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Luo C, Li Q, Wang Z, Duan S, Ma Q. Association between triglyceride glucose-body mass index and all-cause mortality in critically ill patients with acute myocardial infarction: retrospective analysis of the MIMIC-IV database. Front Nutr 2024; 11:1399969. [PMID: 38962445 PMCID: PMC11221264 DOI: 10.3389/fnut.2024.1399969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/03/2024] [Indexed: 07/05/2024] Open
Abstract
Background Insulin resistance (IR) is closely related to the development of cardiovascular diseases. Triglyceride-glucose-body mass index (TyG-BMI) has been proven to be a reliable surrogate of IR, but the relationship between TyG-BMI and acute myocardial infarction (AMI) is unknown. The present study aims to determine the effects of TyG-BMI on the clinical prognosis of critically ill patients with AMI. Methods The data of AMI patients were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. All patients were divided into four groups according to the TyG-BMI quartile. Outcomes were defined as 30-, 90-, 180-, and 365-day all-cause mortality. Kaplan-Meier (K-M) curve was used to compare survival rate between groups. Meanwhile, Cox regression analysis and restricted cubic splines (RCS) were used to explore the relationship between TyG-BMI index and outcome events. Results A total of 1,188 critically ill patients with AMI were included in this study. They were divided into four groups according to TyG-BMI quartiles, there were significant differences in 90-, 180-, and 365-day all-cause mortality while there was no difference in 30-day all-cause mortality. Interestingly, with the increase of TyG-BMI, the 90-, 180-, and 365-day survival rate increased first and then gradually decreased, but the survival rate after decreasing was still higher than that in the group with the lowest TyG-BMI. U-shaped relationships between TyG-BMI index and 90-, 180-, and 365-day all-cause mortality were identified using RCS curve and the inflection point was 311.1, 316.5, and 320.1, respectively, whereas the TyG-BMI index was not non-linearly associated with 30-day all-cause mortality. The results of Cox proportional hazard regression analysis are consistent with those of RCS analysis. Conclusion U-shaped relationships are existed between the TyG-BMI index and 90-, 180-, and 365-day all-cause mortality in critically ill patients with AMI, but not 30-day all-cause mortality. The TyG-BMI index can be used as an effective index for early prevention of critically ill patients with AMI.
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Affiliation(s)
- Chaodi Luo
- Department of Peripheral Vascular Diseases, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qian Li
- Department of Cardiology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Zhuoer Wang
- Medical College of Xi’an Jiaotong University, Xi’an, China
| | - Sifan Duan
- Department of Peripheral Vascular Diseases, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qiang Ma
- Department of Peripheral Vascular Diseases, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Cheng H, Jia Z, Li YT, Yu X, Wang JJ, Xie YJ, Hernandez J, Wang HHX. Metabolic Score for Insulin Resistance and New-Onset Type 2 Diabetes in a Middle-Aged and Older Adult Population: Nationwide Prospective Cohort Study and Implications for Primary Care. JMIR Public Health Surveill 2024; 10:e49617. [PMID: 38569189 PMCID: PMC11184265 DOI: 10.2196/49617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 02/29/2024] [Accepted: 03/29/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND The metabolic score for insulin resistance (METS-IR) has emerged as a noninsulin-based index for the approximation of insulin resistance (IR), yet longitudinal evidence supporting the utility of METS-IR in the primary prevention of type 2 diabetes mellitus (T2DM) remains limited. OBJECTIVE We aimed to investigate the longitudinal association between METS-IR, which combines fasting plasma glucose (FPG), lipid profiles, and anthropometrics that can be routinely obtained in resource-limited primary care settings, and the incidence of new-onset T2DM. METHODS We conducted a closed-cohort analysis of a nationwide, prospective cohort of 7583 Chinese middle-aged and older adults who were free of T2DM at baseline, sampled from 28 out of 31 provinces in China. We examined the characteristics of participants stratified by elevated blood pressure (BP) at baseline and new-onset T2DM at follow-up. We performed Cox proportional hazard regression analysis to explore associations of baseline METS-IR with incident T2DM in participants overall and in participants stratified by baseline BP. We also applied net reclassification improvement and integrated discrimination improvement to examine the incremental value of METS-IR. RESULTS During a mean follow-up period of 6.3 years, T2DM occurred in 527 participants, among which two-thirds (332/527, 62.9%; 95% CI 58.7%-67.1%) had baseline FPG<110 mg/dL. A SD unit increase in baseline METS-IR was associated with the first incidence of T2DM (adjusted hazard ratio [aHR] 1.33, 95% CI 1.22-1.45; P<.001) in all participants. We obtained similar results in participants with normal baseline BP (aHR 1.41, 95% CI 1.22-1.62; P<.001) and elevated baseline BP (aHR 1.29, 95% CI 1.16-1.44; P<.001). The predictive capability for incident T2DM was improved by adding METS-IR to FPG. In study participants with new-onset T2DM whose baseline FPG was <126 mg/dL and <110 mg/dL, 62.9% (332/527; 95% CI 60%-65.9%) and 58.1% (193/332; 95% CI 54.3%-61.9%) of participants had baseline METS-IR above the cutoff values, respectively. CONCLUSIONS METS-IR was significantly associated with new-onset T2DM, regardless of baseline BP level. Regular monitoring of METS-IR on top of routine blood glucose in clinical practice may add to the ability to enhance the early identification of primary care populations at risk for T2DM.
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Affiliation(s)
- Hui Cheng
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Zhihui Jia
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Yu Ting Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Xiao Yu
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Jia Ji Wang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, China (Hong Kong)
| | - Jose Hernandez
- Faculty of Medicine and Health, EDU, Digital Education Holdings Ltd, Kalkara, Malta
- Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - Harry H X Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, China (Hong Kong)
- Usher Institute, Deanery of Molecular, Genetic & Population Health Sciences, The University of Edinburgh, Edinburgh, United Kingdom
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Stefan N, Schulze MB. Metabolic health and cardiometabolic risk clusters: implications for prediction, prevention, and treatment. Lancet Diabetes Endocrinol 2023; 11:426-440. [PMID: 37156256 DOI: 10.1016/s2213-8587(23)00086-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/13/2023] [Accepted: 03/13/2023] [Indexed: 05/10/2023]
Abstract
Among 20 leading global risk factors for years of life lost in 2040, reference forecasts point to three metabolic risks-high blood pressure, high BMI, and high fasting plasma glucose-as being the top risk variables. Building upon these and other risk factors, the concept of metabolic health is attracting much attention in the scientific community. It focuses on the aggregation of important risk factors, which allows the identification of subphenotypes, such as people with metabolically unhealthy normal weight or metabolically healthy obesity, who strongly differ in their risk of cardiometabolic diseases. Since 2018, studies that used anthropometrics, metabolic characteristics, and genetics in the setting of cluster analyses proposed novel metabolic subphenotypes among patients at high risk (eg, those with diabetes). The crucial point now is whether these subphenotyping strategies are superior to established cardiometabolic risk stratification methods regarding the prediction, prevention, and treatment of cardiometabolic diseases. In this Review, we carefully address this point and conclude, firstly, regarding cardiometabolic risk stratification, in the general population both the concept of metabolic health and the cluster approaches are not superior to established risk prediction models. However, both subphenotyping approaches might be informative to improve the prediction of cardiometabolic risk in subgroups of individuals, such as those in different BMI categories or people with diabetes. Secondly, the applicability of the concepts by treating physicians and communication of the cardiometabolic risk with patients is easiest using the concept of metabolic health. Finally, the approaches to identify cardiometabolic risk clusters in particular have provided some evidence that they could be used to allocate individuals to specific pathophysiological risk groups, but whether this allocation is helpful for prevention and treatment still needs to be determined.
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Affiliation(s)
- Norbert Stefan
- Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany; Institute of Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich, Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany.
| | - Matthias B Schulze
- German Center for Diabetes Research (DZD), Neuherberg, Germany; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
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Liu X, Abudukeremu A, Jiang Y, Cao Z, Wu M, Ma J, Sun R, He W, Chen Z, Chen Y, Yu P, Zhu W, Zhang Y, Wang J. U-shaped association between the triglyceride-glucose index and atrial fibrillation incidence in a general population without known cardiovascular disease. Cardiovasc Diabetol 2023; 22:118. [PMID: 37208737 DOI: 10.1186/s12933-023-01777-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/20/2023] [Indexed: 05/21/2023] Open
Abstract
OBJECTIVE The triglyceride-glucose (TyG) index has been shown to be a new alternative measure for insulin resistance. However, no study has attempted to investigate the association of the TyG index with incident atrial fibrillation (AF) in the general population without known cardiovascular diseases. METHODS Individuals without known cardiovascular diseases (heart failure, coronary heart disease, or stroke) from the Atherosclerosis Risk in Communities (ARIC) cohort were recruited. The baseline TyG index was calculated as the Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. The association between the baseline TyG index and incident AF was examined using Cox regression. RESULTS Of 11,851 participants, the mean age was 54.0 years; 6586 (55.6%) were female. During a median follow-up of 24.26 years, 1925 incidents of AF cases (0.78/per 100 person-years) occurred. An increased AF incidence with a graded TyG index was found by Kaplan‒Meier curves (P < 0.001). In multivariable-adjusted analysis, both < 8.80 (adjusted hazard ratio [aHR] = 1.15, 95% confidence interval [CI] 1.02, 1.29) and > 9.20 levels (aHR 1.18, 95% CI 1.03, 1.37) of the TyG index were associated with an increased risk of AF compared with the middle TyG index category (8.80-9.20). The exposure-effect analysis confirmed the U-shaped association between the TyG index and AF incidence (P = 0.041). Further sex-specific analysis showed that a U-shaped association between the TyG index and incident AF still existed in females but not in males. CONCLUSIONS A U-shaped association between the TyG index and AF incidence is observed in Americans without known cardiovascular diseases. Female sex may be a modifier in the association between the TyG index and AF incidence.
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Affiliation(s)
- Xiao Liu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, The Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Ayiguli Abudukeremu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yuan Jiang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Zhengyu Cao
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Maoxiong Wu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Jianyong Ma
- Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, USA
| | - Runlu Sun
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Wanbing He
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Zhiteng Chen
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Yangxin Chen
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Peng Yu
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, The Second Affiliated Hospital of Nanchang University, Jiangxi, China.
- Department of Endocrine, The Second Affiliated Hospital of Nanchang University, Jiangxi, China.
| | - Wengen Zhu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
| | - Yuling Zhang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China.
| | - Jingfeng Wang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China.
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Xuan X, Hamaguchi M, Cao Q, Okamura T, Hashimoto Y, Obora A, Kojima T, Fukui M, Yuan G, Guo Z, Luo Z, Qin Y, Luo X, Xie X. U-shaped association between the triglyceride-glucose index and the risk of incident diabetes in people with normal glycemic level: A population-base longitudinal cohort study. Clin Nutr 2021; 40:1555-1561. [PMID: 33743291 DOI: 10.1016/j.clnu.2021.02.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 02/06/2021] [Accepted: 02/23/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Previous studies have shown that a high baseline triglyceride-glucose (TyG) index is a potential risk factor for type 2 diabetes mellitus (T2DM). However, for a low TyG index, findings have been inconsistent. Moreover, the association between the baseline TyG index and incident T2DM in individuals with normal glycemic levels remains unclear. Therefore, this longitudinal study further examined and characterized the association between the baseline TyG index and incident T2DM in Japanese adults with normal glycemic levels. . METHODS The participants (7857 men and 6440 women) were selected from the NAGALA (NAfld in the Gifu Area Longitudinal Analysis) study that was conducted from 2004 to 2015. Cox proportional hazards models were used to evaluate the associations between baseline TyG index and T2DM incidence, and a two-piecewise linear regression model was used to examine the threshold effect of the baseline TyG index on incident T2DM using a smoothing function. RESULTS During a median follow-up period of 5.26 (women) and 5.88 (men) years, 47 women and 182 men developed T2DM. The risk of T2DM was strongly associated with the baseline TyG index in the fully adjusted model in men but not in women, and no dose-dependent positive relationship between incident T2DM and the TyG index was observed across the TyG tertiles. Interestingly, the two-piecewise linear regression analysis revealed a U-shaped association between the baseline TyG index and incident T2DM. Baseline TyG index lower than the threshold values (TyG index < 7.27 in women and <7.97 in men) were negatively associated with incident T2DM (hazard ratio [HR] = 0.09, 95% confidence interval [CI] = 0.01-0.93, P = 0.0435 for women and HR = 0.21, 95% CI = 0.08-0.57, P = 0.0021 for men). In contrast, baseline TyG index higher than the threshold values (TyG index > 7.27 in women and >7.97 in men) were positively associated with incident T2DM (HR = 2.76, 95% CI = 1.20-6.34, P = 0.0166 for women and HR = 2.42, 95% CI = 1.66-3.53, P < 0.0001 for men). CONCLUSIONS A U-shaped association was observed between the baseline TyG index and incident T2DM in a Japanese population.
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Affiliation(s)
- Xiuping Xuan
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Qiuli Cao
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Akihiro Obora
- Department of Gastroenterology, Asahi University Hospital, 3-23, Hashimoto-cho, Gifu, Japan
| | - Takao Kojima
- Department of Gastroenterology, Asahi University Hospital, 3-23, Hashimoto-cho, Gifu, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Guandou Yuan
- Division of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zhenya Guo
- Division of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zuojie Luo
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yingfen Qin
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
| | - Xiaoping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuemei Xie
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
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Feng S, Tian ZL, Xi HL, Wang XK, Jia GL. Modified billiopancreatic diversion surgery improves glucose levels in Goto-Kakizaki rats. Shijie Huaren Xiaohua Zazhi 2014; 22:766-772. [DOI: 10.11569/wcjd.v22.i6.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare the effect of modified billiopancreatic diversion (MBPD) surgery versus duodenal-jejunal bypass (DJB) surgery in improving glucose levels in Goto-Kakizaki (GK) rats, and to explore the possible mechanisms.
METHODS: Thirty male GK rats were randomized into three groups to undergo sham operation, MBPD surgery and DJB surgery, respectively. Body mass, fasting plasma glucose and random plasma glucose were determined 1 week before and 1, 4, 8 wk after operation. Insulin, oral glucose tolerance test (OGTT), cholesterol, triglyceride and free fatty acid were determined 1 wk before and 4 wk after operation.
RESULTS: One week after the surgery, body mass of MBPD- and DJB-treated rats significantly decreased (304.990 g ± 12.156 g vs 320.568 g ± 10.607 g, P = 0.011; 308.540 g ± 9.637 g vs 320.568 g ± 10.607 g, P = 0.024). MBPD- and DJB-treated rats had better oral glucose tolerance (17.350 mmol/L ± 2.220 mmol/L vs 20.600 mmol/L ± 2.381 mmol/L, P = 0.009; 18.238 mmol/L ± 1.364 mmol/L vs 20.600 mmol/L ± 2.381 mmol/L, P = 0.024) compared with the sham operation group. Random plasma glucose (9.620 mmol/L ± 0.794 mmol/L vs 14.471 mmol/L ± 2.531 mmol/L, P < 0.001; 9.200 mmol/L ± 1.000 mmol/L vs 14.471 mmol/L ± 2.531 mmol/L, P < 0.001), insulin (0.476 ng/mL± 0.068 ng/mL vs 0.724 ng/mL ± 0.192 ng/mL, P < 0.05; 0.542 ng/mL ± 0.055 ng/mL vs 0.724 ng/mL ± 0.192 ng/mL, P < 0.05), cholesterol (2.550 mmol/L ± 0.691 mmol/L vs 3.125 mmol/L ± 0.267 mmol/L, P < 0.05; 2.450 mmol/L ± 0.424 mmol/L vs 3.125 mmol/L ± 0.267 mmol/L, P < 0.05) and free fatty acid (697.667 μEq/L ± 103.77 μEq/L vs 994.667 μEq/L ± 257.817 μEq/L, P < 0.05; 670.333 μEq/L ± 129.421 μEq/L vs 994.667 μEq/L ± 257.817 μEq/L, P < 0.05) of NBPD- and DJB-treated rats were lower than those in the sham operation group after operation, but triglycerides (1.329 mmol/L ± 0.716 mmol/L vs 0.754 mmol/L ± 0.236 mmol/L, P < 0.05; 1.569 mmol/L ± 0.612 mmol/L vs 0.754 mmol/L ± 0.236 mmol/L, P < 0.05) of NBPD- and DJB-treated rats were significantly higher.
CONCLUSION: Modified billiopancreatic diversion surgery is superior to bowel bypass in improving glucose levels in Goto-Kakizaki rats.
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Bozorgmanesh M, Hadaegh F, Saadat N, Azizi F. Fasting glucose cutoff point: where does the risk terminate? Tehran lipid and glucose study. Acta Diabetol 2012; 49:341-8. [PMID: 21617883 DOI: 10.1007/s00592-011-0298-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Accepted: 05/11/2011] [Indexed: 02/02/2023]
Abstract
The aim of this study is to determine safe fasting plasma glucose (FPG) levels. We included data on 5,960 individuals aged ≥20 years at baseline with at least one follow-up examination. Diabetes was ascertained in accordance with American Diabetes Association criteria, using standard 2-h post-challenge plasma glucose test. Multivariate restricted cubic splines Weibull regression was implemented for interval-censored survival data on incident diabetes. We used Harrell's C statistic for discrimination, Nam-D'Agostino χ(2) for calibration, and Royston's R(2) for variations in the outcome explained by models. During a 6-year median follow-up, 369 incident cases of diabetes were ascertained. Family history of diabetes, systolic blood pressure, waist-to-height ratio, and triglyceride-to-high-density lipoprotein cholesterol ratio, independent of FPG and each other remained associated with incident diabetes. The cubic splines model achieved good calibration (χ(2) = 12.1) and discrimination (C = 0.828) and explained 75% of variation in the time until incident diabetes. A J-shaped FPG-diabetes relationship was observed. Descending arm of the dose-response relationship curve corresponded to increasing FPG levels up to 4.0 mmol l(-1), where it started increasing. The risk of incident diabetes decreased with decreasing levels of FPG down to 4.0 mmol l(-1), where the risk stopped decreasing. Multivariate-adjusted risk of incident diabetes was zero at FPG = 5.05 mmol l(-1). Although currently there is no firm evidence to show that early intervention among individuals with the elevated FPG levels could prevent or delay onset of diabetes, individuals with FPG levels below 5.05 mmol l(-1) could be safely reassured about their near-term risk of developing incident diabetes and screened on a less frequent basis.
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Affiliation(s)
- Mohammadreza Bozorgmanesh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
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