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Liu C, Yang H, Yang J, Wang H. Correlation analysis of diabetes based on Copula. Front Endocrinol (Lausanne) 2024; 15:1291895. [PMID: 38419954 PMCID: PMC10899488 DOI: 10.3389/fendo.2024.1291895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/24/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction The ratio of Triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) is a crucial indicator for diabetes diagnosis. Methods This study utilizes the Copula function to model and fit the non-linear correlation among fasting blood glucose (Glu), glycosylated hemoglobin (HbA1C), and TG/HDL-C in patients with diabetes. The Copula function chosen for this study includes the two-dimensional Archimedes and Elliptical distribution family, as well as the multidimensional Vine Copula function, for fitting the data. The evaluation of the fitting effect is performed using the mean absolute error (MAE) and mean square error (MSE). Results The results indicate that the Clayton Copula exhibits the highest effectiveness in fitting the pairwise relationship between Glu and TG/HDL-C, as well as HbA1C and TG/HDL-C, displaying the smallest fitting error. Additionally, the Vine Copula function produces a satisfactory fit for the relationship among all three indicators. Compared to linear analysis methods, the Copula function more accurately depicts the correlation among these three types of indicators. Discussion Moreover, our findings indicate a stronger correlation in the lower tail between Glu and HbA1C, as well as TG/HDL-C, suggesting that the Copula function provides greater accuracy and applicability in depicting the relationship among these indicators. As a result, it can offer a more precise auxiliary diagnosis and serve as a valuable reference in clinical judgment.
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Affiliation(s)
- Chang Liu
- College of Science, Beijing Forestry University, Beijing, China
| | - Hu Yang
- College of Science, Beijing Forestry University, Beijing, China
| | - Junjie Yang
- State Key Laboratory of Vegetation and Environmental Change, Institute of Botany, Chinese Academy of Sciences, Beijing, China
| | - Hongqing Wang
- College of Science, Beijing Forestry University, Beijing, China
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Wu L, Xu J. Relationship Between Cardiometabolic Index and Insulin Resistance in Patients with Type 2 Diabetes. Diabetes Metab Syndr Obes 2024; 17:305-315. [PMID: 38283637 PMCID: PMC10821666 DOI: 10.2147/dmso.s449374] [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: 11/11/2023] [Accepted: 01/13/2024] [Indexed: 01/30/2024] Open
Abstract
Purpose Cardiometabolic index (CMI) has been suggested as innovative measures for assessing the cardiometabolic status. However, there is a lack of relevant studies on exploring the relationship between CMI and insulin resistance (IR). Consequently, this study aims to examine the relationship between CMI and IR in subjects with type 2 diabetes mellitus (T2DM). Patients and Methods A cross-sectional study was performed on 2493 patients with T2DM (including 1505 males and 988 females). IR was measured through the homeostatic model assessment of insulin resistance (HOMA-IR), which was defined as HOMI-IR≥2.69. The relationship between CMI and IR was evaluated with Spearman's correlation, ROC analysis, multiple logistic regression, generalized smooth curve fitting and subgroup analysis. Results CMI was correlated with HOMA-IR in patients with T2DM (Spearman correlation coefficient = 0.391 in females and 0.346 in males, P<0.001). Through the multiple logistic regression analysis, CMI was significantly correlated with IR (OR=1.30, 95% CI=1.15-1.47 in males and OR=1.62, 95% CI=1.32-1.99 in females). In addition, a non-linear correlation between CMI and IR risk was identified. The AUC of CMI (AUC = 0.702 for males and 0.733 for females, all p < 0.01) was the largest compared with traditional indexes of adiposity and blood lipids. According to the subgroup analysis, the two had a more significantly positive correlation in females, the elderly and subjects with HbA1c < 7%. Conclusion In patients with T2DM, elevated CMI is significantly correlated with IR, as a useful index of IR.
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Affiliation(s)
- Limin Wu
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Lucheng District, Wenzhou, Zhejiang Province, People’s Republic of China
| | - Jing Xu
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Lucheng District, Wenzhou, Zhejiang Province, People’s Republic of China
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Song R, Hu M, Qin X, Qiu L, Wang P, Zhang X, Liu R, Wang X. The Roles of Lipid Metabolism in the Pathogenesis of Chronic Diseases in the Elderly. Nutrients 2023; 15:3433. [PMID: 37571370 PMCID: PMC10420821 DOI: 10.3390/nu15153433] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Lipid metabolism plays crucial roles in cellular processes such as hormone synthesis, energy production, and fat storage. Older adults are at risk of the dysregulation of lipid metabolism, which is associated with progressive declines in the physiological function of various organs. With advancing age, digestion and absorption commonly change, thereby resulting in decreased nutrient uptake. However, in the elderly population, the accumulation of excess fat becomes more pronounced due to a decline in the body's capacity to utilize lipids effectively. This is characterized by enhanced adipocyte synthesis and reduced breakdown, along with diminished peripheral tissue utilization capacity. Excessive lipid accumulation in the body, which manifests as hyperlipidemia and accumulated visceral fat, is linked to several chronic lipid-related diseases, including cardiovascular disease, type 2 diabetes, obesity, and nonalcoholic fatty liver disease. This review provides a summary of the altered lipid metabolism during aging, including lipid digestion, absorption, anabolism, and catabolism, as well as their associations with age-related chronic diseases, which aids in developing nutritional interventions for older adults to prevent or alleviate age-related chronic diseases.
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Affiliation(s)
- Rui Song
- College of Food Science & Nutritional Engineering, China Agricultural University, Beijing 100083, China; (R.S.); (M.H.); (X.Q.); (L.Q.)
| | - Mengxiao Hu
- College of Food Science & Nutritional Engineering, China Agricultural University, Beijing 100083, China; (R.S.); (M.H.); (X.Q.); (L.Q.)
| | - Xiyu Qin
- College of Food Science & Nutritional Engineering, China Agricultural University, Beijing 100083, China; (R.S.); (M.H.); (X.Q.); (L.Q.)
| | - Lili Qiu
- College of Food Science & Nutritional Engineering, China Agricultural University, Beijing 100083, China; (R.S.); (M.H.); (X.Q.); (L.Q.)
| | - Pengjie Wang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100193, China; (P.W.); (X.Z.); (R.L.)
| | - Xiaoxu Zhang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100193, China; (P.W.); (X.Z.); (R.L.)
| | - Rong Liu
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100193, China; (P.W.); (X.Z.); (R.L.)
| | - Xiaoyu Wang
- College of Food Science & Nutritional Engineering, China Agricultural University, Beijing 100083, China; (R.S.); (M.H.); (X.Q.); (L.Q.)
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100193, China; (P.W.); (X.Z.); (R.L.)
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Sharafi M, Amiri Z, Pezeshki B, Mohsenpour MA, Eftekhari MH, Afrashteh S, Haghjoo E, Farhadi A, Khaleghi M, Mastaneh Z. Predictive value of triglycerides to high-density lipoprotein cholesterol and triglyceride glycemic index for diabetes incidence in pre-diabetes patients: a prospective cohort study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:67. [PMID: 37434259 DOI: 10.1186/s41043-023-00410-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/28/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND The triglyceride glucose (TyG) and triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-c) are the indices that can predict the progression of pre-diabetes to type 2 diabetes mellitus (T2DM). This study aimed to examine the relationship between TyG and TG/HDL-c indices with the incidence of T2DM in pre-diabetes patients. METHODS A total of 758 pre-diabetic patients aged 35-70 years who were enrolled in a prospective Fasa Persian Adult Cohort were followed up for 60 months. TyG and TG/HDL-C indices were obtained at baseline data and divided into quartiles. The 5-year cumulative incidence of T2DM was analyzed by Cox proportional hazards regression analysis while controlling for baseline covariates. RESULTS During 5 years of follow-up, there were 95 incident cases of T2DM, with an overall incidence rate of 12.53%. After adjusting for age, sex, smoking, marital status, socioeconomic status, body mass index, waist circumference, hip circumference, hypertension, total cholesterol, and dyslipidemia, the multivariate-adjusted hazard ratios (HRs) demonstrated that patients with the highest TyG and TG/HDL-C indices quartile were at higher risk of T2DM (HR = 4.42, 95%CI 1.75-11.21) and (HR = 2.15, 95%CI 1.04-4.47), respectively, compared to participants in the lowest quartile. As the quantiles of these indices increase, the HR value shows a significant increment (P < 0.05). CONCLUSION The results of our study showed that the TyG and TG/HDL-C indices can be important independent predictors for the progression of pre-diabetes to T2DM. Therefore, controlling the components of these indicators in pre-diabetes patients can prevent developing T2DM or delay its occurrence.
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Affiliation(s)
- Mehdi Sharafi
- Social Determinants in Health Promotion Research Center, Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Amiri
- Social Determinants in Health Promotion Research Center, Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Babak Pezeshki
- Social Determinants in Health Promotion Research Center, Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Mohammad Ali Mohsenpour
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hassan Eftekhari
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sima Afrashteh
- Department of Public Health, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Elham Haghjoo
- Department of Persian Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Akram Farhadi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohsen Khaleghi
- Department of Mathematics, Fasa Branch, Islamic Azad University, Fasa, Iran
| | - Zahra Mastaneh
- Health Information Management, School of Allied Medical Sciences, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Paublini H, López González AA, Busquets-Cortés C, Tomas-Gil P, Riutord-Sbert P, Ramírez-Manent JI. Relationship between Atherogenic Dyslipidaemia and Lipid Triad and Scales That Assess Insulin Resistance. Nutrients 2023; 15:2105. [PMID: 37432258 DOI: 10.3390/nu15092105] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Atherogenic dyslipidaemia (AD) and lipid triad (LT) are characterised by high triglyceride levels together with low HDL and normal or high LDL cholesterol and are favoured by a persistent state of insulin resistance (IR), which increases the release of free fatty acids from abdominal adipose tissue. This alteration in the lipid profile favours the accelerated development of atherosclerosis, which is the most important cause of morbidity and mortality in all countries in the developed and developing world. One of the elements that plays a major role in the genesis of AD is IR. The aim of this study was to determine the relationship between variables that assess atherogenic risk (AD and LT) and scales that assess the risk of presenting insulin resistance. METHODS A descriptive cross-sectional study of 418,343 workers was conducted to evaluate atherogenic dyslipidaemia and lipid triad; a relationship with three insulin resistance risk scales (Triglycerides/HDL, TyG index, METS-IR) was established. The usefulness of IR risk scales for predicting AD and LT was calculated by applying ROC curves, obtaining the area under the curve (AUC) and cut-off points with their sensitivity, specificity, and Youden index. Multivariate analysis was performed by binary logistic regression. RESULTS The prevalence of high-risk values for insulin resistance with all of the scales is much higher in people with AD and LT compared to those without. The ROC curves present us with an AUC with the three insulin resistance risk scales for the two dyslipidaemias studied with figures ranging between 0.856 and 0.991, which implies that the results are good/very good. CONCLUSIONS A relationship between atherogenic dyslipidaemia and the three insulin resistance risk scales assessed is revealed, with higher IR mean values and prevalence in people with atherogenic dyslipidaemia and lipid triad. The three scales make it possible to adequately classify the presence of AD and LT. The highest AUC is presented by the triglycerides/HDL scale, with a result close to 1. METS-IR is the most recommended formula to estimate insulin resistance.
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Affiliation(s)
- Hernán Paublini
- Research Group Adema Salud IUNICS, 07003 Palma, Spain
- Faculty of Dentistry, University School ADEMA, 07009 Palma, Spain
| | - Angel Arturo López González
- Research Group Adema Salud IUNICS, 07003 Palma, Spain
- Faculty of Dentistry, University School ADEMA, 07009 Palma, Spain
| | - Carla Busquets-Cortés
- Research Group Adema Salud IUNICS, 07003 Palma, Spain
- Faculty of Dentistry, University School ADEMA, 07009 Palma, Spain
| | - Pilar Tomas-Gil
- Research Group Adema Salud IUNICS, 07003 Palma, Spain
- Faculty of Dentistry, University School ADEMA, 07009 Palma, Spain
| | - Pere Riutord-Sbert
- Research Group Adema Salud IUNICS, 07003 Palma, Spain
- Faculty of Dentistry, University School ADEMA, 07009 Palma, Spain
| | - José Ignacio Ramírez-Manent
- Research Group Adema Salud IUNICS, 07003 Palma, Spain
- IDISBA, Balearic Islands Health Research Institute Foundation, 07004 Palma, Spain
- General Practitioner Department, Balearic Islands Health Service, 07003 Palma, Spain
- Faculty of Medicine, University of the Balearic Islands, 07009 Palma, Spain
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Campos Muñiz C, León-García PE, Serrato Diaz A, Hernández-Pérez E. [Diabetes mellitus prediction based on the triglyceride and glucose index]. Med Clin (Barc) 2023; 160:231-236. [PMID: 35933191 DOI: 10.1016/j.medcli.2022.07.003] [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: 05/05/2021] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 10/16/2022]
Abstract
INTRODUCTION In Mexico, type 2 Diabetes mellitus (DM2) presents epidemiological levels with a prevalence rate of 9.12% and with the highest overweight and obesity rates worldwide. To overcome this situation, strategies must be created focused on the identification of subjects at risk. The Triglyceride and Glucose (TyG) index, was created for the detection of insulin resistance, has recently been used in the prediction of DM. The objective of the present study was to determine the predictive power of the TyG index in a cohort from Mexico City. METHODS 3195 patients were selected from a cohort of patients from the chronic degenerative area of the Health Centers of the Public Health Services of Mexico City. The ability of the TyG index in predicting diabetes was evaluated as: ln [Fasting triglycerides (mg/dl) x fasting glucose (mg/dl)/2]. after a follow-up of at least 4.5 years. A CHAID test was determined that was corroborated by a ROC test. RESULTS the value of the TyG index was significantly higher for patients who develop DM2. Values of AUC=0.934, 95% CI: 0.924-0.924. Obtaining a cut-off point of 9.45 in women; in men: DM2 AUC=0.824, 95% CI: 0.824-0.873, and cut-off point 9.12. CONCLUSIONS The TyG index is a good marker in the prediction of DM2. The CHAID determination is a useful tool in the prediction of DM2.
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Affiliation(s)
- Carolina Campos Muñiz
- Departamento de Ciencias de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana Iztapalapa, Ciudad de México, México
| | - Plácido Enrique León-García
- Secretaría de Salud Pública del Distrito Federal, Servicios de Salud Pública del Distrito Federal, Ciudad de México, México
| | - Alejandra Serrato Diaz
- Departamento de Hidrobiología, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana Iztapalapa, Ciudad de México, México
| | - Elizabeth Hernández-Pérez
- Departamento de Ciencias de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana Iztapalapa, Ciudad de México, México.
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7
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Zha F, Cao C, Hong M, Hou H, Zhang Q, Tang B, Hu H, Han Y, Zan Y, Wang Y, Xu J. The nonlinear correlation between the cardiometabolic index and the risk of diabetes: A retrospective Japanese cohort study. Front Endocrinol (Lausanne) 2023; 14:1120277. [PMID: 36875460 PMCID: PMC9980900 DOI: 10.3389/fendo.2023.1120277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/03/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND The cardiometabolic index (CMI) has been proposed as a novel indicator of cardiometabolic status. However, evidence on the relationship between CMI and diabetes mellitus (DM) risk was limited. Our study aimed to explore the relationship between CMI and DM risk among a large cohort of Japanese adults. METHODS This retrospective cohort study recruited 15453 Japanese adults without diabetes at baseline who underwent physical examinations at the Murakami Memorial Hospital between 2004 and 2015. Cox proportional-hazards regression was applied to evaluate the independent relationship between CMI and diabetes. Our study performed a generalized smooth curve fitting (penalized spline technique) and an additive model (GAM) to determine the non-linear relationship between CMI and DM risk. In addition, a set of sensitivity analyses and subgroup analyses were employed to evaluate the relationship between CMI and incident DM. RESULTS After adjusting for confounding covariates, CMI was positively related to the DM risk in Japanese adults (HR: 1.65, 95%CI: 1.43-1.90, P<0.0001). A series of sensitivity analyses were also employed in this study to guarantee the reliability of the findings. In addition, our study discovered a non-linear association between CMI and diabetes risk. CMI's inflection point was 1.01. A strong positive association between CMI and diabetes incidence was also discovered to the left of the inflection point (HR: 2.96, 95%CI: 1.96-4.46, P<<0.0001). However, their association was not significant when CMI was higher than 1.01 (HR: 1.27, 95%CI: 0.98-1.64, P=0.0702). Interaction analysis showed that gender, BMI, habit of exercise, and smoking status interacted with CMI. CONCLUSION Increased CMI level at baseline is associated with incident DM. The association between CMI and incident DM is also non-linear. A high CMI level is associated with an increased risk for DM when CMI is below 1.01.
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Affiliation(s)
- Fubing Zha
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Department of Rehabilitation, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Mengru Hong
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Huili Hou
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Qionghua Zhang
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Bin Tang
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Yibing Zan
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Yulong Wang
- Department of Rehabilitation, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
- *Correspondence: Yulong Wang, ; Jianwen Xu,
| | - Jianwen Xu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- *Correspondence: Yulong Wang, ; Jianwen Xu,
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Zhang Z, Gu X, Tang Z, Guan S, Liu H, Wu X, Zhao Y, Fang X. Associations of blood pressure components with risks of cardiovascular events and all-cause death in a Chinese population: A Prospective Study. J Clin Hypertens (Greenwich) 2022; 24:825-837. [PMID: 35748650 PMCID: PMC9278591 DOI: 10.1111/jch.14529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/15/2022] [Accepted: 06/04/2022] [Indexed: 01/24/2023]
Abstract
The associations of blood pressure components with cardiovascular risks and death remain unclear, and the definition of wide pulse pressure (PP) is still controversial. Using data from 1257 participants without a history of cardiovascular disease, who were followed for 4.84 years, we performed multivariable Cox regression analyses to assess how systolic blood pressure (SBP), diastolic blood pressure (DBP), and PP contribute to risks of cardiovascular events and all‐cause death. Among all participants, SBP and PP were significantly associated with the risks of cardiovascular events and all‐cause death (all p < .05). DBP was not significantly associated with the risk of all‐cause death; rather, it was only associated with a marginally significant 1% increased risk for cardiovascular events (p = 0.051). In participants aged < 65 years, DBP was significantly associated with a 3% increased risk for cardiovascular events (hazard ratio [HR]: 1.03, 95% confidence interval [95% CI]: 1.01–1.06). The association between PP and cardiovascular events appeared to be J‐shaped in comparison to participants with the lowest‐risk PP (50–60 mmHg), with adjusted HRs of 1.71 (95% CI: 1.03–2.85), 1.63 (95% CI: 1.00–2.68), and 2.13 (95% CI: 1.32–3.43) in the <50, 60.0–72.5, and ≥72.5 mmHg subgroups, respectively. The optimal cutoff points of a wide PP for predicting the risks of cardiovascular events and all‐cause death were 70.25 and 76.25 mmHg, respectively. SBP and PP had a greater effect on cardiovascular risk, whereas DBP independently influenced cardiovascular events in middle‐aged participants. Considerable PP alterations should be avoided in antihypertensive treatment.
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Affiliation(s)
- Zhongying Zhang
- Geriatric department, Xuanwu Hospital Capital Medical University, Beijing, China.,Evidence-based Medical Center, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Xiang Gu
- Medical affair department, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhe Tang
- Beijing Geriatric Healthcare Center, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Shaochen Guan
- Evidence-based Medical Center, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Hongjun Liu
- Evidence-based Medical Center, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Xiaoguang Wu
- Evidence-based Medical Center, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Yan Zhao
- Education department, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Xianghua Fang
- Evidence-based Medical Center, Xuanwu Hospital Capital Medical University, Beijing, China
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Feizi A, Haghighatdoost F, Zakeri P, Aminorroaya A, Amini M. Growth trajectories in lipid profile and fasting blood sugar in prediabetic people over a 16- year follow-up and future risk of type2 diabetes mellitus: A latent growth modeling approach. ALEXANDRIA JOURNAL OF MEDICINE 2022. [DOI: 10.1080/20905068.2022.2062958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Zakeri
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Aminorroaya
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Amini
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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10
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Qiu Y, Yi Q, Li S, Sun W, Ren Z, Shen Y, Wu Y, Wang Z, Xia W, Song P. Transition of Cardiometabolic Status and the Risk of Type 2 Diabetes Mellitus among
Middle‐Aged
and Older Chinese: A National Cohort Study. J Diabetes Investig 2022; 13:1426-1437. [PMID: 35426487 PMCID: PMC9340876 DOI: 10.1111/jdi.13805] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 11/28/2022] Open
Abstract
Aims/Introduction The cardiometabolic index (CMI) has been proposed as a novel indicator of cardiometabolic status. This study aimed to investigate the effects of CMI and its longitudinal transitions on the development of type 2 diabetes mellitus in middle‐aged and older Chinese. Materials and Methods We used data from the China Health and Retirement Longitudinal Study (2011–2018). CMI was calculated as the product of the waist circumference to height ratio and the triglyceride to high‐density lipoprotein cholesterol ratio. At baseline in 2011, the subjects were classified into low‐ and high‐CMI groups, and then divided into four transition patterns during follow‐up, i.e. maintained‐low, low‐to‐high, high‐to‐low, and maintained‐high CMI. The hazard ratios (HRs) of different transition patterns for type 2 diabetes mellitus were calculated using multivariable Cox frailty models. Results During 2011–2018, 7,347 participants were included. Participants with a high‐CMI at baseline had a significantly higher risk of new‐onset type 2 diabetes mellitus than those with a low‐CMI (HR = 1.78, 95% CI:1.55–2.05). For subjects with a low‐CMI at baseline, the risk of developing type 2 diabetes mellitus increased by 75% if their CMI status changed to high during follow‐up (HRlow‐to‐high = 1.75, 95% CI:1.35–2.28). Meanwhile, for subjects with a maintained‐high CMI, no significant risk reduction for type 2 diabetes mellitus was found when their CMI changed to low status (HRhigh‐to‐low = 0.77, 95% CI: 0.58–1.01). Conclusions Baseline CMI levels and longitudinal CMI transition patterns were associated with a higher risk of type 2 diabetes mellitus. Early anti‐lipid measures should be taken to prevent type 2 diabetes mellitus in middle‐aged and older Chinese.
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Affiliation(s)
- Yiwen Qiu
- School of Public Health and Women’s Hospital Zhejiang University School of Medicine, Zhejiang University Hangzhou Zhejiang China
| | - Qian Yi
- School of Public Health and Women’s Hospital Zhejiang University School of Medicine, Zhejiang University Hangzhou Zhejiang China
| | - Shuting Li
- School of Public Health and Women’s Hospital Zhejiang University School of Medicine, Zhejiang University Hangzhou Zhejiang China
| | - Weidi Sun
- School of Public Health and Women’s Hospital Zhejiang University School of Medicine, Zhejiang University Hangzhou Zhejiang China
| | - Ziyang Ren
- School of Public Health and Women’s Hospital Zhejiang University School of Medicine, Zhejiang University Hangzhou Zhejiang China
| | - Yaojia Shen
- School of Public Health and Women’s Hospital Zhejiang University School of Medicine, Zhejiang University Hangzhou Zhejiang China
| | - Yuhang Wu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health Nanchang University Nanchang Jiangxi China
| | - Zhicheng Wang
- Vanke School of Public Health Tsinghua University School of Medicine, Tsinghua University Beijing China
| | - Wei Xia
- School of Nursing Sun Yat‐sen University Guangzhou Guangdong China
| | - Peige Song
- School of Public Health and Women’s Hospital Zhejiang University School of Medicine, Zhejiang University Hangzhou Zhejiang China
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11
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Wang T, Maimaitituersun G, Shi H, Chen C, Ma Q, Su Y, Yao H, Zhu J. The relationship between polymorphism of insulin-like growth factor I gene and susceptibility to type 2 diabetes in Uygur population, Xinjiang, China. Genes Genomics 2022; 44:499-508. [PMID: 35094288 PMCID: PMC8921155 DOI: 10.1007/s13258-021-01209-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 12/17/2021] [Indexed: 12/23/2022]
Abstract
Background Type 2 diabetes (T2DM) susceptibility varies among different populations and is affected by gene single nucleotide polymorphism (SNP). Insulin-like growth factor (IGF)-1 gene, which has many SNP loci, is involved in T2DM pathogenesis. However, the relationship of IGF-1 gene polymorphism with T2DM in Uyghur population is less studied. Objective To investigate the relationship between T2DM susceptibility and polymorphism of IGF-1 gene in Uyghur population of Xinjiang, China. Methods This study enrolled 220 cases (122 males (55.46%) and 98 females (44.54%); mean age of 53.40 ± 10.94 years) of T2DM patients (T2DM group) and 229 (124 males (54.15%) and 105 females (45.85%); mean age of 51.64 ± 10.48 years) healthy controls (control group). Biochemical indexes were determined. IGF-1 gene polymorphism was analyzed by SNP genotyping. Results The levels of TG, HDL, LDL, BUN, and Cr were statistically significant between the T2DM group and the control group. In terms of IGF-1 polymorphism, T2DM group had higher frequency of AA genotype (OR = 2.40, 95% CI = 1.19–4.84) and allele A (OR = 1.55, 95% CI = 1.17–2.06) of rs35767 loci, suggesting that rs35767 is related to the occurrence of T2DM. A total of 5 gene interaction models was obtained through analyzing the interaction of 5 SNP loci with the GMDR method. Among them, the two-factor model that included rs35767 locus and rs5742694 locus had statistical difference with a large cross-validation consistency (10/10). The combination of GG/CC, GA/AA, AA/AA, and AA/AC genotype was in high-risk group, whereas the combination of GG/AA, GG/AC, GA/AC and GA/CC genotype was in the low-risk group. The risk of T2DM in the high-risk group was 2.165 times than that of the low-risk group (OR = 2.165, 95% CI = 1.478–3.171). Conclusion TG, HDL, LDL, BUN, and Cr are influencing factors of T2DM in Uyghur population. The rs35767 locus of IGF-1 gene may be associated with T2DM in Uyghur population. The high-risk group composing of rs35767 locus and rs5742694 locus has a higher risk of T2DM.
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Affiliation(s)
- Tingting Wang
- School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | | | - Haonan Shi
- School of Public Health, Xinjiang Medical University, Urumqi, 830054, China
| | - Cheng Chen
- Clinical Laboratory Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, 830001, China
| | - Qi Ma
- Xinjiang Key Laboratory of Metabolic Disease, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, No.137. Liyushan road, Xinshi District, Urumqi, 830001, China.
| | - Yinxia Su
- School of Public Health, Xinjiang Medical University, Urumqi, 830054, China
- Health Management Institute, Xinjiang Medical University, Urumqi, 830054, China
| | - Hua Yao
- School of Public Health, Xinjiang Medical University, Urumqi, 830054, China
- Health Management Institute, Xinjiang Medical University, Urumqi, 830054, China
| | - Jia Zhu
- Cadre Health Center, People's Hospital of Xinjiang Uygur Autonomous Region, No. 91, Tianchi Road, Tianshan District, Urumqi, 830001, China.
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12
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Blum MR, Popat RA, Nagy A, Cataldo NA, McLaughlin TL. Using metabolic markers to identify insulin resistance in premenopausal women with and without polycystic ovary syndrome. J Endocrinol Invest 2021; 44:2123-2130. [PMID: 33687700 DOI: 10.1007/s40618-020-01430-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/17/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Insulin resistance (IR) is associated with increased risk for type 2 diabetes mellitus and cardiovascular disease. Quantifying IR is invasive and time-consuming, and thus not routinely used in clinical practice. Simple metabolic markers to predict IR exist, but have not been validated in premenopausal women or women with polycystic ovary syndrome (PCOS). OBJECTIVE To evaluate the ability of metabolic markers to identify premenopausal women with/without PCOS who are insulin resistant. DESIGN/SETTING Cross-sectional analysis. PARTICIPANTS One hundred and seventy-one non-diabetic premenopausal overweight/obese women without PCOS and 71 women with PCOS. METHODS IR was quantified by the steady-state plasma glucose during the modified insulin-suppression test. Metabolic markers (BMI, lipid/lipoprotein concentrations, and fasting glucose) were evaluated for their discriminative ability to identify IR, using area under the receiver-operating-characteristic curve (AUROC) analysis. Optimal cut-points were evaluated for predictive power. RESULTS In the non-PCOS group, the triglyceride/HDL cholesterol ratio (TG/HDL-C) was the best marker (AUROC 0.73). Optimal diagnostic cut-point was 1.9. In the PCOS group, the TG/HDL-C ratio, cholesterol/HDL-C ratio (TC/HDL-C), and HDL-C performed well (AUROC > 0.80), with optimal cut-points for TG/HDL-C 1.3, TC/HDL-C 3.4, and HDL-C 52 mg/dL: TG/HDL-C was more sensitive, but HDL-C had a higher PPV for IR. CONCLUSION TG/HDL-C can identify IR in premenopausal women with and/without PCOS; diagnostic cut-points differ from those of men and postmenopausal women. HDL-C is an alternative predictor in women with PCOS. These simple metabolic markers, which are standardized between labs, inexpensive, and routinely measured, can be used to tailor lifestyle and medical interventions to improve health outcomes in insulin-resistant premenopausal women.
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Affiliation(s)
- M R Blum
- Department of Health Research and Policy (Division of Epidemiology), Stanford University School of Medicine, Stanford, CA, USA
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - R A Popat
- Department of Health Research and Policy (Division of Epidemiology), Stanford University School of Medicine, Stanford, CA, USA
| | - A Nagy
- Division of Endocrinology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - N A Cataldo
- America Institute for Reproductive Medicine, Alabama, One Independence Plaza, Suite 810, Birmingham, AL, USA
| | - T L McLaughlin
- Division of Endocrinology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA.
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13
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Wang L, Cong H, Zhang J, Hu Y, Wei A, Zhang Y, Yang H, Ren L, Qi W, Li W. Predictive Value of the Triglyceride to High-Density Lipoprotein Cholesterol Ratio for All-Cause Mortality and Cardiovascular Death in Diabetic Patients With Coronary Artery Disease Treated With Statins. Front Cardiovasc Med 2021; 8:718604. [PMID: 34368266 PMCID: PMC8333610 DOI: 10.3389/fcvm.2021.718604] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Aims: Studies have highlighted the role of the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio on subsequent cardiovascular events. However, the association of the TG/HDL-C ratio with survival outcomes in diabetic patients with coronary artery disease (CAD) treated with statins remains unknown. This study aimed to assess the predictive value of the TG/HDL-C ratio for all-cause mortality and cardiovascular death in diabetic patients with CAD treated with statins. Methods: The data of patients with type 2 diabetes and angiographically-confirmed CAD who were undergoing statin therapy and visited Tianjin Chest Hospital between January 2016 and September 2016 were retrospectively collected. The patients were categorized based on the baseline TG/HDL-C ratio tertile. Kaplan-Meier analysis and multivariate Cox proportional hazard regression were applied to assess the role of the TG/HDL-C ratio in predicting all-cause mortality and cardiovascular death. Results: A total of 2,080 patients were included. During the 4-year follow-up, 209 patients died, 136 of whom from cardiovascular death. The Kaplan-Meier analyses showed that an increased TG/HDL-C ratio was associated with an increased risk of all-cause mortality (P < 0.001) and cardiovascular death (P < 0.001). The multivariate cox hazard regression analysis revealed a similar effect of the TG/HDL-C ratio on the risk of all-cause mortality (P = 0.046) and cardiovascular death (P = 0.009). The role of the TG/HDL-C ratio in predicting all-cause mortality and cardiovascular death was similar among all subgroups (P > 0.050). For all-cause mortality, the TG/HDL-C ratio significantly improved the C-statistic from 0.799 to 0.812 (P = 0.018), and the net reclassification index (NRI) and integrated discrimination index (IDI) were 0.252 (95% CI: 0.112-0.392; P < 0.001) and 0.012 (95% CI: 0.003-0.022; P = 0.012), respectively. Similarly, for cardiovascular death, the TG/HDL-C ratio significantly improved the C-statistic from 0.771 to 0.804 (P < 0.001), and the NRI and IDI were 0.508 (95% CI: 0.335-0.680; P < 0.001) and 0.033 (95% CI: 0.015-0.050; P < 0.001). Conclusion: TG/HDL-C ratio might be useful for predicting all-cause mortality and cardiovascular death in diabetic patients with CAD treated with statins.
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Affiliation(s)
- Le Wang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Hongliang Cong
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Jingxia Zhang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Yuecheng Hu
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Ao Wei
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Yingyi Zhang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Hua Yang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Libin Ren
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Wei Qi
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Wenyu Li
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
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Cao X, Tang Z, Zhang J, Li H, Singh M, Sun F, Li X, Li C, Wang Y, Guo X, Zheng D. Association between high-density lipoprotein cholesterol and type 2 diabetes mellitus among Chinese: the Beijing longitudinal study of aging. Lipids Health Dis 2021; 20:71. [PMID: 34273996 PMCID: PMC8286580 DOI: 10.1186/s12944-021-01499-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/05/2021] [Indexed: 12/18/2022] Open
Abstract
Background Some previous studies on different populations have yielded inconsistent findings with respect to the relationship between levels of high-density lipoprotein cholesterol (HDL-C) and future type 2 diabetes mellitus (T2DM) incidence. This study was designed to gain further insight into this relationship through a cohort study with a 25-year follow-up duration. Methods In total, 1462 individuals that were 55 years of age or older and were free of T2DM at baseline were enrolled in the present study. T2DM incidence among this study population was detected through self-reported diagnoses or the concentration of fasting plasma glucose. The data were derived from nine surveys conducted from 1992 to 2017. The correlation between HDL-C levels and the T2DM risk was assessed through Cox proportional-hazards model and proportional hazards model for the sub-distribution with time-dependent variables. Results Over the follow-up period, 120 participants were newly diagnosed with new-onset T2DM. When research participants were separated into four groups on the basis for quartiles of their levels of HDL-C measured at baseline, and incidence of diabetes declined with higher baseline HDL-C levels at 12.60, 9.70, 5.38, and 5.22 per 1000 person-years, respectively. Adjusted hazard ratios (HRs) were 0.98 (95% confidence interval [CI]: 0.62–1.55), 0.48 (95% CI: 0.27–0.85) and 0.44 (95% CI: 0.25–0.80) for individuals with HDL-C levels within the 1.15–1.39, 1.40–1.69, and ≥ 1.70 mmol/L ranges relative to participants with HDL-C levels < 1.15 mmol/L. Multiple sensitivity analyses similarly revealed reduced risk of diabetes incidence with increased HDL-C levels. Incorporating the levels of HDL-C into a multivariate model significantly enhanced the overall power of the predictive model (P values were 0.0296, 0.0011, respectively, for 5- and 10-year risk of diabetes). Conclusions Levels of HDL-C were independently and negatively associated with the risk of the new-onset T2DM among middle-aged and elderly Chinese. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01499-5.
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Affiliation(s)
- Xue Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Zhe Tang
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Jie Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Haibin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Manjot Singh
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, 6027, Australia
| | - Fei Sun
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Xiaochun Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Changwei Li
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, 30602, USA.,Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 70118, USA
| | - Youxin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Deqiang Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China.
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Cuevas Fernández FJ, García Marrero MR, Iglesias Girón MJ, Pérez de Armas AA, Cerdeña Rodríguez E, Cabrera León A, Aguirre-Jaime A. [Effectiveness of the TG/HDL-C ratio to improve GLP-1 prescription in patients with type 2 diabetes in primary care]. Semergen 2021; 47:521-530. [PMID: 34154909 DOI: 10.1016/j.semerg.2021.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/28/2021] [Accepted: 05/16/2021] [Indexed: 11/20/2022]
Abstract
AIMS Check the usefulness of ratio TG/HDL-C≥2.5 to improve the effectiveness of GLP-1 prescribing in patients with type 2 diabetes (DM2) in primary care, and determine whether any patient profile would higher benefit. DESIGN Descriptive cross-sectional study. LOCATION Barranco Grande Health Center, Tenerife. PARTICIPANTS Random selection of patients with DM2 attended by 12 family doctors and 12 nurses. MAIN MEASUREMENTS Poor control according to the current criteria was compared to poor control according to the proposed rule. To determine who would benefit, the sociodemographic, clinical, therapeutic and follow-up characteristics were analyzed. Descriptive, bivariate and multivariate statistical analysis was performed. RESULTS No predominant characteristics were found in the patients who would be prescribed GLP-1 according to the proposed rule, but those that reached a significance P<.20 were included as potential explanatory factors in a multivariate binary logistic regression model. The adjustment of the model retained the factors of therapeutic non-compliance (OR 3.40 [1.58-5.02]; P=.003), evolution of DM2 less than 15 years (OR 2.74 [1.10-4.89]; P=.031), number of prescribed anti-diabetes drugs (OR 2.30 [1.88-2.81]; P<.001) and age under 65 years (OR 1.67 [1.08-2.58]; P=.021). CONCLUSIONS The use of the rule that we propose for the prescription of GLP-1 (2018 recommendations of the GDPS network combined with the TG/HDL-C ratio≥2.5 or BMI≥30kg/m2), instead of the current criterion adopted by the National Health System, would allow to broaden the spectrum of application of the drug in patients with poor control of their DM2.
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Affiliation(s)
- F J Cuevas Fernández
- Gerencia de Atención Primaria, Santa Cruz de Tenerife, España; Área de Medina Preventiva y Salud Pública, Universidad de La Laguna. San Cristóbal de La Laguna, Santa Cruz de Tenerife, España.
| | | | | | | | | | - A Cabrera León
- Área de Medina Preventiva y Salud Pública, Universidad de La Laguna. San Cristóbal de La Laguna, Santa Cruz de Tenerife, España; Unidad de Investigación, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - A Aguirre-Jaime
- Servicio de Investigación en Cuidados, Colegio de Enfermeros, Santa Cruz de Tenerife, España
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16
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Sang Y, Cao M, Wu X, Ruan L, Zhang C. Use of lipid parameters to identify apparently healthy men at high risk of arterial stiffness progression. BMC Cardiovasc Disord 2021; 21:34. [PMID: 33441079 PMCID: PMC7807880 DOI: 10.1186/s12872-020-01846-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/29/2020] [Indexed: 12/18/2022] Open
Abstract
Background Dyslipidemia contributes to the development and progression of arterial stiffness. We aimed to identify the most informative measures of serum lipids and their calculated ratios in terms of arterial stiffness progression risk. Methods Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and brachial-ankle pulse wave velocity (baPWV) of 659 healthy males (47.4 ± 10.7 years) were measured at baseline. Values for non-HDL-C, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, and non-HDL-C/HDL-C were calculated. BaPWV was re-performed after 4.1 years follow-up. Elevated baPWV was defined as baPWV ≥ 1400 cm/s. Results Over the follow-up period, the mean baPWV value increased from 1340 cm/s to 1410 cm/s, and 331 individuals increased/persisted with high baPWV (outcome 1). Among the 448 subjects who had normal baseline baPWV, 100 incident elevated baPWV occurred (outcome 2). Only baseline logTG (OR 1.64 [95% CI: 1.14–2.37] for outcome 1; 1.89 [1.14–3.17] for outcome 2) and logTG/HDL-C (1.54 [1.15–2.10] for outcome 1; 1.60 [1.05–2.45] for outcome 2) were significantly associated with arterial stiffness progression after adjusting for confounding factors. Adding logTG or logTG/HDL-C to age and blood pressure improved the accuracy of risk predictions for arterial stiffness progression. These associations remained significant when lipids were analyzed as categorical variables. Conclusions Baseline serum TG and TG/HDL-C were independently associated with increases in/persistently high baPWV and incident elevated baPWV, and they performed more effectively than other lipid variables in identifying healthy men at high risk of arterial stiffness progression.
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Affiliation(s)
- Yu Sang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Cao
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaofen Wu
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Ruan
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Cuntai Zhang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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17
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Liu H, Yan S, Chen G, Li B, Zhao L, Wang Y, Hu X, Jia X, Dou J, Mu Y, Wen J, Lyu Z. Association of the Ratio of Triglycerides to High-Density Lipoprotein Cholesterol Levels with the Risk of Type 2 Diabetes: A Retrospective Cohort Study in Beijing. J Diabetes Res 2021; 2021:5524728. [PMID: 33969127 PMCID: PMC8081643 DOI: 10.1155/2021/5524728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/27/2021] [Accepted: 04/10/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Previous studies have shown that the ratio of triglyceride to high-density lipoprotein cholesterol level (TG/HDL-C) is a risk factor for type 2 diabetes mellitus (T2DM). The aim of this study was to investigate the nonlinear relationship between TG/HDL-C and the incidence of T2DM in a Chinese population. METHODS We used logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the incidence of T2DM among 7,791 participants from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) cohort study at baseline. RESULTS After adjusting for age, sex, body mass index, smoking status, alcohol intake, low-density lipoprotein cholesterol level, strenuous activity, education level, family histories of T2DM and tumors, and the presence of hypertension, tumor, stroke, and coronary heart disease, we showed that TG/HDL-C was positively associated with the incidence of T2DM at the 4-year follow-up (OR = 1.49, 95%CI = 1.26-1.78). TG/HDL-C and incidence of T2DM showed a nonlinear relationship; the inflection point of TG/HDL-C was 1.50. The ORs (95% CI) on the left and right sides of the inflection point were 2.50 (1.70-3.67) and 0.96 (0.67-1.37), respectively. After adjusting for age, sex, and body mass index (BMI) in the linear relationship, the OR of the incidence of T2DM was 1.60 (95%CI = 1.37-1.87). When the TG/HDL-C was less than 1.50 or greater than 1.76, the ORs (95% CI) were 2.41 (1.82-3.18) or 0.81 (0.53-1.25), respectively. Subgroup analysis showed no relationships of T2DM incidence with sex, BMI, family history of T2DM, or TG/HDL-C. CONCLUSION TG/HDL-C is positively associated with diabetes risk. In our study, with each increasing quintile, the risk of T2DM after 4 years was 1.60 or 1.49 depending on the variables adjusted. In addition, our cohort study showed a nonlinear relationship between TG/HDL-C and T2DM incidence, with an inflection point of 1.76 or 1.50, depending on the variables adjusted. When the TG/HDL was less than 1.50, the ORs (95% CI) were 2.41 (1.82-3.18) and 2.50 (1.70-3.67). When the TG/HDL-C was greater than 1.76 or 1.50, there was no significant difference in the change in OR.
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Affiliation(s)
- Hongzhou Liu
- The Department and Key Laboratory of Endocrinology and Metabolism, The First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Shuangtong Yan
- Department of Endocrinology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China
| | - Gang Chen
- Department of Endocrinology, Fujian Provincial Hospital, Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou 350001, China
| | - Bing Li
- The Department and Key Laboratory of Endocrinology and Metabolism, The First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Ling Zhao
- The Department and Key Laboratory of Endocrinology and Metabolism, The First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Yajing Wang
- The Department and Key Laboratory of Endocrinology and Metabolism, The First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Xiaodong Hu
- The Department and Key Laboratory of Endocrinology and Metabolism, The First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Xiaomeng Jia
- The Department and Key Laboratory of Endocrinology and Metabolism, The First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Jingtao Dou
- The Department and Key Laboratory of Endocrinology and Metabolism, The First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Yiming Mu
- The Department and Key Laboratory of Endocrinology and Metabolism, The First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Junping Wen
- Department of Endocrinology, Fujian Provincial Hospital, Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou 350001, China
| | - Zhaohui Lyu
- The Department and Key Laboratory of Endocrinology and Metabolism, The First Medical Center of PLA General Hospital, Beijing 100853, China
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Muscella A, Stefàno E, Marsigliante S. The effects of exercise training on lipid metabolism and coronary heart disease. Am J Physiol Heart Circ Physiol 2020; 319:H76-H88. [PMID: 32442027 DOI: 10.1152/ajpheart.00708.2019] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Blood lipoproteins are formed by various amounts of cholesterol (C), triglycerides (TGs), phospholipids, and apolipoproteins (Apos). ApoA1 is the major structural protein of high-density lipoprotein (HDL), accounting for ~70% of HDL protein, and mediates many of the antiatherogenic functions of HDL. Conversely, ApoB is the predominant low-density lipoprotein (LDL) Apo and is an indicator of circulating LDL, associated with higher coronary heart disease (CHD) risk. Thus, the ratio of ApoB to ApoA1 (ApoB/ApoA1) is used as a surrogate marker of the risk of CHD related to lipoproteins. Elevated or abnormal levels of lipids and/or lipoproteins in the blood are a significant CHD risk factor, and several studies support the idea that aerobic exercise decreases CHD risk by partially lowering serum TG and LDL-cholesterol (LDL-C) levels and increasing HDL-C levels. Exercise also exerts an effect on HDL-C maturation and composition and on reverse C transport from peripheral cells to the liver to favor its catabolism and excretion. This process prevents atherosclerosis, and several studies showed that exercise training increases heart lipid metabolism and protects against cardiovascular disease. In these and other ways, it more and more appears that regular exercise, nutrition, and strategies to modulate lipid profile should be viewed as an integrated whole. The purpose of this review is to assess the effects of endurance training on the nontraditional lipid biomarkers, including ApoB, ApoA1, and ApoB/ApoA1, in CHD risk.
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Affiliation(s)
- Antonella Muscella
- Dipartimento di Scienze e Tecnologie Biologiche e Ambientali, Università del Salento, Lecce, Italy
| | - Erika Stefàno
- Dipartimento di Scienze e Tecnologie Biologiche e Ambientali, Università del Salento, Lecce, Italy
| | - Santo Marsigliante
- Dipartimento di Scienze e Tecnologie Biologiche e Ambientali, Università del Salento, Lecce, Italy
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