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Paramanathan T, Sandrasegarampillai B, Arasaratnam V, Thirunavukarasu K. The discriminative ability of the triglyceride-glucose index to identify metabolic syndrome among adults of the northern Sri Lankan population. BMC Endocr Disord 2024; 24:101. [PMID: 38951832 DOI: 10.1186/s12902-024-01632-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 06/21/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND The triglyceride-glucose index (TyG index) is a simple surrogate marker for Insulin Resistance (IR). However, the relationship between the TyG index and Metabolic Syndrome (MetS) remains unknown in the Northern Sri Lankan population. METHODS This was a descriptive, cross-sectional study of adults aged between 18 and 65 years living in Jaffna, Sri Lanka. This study aimed to verify the discriminative ability of the TyG index to identify MetS using the International Diabetes Federation (IDF-2006) criteria and to determine the gender-specific TyG index cut-off values for better prediction of MetS in Northern Sri Lankan adults. TyG index was calculated as Ln[Triglycerides (TG) (mg/dl) × Fasting plasma glucose (FPG) (mg/dl)/2]. RESULTS A total of 540 individuals were included in this study, with a mean age of 42.18 (± 13.89) years for males and 43.80 (± 12.56) years for females. The mean value of the TyG index in the total study population was 8.54 (± 0.53). Individuals in the higher quartiles of the TyG index had a significantly increased risk of MetS compared with those in the lowest quartile (p < 0.01). TyG index showed a stronger association with MetS than the FPG and all the conventional lipid components and the unadjusted odds ratio was 5.47. The area under the curve (AUC) of ROC revealed values of 0.914 (95% confidence interval (CI): 0.884, 0.944) for females, 0.881 (95% CI: 0.830, 0.932) for males and 0.897 (95% CI: 0.870, 0.924) for the total study population. TyG index had a stronger discriminative ability to identify MetS as per IDF criteria in the study population with a cut-off value of 8.60. The mean level of the TyG index significantly increased with the increasing number of MetS components. CONCLUSIONS The mean value of the TyG index increased as the number of MetS components in the study population increased. Individuals with a higher TyG index had a significantly increased risk of having MetS compared with the lowest quartile of the TyG index. TyG index had a good discriminative ability to diagnose MetS as per IDF criteria among the northern Sri Lankan population.
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Affiliation(s)
- Thurka Paramanathan
- Department of Biochemistry, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka.
| | | | - Vasanthy Arasaratnam
- Department of Biochemistry, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
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Noh ES, Hwang IT. Triglyceride-glucose-alanine aminotransferase index: A noninvasive serum predictor for identifying the severity of pediatric nonalcoholic fatty liver disease. Medicine (Baltimore) 2024; 103:e38241. [PMID: 38941428 DOI: 10.1097/md.0000000000038241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
We hypothesized that the triglyceride-glucose (TyG)-alanine aminotransferase (ALT) index, which combines the TyG index with ALT, may enhance sensitivity and specificity in detecting the severity of nonalcoholic fatty liver disease (NAFLD). A total of 131 NAFLD patients with a mean age of 11.5 ± 2.29 years were enrolled, and severity was assessed by ultrasound fatty liver index (US-FLI) scoring. The TyG-ALT index was defined as ln(fasting triglyceride [mg/dL] × fasting glucose [mg/dL] × ALT [IU/L]/2). Multiple linear regression analysis revealed a significant association between the TyG-ALT index and US-FLI (β = 0.317, P < .001) after controlling for sex, age, and body mass index. The TyG-ALT index showed a more stable and superior ability to detect the severity of NAFLD compared to both ALT and the TyG index. The area under the curve values, listed in the order of ALT, TyG index, and TyG-ALT index, were as follows: 0.737 (P < .001), 0.599 (P = .055), and 0.704 (P < .001) at US-FLI ≥ 4 points; 0.717 (P < .001), 0.720 (P < .001), and 0.775 (P < .001) at US-FLI ≥ 5 points; and 0.689 (P < .05), 0.748 (P < .01), and 0.775 (P < .001) at US-FLI ≥ 6 points. The TyG-ALT index is associated with US-FLI score and superior to both ALT and the TyG index in predicting NAFLD severity. These findings indicate the potential of the TyG-ALT index in the management of pediatric NAFLD progression.
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Affiliation(s)
- Eu-Seon Noh
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
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Yin C, Hou Q, Qi Q, Han Q, Wang X, Wu S, Li K. Triglyceride-Glucose Index Predicts Major Adverse Cardiovascular and Cerebrovascular Events in Patients with Atrial Fibrillation. Int Heart J 2024; 65:373-379. [PMID: 38749753 DOI: 10.1536/ihj.23-413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
This study aimed to explore the relationship between the trajectory of the triglyceride-glucose (TyG) index and the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) in patients with atrial fibrillation (AF).This prospective study included 1979 patients with AF, who were initially selected from the Kailuan study. Patients of AF were split into four groups according to the value of TyG index. The clinical endpoint was MACCE, including myocardial infarction and ischemic stroke. Cox proportional hazard models were employed to examine the hazard ratio (HR) and 95% confidence interval (CI) for MACCE in various trajectory groups.The mean age of all patients with AF was 67.65 ± 11.15 years, and 1752 (88.53%) were male. Over a median follow-up duration of 5.31 years, in total 227 MACCE were recorded. MACCE cumulative incidence in Quartile 4 (26.96%) was significantly higher than those in other quartiles (P = 0.023). Multivariate Cox proportional hazards regression analysis showed that a higher TyG index (Quartile 4) was significantly and positively linked to MACCE in patients with AF (P = 0.023, HR: 2.103; 95% CI: 1.107-3.994).The evaluated TyG index is significantly associated with an increased risk of MACCE in patients with AF.
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Affiliation(s)
- Chunhui Yin
- Department of Cardiology, Tangshan Gongren Hospital
| | | | | | - Quanle Han
- Department of Cardiology, Tangshan Gongren Hospital
| | - Xiaoyao Wang
- College of Life Sciences, Hebei Normal University
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital
| | - Kangbo Li
- School of Clinical Medicine, North China University of Science and Technology
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin
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Hou Q, Zhang H, Zhang R, Li B, Li L, Li D, Wang X, Liu Y, Wan Z, Zhang J, Shuai P. Relationship between the longitudinal trajectory of the triglyceride-glucose index and the development of CKD: an 8-year retrospective longitudinal cohort study. Front Endocrinol (Lausanne) 2024; 15:1376166. [PMID: 38859908 PMCID: PMC11163917 DOI: 10.3389/fendo.2024.1376166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/02/2024] [Indexed: 06/12/2024] Open
Abstract
Background The triglyceride-glucose (TyG) index, a simple surrogate marker of insulin resistance, is significantly associated with chronic kidney disease (CKD). However, there is limited research on the longitudinal trajectory of TyG index over time and its relationship with CKD. Objective To analyse the characteristics of the longitudinal trajectory of the TyG index over time and its association with the development of CKD in a health check-up population. Methods Participants who underwent at least three annual health check-ups at the Health Management Center of Sichuan Provincial People's Hospital from 2015 to 2022 were included in this retrospective cohort study. The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. The latent class mixed model (LCMM) was used to identify the TyG index trajectory of the study population. A Cox proportional hazard model was used to estimate the CKD incidence risk in different quartile groups and the association of changes in the TyG index trajectory with the development of CKD. Results A total of 4,921 participants were included in this study, and they were divided into four groups according to the quartiles of the baseline TyG index: Q1 (5.43-6.66), Q2 (6.67-7.04), Q3 (7.05-7.43), and Q4 (7.43-9.97). There was no difference in the risk of CKD occurrence among the TyG groups. Three different TyG index trajectories were identified in this study: a high-level group, middle-level stable group and low-level stable group, respectively. The incidence rate of CKD in the high-level TyG index trajectory group was 2.399 times greater than that in the low-level stable trajectory group (HR=2.399, 95% CI 1.167-4.935). Conclusion Individuals with long-term exposure to high TyG index levels had a significantly greater risk of CKD. Routine monitoring of the TyG index and its longitudinal trend will aid in the risk stratification of CKD in the general population and will be helpful for CKD prevention and targeted management.
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Affiliation(s)
- Qinchuan Hou
- Health Management Center & Health Management Research Institute, Sichuan Provincial People’s Hospital, Chengdu, China
- School of Public Health, Southwest Medical University, Luzhou, China
| | - Huiwang Zhang
- Health Management Center & Health Management Research Institute, Sichuan Provincial People’s Hospital, Chengdu, China
- School of Public Health, Southwest Medical University, Luzhou, China
| | - Rui Zhang
- Health Management Center & Health Management Research Institute, Sichuan Provincial People’s Hospital, Chengdu, China
- School of Public Health, Southwest Medical University, Luzhou, China
| | - Binghong Li
- Health Management Center & Health Management Research Institute, Sichuan Provincial People’s Hospital, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Lei Li
- Health Management Center & Health Management Research Institute, Sichuan Provincial People’s Hospital, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Dongyu Li
- Health Management Center & Health Management Research Institute, Sichuan Provincial People’s Hospital, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xian Wang
- Health Management Center & Health Management Research Institute, Sichuan Provincial People’s Hospital, Chengdu, China
| | - Yuping Liu
- Health Management Center & Health Management Research Institute, Sichuan Provincial People’s Hospital, Chengdu, China
| | - Zhengwei Wan
- Health Management Center & Health Management Research Institute, Sichuan Provincial People’s Hospital, Chengdu, China
| | - Junlin Zhang
- Health Management Center & Health Management Research Institute, Sichuan Provincial People’s Hospital, Chengdu, China
| | - Ping Shuai
- Health Management Center & Health Management Research Institute, Sichuan Provincial People’s Hospital, Chengdu, China
- School of Public Health, Southwest Medical University, Luzhou, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Han Y, Meng X, Wang D. Association Between Triglyceride Glucose Index with Cognitive Impairment and Dementia in Adult Population: A Meta-Analysis. Horm Metab Res 2024. [PMID: 38593823 DOI: 10.1055/a-2284-5667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
The current understanding of the correlation between insulin resistance (IR) and cognitive dysfunction is limited. Therefore, the objective of this systematic review and meta-analysis was to assess the association between the triglyceride glucose (TyG) index, a recently suggested indicator of IR, and cognitive impairment and dementia in the adult population. Observational studies pertinent to our research were identified through comprehensive searches of the PubMed, Embase, and Web of Science databases. To account for potential heterogeneity, the random-effects models were employed to aggregate the findings. This meta-analysis included ten observational studies involving 5602409 participants. Compared to those with the low TyG index, subjects with the high TyG index were significantly associated with the risk of cognitive impairment [risk ratio (RR): 1.39, 95% confidence interval (CI): 1.22 to 1.59, p<0.001; I2=45%) and dementia (RR: 1.30, 95% CI: 1.06 to 1.60, p=0.01; I2=50%). The association was consistent for Alzheimer's disease (RR: 1.35, 95% CI: 1.04 to 1.76, p=0.03; I2=54%) and vascular dementia (RR: 1.18, 95% CI: 1.13 to 1.24, p<0.001; I2=0%). Subgroup analyses showed that the association between TyG index with cognitive impairment and dementia were stronger in cross-sectional studies than that in cohort studies (p for subgroup difference=0.02), but not significantly modified by age, sex, or diabetic status of the participants. In conclusion, a high TyG index may be associated with higher risk of cognitive impartment and dementia in adult population.
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Affiliation(s)
- Yuqing Han
- Department of Psychiatry, The First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Xu Meng
- Department of Psychiatry, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Dahui Wang
- Department of Endocrinology, The First People's Hospital of Xiaoshan District, Hangzhou, China
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Su W, Wang J, Chen K, Yan W, Gao Z, Tang X, Wan Q, Luo Z, Ning G, Mu Y. A higher TyG index level is more likely to have enhanced incidence of T2DM and HTN comorbidity in elderly Chinese people: a prospective observational study from the reaction study. Diabetol Metab Syndr 2024; 16:29. [PMID: 38287450 PMCID: PMC10826216 DOI: 10.1186/s13098-024-01258-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/03/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Triglyceride glucose index (TyG index) was related with both type 2 diabetes (T2DM) and hypertension (HTN). Prospective studies linking the TyG index to the incidence of T2DM and HTN comorbidity remain unclear. This study aimed to to explore the longitudinal association between TyG and new-onset T2DM with HTN. METHODS 4,434 subjects (1249 males and 3185 females) without initial T2DM and HTN were followed up for 7 years. This study was conducted from November 2011 to August 2018 in the Gucheng, Laoshan and Jinding communities of Beijing. The incidence of T2DM with HTN during the 7-year follow-up was identified as the endpoint. The TyG index was divided into four quartiles: the < 25% level, the 25-50% level, the 50-75% level and the ≥ 75% level. The relationships between the TyG index and T2DM with HTN were evaluated by Cox proportional hazards regression models. RESULTS During 7 years, the augmented trend of T2DM with HTN was observed in the participants. After adjusting for all confounding factors, compared with those in the lowest quartile of TyG index, the population in the highest quartile of TyG index had a higher risk of T2DM with HTN (hazard ratio (HR), 2.878; 95% confidence intervals (95% CI), 1.230-6.731, P = 0.015), however, the association remained significant only in the female population (HR 2.753, 95% CI, 1.061-7.139, p = 0.037). The TyG had superior predictive ability of increased risk of T2DM with HTN for the populations of older age (≥ 65 years) (HR 2.694, 95% CI 1.212-5.989, p = 0.015), higher eGFR (≥ 90 mL/(min·1.73 m2)) (HR 2.603, 95% CI 1.164-5.818, p = 0.020) or obesity (BMI ≥ 28 kg/m2) (HR 2.547, 95% CI 1.001-6.478, p = 0.020). CONCLUSION A population with a higher TyG index level was more likely to have an enhanced incidence of T2DM and HTN comorbidity. TyG index could have the significance of clinical in early protection against T2DM with HTN.
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Affiliation(s)
- Wanlu Su
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin, 300071, China
| | - Jie Wang
- Department of Endocrinology, Affiliated Beijing Chaoyang Hospital of Capital Medical University, No. 8 Workers Stadium South Road, Chaoyang District, Beijing, 100853, China
| | - Kang Chen
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Wenhua Yan
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Zhengnan Gao
- Department of Endocrinology, Dalian Municipal Central Hospital, No. 826 Southwest Shahekou District Road, Dalian, 116033, China
| | - Xulei Tang
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Department of Endocrinology, Center Hospital of Dalian, Dalian, Liaoning, China
| | - Qin Wan
- Department of Endocrinology, Affiliated Hospital of Luzhou Medical College, No. 25 Taiping Road, Luzhou, 646000, China
| | - Zuojie Luo
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Guang Ning
- State Key Laboratory of Medical Genomics, Department of Endocrinology, Shanghai National Research Center for Endocrine and Metabolic Disease, Shanghai Institute for Endocrine and Metabolic Disease, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yiming Mu
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin, 300071, China.
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Liu M, Pan J, Meng K, Wang Y, Sun X, Ma L, Yu X. Triglyceride-glucose body mass index predicts prognosis in patients with ST-elevation myocardial infarction. Sci Rep 2024; 14:976. [PMID: 38200157 PMCID: PMC10782013 DOI: 10.1038/s41598-023-51136-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024] Open
Abstract
Triglyceride glycemic-body mass index (TyG-BMI) is a simple and reliable surrogate for insulin resistance (IR). However, it is still unclear if TyG-BMI has any predictive value in patients having percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). The purpose of this study was to examine the TyG-BMI index's prognostic significance and predictive power in patients with STEMI. The study comprised a total of 2648 consecutive STEMI patients who underwent PCI. The primary endpoint was the occurrence of major adverse cardiovascular events (MACE), defined as the combination of all-cause death, nonfatal myocardial infarction, nonfatal stroke, and coronary revascularization. The TyG-BMI index was formulated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2] × BMI. 193 patients in all experienced MACE over a median follow-up of 14.7 months. There was a statistically significant difference between the Kaplan-Meier survival curves for the TyG-BMI index tertiles (log-rank test, p = 0.019) for the cumulative incidence of MACE. The adjusted HRs for the incidence of MACE in the middle and highest quartiles of the TyG-BMI index compared with the lowest quartile were 1.37 (95% CI 0.92, 2.03) and 1.53 (95% CI 1.02, 2.29), respectively, in the fully adjusted Cox regression model. At six months, one year, and three years, the TyG-BMI area under the curve (AUC) for predicting MACE was 0.691, 0.666, and 0.637, respectively. Additionally, adding the TyG-BMI index to the risk prediction model enhanced outcome prediction. In STEMI patients undergoing PCI, TyG-BMI was independently linked to MACE. TyG-BMI could be a simple and solid way to assess MACE risk and prognosis.
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Affiliation(s)
- Ming Liu
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
- Department of Cardiology, Anhui Provincial Hospital Affiliated of Anhui Medical University, Hefei, 230001, Anhui, China
| | - Jianyuan Pan
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Ke Meng
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Yuwei Wang
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Xueqing Sun
- The Second Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Likun Ma
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
| | - Xiaofan Yu
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
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Zhang L, Zeng L. Non-linear association of triglyceride-glucose index with prevalence of prediabetes and diabetes: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1295641. [PMID: 38152130 PMCID: PMC10751584 DOI: 10.3389/fendo.2023.1295641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023] Open
Abstract
Background The Triglyceride-glucose (TyG) index has been acknowledged as a convenient, cost-effective, and relatively simple marker for insulin resistance (IR). Meanwhile, prediabetes, described as an asymptomatic, moderately hyperglycemic state, tends to be more prevalent than diabetes. Thus, the objective of this study was to explore the relationship between the TyG index and the prevalence of both prediabetes and diabetes within the U.S. population. Methods This study utilized a cross-sectional dataset derived from the National Health and Nutrition Survey (NHANES) spanning 1999 to 2018. The subjects were individuals aged 18 years and above, who had available fasting glucose and fasting triglyceride information, permitting a diagnosis of prediabetes or diabetes. The TyG index was computed using laboratory data, and participants were subsequently categorized into quartiles based on this information. The relationship between the TyG index and the prevalence of prediabetes and diabetes was investigated using logistic regression analysis. Results Out of the 25,159 participants, 23.88% were found to have prediabetes, while 16.22% were diagnosed with diabetes. After adjusting for confounding factors, a linear increase in relative odds was observed in Q2 (OR: 1.69; 95% CI: 1.52, 1.89), Q3 (OR: 2.57; 95% CI: 2.30, 2.88), and Q4 (OR: 4.88; 95% CI: 4.33, 5.49) groups in comparison to the reference group, Q1. In addition, a non-linear relationship was observed between the TyG index and the prevalence of prediabetes and diabetes. Specifically, patients with a TyG index greater than 8.00 overall exhibited a significantly higher risk of prediabetes and diabetes, confirming that an increase in the TyG index is associated with a corresponding increase in risk. However, this shift showed gender-specific variations; the threshold was observed at 8.00 in males but shifted to 9.00 in females. Conclusion The TyG index demonstrated a non-linear positive correlation with both prediabetes and diabetes. This suggests that maintaining the TyG index at a certain, reduced level could potentially aid in preventing the onset of prediabetes and diabetes.
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Affiliation(s)
- Linhao Zhang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Ling Zeng
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
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Tao S, Yu L, Li J, Xie Z, Huang L, Yang D, Tan Y, Zhang W, Huang X, Xue T. Prognostic value of triglyceride-glucose index in patients with chronic coronary syndrome undergoing percutaneous coronary intervention. Cardiovasc Diabetol 2023; 22:322. [PMID: 38017540 PMCID: PMC10685592 DOI: 10.1186/s12933-023-02060-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/10/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index has been proposed as a reliable surrogate marker of insulin resistance and an independent predictor of major adverse cardiovascular events (MACEs). Several recent studies have shown the relationship between the TyG index and cardiovascular outcomes; however, the role of the TyG index in chronic coronary syndrome (CCS) progression has not been extensively assessed especially in population after revascularization. This study aimed to investigate the prognostic value of the TyG index in predicting MACEs in CCS patients undergoing percutaneous coronary intervention (PCI). METHODS The data for the study were taken from the Hospital Information System database in China-Japan Friendship Hospital over the period 2019-2021. Eligible participants were divided into groups according to the TyG index tertiles. The Boruta algorithm was performed for feature selection. Multivariate Cox proportional hazards models and restricted cubic spline (RCS) analysis were applied to examine the dose-response relationship between the TyG index and endpoint, and the results were expressed with hazard ratio (HR) and 95% confidence interval (CI) values. The area under the receiver operating characteristic (ROC) curve (AUC), decision curve analysis (DCA), and clinical impact curve (CIC) were plotted to comprehensively evaluate the predictive accuracy and clinical value of the model. The goodness-of-fit of models was evaluated using the calibration curve and χ2 likelihood ratio test. RESULTS After applying inclusion and exclusion criteria, 1353 patients with CCS undergoing PCI were enrolled in the study. After adjusting for all confounders, we found that those with the highest TyG index had a 59.5% increased risk of MACEs over the 1-year follow-up (HR 1.595, 95% CI 1.370 ~ 1.855). Using the lowest TyG index tertile as the reference (T1), the fully adjusted HRs (95% CIs) for endpoints was 1.343 (1.054 ~ 1.711) in the middle (T2) and 2.297 (1.842 ~ 2.864) in highest tertile (T3) (P for trend < 0.001). The TyG index had an excellent predictive performance according to the results of AUC 0.810 (0.786, 0.834) and χ2 likelihood ratio test (χ2 = 7.474, P = 0.486). DCA and CIC analysis also suggested a good overall net benefit and clinical impact of the multivariate model. The results in the subgroup analysis were consistent with the main analyses. RCS model demonstrated that the TyG index was nonlinearly associated with the risk of MACEs within one year (P for nonlinear < 0.001). CONCLUSION The elevated TyG index is associated with an increased risk of cardiovascular events and predicts future MACEs in patients with CCS undergoing PCI independently of known cardiovascular risk factors, indicating that the TyG index may be a potential marker for risk stratification and prognosis in CCS patients undergoing PCI.
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Affiliation(s)
- Shiyi Tao
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Lintong Yu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Jun Li
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Zicong Xie
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Li Huang
- Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Deshuang Yang
- Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Yuqing Tan
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Wenjie Zhang
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Xuanchun Huang
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tiantian Xue
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Chen X, Liu D, He W, Hu H, Wang W. Predictive performance of triglyceride glucose index (TyG index) to identify glucose status conversion: a 5-year longitudinal cohort study in Chinese pre-diabetes people. J Transl Med 2023; 21:624. [PMID: 37715242 PMCID: PMC10503019 DOI: 10.1186/s12967-023-04402-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/29/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE Triglyceride glucose index (TyG index) has been recommended as an alternative indicator of insulin resistance. However, the association between TyG and regression from prediabetes to normoglycemia remains to be elucidated. METHODS This retrospective cohort study involved 25,248 subjects with prediabetes at baseline conducted from 2010 to 2016. A Cox proportional hazard regression model was designed to evaluate the role of TyG in identifying people at converting from prediabetes to normoglycemia. Cox proportional hazards regression with cubic spline functions and smooth curve fitting was used to dig out the nonlinear relationship between them. Detailed evaluations for TyG were also performed using sensitivity and subgroup analyse. RESULTS Among the included prediabetes subjects (n = 25,248), the mean age was 49.27 ± 13.84 years old, and 16,701 (66.15%) were male. The mean TyG was 8.83 ± 0.60. The median follow-up time was 2.96 ± 0.90 years. 11,499 (45.54%) individuals had a final diagnosis of normoglycemia. After adjusting for covariates, TyG was negatively affecting the results of glucose status conversion in prediabetes people (HR 0.895, 95% CI 0.863, 0.928). There was a nonlinear connection between TyG and normoglycemia in prediabetes people, and the inflection point was 8.88. The effect sizes (HR) on the left and right sides of the inflection point were 0.99 (0.93, 1.05) and 0.79 (0.74, 0.85), respectively. Sensitivity analysis confirmed the robustness of these results. Subgroup analysis showed that TyG was more strongly associated with incident glucose status conversion in male, BMI ≥ 25. In contrast, there was a weaker relationship in those with female, BMI < 25. CONCLUSION Based on sample of subjects evaluated between 2010 and 2016, TyG index appears to be a promising marker for predicting normoglycemic conversion among prediabetes people in China. This study demonstrates a negative and non-linear association between TyG and glucose status conversion from prediabetes to normoglycemia. TyG is strongly related to glucose status conversion when TyG is above 8.88. From a therapeutic point of view, it is meaningful to maintain TyG levels within the inflection point to 8.88.
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Affiliation(s)
- Xiaojie Chen
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 106 Zhongshan Er Road, Main Building, Room 1436, Guangzhou, 510080, Guangdong, China
- Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Department of Nephrology, Shenzhen Second People's Hospital, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong, China
| | - Danfeng Liu
- Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 106 Zhongshan Er Road, Main Building, Room 1436, Guangzhou, 510080, Guangdong, China
- Guangdong Academy of Medical Sciences, Guangzhou, China
- South China University of Technology, Guangzhou, China
| | - Weiting He
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 106 Zhongshan Er Road, Main Building, Room 1436, Guangzhou, 510080, Guangdong, China
- Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Haofei Hu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
- Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 106 Zhongshan Er Road, Main Building, Room 1436, Guangzhou, 510080, Guangdong, China.
- Guangdong Academy of Medical Sciences, Guangzhou, China.
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.
- Department of Nephrology, Shenzhen Second People's Hospital, No.3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong, China.
| | - Wenjian Wang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
- Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 106 Zhongshan Er Road, Main Building, Room 1436, Guangzhou, 510080, Guangdong, China.
- Guangdong Academy of Medical Sciences, Guangzhou, China.
- South China University of Technology, Guangzhou, China.
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Kavurt S, Uzlu SE, Bas AY, Tosun M, Çelen Ş, Üstün YE, Demirel N. Can the triglyceride-glucose index predict insulin resistance in LGA newborns? J Perinatol 2023; 43:1119-1124. [PMID: 36564472 DOI: 10.1038/s41372-022-01586-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The aim of this study is to investigate the TyG index and TG/HDL-C ratio and their relationships with insulin resistance in LGA infants. METHODS A prospective controlled study was conducted including 65 LGA and gestational age, gender-matched appropriate for gestational age (AGA) neonates. Serum TG, total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), insulin and glucose levels were measured within two hours after birth, TyG index and HOMA-IR values were calculated. RESULTS TyG index and TG/HDL- C ratio were higher in LGA neonates compared to AGA ones (p = 0.03; p = 0.00, respectively). Compared with AGA newborns, LGA newborns had higher levels of insulin and HOMA-IR (p = 0.00; p = 0.00, respectively). TyG index and TG/HDL-C ratio showed moderate correlation with HOMA-IR (r = 0.59 R2 = 0.35 p < 0.001; r = 0.5 R2 = 0.25 p < 0.001, respectively). CONCLUSıON: The results of this study show that LGA newborns have increased levels of TyG index and TG/HDL-C associated with insulin resistance.
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Affiliation(s)
- Sumru Kavurt
- Department of Neonatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Safiye Elif Uzlu
- Department of Neonatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ahmet Yagmur Bas
- Department of Neonatology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Mehtap Tosun
- Department of Neonatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Şevki Çelen
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Yaprak Engin Üstün
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Nihal Demirel
- Department of Neonatology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
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Liu R, Li L, Wang L, Zhang S. Triglyceride-glucose index predicts death in patients with stroke younger than 65. Front Neurol 2023; 14:1198487. [PMID: 37602260 PMCID: PMC10435085 DOI: 10.3389/fneur.2023.1198487] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/24/2023] [Indexed: 08/22/2023] Open
Abstract
Background The triglyceride-glucose index (TGI), a reliable surrogate indicator of insulin resistance (IR), has been proven to be a predictor of the incidence of ischemic stroke. The role of TGI in predicting the outcomes of stroke patients remains controversial. Susceptibility to IR-related diseases varies among patients of different ages. The study aims to evaluate the predictive value of TGI levels on clinical outcomes of patients with ischemic stroke of different ages. Method This was a retrospective cohort study including patients with ischemic stroke in the Department of Neurology at West China Hospital. TGI was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The patients were subdivided into 3 tertiles according to TGI levels. Multivariate logistic regression analyses were conducted to estimate the association between TGI levels and post-stroke outcomes among the whole patients, younger patients (<65), and older patients (>=65). The outcomes included death and unfavorable functional outcome (modified Rankin scale score 3-6) at 3 and 12 months after stroke. Results A total of 3,704 patients (men, 65.08%, mean age, 61.44 ± 14.15; women 34.92%, mean age, 65.70 ± 13.69) were enrolled in this study. TGI levels were not associated with 3 month or 12 month death in the whole patients. Patients with higher TGI levels (T2 and T3) had a higher risk of 3 month death than those had lower TGI levels (T1) in the younger group (T2 vs. T1: OR 2.64, 95% CI 1.03-6.79, p = 0.043; T3 vs. T1: OR 2.69, 95% CI 1.00-7.10, p = 0.049) but not in the older group. Additionally, Kaplan-Meier estimate analysis illustrated that the 12 month death risk was significantly higher in the group with the highest TGI among younger patients (p for log-rank test = 0.028) but not among older patients. There was an interactive effect between TGI and age on 3 month death (p for interaction = 0.013) and 12 month death (p for interaction = 0.027). However, TGI was not associated with unfavorable functional outcome at 3 month or 12 month after stroke. Conclusion Elevated TGI independently predicts death at 3 months and 12 months in patients under 65 with ischemic stroke. Regulating TGI is expected to be an approach to enhance prognosis in young individuals affected by ischemic stroke.
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Affiliation(s)
- Ruishan Liu
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Lijuan Li
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China
| | - Lu Wang
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China
| | - Shihong Zhang
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
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Zhou Y, Wang C, Che H, Cheng L, Zhu D, Rao C, Zhong Q, Li Z, Wang X, Wu Z, He K. Association between the triglyceride-glucose index and the risk of mortality among patients with chronic heart failure: results from a retrospective cohort study in China. Cardiovasc Diabetol 2023; 22:171. [PMID: 37420232 PMCID: PMC10329381 DOI: 10.1186/s12933-023-01895-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/20/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index has been demonstrated to be a reliable surrogate marker of insulin resistance (IR) and an effective predictive index of cardiovascular (CV) disease risk. However, its long-term prognostic value in patients with chronic heart failure (CHF) remains uncertain. METHODS A total of 6697 consecutive patients with CHF were enrolled in this study. Patients were divided into tertiles according to their TyG index. The incidence of primary outcomes, including all-cause death and CV death, was recorded. The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. RESULTS During a median follow-up of 3.9 years, a total of 2158 (32.2%) all-cause deaths and 1305 (19.5%) CV deaths were documented. The incidence of primary events from the lowest to the highest TyG index tertiles were 50.61, 64.64, and 92.25 per 1000 person-years for all-cause death and 29.05, 39.40, and 57.21 per 1000 person-years for CV death. The multivariate Cox hazards regression analysis revealed hazard ratios for all-cause and CV deaths of 1.84 (95% CI 1.61-2.10; P for trend < 0.001) and 1.94 (95% CI 1.63-2.30; P for trend < 0.001) when the highest and lowest TyG index tertiles were compared. In addition, the predictive ability of the TyG index against all-cause death was more prominent among patients with metabolic syndrome and those with heart failure with preserved ejection fraction phenotype (both P for interaction < 0.05). Furthermore, adding the TyG index to the established model for all-cause death improved the C‑statistic value (0.710 for the established model vs. 0.723 for the established model + TyG index, P < 0.01), the integrated discrimination improvement value (0.011, P < 0.01), the net reclassification improvement value (0.273, P < 0.01), and the clinical net benefit (probability range, 0.07-0.36). CONCLUSIONS The TyG index was significantly associated with the risk of mortality, suggesting that it may be a reliable and valuable predictor for risk stratification and an effective prognostic indicator in patients with CHF.
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Affiliation(s)
- You Zhou
- School of Medicine, Nankai University, No.94 Weijin Road, Nankai District, Tianjin, 300071, China
| | - Chi Wang
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
- Chinese PLA General Hospital and Medical School, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Hebin Che
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Liting Cheng
- School of Medicine, Nankai University, No.94 Weijin Road, Nankai District, Tianjin, 300071, China
| | - Di Zhu
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
- Chinese PLA General Hospital and Medical School, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Chongyou Rao
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
- Chinese PLA General Hospital and Medical School, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Qin Zhong
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
- Chinese PLA General Hospital and Medical School, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Zongren Li
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
- Chinese PLA General Hospital and Medical School, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Xiao Wang
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
- Chinese PLA General Hospital and Medical School, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Zisheng Wu
- Chinese PLA General Hospital and Medical School, No.28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Kunlun He
- School of Medicine, Nankai University, No.94 Weijin Road, Nankai District, Tianjin, 300071, China.
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China.
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Andrade LJDO, Oliveira LMD, Bittencourt AMV, Baptista GM, Oliveira GCMD. ASSOCIATION BETWEEN NONALCOHOLIC FATTY PANCREATIC DISEASE AND TRIGLYCERIDE/GLUCOSE INDEX. ARQUIVOS DE GASTROENTEROLOGIA 2023; 60:345-349. [PMID: 37792764 DOI: 10.1590/s0004-2803.230302023-44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/21/2023] [Indexed: 10/06/2023]
Abstract
•Non-alcoholic fatty pancreatic disease is associated with insulin resistance. •The triglyceride-glucose index has been used as a reliable marker for the diagnosis of insulin resistance. •The triglyceride-glucose index correlates positively with the degree of non-alcoholic fatty pancreatic disease. Background - Nonalcoholic fatty pancreatic disease (NAFPD) is an increase of fat in the pancreas, and has an important association with insulin resistance (IR) and type 2 diabetes mellitus. Research has confirmed that the triglyceridemia/glycemia (TyG) index determines IR as much as does the hyperinsulinemic-euglycemic clamp assessment as the homeostasis model testing of IR (HOMA-IR). Objective - To eva-luate the association between degree of NAFPD and TyG index. Methods - In 72 patients undergoing ultrasound of abdomen with a diagnosis of NAFPD, insulin, glucose, and triglycerides levels were evaluated. The HOMA-IR and TyG indexes were used as a reference for IR. The degrees of NAFPD and the TyG index were presented through the receiver operating characteristics (ROC) curves in order to evaluate the association between different degrees of NAFPD, and the correlation of NAFPD with HOMA-IR was also evaluated. Results - There was a statistically significant correlation between the degree of NAFPD and the TyG index. The AUROC curve for the TyG index for predicting the degree of NADPD was 0.855 (0.840-0.865). The intensity-adjusted probabilities of the degree of NAFPD were more strongly associated with TyG values when compared with HOMA-IR. Conclusion - In this study the TyG index correlated positively with the degree of NAFPD, performing better than HOMA-IR.
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Zhang J, Jia L, Zhu T, Zhu H, Shu L. The relationship and interaction between triglyceride glucose index and obesity in the risk of prehypertension population: a cross-sectional study from a survey in Anhui, Eastern China. BMC Cardiovasc Disord 2023; 23:336. [PMID: 37393221 PMCID: PMC10314550 DOI: 10.1186/s12872-023-03365-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/23/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND The triglyceride glucose (TyG) index has been regarded as an effective proxy of Insulin resistance (IR). Studies on the TyG index, obesity and the risk of prehypertension (PHT) in elderly people are not apparent currently. The study sought to investigate the predictive value of TyG index and the associations with PHT risk and obesity. METHODS A community-based cross-sectional study was conducted in Bengbu City, Anhui province, China. Participants older than 65 years accepted questionnaire surveys, physical examinations and blood biochemistry tests. Based on the testing results, indicators including BMI (body mass index), WC (waist circumference), WHtR (waist-to-height-ratio), LAP(Lipid accumulation products) and TyG were calculated. Residents were classified into quartiles by their TyG indexes. Receiver operating characteristic curve (ROC) analysis was carried out to predict obesity indices for PHT. The three additive interaction indicators, RERI (relative excess risk due to interaction), AP (attributable proportion due to interaction) and S (synergy index) were used to assess the interaction impacts. RESULTS Two thousand six hundred sixty-six eligible elderly people were included in study and the prevalence of PHT was 71.04% (n = 1894). With increasing TyG index quartile, PHT became more prevalent. After adjusting for confounding factors, the prevalence of PHT risk with TyG levels in the fourth quartile (Q4, male: 2.83, 95%CI: 1.77-4.54; female: 2.75, 95%CI:1.91-3.97) was greater than that in the first quartile (Q1:ref). TyG index (AUC: 0.626, 95%CI: 0.602 to 0.650) was superior than BMI (AUC: 0.609, 95%CI: 0.584 to 0.633) in predicting PHT among females. Eventually, there were significant interactions of TyG index with obesity in males (General obesity: AP = 0.87, 95%CI: 0.72 to 1.02, S = 10.48, 95%CI: 3.43 to 31.97; Abdominal obesity: AP = 0.60,95%CI: 0.38 to 0.83, S = 3.53, 95%CI: 1.99 to 6.26) and females (General obesity: AP = 0.89, 95%CI: 0.79 to 0.98, S = 12.46, 95%CI: 5.61 to 27.69; Abdominal obesity: AP = 0.66, 95%CI: 0.51 to 0.82, S = 3.89, 95%CI:2.54 to 5.98). CONCLUSION TyG index and PHT risk are tightly correlated. The risk of chronic disease in the elderly can be decreased by early detection of PHT utilizing the TyG index. In this research, the TyG index was more predictable than other indicators of obesity.
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Affiliation(s)
- Jiaye Zhang
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
| | - Linlin Jia
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
| | - Tongying Zhu
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
| | - Hao Zhu
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
| | - Li Shu
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
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Furdela V, Pavlyshyn H, Shulhai AM, Kozak K, Furdela M. Triglyceride glucose index, pediatric NAFLD fibrosis index, and triglyceride-to-high-density lipoprotein cholesterol ratio are the most predictive markers of the metabolically unhealthy phenotype in overweight/obese adolescent boys. Front Endocrinol (Lausanne) 2023; 14:1124019. [PMID: 37234798 PMCID: PMC10206000 DOI: 10.3389/fendo.2023.1124019] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/19/2023] [Indexed: 05/28/2023] Open
Abstract
Introduction The prevalence of obesity constantly increases worldwide and definitely increases the risk of premature death in early adulthood. While there is no treatment yet with proven efficacy for the metabolic clamp such as arterial hypertension, dyslipidemia, insulin resistance, diabetes type 2, and fatty liver disease, it is imperative to find a way to decrease cardiometabolic complications. Early prevention strategies beginning in childhood are the most logical step to reduce future cardiovascular morbidity and mortality. Therefore, the aim of the current study is to determine the most sensitive and specific predictive markers of the metabolically unhealthy phenotype with high cardiometabolic risk in overweight/obese adolescent boys. Methods This study was carried out at the Ternopil Regional Children's hospital (Western Ukraine) and involved 254 randomly chosen adolescent overweight or obese boys [median age was 16.0 (15.0,16.1) years]. A control group of 30 healthy children with proportional body weight comparable in gender and age to the main group was presented. A list of anthropometrical markers with biochemical values of carbohydrate and lipid metabolism with hepatic enzymes was determined. All overweight/obese boys were divided into three groups: 51.2% of the boys with metabolic syndrome (MetS) based on the IDF criteria; 19.7% of the boys were metabolically healthy obese (MHO) without hypertension, dyslipidemia, and hyperglycemia; and the rest of the boys (29.1%) were classified as metabolically unhealthy obese (MUO) with only one criterion (hypertension, dyslipidemia, or hyperglycemia). Results Based on multiple logistic regression analysis that included all anthropometric and biochemical values and calculated indexes in boys from the MHO group and MetS, it was revealed that the maximum likelihood in the prediction of MetS makes the combination of triglyceride glucose index, pediatric nonalcoholic fatty liver disease fibrosis index (PNFI), and triglyceride-to-high-density lipoprotein cholesterol ratio (R2 =0.713, p<0.000). By tracing the receiver operating characteristic curve, the model is confirmed as a good predictor of MetS (AUC=0.898, odds ratio=27.111 percentage correct=86.03%) in overweight and obese boys. Conclusion Triglyceride glucose index, pediatric NAFLD fibrosis index, and triglyceride-to-high-density lipoprotein cholesterol ratio are a valuable combination of predictive markers of the metabolically unhealthy phenotype in Ukrainian overweight/obese boys.
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Affiliation(s)
- Viktoriya Furdela
- Department of Pediatrics No2, I. Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine, Ternopil, Ukraine
| | - Halyna Pavlyshyn
- Department of Pediatrics No2, I. Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine, Ternopil, Ukraine
| | - Anna-Mariia Shulhai
- Department of Pediatrics No2, I. Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine, Ternopil, Ukraine
| | - Kateryna Kozak
- Department of Pediatrics No2, I. Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine, Ternopil, Ukraine
| | - Mykhailo Furdela
- Department of Pathologic Anatomy, Autopsy Course and Forensic Pathology, I.Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine, Ternopil, Ukraine
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Kuang M, Yang R, Huang X, Wang C, Sheng G, Xie G, Zou Y. Assessing temporal differences in the predictive power of baseline TyG-related parameters for future diabetes: an analysis using time-dependent receiver operating characteristics. J Transl Med 2023; 21:299. [PMID: 37138277 PMCID: PMC10158224 DOI: 10.1186/s12967-023-04159-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/25/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND It is known that measuring the triglyceride glucose (TyG) index and TyG-related parameters [triglyceride glucose-body mass index (TyG-BMI), triglyceride glucose-waist circumference (TyG-WC), and triglyceride glucose-waist to height ratio (TyG-WHtR)] can predict diabetes; this study aimed to compare the predictive value of the baseline TyG index and TyG-related parameters for the onset of diabetes at different future periods. METHODS We conducted a longitudinal cohort study involving 15,464 Japanese people who had undergone health physical examinations. The subject's TyG index and TyG-related parameters were measured at the first physical examination, and diabetes was defined according to the American Diabetes Association criteria. Multivariate Cox regression models and time-dependent receiver operating characteristic (ROC) curves were constructed to examine and compare the risk assessment/predictive value of the TyG index and TyG-related parameters for the onset of diabetes in different future periods. RESULTS The mean follow-up period of the current study cohort was 6.13 years, with a maximum of 13 years, and the incidence density of diabetes was 39.88/10,000 person-years. In multivariate Cox regression models with standardized hazard ratios (HRs), we found that both the TyG index and TyG-related parameters were significantly and positively associated with diabetes risk and that the TyG-related parameters were stronger in assessing diabetes risk than the TyG index, with TyG-WC being the best parameter (HR per SD increase: 1.70, 95% CI 1.46, 1.97). In addition, TyG-WC also showed the highest predictive accuracy in time-dependent ROC analysis for diabetes occurring in the short-term (2-6 years), while TyG-WHtR had the highest predictive accuracy and the most stable predictive threshold for predicting the onset of diabetes in the medium- to long-term (6-12 years). CONCLUSIONS These results suggest that the TyG index combined with BMI, WC, and WHtR can further improve its ability to assess/predict the risk of diabetes in different future periods, where TyG-WC was not only the best parameter for assessing diabetes risk but also the best risk marker for predicting future diabetes in the short-term, while TyG-WHtR may be more suitable for predicting future diabetes in the medium- to long-term.
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Affiliation(s)
- Maobin Kuang
- Medical College of Nanchang University, Nanchang, 330006, Jiangxi, China
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Ruijuan Yang
- Medical College of Nanchang University, Nanchang, 330006, Jiangxi, China
- Department of Endocrinology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Xin Huang
- Medical College of Nanchang University, Nanchang, 330006, Jiangxi, China
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Chao Wang
- Medical College of Nanchang University, Nanchang, 330006, Jiangxi, China
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Guotai Sheng
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Guobo Xie
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China.
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China.
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Zhang J, Wang R, Liu Q, Song G, Tang X. Association of triglyceride-glucose index with incident hypertension among non-overweight healthy adults: A cohort study in China. Nutr Metab Cardiovasc Dis 2023; 33:1057-1065. [PMID: 36948935 DOI: 10.1016/j.numecd.2023.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 02/06/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND AND AIMS Overweight and obesity are well recognized as important and traditional risk factors for hypertension (HTN), but the prevalence of HTN tends to increase in non-overweight people. Triglyceride-glucose (TyG) index has been observed to be associated with HTN. However, whether such association still persists in non-overweight people remains unclear. The aim of our cohort study was to explore the link between TyG index and incident HTN in non-overweight Chinese population. METHODS AND RESULTS As many as 4678 individuals without HTN at baseline were involved, who underwent at least two years of health check-ups in the eight-year study period and maintained non-overweight at follow-up. According to baseline TyG index quintiles, participants were classified into five groups. Compared with the 1st quantile, those in the 5th quantile of TyG index had a 1.73-fold (HR 95% CI 1.13-2.65) risk of incident HTN. The results remained consistent when analyses were restricted to participants without abnormal TG or FPG level at baseline (HR 1.62, 95% CI 1.17-2.26). Furthermore, the subgroup analyses were conducted, the risk of incident HTN was still significantly increased with increasing TyG index for subgroups of older participants (age≥ 40 years), males, females and higher BMI group (BMI≥ 21 kg/m2). CONCLUSIONS The risk of incident HTN increased with increasing TyG index among Chinese non-overweight adults, so TyG index might be a reliable predictor of incident HTN among adults maintaining non-overweight.
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Affiliation(s)
- Jiwei Zhang
- The Department of Health Statistics, School of Public Health, Dalian Medical University, No. 9 South Road, Lvshun District, Dalian City, Liaoning Province, 116044, PR China; Department of Hospital Infection Control, First Affiliated Hospital of Nanchang University, Nanchang University, No. 17 Yong wai zheng street, Nanchang City, Jiangxi Province, 330006, PR China
| | - Runnan Wang
- The Department of Health Statistics, School of Public Health, Dalian Medical University, No. 9 South Road, Lvshun District, Dalian City, Liaoning Province, 116044, PR China
| | - Qigui Liu
- The Department of Health Statistics, School of Public Health, Dalian Medical University, No. 9 South Road, Lvshun District, Dalian City, Liaoning Province, 116044, PR China
| | - Guirong Song
- The Department of Health Statistics, School of Public Health, Dalian Medical University, No. 9 South Road, Lvshun District, Dalian City, Liaoning Province, 116044, PR China.
| | - Xiao Tang
- The Department of Health Statistics, School of Public Health, Dalian Medical University, No. 9 South Road, Lvshun District, Dalian City, Liaoning Province, 116044, PR China.
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Al Akl NS, Haoudi EN, Bensmail H, Arredouani A. The triglyceride glucose-waist-to-height ratio outperforms obesity and other triglyceride-related parameters in detecting prediabetes in normal-weight Qatari adults: A cross-sectional study. Front Public Health 2023; 11:1086771. [PMID: 37089491 PMCID: PMC10117653 DOI: 10.3389/fpubh.2023.1086771] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/17/2023] [Indexed: 04/09/2023] Open
Abstract
IntroductionThe triglyceride-glucose (TyG)-driven indices, incorporating obesity indices, have been proposed as reliable markers of insulin resistance and related comorbidities such as diabetes. This study evaluated the effectiveness of these indices in detecting prediabetes in normal-weight individuals from a Middle Eastern population.MethodsUsing the data of 5,996 adult Qatari participants from the Qatar Biobank cohort, we employed adjusted logistic regression to assess the ability of various obesity and triglyceride-related indices to detect prediabetes in normal-weight (18.5 ≤ BMI <25 kg/m2) adults (≥18 years).ResultsOf the normal-weight adults, 13.62% had prediabetes. TyG-waist-to-height ratio (TyG-WHTR) was significantly associated with prediabetes among normal-weight men [OR per 1-SD 2.68; 95% CI (1.67–4.32)] and women [OR per 1-SD 2.82; 95% CI (1.61–4.94)]. Compared with other indices, TyG-WHTR had the highest area under the curve (AUC) value for prediabetes in men [AUC: 0.76, 95% CI (0.70–0.81)] and women [AUC: 0.73, 95% CI (0.66–0.80)], and performed significantly higher than other indices (p < 0.05) in detecting prediabetes in men. Tyg-WHTR shared similar diagnostic values as fasting plasma glucose (FPG).DiscussionOur findings suggest that the TyG-WHTR index could be a better indicator of prediabetes for general clinical usage in normal weight Qatari adult men than other obesity and TyG-related indices. TyG-WHTR can help identify a person’s risk for developing prediabetes in both men and women when combined with FPG results.
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Affiliation(s)
- Neyla S. Al Akl
- Qatar Foundation, Diabetes Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | | | - Halima Bensmail
- Qatar Computing Research Institute, Hamad Bin Khalifa University, Doha, Qatar
| | - Abdelilah Arredouani
- Qatar Foundation, Diabetes Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Doha, Qatar
- Qatar Foundation, College of Health and Life Sciences, Hamad Bin Khalifa University (HBKU), Doha, Qatar
- *Correspondence: Abdelilah Arredouani,
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Reckziegel MB, Nepomuceno P, Machado T, Renner JDP, Pohl HH, Nogueira-de-Almeida CA, de Mello ED. The triglyceride-glucose index as an indicator of insulin resistance and cardiometabolic risk in Brazilian adolescents. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:153-161. [PMID: 36651702 PMCID: PMC10689041 DOI: 10.20945/2359-3997000000506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 05/11/2022] [Indexed: 01/19/2023]
Abstract
Objective To set cutoff points for the triglyceride and glucose index (TyG) as a marker of insulin resistance (IR) for the pediatric population. Subjects and methods This was a cross-sectional study with schoolchildren population-based data using data of 377 schoolchildren age 10 to 17 years of both sexes. We studied metabolic variables associated with IR indicators, such as fasting insulin and blood glucose, to calculate the homeostatic model assessment (HOMA-IR), and we studied triglycerides (TG) to determine the TyG index. We obtained TyG cutoff values for IR using the receiver operation characteristic (ROC), with definitions of sensitivity (Sen), specificity (Spe), and area under the ROC curve (AUC), with the HOMA-IR as reference. Results The cutoff points of the TyG index for IR in adolescents are 7.94 for both sexes, 7.91 for boys, and 7.94 for girls, indicating moderate discriminatory power. When we also considered anthropometric variables of excess weight [TyG-BMI (body mass index)] and visceral fat [TyG-WC (waist circumference)], these indexes reached AUC values higher than 0.72, enhancing their potential use for a good diagnosis. Conclusion TyG has proven to be a useful instrument for identifying IR in adolescent health screening, with high discrimination capacity when added to anthropometric variables, making it a feasible and inexpensive option.
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Affiliation(s)
- Miriam Beatrís Reckziegel
- Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
- Departamento de Ciências da Saúde, Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil,
| | - Patrik Nepomuceno
- Departamento de Ciências da Saúde, Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil
- Programa de Pós-graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil
- Institute of Health Policy, Management and Evaluation, University of Toronto (UofT), Toronto, ON, Canada
- Kite Research Institute, Lyndhurst Centre, University Health Network (UHN), Toronto, ON, Canada
| | - Tania Machado
- Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
| | - Jane Dagmar Pollo Renner
- Programa de Pós-graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil
| | - Hildegard Hedwig Pohl
- Departamento de Ciências da Saúde, Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil
- Programa de Pós-graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil
| | | | - Elza Daniel de Mello
- Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
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Jeong S, Jang HB, Kim HJ, Lee HJ. Identification of Biomarkers Related to Metabolically Unhealthy Obesity in Korean Obese Adolescents: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020322. [PMID: 36832451 PMCID: PMC9955165 DOI: 10.3390/children10020322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/25/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND The current study aimed to screen for relationships and different potential metabolic biomarkers involved between metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) in adolescents. METHODS The study included 148 obese adolescents aged between 14 and 16. The study participants were divided into MUO and MHO groups based on the age-specific adolescent metabolic syndrome (MetS) criteria of the International Diabetes Federation. The current study was conducted to investigate the clinical and metabolic differences between the MHO and MUO groups. Multivariate analyses were conducted to investigate the metabolites as independent predictors for the odds ratio and the presence of the MetS. RESULTS There were significant differences in the three acylcarnitines, five amino acids, glutamine/glutamate ratio, three biogenic amines, two glycerophospholipids, and the triglyceride-glucose index between the MUO group and those in the MHO group. Moreover, several metabolites were associated with the prevalence of MUO. Additionally, several metabolites were inversely correlated with MHO in the MUO group. CONCLUSIONS In this study, the biomarkers found in this study have the potential to reflect the clinical outcomes of the MUO group. These biomarkers will lead to a better understanding of MetS in obese adolescents.
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Affiliation(s)
| | | | | | - Hye-Ja Lee
- Correspondence: ; Tel.: +82-43-719-8452; Fax: +82-43-719-8709
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Hypertriglyceridemic Waist Phenotype and Its Association with Metabolic Syndrome Components, among Greek Children with Excess Body Weight. Metabolites 2023; 13:metabo13020230. [PMID: 36837848 PMCID: PMC9968003 DOI: 10.3390/metabo13020230] [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: 12/02/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023] Open
Abstract
The hypertriglyceridemic waist (HTGW) phenotype is characterized by abdominal obesity and elevated serum triglycerides. We aimed to assess the prevalence of the HTGW phenotype among children with overweight or obesity and its association with indices of insulin resistance (IR) and dyslipidemia. A total of 145 children with mean age of 10.2 years (SD = 2.31 years), 97.2% of whom with obesity, were analyzed. The HTGW phenotype was defined as WC > 90th Centers for Disease Control and Prevention (CDC) percentile and triglyceride levels of ≥100 mg/dL and ≥130 mg/dL for children 0 to 9 or >10 years of age, respectively. In total, 77.9% of the children had a waist circumference above the 90th percentile and 22.8% had elevated triglycerides. The prevalence of the HTGW phenotype in this sample was 19.3%. Patients with the HTGW phenotype had significantly lower levels of High-Density Lipoprotein (p < 0.001) and were insulin-resistant, as evident by an increased mean Triglycerides Glucose Index 8.64 (SD = 0.24) vs. 7.92 (SD = 0.41) for those without the HTGW phenotype (p < 0.001), and increased prevalence (54.5%) of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) in ≥2.5 in patients with HTGW (p = 0.045). Children with the HTGW phenotype were more likely to have increased HOMA-IR [OR 7.9 95% CI (1.94, 32.1)]. The HTGW phenotype is a low-cost and easily available index that might help to identify children with increased cardiometabolic risk.
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Lourenço LP, Viola PCDAF, Franceschini SDCC, Rosa CDOB, Ribeiro SAV. Metabolic syndrome and risk factors in children: a risk score proposal. Eur J Clin Nutr 2023; 77:278-282. [PMID: 36203009 DOI: 10.1038/s41430-022-01217-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/04/2022] [Accepted: 09/08/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION/OBJECTIVE The lack of international consensus on the definition of Metabolic Syndrome (MS) in the pediatric population makes it difficult to estimate its prevalence. In this study, we intend to identify MS prevalence and a cutoff point based on a continuous score in children aged four to seven years. METHODS A cross-sectional study of 402 children (4-7 years) monitored by the Lactation Support Program (PROLAC). A continuous MS risk score was assessed using Principal Component Analysis (PCA). In order to calculate the score, the following MS risk factors were considered: Waist circumference (WC), High Density Lipoprotein (HDL), Triglycerides (TG), Blood Pressure (BP) and Blood sugar. Using a Receiver Operating Characteristics (ROC) curve, the cutoff point for predicting MS risk based on continuous score was evaluated. RESULTS A progressive increase in MS scores was observed according to increase in the number of risk factors. This increase was also observed when comparing boys and girls (p < 0.001). In the absence of MS, the median score among the children was -0.0486 (-0.2929-0.2151). For children with MS, the median score was 0.5237 (0.2286-0.7104) (p < 0.001). The best cutoff score for predicting MS in children aged four to five years was >0.09 (100% sensitivity and specificity 72.67%). For children aged six to seven years, this value was >0.14 (100% sensitivity and 64.65% specificity). CONCLUSION The calculated continuous risk score can predict MS with good accuracy and high sensitivity and reasonable specificity.
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Affiliation(s)
- Larissa Pereira Lourenço
- Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Minas Gerais, Brazil.
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Relationship between the triglyceride-glucose index and the SYNTAX score 2 in patients with non-ST elevation myocardial infarction. Cardiovasc Endocrinol Metab 2023; 12:e0277. [PMID: 36699193 PMCID: PMC9829247 DOI: 10.1097/xce.0000000000000277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/12/2022] [Indexed: 01/10/2023]
Abstract
We evaluated if admissiontriglyceride-glucose index (TyG index) correlated with the anatomical synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score 2 in non-ST elevation myocardial infarction (NSTEMI), nondiabetic patients. Methods SYNTAX score 2 (SSII) was retrospectively evaluated in 260 nondiabetic patients hospitalized with NSTEMI who underwent coronary angiography. The TyG index was calculated using the following equation: log [fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. We stratified patients according to tertiles of SSII (≤21.5, 21.5-30.6, and ≥30.6). These score ranges were defined as SSII low, SSII mid, and SSII high, respectively. Results The average age of the patients was 57.2 ± 10.9 years; 135 patients (52.2%) were males. The average TyG index was 8.68 ± 0.12, and SSII was 18.9 ± 9.9. A moderate correlation was found between TyG index and SSII (r = 0.347; P < 0.001) and TyG index was independent risk factors for SSII high [odds ratio (OR), 6.0; 95% CI, 2.7-17.0; P < 0.001]. Conclusion In nondiabetic patients with NSTEMI, TyG index correlated with the SSII.
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Gao YM, Chen WJ, Deng ZL, Shang Z, Wang Y. Association between triglyceride-glucose index and risk of end-stage renal disease in patients with type 2 diabetes mellitus and chronic kidney disease. Front Endocrinol (Lausanne) 2023; 14:1150980. [PMID: 37152938 PMCID: PMC10157287 DOI: 10.3389/fendo.2023.1150980] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/10/2023] [Indexed: 05/09/2023] Open
Abstract
Aims It has been suggested that the triglyceride-glucose (TyG) index is a novel and reliable surrogate marker of insulin resistance (IR). However, its relationship with the risk of end-stage renal disease (ESRD) in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) remains uncertain. Accordingly, we sought to examine the relationship between the TyG index and ESRD risk in patients with T2DM and CKD. Methods From January 2013 to December 2021, 1,936 patients with T2DM and CKD hospitalized at Peking University Third Hospital (Beijing, China) were enrolled into the study. The formula for calculating the TyG index was ln[fasting triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2]. ESRD was defined as an estimated glomerular filtration rate of less than 15 mL/min/1.73 m2 or the commencement of dialysis or renal transplantation. The relationship between the TyG index and ESRD risk was analyzed using Cox proportional hazard regression. Results 105 (5.42%) participants developed ESRD over a mean follow-up of 41 months. The unadjusted analysis revealed a 1.50-fold (95% confidence interval [CI] 1.17-1.93; P = 0.001) increased risk for ESRD per one unit rise in the TyG index, and the positive association remained stable in the fully adjusted model (hazard ratio, 1.49; 95% CI, 1.12-1.99; P = 0.006). Analysis using restricted cubic spline revealed a significant positive association between the TyG index and ESRD risk. In addition, Kaplan-Meier analysis revealed significant risk stratification with a TyG index cutoff value of 9.5 (P = 0.003). Conclusion In individuals with T2DM and CKD, a significant and positive association was shown between an elevated TyG index and the risk of ESRD. This conclusion provides evidence for the clinical importance of the TyG index for evaluating renal function decline in individuals with T2DM and CKD.
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Affiliation(s)
- Yue-Ming Gao
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Wei-Jia Chen
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China
| | - Zhen-Ling Deng
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Zhi Shang
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China
- *Correspondence: Zhi Shang, ; Yue Wang,
| | - Yue Wang
- Department of Nephrology, Peking University Third Hospital, Beijing, China
- *Correspondence: Zhi Shang, ; Yue Wang,
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Dong J, Liu YH, Lu YK, Hu LK, Chen N, Ma LL, Chu X, Yan YX. Association between surrogate indicators of insulin resistance and risk of type 2 diabetes combined with hypertension among Chinese adults: two independent cohort studies. Nutr Metab (Lond) 2022; 19:85. [PMID: 36581855 PMCID: PMC9798583 DOI: 10.1186/s12986-022-00720-1] [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: 07/28/2022] [Accepted: 12/20/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) combined with hypertension has a higher risk of developing cardiovascular diseases. This study aimed to investigate the relationships between the surrogate indicators of insulin resistance (TyG, TG/HDL, and Mets-IR) with the risk of T2D combined with hypertension. METHODS This study is based on a functional community cohort from Beijing and the China Health and Retirement Longitudinal Study, comprising 4234 and 4658 participants respectively. Cox proportional hazards models and restricted cubic spline regression were performed to assess the link between TyG, TG/HDL, and Mets-IR with T2D combined with hypertension. The cross-lagged panel analysis and the mediation analysis were used to examine the temporal relationship between insulin resistance and obesity and their temporal relationship with follow-up T2D combined with hypertension. RESULTS In multivariable-adjusted models, higher TyG was associated with a higher risk of developing T2D combined with hypertension, the hazard ratios (95% confidence interval) were 3.46 (2.43-4.93) and 2.02 (1.67-2.44), in two cohorts respectively. A similar positive association was shown for Mets-IR, the hazard ratios (95% confidence interval) were 1.04 (1.03-1.06) and 1.05 (1.03-1.07), in two cohorts respectively. However, the association between TG/HDL with T2D combined with hypertension was different in two cohorts. The restricted cubic spline regression showed a linear association between TyG and T2D combined with hypertension (P-nonlinear > 0.05). The cross-lagged path coefficient from baseline BMI to follow-up TyG index was significantly greater than the path coefficient from baseline TyG to follow-up BMI. TyG partially mediated the effect of BMI on the risk of T2D combined with hypertension and the percentage of mediated association was estimated at 41.58% and 48.41% in two cohorts, respectively. CONCLUSION These findings indicated positive associations between TyG and Mets-IR with the risk of T2D combined with hypertension in two cohorts. In addition, BMI change may precede TyG index change, and the TyG index plays a mediating role in BMI induced T2D combined with hypertension.
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Affiliation(s)
- Jing Dong
- grid.24696.3f0000 0004 0369 153XHealth Management Center, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, People’s Republic of China
| | - Yu-Hong Liu
- grid.24696.3f0000 0004 0369 153XDepartment of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmenWai, Fengtai District, 100069 Beijing, People’s Republic of China
| | - Ya-Ke Lu
- grid.24696.3f0000 0004 0369 153XDepartment of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmenWai, Fengtai District, 100069 Beijing, People’s Republic of China
| | - Li-Kun Hu
- grid.24696.3f0000 0004 0369 153XDepartment of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmenWai, Fengtai District, 100069 Beijing, People’s Republic of China
| | - Ning Chen
- grid.24696.3f0000 0004 0369 153XDepartment of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmenWai, Fengtai District, 100069 Beijing, People’s Republic of China
| | - Lin-Lin Ma
- grid.24696.3f0000 0004 0369 153XDepartment of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmenWai, Fengtai District, 100069 Beijing, People’s Republic of China
| | - Xi Chu
- grid.24696.3f0000 0004 0369 153XHealth Management Center, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, People’s Republic of China
| | - Yu-Xiang Yan
- grid.24696.3f0000 0004 0369 153XDepartment of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmenWai, Fengtai District, 100069 Beijing, People’s Republic of China ,grid.24696.3f0000 0004 0369 153XMunicipal Key Laboratory of Clinical Epidemiology, Beijing, People’s Republic of China
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Wang L, Wang Y, Liu R, Xu L, Zhong W, Li L, Wang C, He C, Fu C, Wei Q. Influence of age on the association between the triglyceride-glucose index and all-cause mortality in patients with cardiovascular diseases. Lipids Health Dis 2022; 21:135. [PMID: 36496414 PMCID: PMC9741797 DOI: 10.1186/s12944-022-01738-3] [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: 09/07/2022] [Accepted: 11/16/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In patients with cardiovascular diseases, it is reported that the triglyceride-glucose index (TGI) potentially indicates prognosis. However, the results are controversial. Moreover, whether age has an impact on the predictive value of TGI remains unclear. METHODS Participants with cardiovascular diseases were enrolled using the China Health and Retirement Longitudinal Study (CHARLS) registry. TGI was calculated as ln (triglyceride×glucose/2). The survival status was recorded every 2 years in the follow-up waves. Multivariate regression analysis was carried out to determine the relationship between TGI levels and long-term all-cause mortality in patients grouped by different age. Patients younger than 65 years old were regarded as middle-aged group. Otherwise, they were classified as old group. RESULTS In total, 2923 patients with cardiovascular diseases and baseline blood test results were included. After 7 years of follow-up, 242 (8.91%) patients died. Cox regression analysis revealed that higher TGI levels were associated with a higher risk of long-term all-cause mortality in middle-aged participants (hazard ratio [HR], 3.64; 95% confidence interval [CI] 1.44-9.22, P = 0.006) but not in old participants (HR 1.20, 95% CI 0.62-2.32, P = 0.594, P for interaction = 0.017), after adjusting physical activity and other factors. Kaplan-Meier estimate analysis and restricted cubic spline curves showed similar results. CONCLUSION TGI was a promising marker for predicting all-cause mortality in middle-aged patients after cardiovascular diseases. Patients younger than 65 years old who have a higher level of TGI may develop a higher risk of all-cause mortality, and they are encouraged to control vascular risk factors and take more physical activity to improve their prognosis. Additionally, whether intervention in regulating TGI levels is beneficial for the prognosis of these patients needs further investigation.
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Affiliation(s)
- Lu Wang
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Yang Wang
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Rui Liu
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Lin Xu
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Wen Zhong
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Lijuan Li
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Changyi Wang
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Chengqi He
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Chenying Fu
- grid.412901.f0000 0004 1770 1022National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Sichuan Chengdu, PR China ,grid.412901.f0000 0004 1770 1022Aging and Geriatric Mechanism Laboratory, West China Hospital, Sichuan University, Sichuan Chengdu, PR China
| | - Quan Wei
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
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Benmohammed K, Valensi P, Omri N, Al Masry Z, Zerhouni N. Metabolic syndrome screening in adolescents: New scores AI_METS based on artificial intelligence techniques. Nutr Metab Cardiovasc Dis 2022; 32:2890-2899. [PMID: 36182336 DOI: 10.1016/j.numecd.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Metabolic syndrome (MetS) definitions in adolescents based on the percentiles of its components are rather complicated to use in clinical practice. The aim of this study was to test the validity of artificial intelligence (AI)-based scores (AI_METS) that do not use these percentiles for MetS screening for adolescents. METHODS AND RESULTS This study included 1086 adolescents aged 12 to 18. The cohort underwent anthropometric measurements and blood tests. Mean blood pressure (MBP), and triglyceride glucose index (TyG) were calculated. Explainable AI methods are used to extract the learned function. Gini importance techniques were tested and used to build new scores for the screening of MetS. IDF, Cook, De Ferranti, Viner, and Weiss definitions of MetS were used to test the validity of these scores. MetS prevalence was 0.4%-4.7% according to these definitions. AI_METS used age, waist circumference, MBP, and TyG index. They offer area under the curves (AUCs) 0.91, 0.93, 0.89, 0.93, and 0.98; specificity 81%, 75%, 72%, 80%, and 97%; and sensitivity 90%, 100%, 90%, 100%, and 100%, respectively, for the detection of MetS according to these definitions. Considering only MBP offers a better specificity and sensitivity to detect MetS than considering only TyG index. MBP offers slightly lower performance than AI_METS. CONCLUSION AI techniques have proven their ability to extract knowledge from data. They allowed us to generate new scores for MetS detection in adolescents without using specific percentiles for each component. Although these scores are less intuitive than the percentile-based definition, their accuracy is rather effective for the detection of MetS.
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Affiliation(s)
- Karima Benmohammed
- Department of Endocrinology, Diabetology and Nutrition, Faculty of Medicine, University of Constantine 3, Algeria; Preventive Medicine of Chronic Diseases Research Laboratory, University of Constantine 3, Algeria.
| | - Paul Valensi
- Unit of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, APHP, Paris 13 University, Sorbonne Paris Cité, CINFO, CRNH-IdF, Bondy, France
| | - Nabil Omri
- FEMTO-ST Institute, Univ. Bourgogne Franche-Comté, CNRS, ENSMM, France
| | - Zeina Al Masry
- FEMTO-ST Institute, Univ. Bourgogne Franche-Comté, CNRS, ENSMM, France
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Mustafa A, Shekhar C. Association between serum 25-hydroxyvitamin-D and Triglycerides-Glucose index among Indian adolescents. BMC Nutr 2022; 8:69. [PMID: 35879737 PMCID: PMC9310494 DOI: 10.1186/s40795-022-00568-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 07/19/2022] [Indexed: 12/02/2022] Open
Abstract
Background Vitamin D deficiency has been found to associated with numerous skeletal and non-skeletal diseases including Diabetes Mellitus. Insulin Resistance (IR) is considered as one of the primary reasons of Type-2 Diabetes Mellitus (T2DM). The association between vitamin D deficiency and IR has been extensively explore in previous studies, but none of them focused on Indian adolescents, and none of them used the TyG index as IR marker. Hence, this population-based cross-sectional study investigates the relationship between insulin resistance (IR) assessed using the Triglycerides Glucose Index (TyG index) and vitamin D measured by serum 25-hydroxyvitamin-D (25(OH)D). Methods For this study, we utilized data from the Comprehensive National Nutrition Survey (CNNS, 2016–18). The study is based on a sample size of 10,167 adolescents aged 10–19 years. The TyG index cut-off value of 4.65 was used to classify IR. We examined associations between the TyG index and serum 25(OH)D using multiple linear regression models adjusted for potential confounders. Odds of Insulin Resistance among vitamin D deficient/insufficient adolescents were assessed using multivariable logistic regression. Results A significant negative association was found between serum 25(OH)D and the TyG index, where a 10% increase in serum 25(OH)D was associated with 0.56 (95% CI = -0.67, -0.45) unit decrement in the TyG index. The odds of having IR were 90% higher among vitamin D deficient adolescents (OR: 1.90; 95% CI = 1.62—2.23) compared to adolescents with adequate levels of vitamin D. The association between vitamin D deficiency and IR was independent of sex; in other words, the association between vitamin D and IR was significant in both the sexes. Conclusion Independent of sex, this study found a significant inverse association between vitamin D and insulin resistance in Indian adolescents. The findings of this study highlight the utility of TyG index and the importance of vitamin D in lowering the risk of T2DM in future generations of the country.
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Triglyceride-glucose index is significantly associated with the risk of hyperuricemia in patients with diabetic kidney disease. Sci Rep 2022; 12:19988. [PMID: 36411302 PMCID: PMC9678876 DOI: 10.1038/s41598-022-23478-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 11/01/2022] [Indexed: 11/23/2022] Open
Abstract
Triglyceride-glucose (TyG) index has been proposed to be a simple, economical, and reliable marker of insulin resistance. We aimed to investigate whether TyG is an independent predictor of hyperuricemia in diabetic kidney disease (DKD) populations by conducting a cross-sectional and longitudinal study. A total of 6,471 patients were enrolled in cross-sectional analysis, and 3,634 patients without hyperuricemia at the baseline were included in longitudinal analysis and were followed up for a median of 23.0 months. Hyperuricemia was categorized as a serum uric acid level ≥ 420 umol/L (7 mg/dL). In this study, 19.58% of participants had hyperuricemia. In the cross-sectional analysis, multivariate logistics regression analysis showed that the ORs (95% CI) for hyperuricemia in the second, third, and fourth TyG quartiles were 1.40 (95% CI 0.73-2.65), 1.69 (95% CI 0.90-3.18), and 4.53 (95% CI 2.39-8.57), respectively, compared with the first quartile. Longitudinally, the Kaplan-Meier survival analysis showed that higher TyG levels predicted higher incidence of hyperuricemia. Multivariate Cox regression model revealed that the hazard ratios for hyperuricemia in the upper quartiles of the TyG index were 1.69 (95% CI 0.97-2.93), 2.23 (95% CI 1.33-3.75), and 2.50 (95% CI 1.46-4.27), respectively, compared with the first quartile. Moreover, the subgroup analyses revealed that the relationship between TyG levels and hyperuricemia was robust in DKD patients. Our findings indicate a significant independent correlation between the TyG index and the risk of hyperuricemia in DKD patients.
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Association between Obesity, Overweight, Elevated Waist Circumference, and Insulin Resistance Markers among Brazilian Adolescent Students. Nutrients 2022; 14:nu14173487. [PMID: 36079745 PMCID: PMC9458155 DOI: 10.3390/nu14173487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: There is still controversy concerning the most effective and efficient strategy to identify insulin resistance in adolescents. We estimated the level of fasting insulin (fasting insulin equivalent, FIeq) that would replicate the strength of the associations of obesity, overweight, and waist circumference with two insulin resistance markers: triglyceride/high-density lipoprotein (TG/HDL) and triglyceride/glucose (TyG); (2) Methods: We studied approximately 38,000 adolescents aged 12 to 17 years, sampled from a multicenter Brazilian school-based survey, The Study of Cardiovascular Risk Factors in Adolescents (Portuguese acronym, ERICA), conducted in 2013–2014. Fasting insulin equivalents for adiposity variables were calculated by dividing the beta coefficient of each adiposity measure by the fasting insulin beta coefficient from linear regression analysis according to age (12–14, 15–17 years old) and sex, and adjusted by smoking, alcohol consumption, physical inactivity, sedentary behavior, socioeconomic status, and Tanner stage; (3) Results: The FIeqs for obesity were greater than those for overweight and elevated waist circumference for both TG/HDL and TyG in early adolescence. The FIeqs for elevated WC were greater than those for obesity and overweight in adolescents aged 15 to 17 years; (4) Conclusions: Our study suggests that WC measurements might be useful to identify adolescents with insulin resistance, particularly in late adolescence.
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Risk factors and prediction model for nonalcoholic fatty liver disease in northwest China. Sci Rep 2022; 12:13877. [PMID: 35974018 PMCID: PMC9381583 DOI: 10.1038/s41598-022-17511-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/26/2022] [Indexed: 11/09/2022] Open
Abstract
In recent years, nonalcoholic fatty liver disease (NAFLD) has become the most important chronic liver disease worldwide. The prevalence of NAFLD in China has also increased year by year. This study aimed to detect NAFLD early by developing a nomogram model in Chinese individuals. A total of 8861 subjects who underwent physical examination in Karamay and were 18 to 62 years old were enrolled. Clinical information, laboratory results and ultrasound findings were retrieved. The participants were randomly assigned to the development set (n = 6203) and the validation set (n = 2658). Significant variables independently associated with NAFLD were identified by least absolute shrinkage and selection operator (LASSO) regression and the multiple logistic regression model. Six variables were selected to construct the nomogram: age, sex, waist circumference (WC), body mass index (BMI), alanine aminotransferase (ALT), triglycerides and glucose index (TyG). The area under the receiver operating characteristic curve (AUROC) of the development set and validation set was 0.886 and 0.894, respectively. The calibration curves showed excellent accuracy of the nomogram model. This physical examination and laboratory test-based nomogram can predict the risk of NAFLD intuitively and individually.
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Liao Y, Zhang R, Shi S, Zhao Y, He Y, Liao L, Lin X, Guo Q, Wang Y, Chen L, Li W, Li S, Chen K, Fang Y. Triglyceride-glucose index linked to all-cause mortality in critically ill patients: a cohort of 3026 patients. Cardiovasc Diabetol 2022; 21:128. [PMID: 35804386 PMCID: PMC9270811 DOI: 10.1186/s12933-022-01563-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 06/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Triglyceride-glucose (TyG) index as a reliable surrogate of insulin resistance (IR) has been shown to be related to adverse clinical outcomes in patients with acute coronary syndrome, heart failure, ischemic stroke and so on. However, the relationship between TyG index and all-cause mortality in intensive care unit (ICU) patients remains unknown. The purpose of this study was to investigate the correlation between TyG index and all-cause mortality to evaluate the impact of IR on the prognosis of this population. METHODS This was a retrospective observational study that included 3026 patients who had an initial triglyceride and glucose data on the first day of ICU admission, and all data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. These patients were grouped into quartiles (Q1-Q4) according to TyG index. The Kaplan-Meier analysis was used to compare all-cause mortality among the above four groups. Cox proportional hazards analyses were performed to examine the association between TyG index and all-cause mortality. RESULTS During 10.46 years of follow-up, 1148 (37.9%) patients died, of which 350 (11.6%) occurred during the hospital stay and 258 (8.5%) occurred during the ICU stay. Kaplan-Meier analysis showed that the risk of all-cause mortality was significantly higher in patients with higher TyG index (log-rank P = 0.021). Multivariable Cox proportional hazards analyses showed that the TyG index was an independent risk predictor of ICU death (HR: 1.72, 95% CI 1.18-2.52, P = 0.005) and hospital death (HR: 2.19, 95% CI 1.59-3.03, P < 0.001), and each 1-unit increased in the TyG index, a 1.19-fold increase in the risk of death during the hospital stay. CONCLUSIONS TyG index is strongly related to the all-cause mortality increasing in critically ill patients. This finding indicates that the TyG index might be useful in identifying people at high risk of ICU death and hospital death.
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Affiliation(s)
- Ying Liao
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Rongting Zhang
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Shanshan Shi
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Yukun Zhao
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Yibo He
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.,Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Lihua Liao
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Xueqin Lin
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Qian Guo
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Yani Wang
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.,The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Liling Chen
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Weiguo Li
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Shihai Li
- Department of Anesthesiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
| | - Kaihong Chen
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
| | - Yong Fang
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
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Yang X, Gao Z, Huang X, Zhang M, Chen Z. The correlation of atherosclerosis and triglyceride glucose index: a secondary analysis of a national cross-sectional study of Japanese. BMC Cardiovasc Disord 2022; 22:250. [PMID: 35659558 PMCID: PMC9164853 DOI: 10.1186/s12872-022-02685-8] [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] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/20/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Few studies examined the relationship between triglyceride/glucose index (TyG index) and atherosclerosis in Japanese adults. Therefore, this study evaluated their relationship, as measured based on the brachial-ankle pulse wave velocity (baPWV) in Japanese adults. METHODS A total of 912 participants was selected from the NAGALA (NAFLD in Gifu Area, Longitudinal Analysis) study conducted from 2004 to 2012. The relationship between the TyG index and baPWV was estimated through a logistic model. Subgroup analyses by sex, age, body mass index (BMI), total cholesterol, low-density lipoprotein cholesterol, estimated glomerular filtration rate (eGFR), and fatty liver was performed. The formula for TyG index was ln (½fasting triglyceride level [mg/dL] × fasting plasma glucose level [mg/dL]). RESULTS A linear relationship between TyG and baPWV was discovered after adjusting for underlying confounders. An increased risk of baPWV was observed after adjusting for sex, age, BMI, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, fatty liver, eGFR, and TyG as a continuous variable (adjusted odds ratio [adj OR], 1.57; 95% confidence interval [95% CI], 1.14-2.18). Compared with the TyG index in the first tertile, the probabilities of subjects in the third tertile that developed to baPWV were 1.78-fold higher (adj OR 1.78, 95% CI 1.08-2.95: P for trend 0.024). Moreover, stable associations were observed between the TyG index and baPWV in different variables through subgroup analyses. CONCLUSIONS The highest tertile (above 8.57) of the TyG index was positively and linearly related to subclinical atherosclerosis in Japanese adults and may be valuable as a predicted marker.
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Affiliation(s)
- Xingping Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jinan University, No. 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510105, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Zhao Gao
- Office of Academic Research, Er Sha Sports Training Center of Guangdong Province, Guangzhou, 510105, China
| | - Xuming Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Mingxing Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Zhuoming Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jinan University, No. 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510105, China.
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Yoon JS, Lee HJ, Jeong HR, Shim YS, Kang MJ, Hwang IT. Triglyceride glucose index is superior biomarker for predicting type 2 diabetes mellitus in children and adolescents. Endocr J 2022; 69:559-565. [PMID: 34924455 DOI: 10.1507/endocrj.ej21-0560] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The triglyceride-glucose (TyG) index is associated with predicting type 2 diabetes mellitus (T2DM), but its relationship with homeostatic model assessment of insulin resistance (HOMA-IR) in T2DM is not established. We aimed to investigate the role of TyG index for detection of T2DM in children and adolescents and compare it with HOMA-IR. A cross sectional study was performed in 176 overweight or obese children and adolescents with mean age of 11.34 ± 3.24 years. TyG index was calculated as ln (fasting triglyceride (TG) [mg/dL] × fasting glucose [mg/dL]/2). Of a total of 176 subjects, 57 (32%) were diagnosed with T2DM. Significant differences were observed in the TyG index between T2DM and non-T2DM (p < 0.001). The TyG index had a positive correlation with fasting glucose (r = 0.519, p < 0.001), HOMA-IR (r = 0.189, p < 0.017), HbA1c (r = 0.429, p < 0.001), total cholesterol (TC) (r = 0.257, p = 0.001), TG (r = 0.759, p < 0.001), and low-density lipoprotein cholesterol (LDL-C)(r = 0.152, p < 0.001), and a negative correlation with high-density lipoprotein cholesterol (HDL-C)(r = -0.107, p < 0.001) after controlling for sex, age and BMI standard deviation scores (SDS). In multiple regression analyses, 91.8% of the variance in TyG index was explained by age, glucose, HOMA-IR, TG, LDL-C, and HDL-C (p < 0.001). In the receiver operating characteristic (ROC) analysis, the TyG index [area under the curve (AUC) 0.839)] showed a better performance compared to HOMA-IR (AUC 0.645) in identifying patients with T2DM (p < 0.001). In conclusion, the TyG index had significant association with insulin resistance in T2DM and was superior to HOMA-IR in predicting T2DM in children and adolescents.
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Affiliation(s)
- Jong Seo Yoon
- Department of Pediatrics, Hallym University College of Medicine, Chuncheon-si, Republic of Korea
| | - Hye Jin Lee
- Department of Pediatrics, Hallym University College of Medicine, Chuncheon-si, Republic of Korea
| | - Hwal Rim Jeong
- Department of Pediatrics, Soonchunhyang University College of Medicine, Cheonan-si, Republic of Korea
| | - Young Suk Shim
- Department of Pediatrics, Ajou University College of Medicine, Suwon-si, Republic of Korea
| | - Min Jae Kang
- Department of Pediatrics, Hallym University College of Medicine, Chuncheon-si, Republic of Korea
| | - Il Tae Hwang
- Department of Pediatrics, Hallym University College of Medicine, Chuncheon-si, Republic of Korea
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Fu X, Liu H, Liu J, Li N, Li L, Ke D, Liu M, Lu Y, Duan L, Ma L, Huo Y, Lei Q, Yan S. Association Between Triglyceride-Glucose Index and the Risk of Type 2 Diabetes Mellitus in an Older Chinese Population Aged Over 75 Years. Front Public Health 2022; 9:796663. [PMID: 35399348 PMCID: PMC8989963 DOI: 10.3389/fpubh.2021.796663] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/14/2021] [Indexed: 01/19/2023] Open
Abstract
Background The association between the triglyceride–glucose (TyG) index and type 2 diabetes mellitus (T2DM) in older adults has not been fully understood. This research aims to explore the association between the TyG index and the incidence of T2DM in an older Chinese population aged over 75 years. Methods This longitudinal analysis study was performed based on a database from a health check screening program in China. The participants were stratified based on the quintile ranges of the TyG index (Q1 to Q5 groups). T2DM was defined as fasting plasma glucose (FPG) ≥ 7.00 mmol/L and/or self-reported T2DM. The cumulative incidences of T2DM in various quintile groups were estimated by the Kaplan–Meier method. The Cox proportional hazard model was used to examine the independent impact of the TyG index on the risk of T2DM during the follow-up period. Subgroup analysis was performed by gender and BMI to further validate the credibility of the results. Results During the follow-up period, a total of 231 new-onset T2DM cases were recorded among the 2,571 individuals aged over 75 years. After adjusting confounding factors, elevated TyG index independently indicated a higher risk of T2DM (HR = 1.89; 95% CI, 1.47–2.44; p < 0.01). Higher TyG index quintile groups (Q3 to Q5) also presented with a higher risk of T2DM (hazard ratio (HR) = 1.36, 1.44, and 2.12, respectively) as compared with the lowest quintile group (Q1). Subgroup analysis showed that increased TyG index led to a higher risk of T2DM with HR = 2.35 (95% CI, 1.73–3.19), 1.90 (95% CI, 1.27–2.83), 2.95 (95% CI, 1.94–4.50), and 1.72 (95% CI, 1.25–2.35) in male subgroup, female subgroup, BMI < 24 kg/m2 subgroup, and BMI ≥ 24 kg/m2 subgroup, respectively. Conclusions Triglyceride–glucose index independently correlated with the risk of incident T2DM in Chinese adults aged over 75 years. The TyG index might be useful in monitoring T2DM in the older populations.
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Affiliation(s)
- Xiaomin Fu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hongzhou Liu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.,Department of Endocrinology, First Hospital of Handan City, Handan, China
| | - Jing Liu
- Clinics of Cadre, Department of Outpatient, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Nan Li
- Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Lele Li
- Department of Endocrinology, Genetics, Metabolism and Adolescent Medicine, National Center for Children's Health, Beijing Children's Hospital, The Capital Medical University, Beijing, China
| | - Dianshan Ke
- Department of Orthopedics, Fujian Provincial Hospital, Fuzhou, China
| | - Minyan Liu
- Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yanhui Lu
- Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Lihua Duan
- Department of Ultrasound Medicine, Handan Central Hospital, Handan, China
| | - Linlin Ma
- General Surgery Department 5, Handan Central Hospital, Handan, China
| | - Yanfei Huo
- Physical Examination Center, Handan Central Hospital, Handan, China
| | - Qinghua Lei
- Physical Examination Center, Handan Central Hospital, Handan, China
| | - Shuangtong Yan
- Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
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Zhou Y, Yang G, Qu C, Chen J, Qian Y, Yuan L, Mao T, Xu Y, Li X, Zhen S, Liu S. Predictive performance of lipid parameters in identifying undiagnosed diabetes and prediabetes: a cross-sectional study in eastern China. BMC Endocr Disord 2022; 22:76. [PMID: 35331213 PMCID: PMC8952267 DOI: 10.1186/s12902-022-00984-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/08/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Dyslipidaemia is a risk factor for abnormal blood glucose. However, studies on the predictive values of lipid markers in prediabetes and diabetes simultaneously are limited. This study aimed to assess the associations and predictive abilities of lipid indices and abnormal blood glucose. METHODS A sample of 7667 participants without diabetes were enrolled in this cross-sectional study conducted in 2016, and all of them were classified as having normal glucose tolerance (NGT), prediabetes or diabetes. Blood glucose, blood pressure and lipid parameters (triglycerides, TG; total cholesterol, TC; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C; non-high-density lipoprotein cholesterol, non-HDL-C; and triglyceride glucose index, TyG) were evaluated or calculated. Logistic regression models were used to analyse the association between lipids and abnormal blood glucose. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to assess the discriminatory power of lipid parameters for detecting prediabetes or diabetes. RESULTS After adjustment for potential confounding factors, the TyG was the strongest marker related to abnormal blood glucose compared to other lipid indices, with odds ratios of 2.111 for prediabetes and 5.423 for diabetes. For prediabetes, the AUCs of the TG, TC, HDL-C, LDL-C, TC/HDL-C, TG/HDL-C, non-HDL-C and TyG indices were 0.605, 0.617, 0.481, 0.615, 0.603, 0.590, 0.626 and 0.660, respectively, and the cut-off points were 1.34, 4.59, 1.42, 2.69, 3.39, 1.00, 3.19 and 8.52, respectively. For diabetes, the AUCs of the TG, TC, HDL-C, LDL-C, TC/HDL-C, TG/HDL-C, non-HDL-C and TyG indices were 0.712, 0.679, 0.440, 0.652, 0.686, 0.692, 0.705, and 0.827, respectively, and the cut-off points were 1.35, 4.68, 1.42, 2.61, 3.44, 0.98, 3.13 and 8.80, respectively. CONCLUSIONS The TyG, TG and non-HDL-C, especially TyG, are accessible biomarkers for screening individuals with undiagnosed diabetes.
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Affiliation(s)
- Yimin Zhou
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China
| | - Guoping Yang
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Chen Qu
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Jiaping Chen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China
| | - Yinan Qian
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China
| | - Lei Yuan
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China
| | - Tao Mao
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Yan Xu
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Xiaoning Li
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Shiqi Zhen
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China.
| | - Sijun Liu
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China.
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Lin SF, Hu HH, Chao HL, Ho BL, Chen CH, Chan L, Lin HJ, Sun Y, Lin YY, Chen PL, Lin SK, Wei CY, Lin YT, Lee JT, Chao AC. Triglyceride-Glucose Index and Intravenous Thrombolysis Outcomes for Acute Ischemic Stroke: A Multicenter Prospective–Cohort Study. Front Neurol 2022; 13:737441. [PMID: 35250801 PMCID: PMC8890321 DOI: 10.3389/fneur.2022.737441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/11/2022] [Indexed: 01/11/2023] Open
Abstract
Background The triglyceride-glucose (TyG) index has recently been proposed as a reliable marker of insulin resistance. There is insufficient evidence to verify that the TyG index is correlated with functional outcomes and hemorrhagic transformation and in patients with stroke treated with intravenous thrombolysis (IVT). Methods We designed a multicenter cohort study, which enrolled patients with acute ischemic stroke treated with IVT between December 2004 and December 2016. The TyG index was divided into tertiles and calculated on a continuous scale. Unfavorable functional outcomes were defined by the modified Rankin Scale of 3–6 at 90 days and the incident rates of symptomatic intracranial hemorrhage (SICH) within 36 h of IVT onset were surveyed. Stroke severity was defined as mild (4–8), moderate (9–15), or high (≥16) based on the National Institutes of Health Stroke Scale (NIHSS) scores. Results Among 914 enrolled patients, the tertiles of the TyG index were 8.48 for T1, 8.48–9.04 for T2, and 9.04 for T3. T3 showed an increased risk of unfavorable functional outcomes at 90 days [odds ratio (OR): 1.76; P = 0.0132]. The TyG index was significantly associated with unfavorable functional outcomes at 90 days (OR: 1.32; P = 0.0431 per unit increase). No association was found between the TyG index and SICH. These findings were applicable for T3 with stroke of moderate (OR, 2.35; P = 0.0465) and high severity (OR: 2.57, P = 0.0440) patients with stroke. Conclusion This study supports the strong association between the increased TyG index and increased unfavorable functional outcomes at 90 days in patients with acute ischemic stroke treated with IVT. These findings were found to be robust in patients with moderate and high stroke severity.
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Affiliation(s)
- Sheng-Feng Lin
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Han-Hwa Hu
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Department of Neurology, Taipei Medical University-Shaung Ho Hospital, Taipei, Taiwan
- *Correspondence: Han-Hwa Hu
| | - Hai-Lun Chao
- Department of Optometry, Chung Hwa University of Medical Technology, Tainan, Taiwan
- Hai-Lun Chao
| | - Bo-Lin Ho
- Department of Neurology, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chih-Hung Chen
- Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan
- Department of Neurology, National Cheng Kung University, Tainan, Taiwan
| | - Lung Chan
- Department of Neurology, Taipei Medical University-Shaung Ho Hospital, Taipei, Taiwan
| | - Huey-Juan Lin
- Department of Neurology, Chi Mei Medical Center, Tainan, Taiwan
| | - Yu Sun
- Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Yung-Yang Lin
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Lin Chen
- Department of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shinn-Kuang Lin
- Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Cheng-Yu Wei
- Department of Neurology, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Yu-Te Lin
- Division of Neurology, Department of Medicine, Kaohsiung Veterans General, Kaohsiung, Taiwan
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - A-Ching Chao
- Department of Neurology, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- A-Ching Chao
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Weyman-Vela Y, Simental-Mendía LE, Camacho-Luis A, Gamboa-Gómez CI, Guerrero-Romero F. The Triglycerides and Glucose Index Is Associated with Mild Cognitive Impairment in Older Adults. Endocr Res 2022; 47:89-93. [PMID: 35393913 DOI: 10.1080/07435800.2022.2061508] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND It has been reported that insulin resistance is related to cognitive decline. The triglycerides and glucose (TyG) index, is a reliable and inexpensive surrogate test for detecting insulin resistance. AIMS The goal of this study was to evaluate the association between the TyG index and the mild cognitive impairment (MCI) in older adults. METHODS A total of 135 individuals, men and women aged 60 to 90 years, were enrolled in a case and control study. Individuals with a diagnosis of MCI (n = 65) were allocated into the case group and compared with individuals without MCI (n = 70) in the control group. Alcohol intake, diabetes duration ≥5 years, diagnoses of cerebrovascular disease, brain injury, folic acid deficiency, dementia, moderate or severe CI, major depressive disorders, and thyroid disease were exclusion criteria. RESULTS Individuals in the case group exhibited higher waist circumference (97.9 ± 13.9 versus 93.5 ± 13.0, p = .001) and TyG index (5.0 ± 0.3 versus 4.1 ± 0.2, p = .001) than individuals in the control group. The TyG index ≥4.68 (OR 6.91; 95% CI 2.05-11.68) and waist circumference (OR 1.03; 95% CI 1.01-1.06) were positively associated with MCI, while education level (OR 0.44; 95% CI 0.30-0.61), occupation (OR 0.75; 95% CI 0.59-0.61), and exercise (OR 0.34; 95% CI 0.22-0.52) were inversely associated with MCI. After controlling for sex, age, waist circumference, education level, occupation, and exercise, a TyG index ≥4.68 remained significantly associated with MCI (OR 2.97; 95% CI 1.12-14.71). CONCLUSION The TyG index is independently associated with the presence of MCI in older people.
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Affiliation(s)
- Yéssika Weyman-Vela
- Unidad de Investigación Biomédica, Instituto Mexicano del Seguro Social, Durango, México
| | - Luis E Simental-Mendía
- Unidad de Investigación Biomédica, Instituto Mexicano del Seguro Social, Durango, México
| | - Abelardo Camacho-Luis
- Nutrición, Universidad Juárez del Estado de DurangoFacultad de Medicina y , Durango, Mexico
| | - Claudia I Gamboa-Gómez
- Unidad de Investigación Biomédica, Instituto Mexicano del Seguro Social, Durango, México
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The triglyceride-glucose index as a clinical useful marker for metabolic associated fatty liver disease (MAFLD): a population-based study among Iranian adults. J Diabetes Metab Disord 2022; 21:97-107. [PMID: 35673435 PMCID: PMC9167320 DOI: 10.1007/s40200-021-00941-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/17/2021] [Indexed: 01/13/2023]
Abstract
Background and aims There is a bi-directional association between non-alcoholic fatty liver disease (NAFLD) and insulin resistance in type 2 diabetes mellitus (T2DM) and metabolic syndrome. The triglyceride-glucose (TyG) index is a novel surrogate marker of insulin resistance. In this population-based study, we aimed firstly to investigate the association of the TyG-index with metabolic-associated fatty liver disease (MAFLD) risk. Methods This case-control study used the data from the first phase of the Persian Cohort Study in Sabzevar. Of 4,241 participants aged 35 to 70 years, we identified and recruited 968 MAFLD cases and 964 age- and sex-adjusted controls. Demographic, lifestyle, anthropometric, and biochemical information were collected. We calculated TyG and a new index combined of TyG and alanine aminotransferase (TyG-ALT). We used the multivariable unconditional logistic regression model to calculate the odds ratios (ORs) of the TyG and TyG-ALT for having MAFLD. Results Among those in the highest relative to the lowest TyG and TyG-ALT tertiles, the multivariable-adjusted ORs were 12.01 (95% CI [confidence interval] 9.03 - 15.98; P trend < 0.001) and 10.89 (95% CI 7.66 - 15.48; P trend = 0.001), respectively. The area under the curves (AUC) for the TyG-index to predict MAFLD was 8.62, resulting in a cut-off value of 8.62 with a sensitivity of 81.66% and specificity of 75.36%. Conclusions The higher TyG and TyG-ALT scores were significantly positively associated with higher MAFLD risk in the Iranian population.
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Jiao Y, Su Y, Shen J, Hou X, Li Y, Wang J, Liu B, Qiu D, Sun Z, Chen Y, Xi Q, Shen M, Fu Z. Evaluation of the long-term prognostic ability of triglyceride-glucose index for elderly acute coronary syndrome patients: a cohort study. Cardiovasc Diabetol 2022; 21:3. [PMID: 34991602 PMCID: PMC8740408 DOI: 10.1186/s12933-021-01443-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/29/2021] [Indexed: 12/13/2022] Open
Abstract
Background With the advancement of the world population aging, more attention should be paid to the prognosis of elderly patients with acute coronary syndrome (ACS). Triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance (IR) and is closely related to traditional risk factors of cardiovascular disease (CVD). However, the effect of TyG index on the prognosis of long-term adverse events in elderly ACS patients has not been reported. This study evaluated the prognostic power of TyG index in predicting adverse events in elderly ACS patients. Methods In this study, 662 ACS patients > 80 years old who were hospitalized from January 2006 to December 2012 were enrolled consecutively and the general clinical data and baseline blood biochemical indicators were collected. The follow-up time after discharge was 40–120 months (median, 63 months; interquartile range, 51‒74 months). In addition, the following formula was used to calculate the TyG index: Ln [fasting TG (mg/dL) × FBG (mg/dL)/2], and patients were divided into three groups according to the tertile of the TyG index. Results The mean age of the subjects was 81.87 ± 2.14 years, the proportion of females was 28.10%, and the mean TyG index was 8.76 ± 0.72. The TyG index was closely associated with the traditional risk factors of CVD. In the fully-adjusted Cox regression model, the Hazard ratio (95% CI) of all-cause mortality (in tertile 3) was 1.64 (1.06, 2.54) and major adverse cardiac event (MACE) (in tertile 3) was 1.36 (1.05, 1.95) for each SD increase in the TyG index. The subgroup analyses also confirmed the significant association of the TyG index and long-term prognosis. Conclusion The TyG index is an independent predictor of long-term all-cause mortality and MACE in elderly ACS patients.
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Affiliation(s)
- Yang Jiao
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Yongkang Su
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China.,Department of Geriatrics, The Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jian Shen
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Xiaoling Hou
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Ying Li
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Jihang Wang
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China.,Department of Cardiology, Hainan Hospital, Chinese PLA General Hospital, Sanya, 572000, Hainan, China
| | - Bing Liu
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China.,Department of Cardiology, 970 Hospital, Chinese PLA Joint Logistic Support Force, Weihai, 264200, Shandong, China
| | - Dongfeng Qiu
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Zhijun Sun
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Yundai Chen
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Qing Xi
- The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Mingzhi Shen
- Department of Cardiology, Hainan Hospital, Chinese PLA General Hospital, Sanya, 572000, Hainan, China.
| | - Zhenhong Fu
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China.
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Song B, Zhao X, Yao T, Lu W, Zhang H, Liu T, Liu C, Wang K. Triglyceride Glucose-Body Mass Index and Risk of Incident Type 2 Diabetes Mellitus in Japanese People With Normal Glycemic Level: A Population-Based Longitudinal Cohort Study. Front Endocrinol (Lausanne) 2022; 13:907973. [PMID: 35909552 PMCID: PMC9336540 DOI: 10.3389/fendo.2022.907973] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/21/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND It has been proved that triglyceride glucose-body mass index (TyG-BMI) is a readily available and clinically significant indicator of insulin resistance (IR). Nevertheless, the association between TyG-BMI and incident Type 2 diabetes mellitus (T2DM) remains uncertain. This study aimed to study the relationship between TyG-BMI and T2DM and explore the predictive characteristics of TyG-BMI. METHODS Our study was conducted as a longitudinal cohort study. 8,430 men and 7,034 women were enrolled and analyzed. They were both non-diabetic subjects with normal glycemic levels. Follow-up lasted for 13 years, from 1994 to 2016. To make the number of TyG-BMI in each group similar, the subjects were divided into four groups with 3866 subjects in each group. RESULTS During the 13-year follow-up period, 373 subjects were diagnosed with incident T2DM. Our multivariate Cox regression analysis revealed that TyG-BMI was an independent predictor of incident T2DM. In addition, our research identified four specific groups, young people (18-44 years old), women, the non-hypertensive population and non-drinkers were at significantly higher risk of developing TyG-BMI-related diabetes (P-interaction< 0.05). The best threshold TyG-BMI for predicting incident T2DM was 197.2987 (area under the curve 0.7738). CONCLUSIONS Our longitudinal cohort study demonstrated the positive correlation between baseline TyG-BMI and risk of incident T2DM in Japanese with normal glycemic levels, and this risk was significantly higher in the young people, women, the non-hypertensive population and non-drinkers.
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Affiliation(s)
| | | | | | | | | | | | | | - Kun Wang
- *Correspondence: Chengyun Liu, ; Kun Wang,
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Hirschler V, Molinari C, Edit S, Miorin C, Bocco P, Guntsche Z, Lapertosa S, Gonzalez CD. Ability of TyG Index as a Marker of Insulin Resistance in Argentinean School Children. Front Pediatr 2022; 10:885242. [PMID: 35586828 PMCID: PMC9110001 DOI: 10.3389/fped.2022.885242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine if the triglycerides and glucose index (TyG) can be used as a marker for insulin resistance (IR) in Argentinean schoolchildren according to age and sex. METHODS Anthropometric data, blood glucose levels, lipid profiles, and insulin levels were measured. The TyG index was defined by Ln [fasting triglyceride (mg/dL)* fasting glucose (mg/dL)/2]. A comparison of the ability of TyG to identify children with IR was performed using receiver operating characteristic (ROC) curves and the area under the ROC (AUROC) curve. IR was defined as HOMA-IR > III quartile. RESULTS A total of 915 (528, 57.7% males) apparently healthy schoolchildren, aged 9.3 ± 2.2, were evaluated. The AUROC using the HOMA-IR > III quartile as the dichotomous variable showed that TyG was a fair marker to identify IR (0.65, 95% CI, 0.61-0.69; p < 0.01). There was a significantly higher TyG AUROC in males (0.69, 95% CI, 0.63-0.75; p < 001) than in females (0.60, 95% CI, 0.54-0.66; p < 0.01). When children were divided according to age into two groups (5.0-9.9 and 10.0-14.9-year-olds); younger children (0.64, 95% CI, 0.58-0.69; p < 0.011) and older children (0.62, 95% CI, 0.55-0.68; p = 0.01) had a similar and fair AUROC. However, when children were divided by age and sex, females older than ten had a non-significant AUROC (0.53, 95% CI, 0.42-0.63; p = 0.61). The TyG index compared with HOMA-IR had low sensitivity and specificity, ranging from 0.62 to 0.56. CONCLUSION The TyG index had a fair AUROC with low sensitivity and specificity, indicating poor discrimination in identifying IR in apparently healthy Argentinean children. The ability to use TyG for screening purposes seems limited in Argentinean schoolchildren.
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Affiliation(s)
- Valeria Hirschler
- Argentine Society of Diabetes, Epidemiology Committee, Buenos Aires, Argentina
| | - Claudia Molinari
- Argentine Society of Diabetes, Epidemiology Committee, Buenos Aires, Argentina.,UBA School of Pharmacy and Biochemistry, Mathematics, Buenos Aires, Argentina
| | - Scaiola Edit
- Argentine Society of Diabetes, Epidemiology Committee, Buenos Aires, Argentina
| | - Cecilia Miorin
- Pediatrica Endocrinology and Diabetes, Hospital of Notti, Mendoza, Argentina
| | - Patricia Bocco
- Argentine Society of Diabetes, Epidemiology Committee, Buenos Aires, Argentina
| | - Zelmira Guntsche
- Pediatrica Endocrinology and Diabetes, Hospital of Notti, Mendoza, Argentina
| | - Silvia Lapertosa
- Argentine Society of Diabetes, Epidemiology Committee, Buenos Aires, Argentina
| | - Claudio D Gonzalez
- Argentine Society of Diabetes, Epidemiology Committee, Buenos Aires, Argentina
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Yao H, Sun Z, Yuan W, Shao C, Cai H, Li L, Qian Y, Wang Z. Relationship Between the Triglyceride-Glucose Index and Type 2 Diabetic Macroangiopathy: A Single-Center Retrospective Analysis. Diabetes Metab Syndr Obes 2022; 15:3483-3497. [PMID: 36388062 PMCID: PMC9656493 DOI: 10.2147/dmso.s387040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/02/2022] [Indexed: 11/11/2022] Open
Abstract
PURPOSE The research explores the relationship between the triglyceride-glucose index (TyG index) and the macroangiopathy risk in single-center hospitalized type 2 diabetes mellitus (T2DM) patients and develops a risk prediction nomogram model. PATIENTS AND METHODS A total of 858 patients with T2DM were studied retrospectively. Lasso regression was used to eliminate unimportant factors, and multivariate logistic regression analysis was used to investigate the association between the TyG index and macrovascular disease in T2DM. A nomogram model was constructed to predict macrovascular disease in T2DM and tested using the bootstrap technique, and the efficacy of the nomogram model was investigated using ROC curves. The multivariate Cox proportional hazards model estimated the association between the TyG index and all-cause mortality. RESULTS TyG index, high-density lipoprotein, red blood cell count, hypertension, history of taking ACEI/ARB drugs, and aortic calcification were closely related to macrovascular complications. In Cox proportional hazard model, the HRs of TyG index were 1.89 (95% confidence interval (CI) 1.29-2.76, p < 0.001) after adjusting for covariates. The risk of all-cause mortality in T2DM with macrovascular complications was significantly higher than in diabetic patients without vascular disease. In the ROC curve analysis, the cut-off value of the TyG index for macrovascular complications of T2DM was 9.31 (AUC: 0.702, 95% CI 0.67-0.74, p < 0.001). CONCLUSION TyG index predicts future macrovascular disease in diabetic patients independently of known cardiovascular risk factors, suggesting that TyG index may be a useful marker for prognosis in diabetic patients.
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Affiliation(s)
- Haipeng Yao
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Zhen Sun
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Wei Yuan
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Chen Shao
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Honghua Cai
- Department of Burns and Plastic Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Lihua Li
- Department of Pathology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Yongjiang Qian
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Zhongqun Wang
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
- Correspondence: Zhongqun Wang, Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, People’s Republic of China, Email
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Zhang R, Guan Q, Zhang M, Ding Y, Tang Z, Wang H, Zhang W, Chen Y, Jiang R, Cui Y, Wang J. Association Between Triglyceride-Glucose Index and Risk of Metabolic Dysfunction-Associated Fatty Liver Disease: A Cohort Study. Diabetes Metab Syndr Obes 2022; 15:3167-3179. [PMID: 36268197 PMCID: PMC9578360 DOI: 10.2147/dmso.s383907] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Insulin resistance (IR) is a major factor involved in the pathogenesis of metabolic dysfunction-associated fatty liver disease (MAFLD). Triglyceride-glucose (TyG) index, an easily detected surrogate marker of IR, has not been explored sufficiently on its relationship with incident MAFLD risk. This study sought to investigate the association of baseline TyG index with the risk of MAFLD in a Chinese cohort. METHODS This health check-up cohort was constructed with eligible 2056 Chinese from a community. The TyG index was calculated as ln (fasting triglyceride [mg/dL]×fasting glucose [mg/dL]/2). Cox proportion hazard models were used to evaluate the longitudinal association between baseline TyG index and the risk of MAFLD. RESULTS During an average follow-up of 2.5 ± 0.5 years, about 12.8% of the subjects developed MAFLD, and the incidence of MAFLD trended to increase with the quartile TyG index (P trend < 0.05). After adjusting for all confounders, TyG index was independently correlated with the risk of incident MAFLD (HR = 1.784, 95% CI = 1.383-2.302, P < 0.001), and the risk of MAFLD in the highest quartile of TyG index was two times higher than that in the lowest quartile (95% CI = 1.377-2.992, P = 0.001). The restricted cubic spline analysis showed that the relationship between TyG index and the risk of MAFLD was linear in males (P for total < 0.001; P for non-linearity = 0.746), but nonlinear in females (P for non-linearity = 0.040). CONCLUSION A high baseline TyG index was independently associated with a high risk of incident MAFLD, and we might develop the strategy of MAFLD prevention based on the TyG index.
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Affiliation(s)
- Ru Zhang
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Qing Guan
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Mengting Zhang
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Yajie Ding
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Zongzhe Tang
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Hongliang Wang
- Department of General Practice, Community Health Service Center, Nanjing, People’s Republic of China
| | - Wei Zhang
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, People’s Republic of China
| | - Yue Chen
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Rong Jiang
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Yan Cui
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Jie Wang
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
- Correspondence: Jie Wang; Yan Cui, School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, 211166, People’s Republic of China, Tel +86-25-86869557, Email ;
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Simental-Mendía LE, Gómez-Díaz R, Wacher NH, Guerrero-Romero F. The Triglycerides and Glucose Index is Negatively Associated with Insulin Secretion in Young Adults with Normal Weight. Horm Metab Res 2022; 54:33-36. [PMID: 34986498 DOI: 10.1055/a-1713-7821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Several studies have supported the usefulness of the triglycerides and glucose (TyG) index as a surrogate measure of insulin resistance; however, it has not been evaluated in insulin secretion. The aim of this study was to assess the association between the TyG index and insulin secretion in young adults with normal weight. Apparently healthy non-pregnant women and men, aged 18 to 23 years, were enrolled in a cross-sectional study. Overweight, obesity, pregnancy, smoking, alcohol consumption, diabetes, liver disease, renal disease, cardiovascular disease, and neoplasia were the exclusion criteria. Normal weight was defined by a body mass index (BMI)≥18.5<25.0 kg/m2 and the TyG index was calculated as the Ln [fasting triglycerides (mg/dl) x fasting glucose (mg/dl)]/2. A total of 1676 young adults with normal-weight, 1141 (68%) women, and 535 (32%) men were enrolled. Of them, 269 (16%) individuals exhibited insulin resistance; 213 (12.7%) women and 56 (3.3%) men. The linear regression analysis adjusted by gender, BMI, and waist circumference showed a significant association between the TyG index and HOMA-B (B=-35.90; 95% CI:-68.25 to-3.54, p=0.03) in the overall population. An additional analysis adjusted by BMI and waist circumference revealed that the TyG index is significantly associated with HOMA-B in subjects with and without insulin resistance (B=-104.73; 95% CI:-204.28 to-5.18, p=0.03 and B=-74.72; 95% CI:-108.04 to-41.40, p<0.001). The results of this study showed that the TyG index is negatively associated with insulin secretion in young adults with normal weight.
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Affiliation(s)
- Luis E Simental-Mendía
- Unidad de Investigación Biomédica, Instituto Mexicano del Seguro Social, Durango, Dgo., México
| | - Rita Gómez-Díaz
- Unidad de Investigación Médica en Epidemiología Clínica, Centro Médico Nacional "Siglo XXI", Instituto Mexicano del Seguro Social, México
| | - Niels H Wacher
- Unidad de Investigación Médica en Epidemiología Clínica, Centro Médico Nacional "Siglo XXI", Instituto Mexicano del Seguro Social, México
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Yoon JS, Shim YS, Lee HS, Hwang IT, Hwang JS. A population-based study of TyG index distribution and its relationship to cardiometabolic risk factors in children and adolescents. Sci Rep 2021; 11:23660. [PMID: 34880367 PMCID: PMC8654923 DOI: 10.1038/s41598-021-03138-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/22/2021] [Indexed: 11/09/2022] Open
Abstract
The purpose of this study was to present age- and sex-specific distributions of the triglyceride-glucose (TyG) index and to evaluate their relationship with cardiometabolic risk factors in children and adolescents. A total of 7404 participants aged 10-18 years from the Korean National Health and Nutrition Survey were included as the reference population. The TyG index was calculated as ln(fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The percentile of the TyG index exhibited a steady linear relationship with age for both sexes. TyG index significantly correlated with waist circumference (WC) standard deviation score (SDS; r = 0.110, p < 0.001), systolic blood pressure (SBP; r = 0.104, p < 0.001), diastolic blood pressure (DBP; r = 0.083, p < 0.001), glucose (r = 0.220, p < 0.001), high-density lipoprotein cholesterol (HDL-C; r = - 0.325, p < 0.001), and triglycerides (TG; r = 0.926, p < 0.001). Multiple linear regression analysis revealed that the TyG index was significantly associated with WC SDS (β = 0.116, p < 0.001), SBP (β = 2.009, p < 0.001), DBP (β = 1.464, p < 0.001), glucose (β = 3.376, p < 0.001), HDL-C (β = - 6.431, p < 0.001), and TG (β = 85.518, p < 0.001). Our results suggest that the TyG index has a steady linear distribution for sex and age in children and adolescents and constitutes an indicator for predicting metabolic disorders that could lead to cardiovascular disease later in life.
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Affiliation(s)
- Jong Seo Yoon
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Young Suk Shim
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, San 5, Wonchon-dong, Yeongtong-gu, Suwon, 443-721, Korea.
| | - Hae Sang Lee
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, San 5, Wonchon-dong, Yeongtong-gu, Suwon, 443-721, Korea
| | - Il Tae Hwang
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jin Soon Hwang
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, San 5, Wonchon-dong, Yeongtong-gu, Suwon, 443-721, Korea
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Liu Y, Chi R, Jiang Y, Chen B, Chen Y, Chen Z. Triglyceride glycemic index as a biomarker for gestational diabetes mellitus: a systemic review and meta-analysis. Endocr Connect 2021; 10:1420-1427. [PMID: 34636743 PMCID: PMC8630762 DOI: 10.1530/ec-21-0234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/11/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Triglyceride glycemic (TyG) index is a novel tool for assessing insulin resistance (IR). Recently, TyG index as a potential biomarker for gestational diabetes mellitus (GDM) has been studied, but its performance is yet inconclusive. Thus, we performed this systemic review and meta-analysis to evaluate the performance of TyG index in predicting GDM. METHODS Studies published before March 1, 2021, with comparison of TyG index between GDM patients and healthy controls were retrieved from multiple databases (PubMed, Web of Science, The Cochrane Library, and Embase). The mean difference (MD) of TyG index in GDM patients and healthy controls was pooled using random-effect models. RESULTS Differentiation of TyG index between patients with GDM and controls showed significant results. Overall, there is a four-fold increase in TyG index in GDM patients compared with controls (MD: 0.22, 95% CI: 0.07-0.36, P = 0.003; I2 = 71%, P = 0.009). In subgroup analyses according to gestational time, TyG index in the second trimester predicted GDM with low heterogeneity (MD: 0.26, 95% CI: 0.15-0.37, P < 0.001; I2 = 0%, P = 0.54), while no such correlation was found in the first trimester. CONCLUSION TyG index, especially in the second trimester, could be a promising biomarker for predicting GDM.
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Affiliation(s)
- Yusen Liu
- Department of Cooperation and Communication, The First Clinical Medical College & The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Ruiwen Chi
- Department of Cooperation and Communication, The First Clinical Medical College & The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Yujie Jiang
- School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou, China
| | - Bicheng Chen
- Department of Cooperation and Communication, The First Clinical Medical College & The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Youli Chen
- Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Correspondence should be addressed to Z Chen or Y Chen: or
| | - Zengrui Chen
- Intensive Care Unit, The People’s Hospital of Yuhuan, Yuhuan, China
- Correspondence should be addressed to Z Chen or Y Chen: or
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Jeong S, Lee JH. The verification of the reliability of a triglyceride-glucose index and its availability as an advanced tool. Metabolomics 2021; 17:97. [PMID: 34724122 DOI: 10.1007/s11306-021-01837-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/07/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The triglyceride-glucose (TyG) index has been considered as insulin resistance (IR) assessment index. The current study aimed to verify the reliability of the TyG index as an IR assessment marker; the study of plasma fatty acids and body fat composition to determine potential metabolic syndrome (MetS) participants with a body mass index (BMI) of between 25.0 and 29.9 kg/m2. METHODS The study included 378 overweight participants with a body mass index of between 25.0 and 29.9 kg/m2. They were divided into tertiles according to the homeostasis model assessment of IR (HOMA-IR) or the TyG index. The role of the IR assessment index and the relationship with IR-related diseases and the risk factors using gas chromatograph-mass spectrometry, computed tomography, and dual energy X-ray absorptiometry, was investigated. RESULTS It was only in the TyG index tertile that the higher TyG index participants showed considerably higher LDL-cholesterol levels. More markedly, a close relationship was observed between the TyG index and the omega-6 polyunsaturated fatty acids compared with the HOMA-IR. Unlike HOMA-IR, with regard to the risks of developing chronic diseases, the MetS, the third tertile of the TyG index, showed an approximately 33.7 times greater odds ratio (OR) of the MetS occurring, compared with the first tertile of the TyG index. CONCLUSIONS The TyG index may be considered as an IR assessment index. In addition, the TyG index is an advanced tool that reflects the relevance of pro-inflammation levels and the presence of IR-related chronic diseases.
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Affiliation(s)
- Sarang Jeong
- Division of Endocrine and Kidney Disease Research, Department of Chronic Disease Convergence Research, Korea National Institute of Health, Korea Disease Control and Prevention Agency, 187 Osongsaengmyeong 2-ro, Osong-eup, Cheongju-si, Chungcheongbuk-do, 28159, Republic of Korea
| | - Jong Ho Lee
- National Leading Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
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50
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Cota BC, Priore SE, Ribeiro SAV, Juvanhol LL, de Faria ER, de Faria FR, Pereira PF. Cardiometabolic risk in adolescents with normal weight obesity. Eur J Clin Nutr 2021; 76:863-870. [PMID: 34711932 DOI: 10.1038/s41430-021-01037-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Normal weight obesity (NWO), which is defined by the excess of body fat in normal weight individuals, has been neglected among adolescents, due to their normal weight and young age. Few studies were carried out on the topic with adolescents. OBJECTIVE To analyze whether the NWO is associated with cardiometabolic risk factors in adolescents. SUBJECTS/METHODS Cross-sectional study, with 506 normal weight adolescents aged 10-19 years, selected in schools in Brazil. Weight, height, waist circumference (WC) and neck circumference were obtained and the body mass index (BMI) and waist/height ratio (WHR) were calculated. Body composition analysis was performed using dual-energy X-ray absorptiometry. The clinical evaluation included lipid and glycid profile, platelets, leukocytes, lymphocytes, monocytes, uric acid and blood pressure, as well as the presence of metabolic syndrome (MS) and its components. NWO was defined by the presence of normal weight, according to BMI for age, and excess body fat (≥25% and ≥30% in males and females, respectively). Logistic regression models were used to analyze associations between normal weight adolescents with and without the NWO phenotype. RESULTS NWO associated positively with abdominal obesity, analyzed through WC (OR = 1.36;95%CI = 1.27-1.47), WHR (OR = 25.89;95%CI = 10.43-64.26) and android fat (OR = 1.49;95%CI = 1.36-1.63); insulin resistance (OR = 4.09;95%CI = 1.72-9.70), hyperinsulinemia (OR = 3.83;95%CI = 1.50-9.76) and the highest values of the triglycerides-glycemia index (OR = 4.28;95%CI = 1.21-15.08); uric acid (OR = 1.81;95%CI = 1.29-2.55), as well as the changes in LDL (OR = 3.39;95%CI = 1.47-7.81), total cholesterol (OR = 2.77;95%CI = 1.22-6.29), and in at least one (OR = 1.87;95%CI = 1.04-3.37) or two (OR = 6.61;95%CI = 1.45-30.19) components of MS. CONCLUSION NWO is associated with the presence of cardiometabolic risk factors in adolescents.
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Affiliation(s)
- Bruna Clemente Cota
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Minas Gerais (MG), Brazil.
| | - Silvia Eloiza Priore
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Minas Gerais (MG), Brazil
| | | | - Leidjaira Lopes Juvanhol
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Minas Gerais (MG), Brazil
| | | | - Franciane Rocha de Faria
- Instituto de Ciências Exatas e Naturais, Universidade Federal de Rondonópolis, Rondonópolis, Mato Grosso, Brazil
| | - Patrícia Feliciano Pereira
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Minas Gerais (MG), Brazil
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