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Bayatian A, Jangi A, Pargar F, Bazyar H, Aghamohammadi V. Investigating the efficiency of novel indicators in predicting risk of metabolic syndrome in the Iranian adult population. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:385. [PMID: 39703642 PMCID: PMC11657903 DOI: 10.4103/jehp.jehp_1137_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/04/2023] [Indexed: 12/21/2024]
Abstract
BACKGROUND Whether new anthropometric indicators are superior to conventional anthropometric indicators and whether they can better identify MetS in apparently healthy people needs further research. Thus, this study aimed to estimate the efficiency of novel indicators in predicting the risk of metabolic syndrome (MetS) in the Iranian adult population. MATERIAL AND METHODS In this cross-sectional study, 800 subjects were selected by clustered random sampling. The metabolic factors, traditional and novel anthropometric indices, the triglyceride and glucose index (TyG index) and modified TyG indices (TyG-BMI, TyG-WC, TyG-WHR, and TyG-WHtR), and metabolic score for insulin resistance (METS-IR) were evaluated. The MetS was calculated according to the IDF criteria. To investigate the risk of MetS, logistic regression was used along with modeling. RESULTS In all three models, all traditional anthropometric indices were associated with MetS (P < 0.001). Regarding novel anthropometric indices, all indices (except for ABSI) significantly predicted the risk of MetS in all participants before and after adjustment (P < 0.001). WTI index presented the highest Odds ratios for MetS (29.50, 95% CI: 15.53-56.03). A positive association was found in all models between TyG and modified TyG indices and METS-IR with MetS (P for all < 0.001). TyG-WHtR index presented the highest Odds ratios for MetS (70.07, 95% CI: 32.42-151.43). CONCLUSION A combination of the TyG index and WHtR (TyG-WHtR index) was better than the TyG index alone, with a higher odds ratio in predicting MetS. Due to the simplicity of these indices, cost-effectiveness, and facility at small-scale labs and being predictive of MetS risk it is suggested to include these markers in clinical practice.
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Affiliation(s)
- Ayatollah Bayatian
- Research Center for Life & Health Sciences & Biotechnology of the Police, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran
| | - Allahwardi Jangi
- Research Center for Life & Health Sciences & Biotechnology of the Police, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran
| | - Farideh Pargar
- Research Center for Life & Health Sciences & Biotechnology of the Police, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran
| | - Hadi Bazyar
- Department of Public Health, Student Research Committee, Sirjan School of Medical Sciences, Sirjan, Iran
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Wu J, Lin X, Yin X, Xu Z, Wu N, Zhang Z, Zhou J, Li H. Comparison of Incidence of Metabolic Syndrome and Five Obesity- and Lipid-Linked Indicators for Predicting Metabolic Syndrome Among Normal-Weight and Overweight Adults. Diabetes Metab Syndr Obes 2024; 17:3509-3520. [PMID: 39319305 PMCID: PMC11421436 DOI: 10.2147/dmso.s483497] [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: 06/20/2024] [Accepted: 09/12/2024] [Indexed: 09/26/2024] Open
Abstract
Purpose Metabolic syndrome (MetS) is an increasingly prevalent issue in China's public health landscape. Few studies have investigated the metabolic syndrome (MetS) in overweight people. We proposed to analyze and contrast the occurrence of MetS in normal-weight and overweight individuals and identify potential indicators for forecasting MetS in adults in Zhejiang Province. Methods This cohort study included 359 adults aged 40-65 years and followed up for five years in Zhejiang Province. The study assessed the predictive capabilities of five indicators linked to obesity and lipid levels, namely body mass index (BMI), waist-to-height ratio (WHtR), triglyceride-glucose index (TyGi), and their combined indices (TyG-BMI, TyG-WHtR). The evaluation was done employing the area under the Receiver Operating Characteristic (ROC) Curve (AUC). DeLong test was applied to compare area under different ROC curves.We evaluated the relationships between five variables and MetS using multivariate logistic regression. Results In normal-weight individuals, the five-year cumulative incidence of MetS was 21.85%, but in overweight people, it was 60.33%. After adjusting for confounding factors, BMI, WHtR, TyGi, TyG-BMI, and TyG-WHtR were independently linked to MetS in normal-weight individuals, while BMI, TyGi, TyG-BMI, and TyG-WHtR were independently linked to MetS in overweight individuals. In normal-weight individuals, the WHtR (AUC=0.738 and optimal threshold value =0.469) and TyG-WHtR (AUC=0.731 and optimal threshold value =4.121) had the larger AUC, which was significantly greater than that of the different three indicators. The TyG-BMI (AUC=0.769 and optimal threshold value = 211.099) was the best predictor of MetS in overweight individuals. Conclusion The five-year cumulative incidence of MetS in overweight people was approximately triple that of normal-weight people in Zhejiang Province. In the overweight population, the TyG-BMI performed better than the other indices in predicting MetS. WHtR and TyG-WHtR outperformed BMI, TyGi, and TyG-BMI in anticipating MetS in a normal-weight population.
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Affiliation(s)
- Jiahua Wu
- Department of Endocrinology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Xihua Lin
- Department of Endocrinology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Xueyao Yin
- Department of Endocrinology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Zhiye Xu
- Department of Endocrinology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Nan Wu
- Department of Endocrinology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Ziyi Zhang
- Department of Endocrinology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Jiaqiang Zhou
- Department of Endocrinology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Hong Li
- Department of Endocrinology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
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Feng Y, Li M, Li X, Tang Q, Li X, Ji X, Tian W, Zhang H. Characteristics of Different Obesity Metabolic Indexes and their Correlation with Insulin Resistance in Patients with Polycystic Ovary Syndrome. Reprod Sci 2024; 31:2829-2835. [PMID: 38649666 DOI: 10.1007/s43032-024-01532-9] [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: 10/31/2023] [Accepted: 03/29/2024] [Indexed: 04/25/2024]
Abstract
This study is aimed to investigate the characteristics of different obesity metabolic indexes [body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), cardiometabolic index (CMI), body roundness index (BRI), visceral adiposity index (VAI), and lipid aggregation products (LAP)] and their correlation with insulin resistance (IR) in patients with polycystic ovary syndrome (PCOS). The study was conducted on 140 subjects with PCOS and 133 control subjects aged 18-44 years. According to insulin resistance index (HOMA-IR) ≥ 2.69 and HOMA-IR < 2.69, PCOS group members were divided into insulin resistance group and non-insulin resistance group. Anthropometric and serological characteristics of the population with PCOS focused on calculating different obesity metabolic indexes and HOMA-IR. BMI, WC, WHR, WHtR, CMI, BRI, VAI, and LAP were significantly higher in PCOS patients than in the control group, and the differences were all statistically significant (P < 0.05); In the insulin resistance group of PCOS patients, BMI, WC, WHR, WHtR, CMI, BRI, VAI, and LAP were significantly higher than in the non-insulin resistance group (P < 0.05). In PCOS patients, BMI (r = 0.658, P < 0.001), WC (r = 0.0.662, P < 0.001), WHR (r = 0.377, P < 0.001), WHtR (r = 0.660, P < 0.001), CMI (r = 0.698, P < 0.001), BRI (r = 0.757, P < 0.001), VAI (r = 0.640, P < 0.001), and LAP (r = 0.767, P < 0.001) were positively correlated with IR. Obesity metabolic indexes associated with PCOS were elevated in the PCOS group compared to the control group, and in the PCOS insulin-resistant group compared to the non-insulin resistant group. Novel obesity metabolic indexes, especially CMI, BRI and LAP, might be more appropriate for evaluating the risk of concurrent IR in PCOS.
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Affiliation(s)
- Yaru Feng
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, NO 154, Anshan Road, Tianjin, He Ping District, 300052, People's Republic of China
| | - Mengying Li
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, NO 154, Anshan Road, Tianjin, He Ping District, 300052, People's Republic of China
| | - Xue Li
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, NO 154, Anshan Road, Tianjin, He Ping District, 300052, People's Republic of China
| | - Qingtao Tang
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, NO 154, Anshan Road, Tianjin, He Ping District, 300052, People's Republic of China
| | - Xiaoyan Li
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, NO 154, Anshan Road, Tianjin, He Ping District, 300052, People's Republic of China
| | - Xia Ji
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, NO 154, Anshan Road, Tianjin, He Ping District, 300052, People's Republic of China
| | - Wenyan Tian
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, NO 154, Anshan Road, Tianjin, He Ping District, 300052, People's Republic of China
| | - Huiying Zhang
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, NO 154, Anshan Road, Tianjin, He Ping District, 300052, People's Republic of China.
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Bazyar H, Zare Javid A, Masoudi MR, Haidari F, Heidari Z, Hajializadeh S, Aghamohammadi V, Vajdi M. Assessing the predictive value of insulin resistance indices for metabolic syndrome risk in type 2 diabetes mellitus patients. Sci Rep 2024; 14:8917. [PMID: 38632455 PMCID: PMC11024148 DOI: 10.1038/s41598-024-59659-3] [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: 10/31/2023] [Accepted: 04/12/2024] [Indexed: 04/19/2024] Open
Abstract
Limited research has explored the effectiveness of insulin resistance (IR) in forecasting metabolic syndrome (MetS) risk, especially within the Iranian population afflicted with type 2 diabetes mellitus (T2DM). The present investigation aimed to assess the efficacy of IR indices in predicting the risk of MetS among T2DM patients. Convenient sampling was utilized to select four hundred subjects with T2DM. Metabolic factors and IR indices, including the Waist Circumference-Triglyceride Index (WTI), Triglyceride and Glucose Index (TyG index), the product of TyG index and abdominal obesity indices, and the Metabolic Score for Insulin Resistance (METS-IR), were evaluated. Logistic regression, coupled with modeling, was employed to explore the risk of MetS. The predictive performance of the indices for MetS stratified by sex was evaluated via receiver operating characteristic (ROC) curve analysis and estimation of the area under the curve (AUC) values. The TyG-Waist Circumference (TyG-WC) index exhibited the largest AUCs in both males (0.91) and females (0.93), while the TyG-Body Mass Index (TyG-BMI) demonstrated the smallest AUCs (0.77 in males and 0.74 in females). All indices significantly predicted the risk of MetS in all subjects before and after adjustment (p < 0.001 for all). The TyG-WC index demonstrated the highest odds ratios for MetS (8.06, 95% CI 5.41-12.00). In conclusion, all IR indices assessed in this study effectively predicted the risk of MetS among Iranian patients with T2DM, with the TyG-WC index emerging as the most robust predictor across both genders.
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Affiliation(s)
- Hadi Bazyar
- Student Research Committee, Sirjan School of Medical Sciences, Sirjan, Iran
- Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Ahmad Zare Javid
- Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Fatemeh Haidari
- School of Health, Medical and Applied Sciences, Central Queensland University, Brisbane, Australia
| | - Zeinab Heidari
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | | | - Mahdi Vajdi
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Han W, Zhang M, Wang H, Yang Y, Wang L. Lipid accumulation product is an effective predictor of metabolic syndrome in non-obese women with polycystic ovary syndrome. Front Endocrinol (Lausanne) 2024; 14:1279978. [PMID: 38269246 PMCID: PMC10807289 DOI: 10.3389/fendo.2023.1279978] [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: 08/19/2023] [Accepted: 12/06/2023] [Indexed: 01/26/2024] Open
Abstract
Objective To explore the correlation of lipid accumulation product (LAP) with metabolic syndrome (MS) and to assess the predictive value of LAP for MS risk in polycystic ovary syndrome (PCOS) with different body mass index (BMI). Methods A total of 242 PCOS patients and 150 controls were recruited and divided into normal-weight, overweight, and obese groups, then further divided into MS and without MS subgroups. Clinical and anthropometric variables and laboratory results were recorded. LAP was calculated from waist circumference (WC) and triglyceride using sex-specific formulae. Logistic regression analysis and receiver operating characteristic (ROC) curve were applied to determine and analyze the predictive value of LAP for MS. Results The prevalence of MS among PCOS patients was 45.04%, which was significantly higher than that of the controls (10%). Stratified by BMI, the incidence of MS in the normal-weight, overweight, and obese PCOS groups were 15.58%, 41.43%, and 71.58%, respectively. Logistic regression analysis indicated that LAP was an independent risk factor for MS in both normal-weight and overweight groups; however, the results were not significant in the obese group. ROC curve analysis showed that LAP had an outstanding discrimination index for MS in normal-weight (AUC=0.960, cut-off value=42.5) and overweight (AUC=0.937, cut-off value=47.93) PCOS patients, with a sensitivity of 0.917/0.931 (normal-weight/overweight) and a specificity of 0.969/0.854 (normal-weight/overweight), respectively. Conclusion Normal-weight and overweight PCOS patients also have a fairly high incidence of MS and should receive as much attention as obese patients. Compared to applying multiple clinical indicators, LAP is more convenient and facilitates acquiring early and accurate diagnoses of MS among non-obese PCOS patients using fewer MS markers.
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Affiliation(s)
- Wenju Han
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
- School of Public Health, China Medical University, Shenyang, China
| | - Meiwei Zhang
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
| | - Haiyan Wang
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
| | - Yitian Yang
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
| | - Lei Wang
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
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Yin Q, Yan X, Cao Y, Zheng J. Evaluation of novel obesity- and lipid-related indices as predictors of abnormal glucose tolerance in Chinese women with polycystic ovary syndrome. BMC Endocr Disord 2022; 22:272. [PMID: 36348340 PMCID: PMC9644461 DOI: 10.1186/s12902-022-01179-0] [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: 04/24/2022] [Accepted: 10/16/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE We aimed to evaluate the performance of Chinese visceral adiposity index (CVAI), visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride glucose (TyG) as indices in screening abnormal glucose tolerance (AGT) in Chinese women with polycystic ovary syndrome (PCOS), using the oral glucose tolerance test (OGTT) as a reference test. In addition, we essentially compared the abilities of these indices with body mass index (BMI), waist circumference (WC), fasting plasma glucose (FPG). MATERIALS AND METHODS All 1113 PCOS patients evaluated in this study underwent OGTTs. The 2-h post-oral glucose load (2 h-PG) level was used to categorize subjects into two groups: those having AGT or normal glucose tolerance (NGT) levels. RESULTS A statistically significant positive correlation between levels of 2 h-PG and FPG, BMI, WC, LAP, VAI, CVAI, TyG, (P < 0.05), was observed. The strongest correlation was found between the levels of 2 h-PG and CVAI (r = 0.47). The CVAI provided the highest area under the receiver-operating characteristic curve (AUC) for AGT, followed by LAP, BMI, TyG, VAI, WC, and FPG. The CVAI of 32.61 (with AUC: 0.76, sensitivity: 73%, specificity: 70%, positive preductive value (PPV): 0.41, negative predictive value (NPV): 0.90) was found to be the cut-off point for AGT in Chinese women with PCOS. CONCLUSIONS CVAI may not reliably detect AGT in Chinese women with PCOS. However, it is suitable as a first screening indicator to guide physicians to ordering OGTT.
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Affiliation(s)
- Qianqian Yin
- Center for Reproductive Medicine, XuZhou Central Hospital, No. 199, Jiefang Road, Xuzhou, 221009, Jiangsu, China
| | - Xiaonan Yan
- Center for Reproductive Medicine, XuZhou Central Hospital, No. 199, Jiefang Road, Xuzhou, 221009, Jiangsu, China
| | - Yijuan Cao
- Center for Reproductive Medicine, XuZhou Central Hospital, No. 199, Jiefang Road, Xuzhou, 221009, Jiangsu, China.
| | - Jianhua Zheng
- Department of Obstetrics and Gynecology, XuZhou Central Hospital, No. 199, Jiefang Road, Xuzhou, 221009, Jiangsu, China.
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Hu J, Jiang Y, Shen H, Ding L, Xu X, Wu W. What is the best anthropometry index to evaluate the risk of metabolic abnormalities in Chinese adults? Diabetes Metab Res Rev 2022; 38:e3580. [PMID: 36210641 DOI: 10.1002/dmrr.3580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/18/2022] [Accepted: 08/26/2022] [Indexed: 11/08/2022]
Abstract
AIMS Obesity, defined by body mass index (BMI), is a heterogeneous condition with varying metabolic manifestations, and the best index for predicting metabolic abnormalities remains unclear. This study aimed to explore the most suitable anthropometry index for predicting metabolic abnormalities in Chinese adults. METHODS A cross-sectional study was conducted using the data obtained from 9517 Chinese adults who underwent physical examination, bioelectrical impedance analysis, and laboratory examinations between March 2018 and March 2022. Participants were further divided into eight subgroups according to age, BMI, and sex. Descriptive statistics were calculated, and the area under the receiver operating characteristic curve and Youden index values were calculated to identify the best predictor of metabolic abnormalities in Chinese adults. RESULTS The waist-to-height ratio (WHtR) had the largest area under the curve for predicting metabolic abnormalities in men of any age and women aged 18-49 years. However, BMI showed the highest accuracy in predicting metabolic abnormalities in women aged 50 years and older. Based on the highest Youden index, the optimal WHtR threshold was 0.51 in women and 0.53 in men. CONCLUSIONS The WHtR was the most effective index for predicting metabolic abnormalities in most Chinese adults, whereas BMI showed a higher accuracy only in elderly women. This observation supports WHtR as a novel adiposity marker for screening metabolic abnormalities and shows value for public health practice.
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Affiliation(s)
- Jun Hu
- Department of Health Management Center, Huadong Sanatorium, Jiangsu, China
| | - Yongbin Jiang
- Department of Health Management Center, Huadong Sanatorium, Jiangsu, China
| | - Hui Shen
- Department of Health Management Center, Huadong Sanatorium, Jiangsu, China
| | - Limin Ding
- Department of Health Management Center, Huadong Sanatorium, Jiangsu, China
| | - Xiaopao Xu
- Department of Health Management Center, Huadong Sanatorium, Jiangsu, China
| | - Wenjun Wu
- Department of Endocrinology, Wuxi People's Hospital, Jiangsu, China
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Selected Organ and Endocrine Complications According to BMI and the Metabolic Category of Obesity: A Single Endocrine Center Study. Nutrients 2022; 14:nu14061307. [PMID: 35334964 PMCID: PMC8954480 DOI: 10.3390/nu14061307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/01/2023] Open
Abstract
Obesity is a chronic and complex disease associated with metabolic, organ and endocrine complications. In the study, we analyzed a group of 105 patients suffering from obesity without any other previously recognized serious disorders who had been referred to a single endocrine center. The study aimed to assess the prevalence of selected organ and endocrine complications by subdividing the group, firstly according to body mass index (BMI) and secondly with regard to metabolic syndrome (MetS), pre-MetS and the metabolically healthy obesity (MHO) category. We have observed that in our groups, the prevalence of hyperlipidemia, hypertension, asthma, obstructive sleep apnea (OSA) depended on BMI category, whereas the incidence of hyperlipidemia, hypertension, OSA, hypothyroidism, non-alcoholic fatty liver disease, prediabetes, and type 2 diabetes was related to the metabolic category. We concluded that the distribution of particular organ and endocrine complications change significantly with increased BMI and with the shift from MHO to pre-MetS and MetS. Thus, to determine the risk of organ and endocrine complications more effectively, BMI and metabolic status should be assessed during the examination of patients with obesity.
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