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Zhuang Y, Qiu L, Han D, Qiao Z, Wang F, Jiang Q, An Q, Li Y, Shangguan J, Bi X, Shen D. The association between triglyceride-glucose index and related parameters and risk of cardiovascular disease in American adults under different glucose metabolic states. Diabetol Metab Syndr 2024; 16:102. [PMID: 38760860 PMCID: PMC11100199 DOI: 10.1186/s13098-024-01340-w] [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: 01/14/2024] [Accepted: 04/29/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) encompasses an array of cardiac and vascular disorders, posing a significant threat to global health. It remains unclear whether there exists an association between triglyceride-glucose index (TyG) and its derived indices and the incidence of cardiovascular disease, and in particular, the strength of the association in populations with different glucose metabolisms is not known. METHODS Data extracted from the National Health and Nutrition Examination Survey (NHANES) covering the period from 1999 to 2020, involving a cohort of 14,545 participants, were leveraged for the analysis. Statistical assessments were executed utilizing R software, employing multivariable logistic regression models to scrutinize the correlation between TyG and its associated parameters with the incidence of cardiovascular disease across diverse glucose metabolism categories. Interaction analyses and restricted cubic splines were applied to evaluate potential heterogeneity in associations and investigate the link between TyG and its derivatives with the occurrence of cardiovascular disease. Furthermore, receiver operating characteristic curves were constructed to evaluate the extent of variability in the predictive performance of TyG and its derived parameters for cardiovascular disease across distinct glucose metabolic statuses. RESULTS This study found that TyG and its related parameters were differentially associated with the occurrence of cardiovascular disease in different glucose metabolic states. Curvilinear correlations were found between TyG in the IFG population and TyG-WC, TyG-BMI, and TyG-WHtR in the impaired glucose tolerance (IGT) population with the occurrence of cardiovascular disease. In addition, the introduction of TyG and its derived parameters into the classical Framingham cardiovascular risk model improved the predictive performance in different glucose metabolism populations. Among them, the introduction of TyG-WHtR in the normal glucose tolerance (NGT), impaired fasting glucose (IFG), IFG & IGT and diabetes groups and TyG in the IGT group maximized the predictive power. CONCLUSIONS The findings provide new insights into the relationship between the TyG index and its derived parameters in different glucose metabolic states and the risk of cardiovascular disease, offering important reference value for future clinical practice and research. The study highlights the potential for improved risk stratification and prevention strategies based on TyG and its derived parameters.
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Affiliation(s)
- Yuansong Zhuang
- Cardiology Department, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Liliang Qiu
- Department of Respiratory Medicine, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Dongjian Han
- Cardiology Department, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Zhentao Qiao
- Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Fuhang Wang
- Cardiology Department, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Qingjiao Jiang
- Cardiology Department, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Quanxu An
- Cardiology Department, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Yuhang Li
- Cardiology Department, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Jiahong Shangguan
- Cardiology Department, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Xuanye Bi
- Cardiology Department, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Deliang Shen
- Cardiology Department, First Affiliated Hospital of Zhengzhou University, Henan, China.
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Ma K, Liu H, Guo L, Li J, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Li J, Liu M, Hua Y, Zhang L. Comparison of metabolic syndrome prevalence and characteristics using five different definitions in China: a population-based retrospective study. Front Public Health 2024; 12:1333910. [PMID: 38439751 PMCID: PMC10909998 DOI: 10.3389/fpubh.2024.1333910] [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: 12/01/2023] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
Background Metabolic syndrome (MetS) is on the rise in developing countries and is characterized by a series of indications of metabolic disturbance. However, the prevalence of MetS varies under different definitions. The study aimed to compare five definitions of MetS in the China adult population, to explore their prevalence, characteristics and agreement. Methods The data for the retrospective study came from the China Health and Retirement Longitudinal Study (CHARLS), consisting of 9,588 participants (≥45). MetS definitions from International Diabetes Federation (IDF) (2006), National Cholesterol Education Program Adult Treatment Panel III (ATPIII) (2005), National Cholesterol Education Program Adult Treatment Panel III (ATPIII) (2001), Chinese Diabetes society (CDS) (2004) and the World Health Organization (WHO) (1999). We used binary and multivariable logistic analysis to explore factors connected with MetS. Results The five definitions of MetS led to different prevalence of MetS:34.52% by IDF (2006), 38.63% by ATP (2005), 25.94% by ATP (2001), 26.31% by CDS (2004), 21.57% by WHO (1999). According to the definition of IDF (2006) (22.32% vs. 45.06%), ATPIII (2005) definition (27.99% vs. 47.82%), ATPIII (2001) definition (15.37% vs. 35.07%), CDS (2004) definition (19.96% vs. 31.80%), and WHO (1999) definition (17.44% vs. 25.14%), the prevalence of MetS in men was low but in women was high. The agreement between the five definitions for men was good except for the IDF (2006) definition and ATPIII (2001) definition (kappa = 0.51), with kappa values from 0.64 to 0.85. For women, the agreement between the five definitions was good ranging from 0.67 to 0.95, however, except for the definition of CDS (2004) and the definition of IDF (2006) (kappa = 0.44), the definition of WHO (1999) and the definition of IDF (2006) (kappa = 0.55), and the definition of WHO (1999) and the definition of ATPIII (2005) (kappa = 0.54). Binary logistic analysis indicated that although the impact and relevance varied by sex and definition, age, education, marital status, current residence, current smoking, alcohol using, taking activities and number of chronic diseases were factors connected to MetS. Conclusion the prevalence and characteristics of the five definitions of MetS are different in the Chinese population. Therefore, it is vital to use the same definition for a country to diagnose MetS. On the other side, a lower prevalence in men than in women and the consistency of five MetS definitions are good in men but relatively poor in women.
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Affiliation(s)
- Keli Ma
- Department of Graduate School, Wannan Medical College, Wuhu, Anhui, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, Anhui, China
| | - Leilei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Jinlong Li
- Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, Department of Occupational and Environmental Health, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
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Niu ZJ, Cui Y, Wei T, Dou M, Zheng BX, Deng G, Tian PX, Wang Y. The effect of insulin resistance in the association between obesity and hypertension incidence among Chinese middle-aged and older adults: data from China health and retirement longitudinal study (CHARLS). Front Public Health 2024; 12:1320918. [PMID: 38414903 PMCID: PMC10898648 DOI: 10.3389/fpubh.2024.1320918] [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: 10/13/2023] [Accepted: 02/02/2024] [Indexed: 02/29/2024] Open
Abstract
Background and aims Obesity and insulin resistance are well-known important risk factors for hypertension. This study aimed to investigate the mediating effect of the triglyceride-glucose index (TyG) in the association between Chinese visceral obesity index (CVAI) and hypertension among Chinese middle-aged and older adults. Methods A total of 10,322 participants aged 45 years and older from CHARLS (2011-2018) were included. Baseline data were collected in 2011 and hypertension incidence data were gathered during follow-up in 2013, 2015 and 2018. Multivariate logistic regression models were constructed to investigate the association of CVAI and TyG with the incidence of hypertension. Additionally, mediation analyses were conducted to evaluate the mediating role of the TyG index in the relationship between CVAI and hypertension. Subgroup analysis was also performed. Results A total of 2,802 participants developed hypertension during the follow-up period. CVAI and TyG index were independently and significantly associated with hypertension incidence. Increasing quartiles of CVAI and TyG index were associated with high hypertension incidence in middle-aged and older adults. The TyG index was identified as a mediator in the relationship between CVAI and hypertension incidence, with a mediation effect (95% confidence interval) was 12.38% (6.75, 31.81%). Conclusion Our study found that CVAI and TyG were independently associated with hypertension incidence. TyG played a partial mediating effect in the positive association between CVAI and hypertension incidence.
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Affiliation(s)
- Ze-Jiaxin Niu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China
- Department of Kidney Transplantation, Hospital of Nephropathy, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China
| | - Ying Cui
- Department of Neurological Rehabilitation, North Hospital, Xi’an International Medical Center Hospital, Xi'an, China
| | - Tian Wei
- Department of Kidney Transplantation, Hospital of Nephropathy, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China
| | - Meng Dou
- Department of Kidney Transplantation, Hospital of Nephropathy, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China
| | - Bing-Xuan Zheng
- Department of Kidney Transplantation, Hospital of Nephropathy, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China
| | - Ge Deng
- Department of Kidney Transplantation, Hospital of Nephropathy, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China
| | - Pu-Xun Tian
- Department of Kidney Transplantation, Hospital of Nephropathy, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China
| | - Yang Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
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Yang C, Song Y, Wang X, Yang Y, Zhou Y, Wang D, Hou J, Wang P. Association of hypertension with the triglyceride-glucose index and its associated indices in the Chinese population: A 6-year prospective cohort study. J Clin Hypertens (Greenwich) 2024; 26:53-62. [PMID: 38133535 PMCID: PMC10795092 DOI: 10.1111/jch.14758] [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: 10/24/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
The authors aim to assess the correlation between hypertension and the triglyceride-glucose (TyG) index and its associated indices, and to compare their abilities to identify hypertension. Four thousand eight hundred and sixty-six non-hypertensive participants were enrolled from the China National Health Survey in 2009. The data on new-onset hypertension were gathered in both 2011 and 2015. The TyG index and its associated indices were derived from the fasting triglyceride, blood glucose levels, and anthropometric parameters. Multivariate logistic regression analyses and receiver operating characteristic curve analysis were used. The adjusted odds ratio (OR) and 95% confidence interval (CI) for the new-onset hypertension for the TyG-waist-to-height ratio (TyG-WHtR), TyG-waist circumference (TyG-WC), TyG-waist-to-hip ratio (TyG-WHR), TyG-body mass index (TyG-BMI), and TyG index were 1.379 (1.230-1.546), 1.002 (1.001-1.003), 1.156 (1.069-1.251), 1.007 (1.005-1.009), and 1.187 (1.051-1.341), respectively. In addition, comparing the lowest quartile (Q1) group with the highest quartile (Q4), the adjusted OR and 95% CI for the new-onset hypertension were found to be 1.86 (1.48-2.35), 1.93 (1.53-2.43), 1.71 (1.36-2.16), 2.00 (1.60-2.50), and 1.49 (1.19-1.88) for TyG-WHtR, TyG-WC, TyG-WHR, TyG-BMI, and TyG index, respectively, among all participants. The TyG-WHtR had the largest area under the curve (AUC) for hypertension (AUC, 0.628; 95% CI, 0.614-0.641) in all participants. Stratified analysis also indicated that the TyG-WHtR exhibited the greatest AUC in both males (AUC, 0.608; 95% CI, 0.587-0.629) and females (AUC, 0.648; 95% CI, 0.629-0.666). In conclusions, the TyG index and its associated indices were positively associated with hypertension. Among these indices, TyG-WHtR was the most valuable indicator for predicting hypertension.
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Affiliation(s)
- Changqiang Yang
- Department of Cardiologythe First Affiliated Hospital, Chengdu Medical CollegeChengduSichuanChina
- Sichuan Clinical Research Center for Geriatricsthe First Affiliated Hospital of Chengdu Medical CollegeChengduSichuanChina
- Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education InstitutesChengduSichuanChina
| | - Yue Song
- Department of Pediatricsthe First Affiliated Hospital, Chengdu Medical CollegeChengduSichuanChina
| | - Xinquan Wang
- Department of Cardiologythe First Affiliated Hospital, Chengdu Medical CollegeChengduSichuanChina
- Sichuan Clinical Research Center for Geriatricsthe First Affiliated Hospital of Chengdu Medical CollegeChengduSichuanChina
- Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education InstitutesChengduSichuanChina
| | - Yi Yang
- Department of Cardiologythe First Affiliated Hospital, Chengdu Medical CollegeChengduSichuanChina
- Sichuan Clinical Research Center for Geriatricsthe First Affiliated Hospital of Chengdu Medical CollegeChengduSichuanChina
- Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education InstitutesChengduSichuanChina
| | - Yaqiong Zhou
- Department of Cardiologythe First Affiliated Hospital, Chengdu Medical CollegeChengduSichuanChina
- Sichuan Clinical Research Center for Geriatricsthe First Affiliated Hospital of Chengdu Medical CollegeChengduSichuanChina
- Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education InstitutesChengduSichuanChina
| | - Dan Wang
- Department of Cardiologythe First Affiliated Hospital, Chengdu Medical CollegeChengduSichuanChina
- Sichuan Clinical Research Center for Geriatricsthe First Affiliated Hospital of Chengdu Medical CollegeChengduSichuanChina
- Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education InstitutesChengduSichuanChina
| | - Jixin Hou
- Department of Cardiologythe First Affiliated Hospital, Chengdu Medical CollegeChengduSichuanChina
- Sichuan Clinical Research Center for Geriatricsthe First Affiliated Hospital of Chengdu Medical CollegeChengduSichuanChina
- Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education InstitutesChengduSichuanChina
| | - Peijian Wang
- Department of Cardiologythe First Affiliated Hospital, Chengdu Medical CollegeChengduSichuanChina
- Sichuan Clinical Research Center for Geriatricsthe First Affiliated Hospital of Chengdu Medical CollegeChengduSichuanChina
- Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education InstitutesChengduSichuanChina
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Xu AR, Jin Q, Shen Z, Zhang J, Fu Q. Association between the risk of hypertension and triglyceride glucose index in Chinese regions: a systematic review and dose-response meta-analysis of a regional update. Front Cardiovasc Med 2023; 10:1242035. [PMID: 37583585 PMCID: PMC10424922 DOI: 10.3389/fcvm.2023.1242035] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 07/17/2023] [Indexed: 08/17/2023] Open
Abstract
Background Triglyceride-glucose (TyG) index has been reported to be associated with various cardiovascular diseases in recent years. However, the conclusive association between the TyG index and hypertension was not established in the last meta-analysis. Furthermore, it remains unclear whether a linear relationship exists between these two variables. Methods We conducted a comprehensive search of the CNKI, VIP, WanFang Data, CBM, PubMed, EMbase, Web of Science, and The Cochrane Library databases up until May 10, 2023, to identify relevant studies conducted in China. We used Stata version 17.0 and Rstudio version 4.2.1 to analyze the data and assess the association between the TyG index and the risk of hypertension, as well as the dose-response relationship between these two variables. We will select either a random-effects model or a fixed-effects model based on the results of the heterogeneity tests and report 95% confidence intervals accordingly. Results In the end, our analysis encompassed 22 studies involving a total of 668,486 participants, comprising 12 cross-sectional studies and 10 cohort studies. Meta-analysis results showed: Analysis of data from China revealed that an elevated TyG index was associated with a higher risk of developing hypertension, as indicated by an OR/HR of 1.36 [95%CI (1.28-1.45) I2 = 69.0% P < 0.001]. Through meta-regression analysis of multiple covariates, we found that study type, study region, sample size, database source, and study quality score, the above five variables were able to explain 63.0% of the total heterogeneity. The results of the dose-response Meta-analysis showed: The TyG index has a linear relationship with the risk of developing hypertension, as indicated by non-significant coefficients of higher-order terms in the nonlinear model (P > 0.05). The linear trend analysis showed that for every one-unit increase in the TyG index, the risk of developing hypertension increased by 1.5 times [1.532 95%CI (1.294, 1.813) P < 0.001]. However, this result is influenced by the number of studies included in the dose-response analysis and requires further corroboration. Conclusion In the Chinese region, there was an independent association between TyG index and the risk of developing hypertension, with a linear trend. However, the results of the linear trend need to be corrected by the more number of related studies. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023425836.
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Affiliation(s)
- An-ran Xu
- The First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Qiuyu Jin
- Department of Gastroenterology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Zhisheng Shen
- The First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jiaqi Zhang
- The First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Qiang Fu
- Medical Diagnosis Teaching and Research Room, The College of Basic Medicine of Heilongjiang University of Chinese Medicine, Harbin, China
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