscopy in mesentery. The contribution of GPIIb/IIIa and GPIb-IX-V was evaluated by the injection of Fab fragments of respective antibodies. The integrity of the endothelium and vWf expression were evaluated histochemically. Basal activation and reactivity of platelets in streptozotocin-diabetic mice were elevated. Blood platelets adhered more often to the vascular wall of diabetic mice than nondiabetic animals: 11.9 (6.4; 32.8) plt/min/mm2 (median [IQR]) vs 2.7 (1.3; 6.4) plt/min/mm2. The injection of anti-GPIbα antibodies decreased the number of adhering platelets from 89.5 (34.0; 113.1) plt/min/mm2 (median [IQR]) in mice treated with isotype antibodies to 3.1 (1.7; 5.6) plt/min/mm2 in mice treated with blocking antibodies. The effect of GPIIb/IIIa blockage was not significant. Immunohistochemistry revealed a higher expression of vWF in the endothelium of STZ mice, but no substantial changes in endothelial morphology were detected. To conclude, the study shows that the platelets interact more frequently with the mesenteric vascular bed in mice with 1-month STZ-induced diabetes than in healthy mice. These interactions are mediated via platelet GPIb-IX-V and are driven by increased expression of vWF in endothelial cells.
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Affiliation(s)
- Tomasz Przygodzki
- a Department of Haemostasis and Haemostatic Disorders , Medical University of Lodz , Lodz , Poland
| | - Marcin Talar
- a Department of Haemostasis and Haemostatic Disorders , Medical University of Lodz , Lodz , Poland
| | - Hassan Kassassir
- a Department of Haemostasis and Haemostatic Disorders , Medical University of Lodz , Lodz , Poland
| | - Lukasz Mateuszuk
- b Jagiellonian Centre for Experimental Therapeutics (JCET) , Jagiellonian University , Krakow , Poland
| | - Jacek Musial
- c Synevo Central Laboratory , Department of Pathology , Lodz , Poland
| | - Cezary Watala
- a Department of Haemostasis and Haemostatic Disorders , Medical University of Lodz , Lodz , Poland
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Ponsuksili S, Reyer H, Trakooljul N, Murani E, Wimmers K. Single- and Bayesian Multi-Marker Genome-Wide Association for Haematological Parameters in Pigs. PLoS One 2016; 11:e0159212. [PMID: 27434032 PMCID: PMC4951017 DOI: 10.1371/journal.pone.0159212] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/28/2016] [Indexed: 12/15/2022] Open
Abstract
Haematological traits are important traits that show associations with immune and metabolic status, as well as diseases in humans and animals. Mapping genome regions that affect the blood cell traits can contribute to the identification of genomic features useable as biomarkers for immune, disease and metabolic status. A genome-wide association study (GWAS) was conducted using PorcineSNP60 BeadChips. Single-marker and Bayesian multi-marker approaches were integrated to identify genomic regions and corresponding genes overlapping for both methods. GWAS was performed for haematological traits of 591 German Landrace pig. Heritability estimates for haematological traits were medium to high. In total 252 single SNPs associated with 12 haematological traits were identified (NegLog10 of p-value > 5). The Bayesian multi-marker approach revealed 102 QTL regions across the genome, indicated by 1-Mb windows with contribution to additive genetic variance above 0.5%. The integration of both methods resulted in 24 overlapping QTL regions. This study identified overlapping QTL regions from single- and multi-marker approaches for haematological traits. Identifying candidate genes that affect blood cell traits provides the first step towards the understanding of the molecular basis of haematological phenotypes.
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Affiliation(s)
- Siriluck Ponsuksili
- Research Unit ‘Functional Genome Analyses’, Institute for Genome Biology, Leibniz Institute for Farm Animal Biology (FBN), Wilhelm-Stahl-Allee 2, D-18196, Dummerstorf, Germany
| | - Henry Reyer
- Research Unit ‘Genomics’, Institute for Genome Biology, Leibniz Institute for Farm Animal Biology (FBN), Wilhelm-Stahl-Allee 2, D-18196, Dummerstorf, Germany
| | - Nares Trakooljul
- Research Unit ‘Genomics’, Institute for Genome Biology, Leibniz Institute for Farm Animal Biology (FBN), Wilhelm-Stahl-Allee 2, D-18196, Dummerstorf, Germany
| | - Eduard Murani
- Research Unit ‘Genomics’, Institute for Genome Biology, Leibniz Institute for Farm Animal Biology (FBN), Wilhelm-Stahl-Allee 2, D-18196, Dummerstorf, Germany
| | - Klaus Wimmers
- Research Unit ‘Genomics’, Institute for Genome Biology, Leibniz Institute for Farm Animal Biology (FBN), Wilhelm-Stahl-Allee 2, D-18196, Dummerstorf, Germany
- * E-mail:
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28
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Cubbon RM, Kearney MT, Wheatcroft SB. Endothelial IGF-1 Receptor Signalling in Diabetes and Insulin Resistance. Trends Endocrinol Metab 2016; 27:96-104. [PMID: 26712712 DOI: 10.1016/j.tem.2015.11.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 11/22/2015] [Accepted: 11/24/2015] [Indexed: 01/19/2023]
Abstract
Despite contemporary medical therapy, people with diabetes and insulin resistance experience substantially increased risk of cardiovascular events caused by atherosclerosis. Dysfunction of the endothelium is a key phase in early atherogenesis and represents a promising therapeutic target. The evolutionarily related insulin and insulin-like growth factor-1 (IGF-1) axes are implicated in the development of vascular disease. In this review, we summarise recent developments in our understanding of how modulating the IGF-1 axis influences vascular disease in the setting of insulin resistance. By contrasting data from models of altered insulin and/or IGF-1 signalling, we emphasise the complex spatiotemporal interplay of these systems in health and disease. We then discuss therapeutic opportunities, before detailing important gaps in our knowledge relevant to therapeutic translation.
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Affiliation(s)
- Richard M Cubbon
- Leeds Institute for Cardiovascular and Metabolic Medicine, LIGHT laboratories, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK
| | - Mark T Kearney
- Leeds Institute for Cardiovascular and Metabolic Medicine, LIGHT laboratories, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
| | - Stephen B Wheatcroft
- Leeds Institute for Cardiovascular and Metabolic Medicine, LIGHT laboratories, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK
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