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Minh HV, Tien HA, Sinh CT, Thang DC, Chen C, Tay JC, Siddique S, Wang T, Sogunuru GP, Chia Y, Kario K. Assessment of preferred methods to measure insulin resistance in Asian patients with hypertension. J Clin Hypertens (Greenwich) 2021; 23:529-537. [PMID: 33415834 PMCID: PMC8029536 DOI: 10.1111/jch.14155] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/18/2022]
Abstract
Insulin resistance (IR), a metabolic risk factor, is linked to the pathogenetic mechanism of primary hypertension. Detecting IR in the patients with hypertension will help to predict and stratify the added cardiovascular risk, institute appropriate IR management, and manage hypertension optimally. There are many methods for assessing IR, each with distinct advantages and disadvantages. The euglycemic insulin clamp and intravenous glucose tolerance test, gold standards for measuring IR, are used in research but not in clinical practice. Homeostatic model assessment (HOMA-IR), a method for assessing β-cell function and IR, is frequently applied presently, particularly in Asia. Besides, the triglyceride-glucose index (TyG) first published by South American authors showed a good correlation with the insulin clamp technique and HOMA-IR index. This simple, convenient, and low-cost TyG index is of research interest in many countries in Asia and can be used to screen for IR in the Asian hypertensive community.
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Affiliation(s)
- Huynh Van Minh
- Department of Internal MedicineUniversity of Medicine and PharmacyHue UniversityHueVietnam
| | - Hoang Anh Tien
- Department of Internal MedicineUniversity of Medicine and PharmacyHue UniversityHueVietnam
| | - Cao Thuc Sinh
- Departement of Internal MedicineUniversity of MedicineVinh UniversityVinhVietnam
| | | | - Chen‐Huan Chen
- Institute of Public Health and Community Medicine Research CenterNational Yang‐Ming University School of MedicineTaipeiTaiwan
- Division of CardiologyDepartment of MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Faculty of MedicineNational Yang‐Ming University School of MedicineTaipeiTaiwan
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingapore CitySingapore
| | | | - Tzung‐Dau Wang
- Cardiovascular Center and Division of CardiologyDepartment of Internal MedicineNational Taiwan University HospitalTaipei CityTaiwan
- Division of Hospital MedicineDepartment of Internal MedicineNational Taiwan University HospitalTaipei CityTaiwan
| | - Guru Prasad Sogunuru
- MIOT International HospitalChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Yook‐Chin Chia
- Department of Primary Care MedicineFaculty of MedicineUniversity of Malaya KualaLumpurMalaysia
- Department of Medical SciencesSchool of Healthcare and Medical SciencesSunway UniversityBandar SunwayMalaysia
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
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Salazar J, Bermúdez V, Olivar LC, Torres W, Palmar J, Añez R, Ordoñez MG, Rivas JR, Martínez MS, Hernández JD, Graterol M, Rojas J. Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study. F1000Res 2018; 7:44. [PMID: 30210784 PMCID: PMC6107995 DOI: 10.12688/f1000research.13610.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2018] [Indexed: 09/29/2023] Open
Abstract
Background: Insulin resistance (IR) is a metabolic disorder related to atherosclerosis. Its measurement is of great importance not only as a marker of diabetes but also for cardiovascular disease. The aim of this research study was to evaluate the relationship between various IR indices and coronary risk in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub study, 1272 individuals of both genders were selected with the measurement of basal insulin and coronary risk according to the Framingham-Wilson formula calibrated for our population. The insulin resistance indices evaluated were HOMA2-IR, triglycerides and glucose index (TyG) and triglycerides/HDL ratio (TG/HDL). The predictive capacity and association between each index and the coronary risk event in 10 years were determined. Results: Of the evaluated population, 55.2% were female, 34.8% had a coronary risk ≥5% in 10 years, with the TG/HDL and TyG indices showing the highest AUC 0.712 (0.681-0.743) and 0.707 (0.675-0.739), respectively; compared to HOMA2-IR. Both were also the indices most associated with increased coronary risk, especially TG/HDL ≥3 with a higher association [OR = 2.83 (1.74-4.61); p<0.01] after multivariable adjustment. Conclusions: TyG (≥4.5) and TG/HDL (≥3) indices showed a great predictive capacity of higher coronary risk, with being TG/HDL more associated even after adjusting for abdominal obesity and hs-CRP. Therefore, these represent useful tools for determining IR.
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Affiliation(s)
- Juan Salazar
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - Valmore Bermúdez
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Luis Carlos Olivar
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - Wheeler Torres
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - Jim Palmar
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - Roberto Añez
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - Maria Gratzia Ordoñez
- Centro de Salud San Marcos, Ministerio de Salud Pública, Provincia de Santa Elena, Ecuador
| | - José Ramón Rivas
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - María Sofía Martínez
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - Juan Diego Hernández
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Modesto Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Joselyn Rojas
- Pulmonary and Critical Care Medicine Department, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Salazar J, Bermúdez V, Olivar LC, Torres W, Palmar J, Añez R, Ordoñez MG, Rivas JR, Martínez MS, Hernández JD, Graterol M, Rojas J. Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study. F1000Res 2018; 7:44. [PMID: 30210784 PMCID: PMC6107995 DOI: 10.12688/f1000research.13610.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/07/2018] [Indexed: 12/19/2022] Open
Abstract
Background: Insulin resistance (IR) is a metabolic disorder related to atherosclerosis. Its measurement is of great importance not only as a marker of diabetes but also for cardiovascular disease. The aim of this research study was to evaluate the relationship between various IR indices and coronary risk in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub study, 1272 individuals of both genders were selected with the measurement of basal insulin and coronary risk according to the Framingham-Wilson formula calibrated for our population. The insulin resistance indices evaluated were HOMA2-IR, triglycerides and glucose index (TyG) and triglycerides/HDL ratio (TG/HDL). The predictive capacity and association between each index and the coronary risk event in 10 years were determined. Results: Of the evaluated population, 55.2% were female, 34.8% had a coronary risk ≥5% in 10 years, with the TG/HDL and TyG indices showing the highest AUC 0.712 (0.681-0.743) and 0.707 (0.675-0.739), respectively; compared to HOMA2-IR. Both were also the indices most associated with increased coronary risk, especially TG/HDL ≥3 with a higher association [OR = 2.83 (1.74-4.61); p<0.01] after multivariable adjustment. Conclusions: TyG (≥4.5) and TG/HDL (≥3) indices showed a great predictive capacity of higher coronary risk, with being TG/HDL more associated even after adjusting for abdominal obesity and hs-CRP. Therefore, these represent useful tools for determining IR.
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Affiliation(s)
- Juan Salazar
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - Valmore Bermúdez
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Luis Carlos Olivar
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - Wheeler Torres
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - Jim Palmar
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - Roberto Añez
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - Maria Gratzia Ordoñez
- Centro de Salud San Marcos, Ministerio de Salud Pública, Provincia de Santa Elena, Ecuador
| | - José Ramón Rivas
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - María Sofía Martínez
- Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela
| | - Juan Diego Hernández
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Modesto Graterol
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia
| | - Joselyn Rojas
- Pulmonary and Critical Care Medicine Department, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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