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Song G, Wei Y, Juan J, Niu J, Yang H. The predictive ability of the triglyceride glucose index, fasting glucose and oral glucose tolerance test for postpartum hyperglycemia in women with a GDM history. J Matern Fetal Neonatal Med 2024; 37:2395495. [PMID: 39198029 DOI: 10.1080/14767058.2024.2395495] [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: 05/21/2024] [Revised: 07/15/2024] [Accepted: 08/18/2024] [Indexed: 09/01/2024]
Abstract
OBJECTIVE This study aimed to determine the likelihood of hyperglycemia postpartum in women with gestational diabetes mellitus (GDM) and to identify the predictors. METHODS The retrospective cohort study involved 1 527 GDM patients who delivered at Peking University First Hospital from 1 January 2021, to 31 December 2021. According to the blood glucose level of postpartum oral glucose tolerance test (OGTT), women were divided into a normal glucose tolerance (NGT) group and a hyperglycemia group, and their characteristics and risk factors of hyperglycemia were compared. RESULTS The prevalence of hyperglycemia was 33.9% (184/543) at 6-12 weeks postpartum. Compared with the NGT group, the fasting plasma glucose (FPG) of hyperglycemia group increased significantly during pregnancy and postpartum, the OGTT 1h postprandial glucose (PG) and 2hPG increased in the second trimester of pregnancy, the triglyceride (TG) increased in the first trimester of pregnancy and postpartum, the triglyceride glucose (TyG) index increased in the first trimester of pregnancy and postpartum, and the total cholesterol (TCHO) and low density lipoprotein cholesterol (LDL-C) decreased in the second trimester (p < 0.05). Fasting plasma glucose (FPG) in the first trimester [odds ratio (OR) = 3.583, p < 0.001], OGTT 2hPG in the second trimester (OR = 1.604, p < 0.001), the TyG index in the first trimester (OR = 1.863, p = 0.045) and FPG in third trimester (OR = 1.985, p = 0.024) were independent risk factors for postpartum hyperglycemia. CONCLUSIONS Approximately one-third of women with GDM have hyperglycemia 6-12 weeks after delivery. FPG and the TyG index in the first trimester, OGTT 2hPG in the second trimester and FPG in third trimester are risk factors for postpartum hyperglycemia.
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Affiliation(s)
- Geng Song
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China
| | - Yumei Wei
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China
| | - Juan Juan
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China
| | - Jianhua Niu
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China
| | - Huixia Yang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China
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Zhang C, Wang H, Li Y, Wang X, Han Y, Gao X, Lai Y, Wang C, Teng W, Shan Z. Association between the triglyceride-glucose index and thyroid disorders: a cross-sectional survey and Mendelian randomization analysis. Endocrine 2024; 86:173-185. [PMID: 38782862 DOI: 10.1007/s12020-024-03858-5] [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: 12/04/2023] [Accepted: 04/30/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Metabolic diseases are associated with thyroid disorders. Insulin resistance is the common pathological basis of metabolic diseases. We explored the relationship between the triglyceride-glucose (TyG) index, a simple insulin-resistance marker, and thyroid disorders. METHODS Eligible TIDE (Thyroid Diseases, Iodine Status and Diabetes Epidemiology) subjects (n = 47,710) were screened with inclusion/exclusion criteria. Thyroid disorder prevalence among different TyG index groups was stratified by sex. Logistic regression evaluated the correlation between the TyG index and thyroid disorders. Multiple linear regression evaluated the association between the TyG index and TSH. Additionally, two-sample Mendelian randomization (MR) using published genome-wide association study data evaluated causality in the association between the TyG index and TSH. RESULTS Men and women with greater TyG indices had a significantly greater prevalence of thyroid disorders than individuals with the lowest quartile (Q1) of TyG index (p < 0.05). Following adjustment for confounding factors, we observed that a greater TyG index significantly increased the risk of subclinical hypothyroidism in men and women (men: Q2: odds ratio (OR) [95% confidence interval (CI)] = 1.22 [1.07-1.38], p = 0.002; Q3: OR [95% CI] = 1.28 [1.12-1.45], p < 0.001; Q4: OR [95% CI] = 1.29 [1.12-1.50], p = 0.001; women: Q2: OR [95% CI] = 1.25 [1.12-1.39], p < 0.001; Q3: OR [95% CI] = 1.47 [1.31-1.64], p < 0.001; Q4: OR [95% CI] = 1.61 [1.43-1.82], p < 0.001). Only among women was the highest TyG index quartile associated with hypothyroidism (OR [95% CI] = 1.70 [1.15-2.50], p = 0.007). Additionally, in men, the association exists only in the more than adequate iodine intake population. In women, the relationship between the TyG index and thyroid disorders disappears after menopause. Furthermore, the TyG index exhibited a linear positive correlation with TSH levels. The MR analysis results revealed a causal relationship between a genetically determined greater TyG index and increased TSH (inverse-variance weighting (IVW): OR [95% CI] = 1.14 [1.02-1.28], p = 0.020); however, this causal relationship disappeared after adjusting for BMI in multivariable MR (MVMR) analysis (MVMR-IVW: OR 1.03, 95% CI 0.87-1.22, p = 0.739). CONCLUSIONS A greater TyG index is associated with hypothyroidism and subclinical hypothyroidism and varies by sex and menopausal status. MR analysis demonstrated that the causal relationship between a genetically determined greater TyG index and elevated TSH levels is confounded or mediated by BMI.
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Affiliation(s)
- Chenyu Zhang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Haoyu Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Yongze Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Xichang Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Yutong Han
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Xiaotong Gao
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Yaxin Lai
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Chuyuan Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Weiping Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China.
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Jia H, Zhang W, Jia S, Zhang J, Xu Z, Xu Z, Li Y. Correlation between triglyceride glucose index and coronary plaque: An observational study. Medicine (Baltimore) 2024; 103:e39576. [PMID: 39287294 PMCID: PMC11404926 DOI: 10.1097/md.0000000000039576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 08/14/2024] [Accepted: 08/15/2024] [Indexed: 09/19/2024] Open
Abstract
The association between the triglyceride-glucose (Tyg) index and coronary plaque in patients with coronary heart disease remains unclear. This study aimed to investigate the relationship between Tyg index and coronary plaque under different levels of blood glucose metabolism. This retrospective study included patients with coronary artery disease who underwent coronary angiography and OCT between January 1, 2023 and January 1, 2024, and ultimately collected 232 coronary plaques. All patients were grouped according to the median Tyg index (T1 group 7.71 ≤ TyG index ≤ 9.13; T2 group 9.14 ≤ TyG index ≤ 10.99). The thickness of plaque fiber cap was measured under OCT, and the plaques were divided into vulnerable plaque and non-vulnerable plaque. The status of glucose metabolism is divided into non-diabetic and diabetic. Baseline data analysis showed that there were significant differences in clinical and biological characteristics between the T1 and T2 groups (P < .05). Logistic regression analysis showed that T2 group was significantly associated with vulnerable plaques compared with T1 group (odds ratio [OR]: 2.638; 95% confidence interval [CI] 1.548-4.494; P < .001). The OR of Tyg index was 2.175 (95% CI 1.409-3.357; P < .001). Receiver operating characteristic showed that the area under ROC curve (AUC) was 0.727 (95% CI 0.663-0.792; P < .001), the best cutoff value was 9.23, the sensitivity was 60%, and the specificity was 81%. In diabetic patients, there was a statistically significant correlation between Tyg index and coronary vulnerable plaque (OR: 3.273; 95% CI 1.240-8.636, P < .05). Triglyceride glucose index is a good predictor of coronary vulnerable plaque.
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Affiliation(s)
- Haiyan Jia
- Department of Cardiology, Cangzhou Central Hospital, Tianjin Medical University, Tianjin, China
- Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China
| | - Weifeng Zhang
- Department of Cardiology, Cangzhou Central Hospital, Tianjin Medical University, Tianjin, China
- Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China
| | - Shengqi Jia
- Department of Cardiology, Second Hospital of Hebei Medical University
| | - Jun Zhang
- Department of Cardiology, Cangzhou Central Hospital, Tianjin Medical University, Tianjin, China
| | - Zesheng Xu
- Department of Cardiology, Cangzhou Central Hospital, Tianjin Medical University, Tianjin, China
| | - Zhanwen Xu
- Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China
| | - Yaqin Li
- Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China
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Han J, Dai W, Chen L, Huang Z, Li C, Wang K. Elevated triglyceride-glucose index associated with increased risk of diabetes in non-obese young adults: a longitudinal retrospective cohort study from multiple Asian countries. Front Endocrinol (Lausanne) 2024; 15:1427207. [PMID: 39175577 PMCID: PMC11338785 DOI: 10.3389/fendo.2024.1427207] [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: 05/03/2024] [Accepted: 07/24/2024] [Indexed: 08/24/2024] Open
Abstract
Objective Previous studies have confirmed a positive correlation between the Triglyceride-Glucose (TyG) index and future risk of diabetes. However, evidence of this association in non-obese young populations remains limited. This study aims to investigate the relationship between the TyG index and the future risk of diabetes among non-obese young adults. Methods This retrospective cohort study included 113,509 non-obese young adults from China and 9,549 from Japan. The mean age was 35.73 ± 6.38 years, and 56,469 participants (45.89%) were male. The median follow-up duration was 3.38 years. The association between baseline TyG index and risk of diabetes was examined using Cox proportional hazards regression models. Non-linear relationships between the TyG index and risk of diabetes were identified using cubic splines and smoothed curve fitting in the Cox models. Sensitivity and subgroup analyses were also conducted. Results After adjusting for covariates, the results indicated a positive correlation between the TyG index and risk of diabetes in non-obese young adults (HR=3.57, 95% CI: 2.92-4.36, P<0.0001). A non-linear relationship was observed with an inflection point at 7.3. The HR to the right of this inflection point was 3.70 (95% CI: 3.02-4.52, P<0.0001), while to the left, it was 0.34 (95% CI: 0.06-1.88, P=0.2161). The robustness of our findings was confirmed through a series of sensitivity analyses and subgroup analyses. Conclusion This study reveals a positive and non-linear association between the TyG index and risk of diabetes among non-obese young adults. Interventions aimed at reducing the TyG index by lowering triglycerides or fasting glucose levels could substantially decrease the future likelihood of developing diabetes in this population.
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Affiliation(s)
- Jian Han
- Department of Interventional Radiology and Vascular Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Weifeng Dai
- Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Lixia Chen
- Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Zhenhua Huang
- Department of Emergency Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Chengzhi Li
- Department of Interventional Radiology and Vascular Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Keke Wang
- Department of Emergency Medicine, The First Affiliated Hospital, Sun Yet-sen University, Guangzhou, China
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Baek G, Lee YJ, Kwon SC, Min YS, Yun J, Ahn TJ, Jang EC. The association of shift work and TyG index among male workers in a chemical plant of Korea: a cross-sectional study. Ann Occup Environ Med 2024; 36:e18. [PMID: 39144152 PMCID: PMC11322566 DOI: 10.35371/aoem.2024.36.e18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/31/2024] [Accepted: 04/17/2024] [Indexed: 08/16/2024] Open
Abstract
Background Disturbance of circadian rhythms caused by shift work has adverse effects on insulin resistance. Many previous studies have confirmed that shift work and insulin resistance are related using homeostasis model assessment-insulin resistance, one of the insulin resistance indicators. However, the triglycerides and glucose index (TyG index) has recently been studied as an insulin resistance indicator. The aim of this study is to investigate the association of shift work and TyG index, one of the indirect indicators of insulin resistance, using results of health checkups in one workplace. Methods Based on medical examination data collected in February 2019, a total of 3,794 subjects from one chemical plant in Korea were selected for this study. Cut-off value of TyG index for predicting development of diabetes mellitus (DM) was 4.69. A multiple logistic regression analysis was performed after adjusting for age, employment period, obesity, abdominal obesity, smoking, drinking, physical activity, hypertension, stroke, heart disease. Results As a result of logistic regression analysis, compared to day workers, odds ratio (OR) with a TyG index above cut-off value for predicting development of DM in shift workers was 1.220 after adjusting for age, employment period, obesity, abdominal obesity, smoking, drinking, physical activity, hypertension, stroke, heart disease (Model 1, OR: 1.276; 95% confidence interval [CI]: 1.099-1.482; Model 2, OR: 1.232; 95% CI: 1.055-1.438; Model 3, OR: 1.220, 95% CI: 1.030-1.444). Conclusions There was a significant association between shift work and TyG index among male workers in a chemical plant. More research studies on the association between shift work and TyG index are needed in the future.
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Affiliation(s)
- Gwangin Baek
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Yong-Jin Lee
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Soon-Chan Kwon
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Young-Sun Min
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Jisuk Yun
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Tae Jin Ahn
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Eun-Chul Jang
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
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Thakur R, Kumar S, Neeraj RK, Saleem M, Kumar C, Mohan L. Evaluation of the Association between Insulin Resistance and Subclinical Hypothyroidism Using Triglyceride-Glucose Index: a Cross-Sectional Study. MAEDICA 2024; 19:255-259. [PMID: 39188835 PMCID: PMC11345053 DOI: 10.26574/maedica.2024.19.2.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
BACKGROUND Thyroid disorders and diabetes mellitus are often known to co-exist, implying an interrelationship between thyroid dysfunction and insulin resistance. Triglyceride-glucose (TyG) index is a relatively new surrogate marker of insulin resistance, which is cost-effective and easily calculated with routine lab tests. Data about association of subclinical hypothyroidism (SCH) and insulin resistance, especially with reference to TyG index, is lacking. OBJECTIVES To evaluate the association of SCH and insulin resistance using the TyG index by comparing its value in patients with SCH and age- and gender-matched euthyroid controls. Also, to determine if there is a correlation between TyG index values and thyroid profile parameters (TSH, FT3 and FT4) in both study groups. MATERIALS AND METHODS Thirty-five patients with SCH and an equal number of age- and gender-matched euthyroid controls were included in the present study. The TyG index was calculated for each group and compared. The correlation between TyG index and thyroid profile parameters (TSH, FT3 and FT4) was also assessed. RESULTS The TSH values were significantly higher in the SCH group (6.6±1.7 µIU/mL) than the control one (2.5±1.2 µIU/mL; p<0.0001). There was no significant difference in FT3 in the SCH group (2.93±0.49 pg/ mL) and the control one (3.05±0.64 pg/mL; p=0.310). The level of FT4 was also not found to be significantly different in SCH subjects (1.23±0.44 ng/dL) and controls (1.4±0.42 ng/dL; p=0.077). The TyG index values were significantly higher in the SCH group (4.8±0.2) as compared to the control one (4.7±0.2; p = 0.015). The TyG index did not show any significant correlation with the thyroid parameters in any of the two groups. CONCLUSION There is a positive association between SCH and insulin resistance in terms of TyG index. This index may thus be helpful in early screening and management of such patients for insulin resistance related conditions like diabetes mellitus, metabolic syndrome and cardiovascular disorders.
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Affiliation(s)
- Rinky Thakur
- Senior Resident, Department of Pharmacology, IGIMS, Patna, India
| | - Samir Kumar
- Assistant Professor, Department of General Medicine, IGIMS, Patna, India
| | | | - Mohd Saleem
- Junior Resident, Department of General Medicine, IGIMS, Patna, India
| | - Chakrapani Kumar
- Senior Resident, Department of Pharmacology, IGIMS, Patna, India
| | - Lalit Mohan
- Professor and HOD, Department of Pharmacology, IGIMS, Patna, India
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Yoshida D, Ikeda S, Shinohara K, Kazurayama M, Tanaka S, Yamaizumi M, Nagayoshi H, Toyama K, Kinugawa S. Triglyceride-Glucose Index Associated with Future Renal Function Decline in the General Population. J Gen Intern Med 2024:10.1007/s11606-024-08809-4. [PMID: 38782808 DOI: 10.1007/s11606-024-08809-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 05/09/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND The triglyceride-glucose index (TyG index), calculated as the logarithmic product of fasting triglyceride and glucose concentrations, is recognized as a simple marker of insulin resistance. However, the association between the TyG index and future decline of renal function remains unclear in the general population. OBJECTIVE To investigate whether the TyG index was associated with future decline of renal function in the general population who had not progressed to chronic kidney disease stage G2. DESIGN Retrospective longitudinal observational cohort study. PARTICIPANTS Individuals who received a population-based health checkup at JA Ehime Kouseiren Checkup Center from 2010 to 2019 (n = 134,007). Individuals without data of baseline fasting triglyceride or glucose levels, or baseline and follow-up data of estimated glomerular filtration rate (eGFR), or those with baseline eGFR < 60 mL/min/1.73 m2 were excluded. MAIN MEASURES Future renal function decline, defined as a ≥ 25% decrease in eGFR from baseline. KEY RESULTS Of 10,758 participants, 8,076 were classified into the low TyG index group (TyG index < 8.76, 1st to 3rd quartiles) and 2,682 into the high TyG index group (TyG index ≥ 8.76, 4th quartile). The mean follow-up period was 37.8 ± 23.6 months. The incidence rates of renal function decline were 0.31 and 0.69 per 100 person-years in the low and high TyG index groups, respectively. In multivariate Cox proportional hazard models, high TyG index was significantly associated with future renal function decline (hazard ratio 2.25, 95% CI 1.40-3.60). This association was consistent across subgroups stratified by age, sex, body mass index, baseline eGFR, and diagnosed hypertension, diabetes, or dyslipidemia. CONCLUSION In the general population, high TyG index was associated with future renal function decline. The TyG index may be useful in identifying individuals at high risk for future renal function decline in the setting of health checkups.
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Affiliation(s)
- Daisuke Yoshida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shota Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
- Cardiovascular Center, Steel Memorial Yawata Hospital, Fukuoka, Japan
| | - Keisuke Shinohara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | | | | | | | | | - Kensuke Toyama
- JA Ehime Kouseiren Checkup Center, Ehime, Japan
- Department of Pharmacology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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Babaahmadi-Rezaei H, Raeisizadeh M, Zarezade V, Noemani K, Mashkournia A, Ghaderi-Zefrehi H. Comparison of atherogenic indices for predicting the risk of metabolic syndrome in Southwest Iran: results from the Hoveyzeh Cohort Study (HCS). Diabetol Metab Syndr 2024; 16:112. [PMID: 38783371 PMCID: PMC11112906 DOI: 10.1186/s13098-024-01349-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a cluster of risk factors related to diabetes and cardiovascular disease (CVD). Given that early identification of MetS might decrease CVD risk, it is imperative to establish a simple and cost-effective method to identify individuals at risk of MetS. The purpose of this study was to explore the relationships between several atherogenic indices (including AIP, TyG index, non-HDL-C, LDL-c/HDL-c, and TC/HDL-c) and MetS, and to assess the ability of these indices to predict MetS. METHODS The present cross-sectional study was conducted using baseline data from 9809 participants of the Hoveyzeh Cohort Study (HCS). MetS was defined based on the International Diabetes Federation (IDF). To examine the discriminatory abilities of each atherogenic indices in the identification of MetS, a receiver-operating characteristic curve was conducted. Logistic regression analysis was also performed to evaluate the relationship between atherogenic indices and MetS. RESULTS All of the atherogenic indices including the TyG index, AIP, non-HDL-C, TC/HDL-c, and LDL-c/HDL-c were significantly higher in participants with MetS than in those without MetS. According to the ROC curve analysis, the TyG index revealed the highest area under the curve (0.79 and 0.85 in men and women, respectively), followed by the AIP (0.76 and 0.83 in men and women, respectively). The best cutoff values for the TyG index and AIP were 8.96 and 0.16 for men and 8.84 and 0.05 for women, respectively. The TyG index and AIP were also strongly associated with MetS. CONCLUSION Among the 5 atherogenic indices evaluated, the TyG index and AIP were strongly related to MetS. The TyG index also demonstrated superior discriminative ability compared to other atherogenic indices in predicting MetS.
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Affiliation(s)
- Hossein Babaahmadi-Rezaei
- Hyperlipidemia Research Center, Department of Clinical Biochemistry, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maedeh Raeisizadeh
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Kourosh Noemani
- Department of Disease Prevention and Control, Deputy of Health Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Mashkournia
- Department of Internal Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Ghaderi-Zefrehi
- Hyperlipidemia Research Center, Department of Clinical Biochemistry, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Zhang X, Wang Y, Li Y, Gui J, Mei Y, Yang X, Liu H, Guo LL, Li J, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Li J, Liu M, Hua Y, Zhang L. Optimal obesity- and lipid-related indices for predicting type 2 diabetes in middle-aged and elderly Chinese. Sci Rep 2024; 14:10901. [PMID: 38740846 DOI: 10.1038/s41598-024-61592-4] [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: 12/22/2023] [Accepted: 05/07/2024] [Indexed: 05/16/2024] Open
Abstract
To investigate the screening and predicting functions of obesity- and lipid-related indices for type 2 diabetes (T2D) in middle-aged and elderly Chinese, as well as the ideal predicted cut-off value. This study's data comes from the 2011 China Health and Retirement Longitudinal Study (CHARLS). A cross-sectional study design was used to investigate the relationship of T2D and 13 obesity- and lipid-related indices, including body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), visceral adiposity index (VAI), a body shape index (ABSI), body roundness index (BRI), lipid accumulation product (LAP), conicity index (CI), Chinese visceral adiposity index (CVAI), triglyceride- glucose index (TyG index) and its correlation index (TyG-BMI, TyG-WC, TyG-WHtR). The unadjusted and adjusted correlations between 13 indices and T2D were assessed using binary logistic regression analysis. The receiver operating characteristic curve (ROC) was used to determine the usefulness of anthropometric indices for screening for T2D and determining their cut‑off value, sensitivity, specificity, and area under the curve (AUC). The study comprised 9488 people aged 45 years or above in total, of whom 4354 (45.89%) were males and 5134 (54.11%) were females. Among them were 716 male cases of T2D (16.44%) and 870 female cases of T2D (16.95%). A total of 13 obesity- and lipid-related indices were independently associated with T2D risk after adjusted for confounding factors (P < 0.05). According to ROC analysis, the TyG index was the best predictor of T2D among males (AUC = 0.780, 95% CI 0.761, 0.799) and females (AUC = 0.782, 95% CI 0.764, 0.799). The AUC values of the 13 indicators were higher than 0.5, indicating that they have predictive values for T2D in middle-aged and elderly Chinese. The 13 obesity- and lipid-related indices can predict the risk of T2D in middle‑aged and elderly Chinese. Among 13 indicators, the TyG index is the best predictor of T2D in both males and females. TyG-WC, TyG-BMI, TyG-WHtR, LAP, and CVAI all outperformed BMI, WC, and WHtR in predicting T2D.
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Affiliation(s)
- Xiaoyun Zhang
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Ying Wang
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Yuqing Li
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Jiaofeng Gui
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Yujin Mei
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Xue Yang
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Lei-Lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Jinlong Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, People's Republic of China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China.
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10
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Ko YE, Kim HW, Park JT, Han SH, Kang SW, Sung S, Lee KB, Lee J, Oh KH, Yoo TH. Triglyceride-glucose index is an independent predictor of coronary artery calcification progression in patients with chronic kidney disease. Kidney Res Clin Pract 2024; 43:381-390. [PMID: 38738273 PMCID: PMC11181041 DOI: 10.23876/j.krcp.23.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Coronary artery calcification (CAC) is highly prevalent in patients with chronic kidney disease (CKD) and is associated with major adverse cardiovascular events and metabolic disturbances. The triglyceride-glucose index (TyGI), a novel surrogate marker of metabolic syndrome and insulin resistance, is associated with CAC in the general population and in patients with diabetes. This study investigated the association between the TyGI and CAC progression in patients with CKD, which is unknown. METHODS A total of 1,154 patients with CKD (grades 1-5; age, 52.8 ± 11.9 years; male, 688 [59.6%]) were enrolled from the KNOWCKD (KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease). The TyGI was calculated as follows: ln (fasting triglycerides × fasting glucose/2). Patients were classified into tertiles (low, intermediate, high) based on the TyGI. The primary outcome was annualized percentage change in CAC score [(percent change in CAC score + 1)12/follow-up months - 1] of ≥15%, defined as CAC progression. RESULTS During the 4-year follow-up, the percentage of patients with CAC progression increased across TyGI groups (28.6%, 37.5%, and 46.2% in low, intermediate, and high groups, respectively; p < 0.001). A high TyGI was associated with an increased risk of CAC progression (odds ratio [OR], 2.11; 95% confidence interval [CI], 1.14-3.88; p = 0.02) compared to the low group. Moreover, a 1-point increase in the TyGI was related to increased risk of CAC progression (OR, 1.55; 95% CI, 1.06-1.76; p = 0.02) after adjustment. CONCLUSION A high TyGI may be a useful predictor of CAC progression in CKD.
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Grants
- 2011E3300300, 2012E3301100, 2013E3301600, 2013 E3301601, 2013E3301602, 2016E3300200, 2016E3300201, 2016E3300202, 2019E320100, 2019E320101, 2019E320102, and 2022-11-007 Korea Disease Control and Prevention Agency
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Affiliation(s)
- Ye Eun Ko
- Department of Internal Medicine and Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyung Woo Kim
- Department of Internal Medicine and Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Tak Park
- Department of Internal Medicine and Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Hyeok Han
- Department of Internal Medicine and Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Shin-Wook Kang
- Department of Internal Medicine and Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suah Sung
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Kyu-Beck Lee
- Department of Internal Medicine, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joongyub Lee
- Department of Internal Medicine, Inje University Pusan Paik Hospital, Busan, Republic of Korea
| | - Kook-Hwan Oh
- Medical Research Collaborating Center, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine and Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - on behalf of the KNOW-CKD investigators
- Department of Internal Medicine and Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
- Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
- Department of Internal Medicine, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Inje University Pusan Paik Hospital, Busan, Republic of Korea
- Medical Research Collaborating Center, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Republic of Korea
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11
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Kurniawan LB. Triglyceride-Glucose Index As A Biomarker Of Insulin Resistance, Diabetes Mellitus, Metabolic Syndrome, And Cardiovascular Disease: A Review. EJIFCC 2024; 35:44-51. [PMID: 38706737 PMCID: PMC11063788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
The triglyceride-glucose (TyG) index is one of the parameters that have been used in assessing insulin resistance. Triglycerides and fasting blood glucose are two low-cost, common laboratory indicators that are used to compute the TyG index. This article reviews the link between the TyG index and several aspects concerning insulin resistance-related disorders and cardiovascular disease, as well as the use of various TyG index cutoffs in the above conditions with sensitivity and specificity, respectively, in various populations in the world.
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Affiliation(s)
- Liong Boy Kurniawan
- Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
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12
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Kim B, Taniguchi K, Isobe T, Oh S. Triglyceride-glucose index is capable of identifying metabolically obese, normal-weight older individuals. J Physiol Anthropol 2024; 43:8. [PMID: 38310267 PMCID: PMC10837892 DOI: 10.1186/s40101-024-00355-6] [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: 08/02/2023] [Accepted: 01/19/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND The concept of metabolically obese, normal weight (MONW) has emerged to describe individuals with a normal body mass index (BMI) who are at a relatively high risk of chronic diseases. However, BMI itself is a suboptimal index for the assessment of the health risks associated with visceral fat. The triglyceride-glucose (TyG) index is considered to be a reliable and cost-effective marker of insulin resistance. Therefore, in the present study, we aimed to determine the TyG index cut-off values that could be used to define MONW in older people and to determine the usefulness of these values for the prediction of chronic diseases. METHODS A total of 4,721 participants in the Korea National Health and Nutritional Examination Survey who were ≥ 60 years of age and did not have underweight or obesity were included. MONW was defined using the criteria for metabolic syndrome (MS), and the TyG index was calculated on the basis of the fasting plasma triglyceride and glucose concentrations. Chronic diseases, including T2DM, hypertension, and non-alcoholic fatty liver disease (NAFLD), were diagnosed. RESULTS The prevalence of MS increased from the lowest to the highest TyG index tertile. The cut-off values of the TyG index for MONW were calculated as 8.88 and 8.80 for males and females, respectively. MONW, defined using these cut-off values, was associated with high odds ratios for NAFLD, T2DM, and hypertension in both males and females. CONCLUSIONS The TyG index cut-off values calculated in the present study can be used to discriminate individuals with MONW from other older individuals without obesity and to predict the risk of chronic diseases. These findings show that the TyG index is an effective and cost-efficient method of assessing the risk of chronic diseases in people with MONW.
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Affiliation(s)
- Bokun Kim
- Future Convergence Research Institute, Changwon National University, Changwon, Republic of Korea
- Human Community Renovation Research Center, R Professional University of Rehabilitation, Tsuchiura, Ibaraki, Japan
| | - Keisuke Taniguchi
- Human Community Renovation Research Center, R Professional University of Rehabilitation, Tsuchiura, Ibaraki, Japan
- Faculty of Rehabilitation, R Professional University of Rehabilitation, 2-10-35 Kohoku, Tsuchiura, Ibaraki, 300-0032, Japan
| | - Tomonori Isobe
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Sechang Oh
- Human Community Renovation Research Center, R Professional University of Rehabilitation, Tsuchiura, Ibaraki, Japan.
- Faculty of Rehabilitation, R Professional University of Rehabilitation, 2-10-35 Kohoku, Tsuchiura, Ibaraki, 300-0032, Japan.
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
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13
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Tajima T, Kaga H, Someya Y, Tabata H, Naito H, Kakehi S, Ito N, Yamasaki N, Sato M, Kadowaki S, Sugimoto D, Nishida Y, Kawamori R, Watada H, Tamura Y. Low Handgrip Strength (Possible Sarcopenia) With Insulin Resistance Is Associated With Type 2 Diabetes Mellitus. J Endocr Soc 2024; 8:bvae016. [PMID: 38370441 PMCID: PMC10872678 DOI: 10.1210/jendso/bvae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Indexed: 02/20/2024] Open
Abstract
Context Older adults with sarcopenic obesity are at high risk for type 2 diabetes mellitus (T2DM). However, few East Asians have sarcopenic obesity. Since many East Asians have insulin resistance (IR) without obesity, it is possible that older East Asians with sarcopenia and IR might be at high risk for T2DM. However, this relationship has not been studied. Methods This cross-sectional study included 1629 older adults aged 65 to 84 years registered in the Bunkyo Health Study. All underwent a 75-g oral glucose tolerance test and handgrip strength measurement. Participants were classified into 4 groups by possible sarcopenia (handgrip strength <28 kg in men and <18 kg in women) and IR status (triglyceride glucose [TyG] index ≥8.79 for men and ≥8.62 for women [third quartile]). Modified Poisson regression was used to estimate relative risk (RR) and 95% CIs for T2DM with adjustment for confounding factors. Results The mean age was 73.1 ± 5.4 years. T2DM was diagnosed in 212 (13.0%) participants. After adjusting for age, sex, body mass index, use of lipid-lowering medications, hypertension, and cardiovascular disease, possible sarcopenia and IR were associated with T2DM, with their coexistence showing a notably stronger association (control: RR, 1.00 [Reference]; possible sarcopenia: RR, 1.55 [95% CI, 1.04-2.30]; IR: RR, 2.69 [95% CI, 1.99-3.65]; and IR possible sarcopenia: RR, 4.76 [95% CI, 3.34-6.79]). Conclusion Possible sarcopenia based on low handgrip strength and IR based on the TyG index are independently associated with T2DM in older Japanese individuals. Their coexistence shows a particularly strong association with T2DM.
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Affiliation(s)
- Tsubasa Tajima
- Department of Metabolism & Endocrinology, Juntendo University, Tokyo, 113-8421, Japan
| | - Hideyoshi Kaga
- Department of Metabolism & Endocrinology, Juntendo University, Tokyo, 113-8421, Japan
| | - Yuki Someya
- Sportology Center, Juntendo University, Tokyo, 113-8421, Japan
| | - Hiroki Tabata
- Sportology Center, Juntendo University, Tokyo, 113-8421, Japan
| | - Hitoshi Naito
- Department of Metabolism & Endocrinology, Juntendo University, Tokyo, 113-8421, Japan
| | - Saori Kakehi
- Sportology Center, Juntendo University, Tokyo, 113-8421, Japan
- Sports Medicine & Sportology, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
| | - Naoaki Ito
- Department of Metabolism & Endocrinology, Juntendo University, Tokyo, 113-8421, Japan
| | - Nozomu Yamasaki
- Department of Metabolism & Endocrinology, Juntendo University, Tokyo, 113-8421, Japan
| | - Motonori Sato
- Department of Metabolism & Endocrinology, Juntendo University, Tokyo, 113-8421, Japan
| | - Satoshi Kadowaki
- Department of Metabolism & Endocrinology, Juntendo University, Tokyo, 113-8421, Japan
| | - Daisuke Sugimoto
- Department of Metabolism & Endocrinology, Juntendo University, Tokyo, 113-8421, Japan
| | - Yuya Nishida
- Department of Metabolism & Endocrinology, Juntendo University, Tokyo, 113-8421, Japan
| | - Ryuzo Kawamori
- Department of Metabolism & Endocrinology, Juntendo University, Tokyo, 113-8421, Japan
- Sportology Center, Juntendo University, Tokyo, 113-8421, Japan
- Sports Medicine & Sportology, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University, Tokyo, 113-8421, Japan
- Sportology Center, Juntendo University, Tokyo, 113-8421, Japan
| | - Yoshifumi Tamura
- Department of Metabolism & Endocrinology, Juntendo University, Tokyo, 113-8421, Japan
- Sportology Center, Juntendo University, Tokyo, 113-8421, Japan
- Sports Medicine & Sportology, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
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14
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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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15
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Kim S, Lee JW, Lee Y, Song Y, Linton JA. Association between triglyceride-glucose index and low-density lipoprotein particle size in korean obese adults. Lipids Health Dis 2023; 22:94. [PMID: 37403101 DOI: 10.1186/s12944-023-01857-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/22/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Small dense low-density lipoprotein cholesterol (sdLDL-C) is the lipoprotein marker among the various lipoproteins that is most strongly related to atherosclerosis. Insulin resistance (IR) can alter lipid metabolism, and sdLDL-C is characteristic of diabetic dyslipidemia. Therefore, this study sought to inspect the relationship between the triglyceride-glucose (TyG) index and mean low-density lipoprotein (LDL) particle size. METHODS In this study, a total of 128 adults participated. The correlation coefficients between various lipoproteins and the TyG index were compared using Steiger's Z test and the Spearman correlation. The independent link between the TyG index and mean LDL particle size was demonstrated by multiple linear regression analysis. To identify the TyG index cutoff value for the predominance of sdLDL particles, receiver operating characteristic curves were plotted. RESULTS Mean LDL particle size correlated more strongly with the TyG index than did very low-density lipoprotein, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Regression analysis demonstrated that mean LDL particle size had a strong association with the TyG index (β coefficient = -0.038, P-value < 0.001). The TyG index optimal cutoff value for sdLDL particle predominance and the corresponding area under the curve (standard error: 0.028, 95% confidence interval: 0.842-0.952) were 8.72 and 0.897, respectively, which were close to the cutoff value of diabetes risk in Koreans. CONCLUSIONS Mean LDL particle size is more strongly correlated with the TyG index than do other lipid parameters. After correcting for confounding variables, mean LDL particle size is independently linked with the TyG index. The study indicates that the TyG index is strongly related to atherogenic sdLDL particles predominance.
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Affiliation(s)
- Sanghoon Kim
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, 06237, Republic of Korea
| | - Yaeji Lee
- Department of Biostatistics and Computing, Yonsei University, Seoul, 03722, Republic of Korea
| | - Youhyun Song
- Healthcare Research Team, Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 06273, Republic of Korea.
| | - John A Linton
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
- International Health Care Center, Severance Hospital, Yonsei University Health System, Seoul, 03722, Republic of Korea.
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16
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Kim B, Kim G, Lee Y, Taniguchi K, Isobe T, Oh S. Triglyceride-Glucose Index as a Potential Indicator of Sarcopenic Obesity in Older People. Nutrients 2023; 15:nu15030555. [PMID: 36771263 PMCID: PMC9920571 DOI: 10.3390/nu15030555] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
PURPOSE This population-based cross-sectional study aimed to determine whether the triglyceride-glucose index (TyG index) is associated with sarcopenic obesity (SO) and whether it would be a helpful indicator of SO. METHODS A total of 3821 participants aged ≥ 60 years were selected for the study group, and 4919 participants aged 20-39 years were included as a reference group. The participants were allocated to sarcopenia, obesity, and SO groups depending on if their body mass index (BMI) was ≥25 kg/m2 and their sarcopenia index was ≤1 standard deviation (SD) lower than the mean of the reference group. The sex-specific differences and trends among the participants were analyzed by using the TyG index tertiles, and appropriate cut-off values of the TyG index for SO were calculated. RESULTS As the TyG index increased, BMI increased, but the sarcopenia index decreased in both sexes. Males and females in the middle and highest tertiles of the TyG index were 1.775 and 3.369, and they were 1.993 and 3.157 times more likely to have SO, respectively. The cut-off values of the TyG index for SO in males and females were ≥8.72 and 8.67, respectively. CONCLUSION A high TyG index is positively associated with SO, and the TyG index may be considered a potential indicator of SO.
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Affiliation(s)
- Bokun Kim
- Department of Anti-Ageing Health Care, Changwon National University, Changwon 51140, Republic of Korea
- Future Convergence Research Institute, Changwon National University, Changwon 51140, Republic of Korea
| | - Gwonmin Kim
- Medical Research Institute, Pusan National University, Busan 46241, Republic of Korea
| | - Yongkook Lee
- Department of Leisure Sports, Seoil University, Seoul 02192, Republic of Korea
| | - Keisuke Taniguchi
- Department of Physical Therapy, AHRU Medical Care and Welfare Professional Training College, Tsuchiura 300-0032, Japan
| | - Tomonori Isobe
- Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Sechang Oh
- Faculty of Rehabilitation, R Professional University of Rehabilitation, Tsuchiura 300-0032, Japan
- Correspondence: ; Tel.: +81-29-824-7611
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17
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Moh MC, Cheng A, Tan CH, Low S, Tan BC, Ng D, Subramaniam T, Sum CF, Lim SC. Association of Baseline Triglyceride-Glucose Index with Poor Glycemic Control and Diabetes Remission After Metabolic Surgery. Obes Surg 2023; 33:164-172. [PMID: 36374378 DOI: 10.1007/s11695-022-06342-z] [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: 06/17/2022] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE The utility of insulin resistance (IR) as a predictor of diabetes remission after metabolic surgery is not well-defined. We assessed the association of baseline surrogate IR indices including triglyceride-glucose (TyG) index and homeostatic model assessment for IR (HOMA-IR) with glycemic control and diabetes remission after metabolic surgery. MATERIALS AND METHODS Patients with type 2 diabetes scheduled for metabolic surgery were recruited at a single-center (n = 149; age: 44 ± 10 years, 47.7% men, body mass index: 41.5 ± 7.5 kg/m2), and followed-up for 12 months postoperatively. The relationships between the IR indices and poor glycemic control (HbA1c ≥ 7%) at baseline or complete diabetes remission (HbA1c < 6% without glucose-lowering medications at 12 months) post-surgery were examined. RESULTS Elevated TyG index was associated with poor glycemic control cross-sectionally. Compared with non-remitters, lower baseline TyG index levels were observed in individuals with complete diabetes remission after surgery (P = 0.012); whereas HOMA-IR was not significantly different. Consistently, the proportion of diabetes non-remitters (compared to remitters) increased with increasing TyG tertiles from 1 to 3 (P = 0.015). Both TyG index (relative risk = 0.62, 95% CI = 0.42-0.91, P = 0.014) and TyG tertile 1 (relative risk = 1.99, 95% CI = 1.25-3.24, P = 0.003) independently predicted diabetes remission. The TyG index identified diabetes remission with an area under the curve of 0.68. The optimal TyG threshold was 9.41, yielding a sensitivity of 69.6%, specificity of 60.9%, positive predictive value of 64.0%, and negative predictive value of 66.7%. CONCLUSION TyG index, previously suggested to predominantly reflect muscle IR, outperforms HOMA-IR as an IR indicator associated with glycemic control and diabetes remission after metabolic surgery.
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Affiliation(s)
- Mei Chung Moh
- Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore
| | - Anton Cheng
- Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore.,General Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore.,Integrated Care for Obesity and Diabetes, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore
| | - Chun Hai Tan
- General Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore.,Integrated Care for Obesity and Diabetes, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore
| | - Serena Low
- Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore.,Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, 676 Woodlands Drive 71, #03-01, Singapore, 730676, Singapore
| | - Bo Chuan Tan
- General Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore.,Integrated Care for Obesity and Diabetes, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore
| | - Deborah Ng
- General Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore.,Integrated Care for Obesity and Diabetes, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore
| | - Tavintharan Subramaniam
- Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore.,Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, 676 Woodlands Drive 71, #03-01, Singapore, 730676, Singapore
| | - Chee Fang Sum
- Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, 676 Woodlands Drive 71, #03-01, Singapore, 730676, Singapore
| | - Su Chi Lim
- Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore. .,Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, 676 Woodlands Drive 71, #03-01, Singapore, 730676, Singapore. .,Saw Swee Hock School of Public Health, National University Hospital, 12 Science Drive 2, Singapore, 117549, Singapore. .,Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Singapore, 636921, Singapore.
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18
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Pereira A, Reyes M, Corvalán C, Espejo JP, Mericq V, Cifuentes M. Assessment of a consensus definition of obesity and metabolic health phenotypes in children at different pubertal stages. Sci Rep 2022; 12:21129. [PMID: 36477173 PMCID: PMC9729631 DOI: 10.1038/s41598-022-25771-5] [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] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022] Open
Abstract
Not all individuals with obesity develop metabolic complications, which has brought about the concepts of metabolically healthy and unhealthy obesity (MHO/MUO). However, inconsistent definitions of these conditions have limited their understanding. We assessed whether a recently-proposed consensus definition for MHO/MUO correlates with adiposity and reflects metabolic risk parameters during puberty. Low-middle income children from the Growth and Obesity Cohort Study (Santiago, Chile) were included (n = 949; 1692 visits at Tanner (T)2, T4 and/or one-year post menarche (1YPM)). Anthropometry, body composition and metabolic parameters were compared between MUO and MHO, and also in children without obesity. The risk for presenting MUO phenotype was significantly elevated with higher waist-height ratio (T2), zBMI (T2, T4), trunk fat, and C-reactive protein (T4). Elevated cardiometabolic indices were important predictors of the "unhealthy" phenotype allocation in children with or without obesity. Our observations suggest that the consensus definition in children at T2, T4 and 1YPM reflects metabolic risk and central obesity. Metabolic health phenotype allocation by this equation enables easy detection of risk factors that call for action to prevent long-term metabolic derangements in children with obesity and, importantly, also those without obesity.
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Affiliation(s)
- Ana Pereira
- Institute of Nutrition and Food Technology (INTA), Universidad de Chile, El Libano Macul, 5524, Santiago, Chile
| | - Marcela Reyes
- Institute of Nutrition and Food Technology (INTA), Universidad de Chile, El Libano Macul, 5524, Santiago, Chile
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), Universidad de Chile, El Libano Macul, 5524, Santiago, Chile
| | - Juan Pablo Espejo
- Institute of Nutrition and Food Technology (INTA), Universidad de Chile, El Libano Macul, 5524, Santiago, Chile
| | - Verónica Mericq
- Institute of Maternal and Child Research, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Mariana Cifuentes
- Institute of Nutrition and Food Technology (INTA), Universidad de Chile, El Libano Macul, 5524, Santiago, Chile.
- Advanced Center for Chronic Diseases (ACCDiS), Santiago, Chile.
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19
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Triglyceride-glucose index is associated with gastroesophageal reflux disease and erosive reflux disease: a health checkup cohort study. Sci Rep 2022; 12:20959. [PMID: 36470993 PMCID: PMC9722682 DOI: 10.1038/s41598-022-25536-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
The triglyceride-glucose (TyG) index was proposed as a useful marker of metabolic syndrome. Insulin resistance, the main mechanism underlying metabolic syndrome, is related to gastroesophageal reflux disease (GERD). This study aimed to elucidate the association between the TyG index and GERD/erosive reflux disease (ERD). We retrospectively reviewed the electronic medical records of patients who underwent gastroduodenoscopy at a checkup center. The calculation of TyG index used following formula: ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2). We divided the patients into four groups according to the TyG index quartile (Q). We evaluated the relationship between the alteration of the TyG index and GERD in patients who received health checkups two times. Among the 52,605 enrolled patients, 3073 (5.8%) and 434 (0.8%) were diagnosed with GERD and ERD, respectively. The odds ratios (ORs) for GERD in the TyG index progressively increased across quartiles (P < 0.001): Q2 (OR = 2.477), Q3 (OR = 3.013), and Q4 (OR = 4.027) compared with Q1, which was used as a reference, respectively. Those for ERD also progressively increased across quartiles (P < 0.001): Q2 (OR = 4.264), Q3 (OR = 4.841), and Q4 (OR = 7.390) compared with Q1, respectively. Moreover, the degree of TyG index increase during the first and second tests in the GERD group was more prominent than in the control group (P = 0.001). In conclusion, the higher TyG index was significantly associated with GERD. The TyG index may be a novel predictive biomarker of GERD and ERD.
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20
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Huang R, Cheng Z, Jin X, Yu X, Yu J, Guo Y, Zong L, Sheng J, Liu X, Wang S. Usefulness of four surrogate indexes of insulin resistance in middle-aged population in Hefei, China. Ann Med 2022; 54:622-632. [PMID: 35175162 PMCID: PMC8856080 DOI: 10.1080/07853890.2022.2039956] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Previous study have shown that lipid accumulation product (LAP), visceral adiposity index (VAI), triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C) and triglycerides/glucose index (TyG index) could be simple clinical indicators of insulin resistance (IR) based on anthropometric and/or biochemical parameters. However, the rational and preferred surrogate marker of IR in different population has yet to be validated. The aim of this study was evaluating the practicability of the LAP, VAI, TG/HDL-C, and TyG in predicting IR in middle-aged Chinese population. METHODS A cross-sectional study was conducted in 569 Chinese participants (mean age was 48.5; man 67.7%), and each participant completed a questionnaire survey, anthropometric measurement, and biochemical testing. One-way ANOVAs, Chi-squared test, Pearson's correlation, and multiple logistic regression were used to evaluate the association between VAI, LAP, TG/HDL-C, and TyG with IR. To correctly discriminate individuals with insulin resistance, a receiver operating characteristic (ROC) analysis was conducted for each evaluated variable and the overall diagnostic accuracy was quantified using the area under the ROC curve (AUC). The AUC of evaluated variables were compared using a nonparametric approach. The optimal cut-off points were determined by the Youden's index, and the corresponding sensitivity and specificity were provided. RESULTS Significant positive correlation was identified between HOMA-IR with TG/HDL-C (r = 0.306), VAI (r = 0.217), LAP (r = 0.381), and TyG (r = 0.371), respectively (all p < .001). After adjustment for potential confounders of IR, compared with the lowest tertiles, odds ratio (95% CI) having IR in the highest tertiles of TG/HDL-C, VAI, LAP and TyG were 6.07 (2.89-12.71), 10.89 (4.37-27.13), 4.68 (2.00-10.92), and 12.20 (5.04-29.56). The area under ROC curves to predict HOMA-diagnosed IR was 0.773 for TG/HDL-C, 0.767 for VAI, 0.806 for LAP, and 0.800 for TyG, respectively. Among those, LAP showed the greatest value of AUC [0.806 (0.763-0.850)] and highest specificity (0.804). CONCLUSION Compared with other indicators, the LAP and TyG are simple, relatively accurate, clinically available surrogate markers of insulin resistance in middle-aged population in Hefei, China. Among 4 evaluated parameters, the LAP have the highest specificity and the TyG have the highest sensitivity.Key MessagesLAP and TyG could be used as simple and alternative methods to identify the individuals at risk for insulin resistance.LAP and TyG have relatively high predictive ability in diagnosis of IR compared with VAI and TG/HDL-C.No significant difference is observed between LAP and TyG in the ability of predicting insulin resistance.
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Affiliation(s)
- Rui Huang
- School of Public Health, Anhui Medical University, Hefei, China
| | - Zi Cheng
- School of Public Health, Anhui Medical University, Hefei, China
| | - Xingyi Jin
- School of Public Health, Anhui Medical University, Hefei, China
| | - Xuemin Yu
- School of Public Health, Anhui Medical University, Hefei, China
| | - Jinhui Yu
- School of Public Health, Anhui Medical University, Hefei, China
| | - Yunpeng Guo
- Hongguang Street Community Health Service Center, Hefei, China
| | - Li Zong
- Hongguang Street Community Health Service Center, Hefei, China
| | - Jie Sheng
- School of Public Health, Anhui Medical University, Hefei, China
| | - Xing Liu
- Hongguang Street Community Health Service Center, Hefei, China
| | - Sufang Wang
- School of Public Health, Anhui Medical University, Hefei, China
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21
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The Correlation between the Triglyceride-Glucose Index and Coagulation Markers in Patients with Recent Acute Myocardial Infarction. DISEASE MARKERS 2022; 2022:6206802. [PMID: 36312588 PMCID: PMC9613396 DOI: 10.1155/2022/6206802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 11/17/2022]
Abstract
Background Metabolic abnormalities and hypercoagulability seem to have an important predictive role in patients with coronary artery disease (CAD). The triglyceride-glucose (TyG) index has emerged as a good marker for metabolic syndrome with predictive value for cardiovascular events. Overall haemostatic potential (OHP) is a reliable global haemostatic essay to identify hypercoagulability in CAD patients. The aim of our study was therefore to evaluate a possible correlation between the TyG index and haemostatic derangements in patients with CAD. Methods Consecutive patients referred for the first follow-up visit after acute myocardial infarction between December 1, 2018, and March 31, 2020, and did not meet exclusion criteria were included. We determined OHP, overall coagulation potential (OCP), overall fibrinolytic potential (OFP), fibrinogen, D-dimer, and von Willebrand factor from peripheral blood samples. The TyG index was calculated with the previously described and validated formula. Linear regression models were constructed for the multivariate analysis. Results A total of 117 patients (mean age 56 ± 10 years, 20% women) were included. A correlation was found between TyG index and OCP (r = 0.229, p = 0.026), TyG index and OHP (r = 0.202, p = 0.050), and TyG index and fibrinogen (r = 0.271, p = 0.005). In the multivariate model which accounted for sex, age, and BMI, the correlation between TyG index and OCP (R2 0.108; ANOVA for regression p = 0.035; beta 2.08 [0.79-4.01], p = 0.042) and between TyG index and fibrinogen (R2 0.11; ANOVA for regression p = 0.015; beta 0.35 [0.08-0.62], p = 0.012) emerged as statistically significant. Conclusion The TyG index, a marker of metabolic syndrome, has a strong correlation with a hypercoagulability state in CAD, as determined by the OCP and higher fibrinogen levels. Our findings suggest that metabolic syndrome may be an important driver of atherothrombotic risk in patients with CAD.
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22
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Primo D, Izaola O, de Luis DA. Triglyceride-Glucose Index Cutoff Point Is an Accurate Marker for Predicting the Prevalence of Metabolic Syndrome in Obese Caucasian Subjects. ANNALS OF NUTRITION & METABOLISM 2022; 79:238-245. [PMID: 36209727 DOI: 10.1159/000526988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/28/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Recently, the triglyceride-glucose (TyG) index has been suggested as a surrogate insulin resistance marker. This index could act as an early screening marker in individuals with a high risk of metabolic syndrome (MS) such as obese subjects. AIMS The objective of this work was to detect the cutoff point of the TyG index for the diagnosis of MS according to ATPIII criteria on obese subjects and to compare with HOMA-IR. METHODS We conducted a cross-sectional study in 1,494 obese subjects. Measurements of adiposity parameters, blood pressure, fasting blood glucose, insulin concentration, insulin resistance (HOMA-IR), lipid profile, C-reactive protein, adipokines, and the prevalence of MS were determined. The TyG index was calculated from the next equation: Ln (fasting triglycerides (mg/dL) × fasting glucose (mg/dL))/2. RESULTS A total of 1,494 subjects were recruited, 421 males (28.1%) and 1,073 females (71.8%), with an average age of 45.8 ± 15.3 years (range: 29-62). A total of 677 subjects had MS (45.5%) and 817 did not show MS (54.6%). The averages of HOMA-IR and TyG index values increased as the components of MS were aggregated, and both indexes were higher in subjects with MS. The area under the curve (AUC) of the TyG index according to ATPIII criteria showed values of 0.746 (0.721-0.771; p = 0.001). The cutoff point according to the Youden index was 4.72, with sensitivity and specificity of 87% and 88.2%, respectively. For the HOMA-IR, AUC showed values of 0.682 (0.654-0.710; p = 0.01). The cutoff point was 3.23, with sensitivity and specificity of 78% and 70.1%, respectively. CONCLUSIONS The TyG index is more powerful for predicting MS than HOMA-IR in Caucasian obese subjects.
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Affiliation(s)
- David Primo
- Endocrinology and Nutrition Department, Hospital Clínico Universitario de Valladolid, Investigation Centre on Endocrinology and Nutrition (IEN), University of Valladolid, Valladolid, Spain
| | - Olatz Izaola
- Endocrinology and Nutrition Department, Hospital Clínico Universitario de Valladolid, Investigation Centre on Endocrinology and Nutrition (IEN), University of Valladolid, Valladolid, Spain
| | - Daniel A de Luis
- Endocrinology and Nutrition Department, Hospital Clínico Universitario de Valladolid, Investigation Centre on Endocrinology and Nutrition (IEN), University of Valladolid, Valladolid, Spain
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23
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Prognostic significance of multiple triglycerides-derived metabolic indices in patients with acute coronary syndrome. J Geriatr Cardiol 2022; 19:456-468. [PMID: 35845160 PMCID: PMC9248272 DOI: 10.11909/j.issn.1671-5411.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Triglyceride (TG) and its related metabolic indices, all recognized as surrogates of insulin resistance, have been demonstrated to be relevant to clinical prognosis. However, the relative value of these TG-related indices for predicting cardiovascular events among patients with acute coronary syndrome (ACS) has not been examined. METHODS The TG, the triglyceride-glucose (TyG) index, the atherogenic index of plasma, TG to high-density lipoprotein cholesterol ratio, and the lipoprotein combine index were assessed in 1694 ACS patients undergoing percutaneous coronary intervention. The primary endpoint was major adverse cardiovascular event (MACE), which was the composite of all-cause mortality, stroke, myocardial infarction, or unplanned repeat revascularization. RESULTS During a median follow-up of 31 months, 345 patients (20.4%) had MACE. The risk of the MACE was increased with higher TG and the four TG-derived metabolic indices [TG-adjusted hazard ratio (HR) = 1.002, 95% CI: 1.001-1.003; TyG index-adjusted HR = 1.736, 95% CI: 1.398-2.156; atherogenic index of plasma-adjusted HR = 2.513, 95% CI: 1.562-4.043; TG to high-density lipoprotein cholesterol ratio-adjusted HR = 1.148, 95% CI: 1.048-1.258; and lipoprotein combine index-adjusted HR = 1.009, 95% CI: 1.004-1.014; P < 0.001 for all indices]. TG and all the four indices significantly improved the predictive ability for MACE in addition to the baseline model. Among them, TyG index showed the best ability for predicting MACE compared with the other three indices from all the three measurements ( P < 0.05 for all comparison). CONCLUSIONS TG and TG-derived metabolic indices were all strongly associated with MACE among ACS patients undergoing percutaneous coronary intervention. Among all the indices, TyG index showed the best ability to predict the risk of MACE.
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Fu X, Liu H, Liu J, Li N, Li L, Ke D, Liu M, Lu Y, Duan L, Ma L, Huo Y, Lei Q, Yan S. Association Between Triglyceride-Glucose Index and the Risk of Type 2 Diabetes Mellitus in an Older Chinese Population Aged Over 75 Years. Front Public Health 2022; 9:796663. [PMID: 35399348 PMCID: PMC8989963 DOI: 10.3389/fpubh.2021.796663] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/14/2021] [Indexed: 01/19/2023] Open
Abstract
Background The association between the triglyceride–glucose (TyG) index and type 2 diabetes mellitus (T2DM) in older adults has not been fully understood. This research aims to explore the association between the TyG index and the incidence of T2DM in an older Chinese population aged over 75 years. Methods This longitudinal analysis study was performed based on a database from a health check screening program in China. The participants were stratified based on the quintile ranges of the TyG index (Q1 to Q5 groups). T2DM was defined as fasting plasma glucose (FPG) ≥ 7.00 mmol/L and/or self-reported T2DM. The cumulative incidences of T2DM in various quintile groups were estimated by the Kaplan–Meier method. The Cox proportional hazard model was used to examine the independent impact of the TyG index on the risk of T2DM during the follow-up period. Subgroup analysis was performed by gender and BMI to further validate the credibility of the results. Results During the follow-up period, a total of 231 new-onset T2DM cases were recorded among the 2,571 individuals aged over 75 years. After adjusting confounding factors, elevated TyG index independently indicated a higher risk of T2DM (HR = 1.89; 95% CI, 1.47–2.44; p < 0.01). Higher TyG index quintile groups (Q3 to Q5) also presented with a higher risk of T2DM (hazard ratio (HR) = 1.36, 1.44, and 2.12, respectively) as compared with the lowest quintile group (Q1). Subgroup analysis showed that increased TyG index led to a higher risk of T2DM with HR = 2.35 (95% CI, 1.73–3.19), 1.90 (95% CI, 1.27–2.83), 2.95 (95% CI, 1.94–4.50), and 1.72 (95% CI, 1.25–2.35) in male subgroup, female subgroup, BMI < 24 kg/m2 subgroup, and BMI ≥ 24 kg/m2 subgroup, respectively. Conclusions Triglyceride–glucose index independently correlated with the risk of incident T2DM in Chinese adults aged over 75 years. The TyG index might be useful in monitoring T2DM in the older populations.
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Affiliation(s)
- Xiaomin Fu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hongzhou Liu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.,Department of Endocrinology, First Hospital of Handan City, Handan, China
| | - Jing Liu
- Clinics of Cadre, Department of Outpatient, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Nan Li
- Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Lele Li
- Department of Endocrinology, Genetics, Metabolism and Adolescent Medicine, National Center for Children's Health, Beijing Children's Hospital, The Capital Medical University, Beijing, China
| | - Dianshan Ke
- Department of Orthopedics, Fujian Provincial Hospital, Fuzhou, China
| | - Minyan Liu
- Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yanhui Lu
- Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Lihua Duan
- Department of Ultrasound Medicine, Handan Central Hospital, Handan, China
| | - Linlin Ma
- General Surgery Department 5, Handan Central Hospital, Handan, China
| | - Yanfei Huo
- Physical Examination Center, Handan Central Hospital, Handan, China
| | - Qinghua Lei
- Physical Examination Center, Handan Central Hospital, Handan, China
| | - Shuangtong Yan
- Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
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25
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Zhou Y, Yang G, Qu C, Chen J, Qian Y, Yuan L, Mao T, Xu Y, Li X, Zhen S, Liu S. Predictive performance of lipid parameters in identifying undiagnosed diabetes and prediabetes: a cross-sectional study in eastern China. BMC Endocr Disord 2022; 22:76. [PMID: 35331213 PMCID: PMC8952267 DOI: 10.1186/s12902-022-00984-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/08/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Dyslipidaemia is a risk factor for abnormal blood glucose. However, studies on the predictive values of lipid markers in prediabetes and diabetes simultaneously are limited. This study aimed to assess the associations and predictive abilities of lipid indices and abnormal blood glucose. METHODS A sample of 7667 participants without diabetes were enrolled in this cross-sectional study conducted in 2016, and all of them were classified as having normal glucose tolerance (NGT), prediabetes or diabetes. Blood glucose, blood pressure and lipid parameters (triglycerides, TG; total cholesterol, TC; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C; non-high-density lipoprotein cholesterol, non-HDL-C; and triglyceride glucose index, TyG) were evaluated or calculated. Logistic regression models were used to analyse the association between lipids and abnormal blood glucose. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to assess the discriminatory power of lipid parameters for detecting prediabetes or diabetes. RESULTS After adjustment for potential confounding factors, the TyG was the strongest marker related to abnormal blood glucose compared to other lipid indices, with odds ratios of 2.111 for prediabetes and 5.423 for diabetes. For prediabetes, the AUCs of the TG, TC, HDL-C, LDL-C, TC/HDL-C, TG/HDL-C, non-HDL-C and TyG indices were 0.605, 0.617, 0.481, 0.615, 0.603, 0.590, 0.626 and 0.660, respectively, and the cut-off points were 1.34, 4.59, 1.42, 2.69, 3.39, 1.00, 3.19 and 8.52, respectively. For diabetes, the AUCs of the TG, TC, HDL-C, LDL-C, TC/HDL-C, TG/HDL-C, non-HDL-C and TyG indices were 0.712, 0.679, 0.440, 0.652, 0.686, 0.692, 0.705, and 0.827, respectively, and the cut-off points were 1.35, 4.68, 1.42, 2.61, 3.44, 0.98, 3.13 and 8.80, respectively. CONCLUSIONS The TyG, TG and non-HDL-C, especially TyG, are accessible biomarkers for screening individuals with undiagnosed diabetes.
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Affiliation(s)
- Yimin Zhou
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China
| | - Guoping Yang
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Chen Qu
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Jiaping Chen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China
| | - Yinan Qian
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China
| | - Lei Yuan
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China
| | - Tao Mao
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Yan Xu
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Xiaoning Li
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China
| | - Shiqi Zhen
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China.
| | - Sijun Liu
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China.
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Jung DH, Park B, Lee YJ. Relationship of the Triglyceride-Glucose Index with Subclinical White Matter Hypersensitivities of Presumed Vascular Origin Among Community-Dwelling Koreans. Int J Gen Med 2022; 15:603-608. [PMID: 35068939 PMCID: PMC8766995 DOI: 10.2147/ijgm.s346997] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/07/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose The triglyceride-glucose (TyG) index, a widely accessible measure, has been a surrogate indicator of peripheral insulin resistance, and its clinical importance continues to grow in East Asia. We hypothesized that the TyG index is relevant to subclinical white matter hypersensitivities (WMHs) of presumed vascular origin among community-dwelling Koreans. Methods We investigated the relationship between the TyG index and WMHs on brain magnetic resonance imaging scans in 2417 Koreans over 45 years of age without a history of cancer, stroke, or ischemic heart disease. The study population was divided into four groups according to the TyG index quartiles. Using multiple logistic regression analysis, we assessed the odds ratios (ORs) and 95% confidence intervals (95% CIs) for WMHs across the TyG index quartiles. Results The prevalence of WMHs was significantly higher in the fourth TyG index quartile, with an overall rate of 9.3%. After adjusting for potential confounding variables, the ORs of WMHs for the TyG index quartiles were 1.00, 1.47 (95% CI, 0.91–2.40), 1.76 (95% CI, 1.05–2.97), and 6.79 (95% CI, 3.85–1.54), respectively. Conclusion We found that higher TyG index values were associated with the brain’s WMHs of presumed vascular origin. Our findings suggest that the serum TyG index could be an additional valuable biomarker for assessing the risk of cerebral small vessel disease in the preclinical stage.
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Affiliation(s)
- Dong-Hyuk Jung
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Byoungjin Park
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
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Guo Q, Feng X, Zhang B, Zhai G, Yang J, Liu Y, Liu Y, Shi D, Zhou Y. Influence of the Triglyceride-Glucose Index on Adverse Cardiovascular and Cerebrovascular Events in Prediabetic Patients With Acute Coronary Syndrome. Front Endocrinol (Lausanne) 2022; 13:843072. [PMID: 35295991 PMCID: PMC8920560 DOI: 10.3389/fendo.2022.843072] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/26/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cardiovascular disease and insulin resistance are closely related. The triglyceride-glucose (TyG) index is frequently used as an indicator of insulin resistance. However, there is scant information on the TyG index in the prediabetic population, nor is the prognostic significance of the index known for prediabetes and acute coronary syndrome (ACS) patients. METHODS The clinical endpoint was a major adverse cardiovascular and cerebrovascular event (MACCEs), including cardiac-related death, non-fatal myocardial infarction, ischemia-driven revascularization, and stroke. The TyG index was calculated as = ln [(triglyceride level, mg/dL) × (glucose level, mg/dL)÷2] under fasting conditions. RESULTS The study included 2,030 prediabetic patients with ACS. Patients were followed up for 2.5 years, during which the total incidence of MACCEs was 12%. After adjustment for covariates, the TyG index was found to be predictive of prediabetes with ACS (HR 4.942, 95%CI: 3.432-6.115, P<0.001). Using propensity score matching, 574 pairs were successfully matched, and the two groups were analyzed in terms of survival. This showed that there was a significantly greater incidence of MACCEs in patients with high TyG indices (HR 3.526, 95%CI: 2.618-4.749, P<0.001), mainly due to ischemia-driven revascularization and stroke. CONCLUSIONS The TyG index independently predicts future MACCEs and may be an important prognostic indicator for patients with prediabetes and ACS.
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Affiliation(s)
- Qianyun Guo
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Xunxun Feng
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Bin Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Guangyao Zhai
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Jiaqi Yang
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Yang Liu
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Yuyang Liu
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Dongmei Shi
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
- *Correspondence: Yujie Zhou, ; Dongmei Shi,
| | - Yujie Zhou
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
- *Correspondence: Yujie Zhou, ; Dongmei Shi,
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Malek M, Khamseh ME, Chehrehgosha H, Nobarani S, Alaei-Shahmiri F. Triglyceride glucose-waist to height ratio: a novel and effective marker for identifying hepatic steatosis in individuals with type 2 diabetes mellitus. Endocrine 2021; 74:538-545. [PMID: 34355342 DOI: 10.1007/s12020-021-02815-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/29/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The triglyceride-glucose index (TyG), and TyG-driven parameters incorporating TyG and obesity indices have been proposed as reliable indicators of insulin resistance and its related comorbidities. This study evaluated the effectiveness of these indices in identifying hepatic steatosis in individuals with Type 2 diabetes (T2DM). METHODS This was a cross-sectional study consisting of 175 patients with T2DM (122 with and 53 without NAFLD). TyG index, triglyceride glucose-body mass index (TyG-BMI), triglyceride glucose-waist circumference (TyG-WC), and triglyceride glucose-waist-to-height ratio (TyG-WHtR) were determined using standard formulas. Controlled attenuation parameter (CAP) was measured by transient elastography (FibroScan). RESULTS Among obesity parameters, CAP showed the strongest correlation with WHtR, followed by BMI and WC (all P < 0.001). Regression analyses demonstrated TyG-WHtR as a significant predictor of NAFLD with the highest odds ratio, reaching 10.69 (95% CI: 1.68-68.22) for the top quartile (Q4) compared to the first quartile (P = 0.01), followed by TyG-BMI (Q4: 6.75; 95% CI: 1.49-30.67) and TyG-WC (Q4: 5.90; 95% CI: 0.99-35.18). Moreover, TyG-WHtR presented the largest AUC for detection of NAFLD (0.783, P < 0.001) in ROC analysis, followed by TyG-BMI (AUC: 0.751, P < 0.001), TyG-WC (AUC: 0.751, P < 0.001), and TyG (AUC: 0.647, P = 0.002). TyG-WHtR value of 5.58 (sensitivity: 79%, specificity: 68%, P < 0.001) was the best cut-off point to identify hepatic steatosis in this population. CONCLUSIONS This study confirmed that the TyG-related indices comprising TyG and obesity parameters can identify hepatic steatosis more successfully than TyG alone. Furthermore, our results highlighted TyG-WHtR as a simple and effective marker for screening fatty liver in patients with T2DM, which may be used practically in clinical setting.
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Affiliation(s)
- Mojtaba Malek
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mohammad E Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Haleh Chehrehgosha
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Sohrab Nobarani
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Fariba Alaei-Shahmiri
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran.
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Pranata R, Huang I, Lim MA, Vania R. The association between triglyceride-glucose index and the incidence of type 2 diabetes mellitus-a systematic review and dose-response meta-analysis of cohort studies. Endocrine 2021; 74:254-262. [PMID: 34086260 DOI: 10.1007/s12020-021-02780-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/25/2021] [Indexed: 01/29/2023]
Abstract
ABSTARCT AIMS: We aimed to assess the dose-response relationship between triglyceride-glucose (TyG) index and the incidence of type 2 diabetes mellitus (T2DM). METHODS We performed a comprehensive systematic literature search using PubMed, Scopus, and Embase for records published from inception until 9 February 2021. The effect estimates were reported as relative risks (RRs). RESULTS 270,229 subjects from 14 studies were included in this systematic review and meta-analysis. The pooled incidence of T2DM was 9%. Meta-regression analysis indicates that baseline age (coefficient: 0.67, p = 0.026), drinking (coefficient: 0.03, p = 0.035), and HDL (coefficient: -0.89, p = 0.035) affected the incidence of T2DM in future. High TyG index was associated with increased incidence of T2DM in pooled unadjusted (RR 4.68 [3.01, 7.29], p < 0.001; I2: 96.6%) and adjusted model (adjusted RR 3.54 [2.75, 4.54], p < 0.001; I2: 83.7%). Dose-response meta-analysis for the adjusted RR showed that the linear association analysis was not significant per 0.1 increase in TyG index (RR 1.01 [0.99, 1.03], p = 0.223). There is a non-linear trend (p < 0.001) for the association between TyG index and incidence of T2DM. The dose-response curve became increasingly steeper at TyG index above 8.6. CONCLUSIONS TyG index was associated with the incidence of T2DM in a non-linear fashion.
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Affiliation(s)
- Raymond Pranata
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia.
| | - Ian Huang
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
- Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia
| | | | - Rachel Vania
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
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Guo Y, Zhao J, Zhang Y, Wu L, Yu Z, He D, Huang H, Qu W, Luo X. Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients. BMC Neurol 2021; 21:409. [PMID: 34702218 PMCID: PMC8549262 DOI: 10.1186/s12883-021-02443-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/18/2021] [Indexed: 12/23/2022] Open
Abstract
Aim Insulin resistance was reported to increase the risk of ischemic stroke, which can be assessed by the triglyceride glucose (TyG) index. However, it remains unclear whether the TyG index influences the platelet reactivity during the treatment of ischemic patients. Methods Ischemic stroke patients receiving dual antiplatelet therapy (DAPT) within 48 h onset were consecutively included. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The top quartile of TyG index was defined as insulin resistance. The platelet reactivity was assessed by thromboelastography. The platelet inhibition rate induced by arachidonic acid (AA) or adenosine diphosphate (ADP) was used to confirm the high residual on-treatment platelet reactivity (HRPR) to aspirin or clopidogrel, respectively. The association between TyG index and platelet reactivity was assessed by Kruskal–Wallis test. The independent risk factors of HRPR were determined by multivariate logistic regression analysis. Results A total of 1002 patients were included and divided into 4 groups by quartiles of the TyG index (< 2.02; 2.02–2.27; 2.27–2.52; ≥2.52). The findings demonstrated that the maximum intensity of the clot increased, but the AA-induced platelet inhibition rate decreased, depending on the TyG index quartiles. No significant difference was found in the ADP-induced platelet inhibition rate among groups. The prevalence of aspirin HRPR increased depending on the TyG index quartile. Unlike the non-insulin resistance group, the insulin resistance group was independently associated with aspirin HRPR (OR = 1.689, 95% CI 1.14 to 2.51, P = 0.009). Conclusions In acute ischemic stroke patients taking DAPT, the elevation of the TyG index is associated with enhanced platelet reactivity and higher prevalence of aspirin HRPR. Insulin resistance assessed by the TyG index could be an independent risk factor for aspirin HRPR.
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Affiliation(s)
- Yinping Guo
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Jing Zhao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Yi Zhang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Lingshan Wu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Zhiyuan Yu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Dan He
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, Guangdong, China
| | - Hao Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Wensheng Qu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
| | - Xiang Luo
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
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Park HM, Lee HS, Lee YJ, Lee JH. The triglyceride-glucose index is a more powerful surrogate marker for predicting the prevalence and incidence of type 2 diabetes mellitus than the homeostatic model assessment of insulin resistance. Diabetes Res Clin Pract 2021; 180:109042. [PMID: 34506839 DOI: 10.1016/j.diabres.2021.109042] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/28/2021] [Accepted: 09/02/2021] [Indexed: 01/22/2023]
Abstract
AIMS Insulin resistance is an independent risk factor for developing type 2 diabetes. Therefore, this study compared the predictability of the triglyceride-glucose (TyG) index and the homeostatic model assessment of insulin resistance (HOMA-IR) for the prevalence and incidence of type 2 diabetes. METHODS We analyzed data from 9730 adults aged 40-69 years at baseline and 7783 participants without diabetes who were followed up in the Korean Genome and Epidemiology Study survey. From 2001 to 2002 (baseline survey) to 2013-2014, this survey was conducted biennially (six follow-ups). The average follow-up period was 9.0 years. RESULTS The TyG index showed better predictability for the prevalence of type 2 diabetes than HOMA-IR (TyG index: 0.784, HOMA-IR: 0.728, p < 0.001). The area under the time-dependent receiver operating characteristic curve of the TyG index for incident type 2 diabetes was 0.640 (0.628-0.652), which was significantly higher than that of HOMA-IR [0.531 (0.521-0.541)] (p < 0.001). CONCLUSIONS The TyG index is superior to HOMA-IR for predicting type 2 diabetes. The TyG index could, therefore, be more useful for the early detection and prevention of type 2 diabetes.
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Affiliation(s)
- Hye Min Park
- Department of Family Medicine, Chaum Medical Checkup Center Samseongdong Branch, Cha University, Seoul 06125, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Republic of Korea
| | - Jun-Hyuk Lee
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, Republic of Korea.
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Choi W, Park JY, Hong AR, Yoon JH, Kim HK, Kang HC. Association between triglyceride-glucose index and thyroid function in euthyroid adults: The Korea National Health and Nutritional Examination Survey 2015. PLoS One 2021; 16:e0254630. [PMID: 34264998 PMCID: PMC8281995 DOI: 10.1371/journal.pone.0254630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/30/2021] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES Low-normal thyroid function is associated with numerous metabolic risk factors including insulin resistance (IR). Triglyceride-glucose (TyG) index is a new surrogate marker of IR calculated by fasting triglyceride and glucose levels. Here, we investigated the association between thyroid function and TyG index in non-diabetic euthyroid adults. METHODS This cross-sectional study was based on data from the Korean National Health and Nutritional Examination Survey 2015 including 1482 individuals (741 men and 741 women). Serum thyrotropin (TSH) and free thyroxine (fT4) levels were measured. RESULTS After adjusting for confounders, there was an inverse relationship of TyG index with fT4 in men (β = -0.094, P = 0.009) and a positive relationship of TyG index with TSH in women (β = 0.078, P = 0.018). The lowest fT4 tertile in men (P = 0.001) and the highest TSH tertile in women (P = 0.010) exhibited increased TyG index after adjusting for confounders. The lowest fT4 tertile also showed increased homeostatic model assessment for IR (HOMA-IR) only in men (P = 0.006). Odds ratios (ORs) for the high TyG index, which was defined as the highest TyG quartile decreased in the highest and second highest tertile of fT4 in men (OR = 0.41 and OR = 0.45, respectively; P < 0.001) and increased in highest tertile of TSH in women (OR = 1.81, P = 0.031) after adjusting for confounders. The OR for high HOMA-IR defined as the highest HOMA-IR quartile was also lower in the highest and second highest fT4 tertiles in men (both OR = 0.47; P = 0.003). CONCLUSIONS This is the first study to suggest that TyG index is a good surrogate marker of IR in evaluating its relationship with thyroid function.
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Affiliation(s)
- Wonsuk Choi
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ji Yong Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - A. Ram Hong
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jee Hee Yoon
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hee Kyung Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ho-Cheol Kang
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
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Wu Z, Wang J, Li Z, Han Z, Miao X, Liu X, Li X, Wang W, Guo X, Tao L. Triglyceride glucose index and carotid atherosclerosis incidence in the Chinese population: A prospective cohort study. Nutr Metab Cardiovasc Dis 2021; 31:2042-2050. [PMID: 34045133 DOI: 10.1016/j.numecd.2021.03.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS The association of the triglyceride glucose (TyG) index with carotid atherosclerosis has not been reported in longitudinal studies. The present study aimed to investigate whether the TyG index increases the risk of carotid atherosclerosis incidence. METHODS AND RESULTS This study included data from the Beijing Health Management Cohort (BHMC; n = 6955) and the Beijing Physical Examination Cohort (BPEC; n = 8473). Participants without a history of carotid atherosclerosis who underwent health examination in 2011 or 2012 were annually followed until 2019. The TyG index was denoted as ln [triglycerides (mmol/L)∗fasting glucose (mmol/L)/2]. During a median follow-up of 5.02 years and 5.36 years, 1441 individuals in the BHMC group and 2181 individuals in the BPEC group developed carotid plaque, respectively. The adjusted hazard ratios (HRs) of the continuous TyG index were 1.253 (95% CI, 1.044 to 1.505) and 1.252 (95% CI, 1.091 to 1.437) for the BHMC and BPEC groups, respectively. Individuals in the highest quartile of the TyG index were associated with an increased risk of carotid plaque compared with those in the lowest quartile (BHMC: HR, 1.366; 95% CI, 1.101 to 1.695, P for trend = 0.010; BPEC: HR, 1.379; 95% CI, 1.196 to 1.591, P for trend = 0.013). CONCLUSION These findings suggested that a higher TyG index increases the risk of carotid atherosclerosis incidence in the general population.
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Affiliation(s)
- Zhiyuan Wu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Department of Public Health, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
| | - Jinqi Wang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
| | - Zhiwei Li
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
| | - Ze Han
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
| | - Xinlei Miao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
| | - Xiangtong Liu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia.
| | - Wei Wang
- Department of Public Health, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
| | - Xiuhua Guo
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
| | - Lixin Tao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
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Sanlialp SC. Points to Be Resolved Regarding the Use of the Triglyceride Glucose Index for Cardiovascular Disease. Angiology 2021; 72:1001-1002. [PMID: 34189954 DOI: 10.1177/00033197211028429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Lin HY, Zhang XJ, Liu YM, Geng LY, Guan LY, Li XH. Comparison of the triglyceride glucose index and blood leukocyte indices as predictors of metabolic syndrome in healthy Chinese population. Sci Rep 2021; 11:10036. [PMID: 33976344 PMCID: PMC8113526 DOI: 10.1038/s41598-021-89494-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/21/2021] [Indexed: 02/08/2023] Open
Abstract
Triglyceride glucose (TyG) index and inflammatory markers are reported to have a positive association with metabolic syndrome (MetS). However, no previous study has assessed the value of TyG index and inflammatory markers as predictors of metabolic syndrome in the same study. This study looks at the comparison of the triglyceride index and blood leukocyte indices as predictors of metabolic syndrome in the Chinese population. The study cohort involved 1542 Chinese population without metabolic syndrome. The subjects underwent comprehensive routine health examination in 2011 and returned for a follow-up examination in 2016. Metabolic syndrome was defined according to Chinese Diabetes Society criteria, using body mass index for the replacement of waist circumference. TyG index, total leukocytes, neutrophils, lymphocytes, and neutrophil-to-lymphocyte ratio (NLR) were measured. Adjust d logistic models were used to assess the relationship between TyG index, blood leukocyte indices, and incident MetS. Receiver operating characteristic (ROC) curves were performed to determine the predictive value of TyG index and blood leukocyte indices for MetS. Results from multivariate logistic regression analysis showed that, in the adjusted model, the subjects with the highest quartile of TyG index and neutrophils had a 3.894- and 1.663-fold increased incidence of MetS (P < 0.0001 and P = 0.027), respectively. No significant association was observed between total leukocytes, lymphocytes, NLR with incident MetS. ROC analysis showed that the AUC of TyG index and neutrophils were 0.674 and 0.568 for incident MetS, respectively. TyG index rather than blood leukocyte indices may have the strongest predictive value in MetS development over a 5-year period.
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Affiliation(s)
- Hai-Yan Lin
- Health Management Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Xiu-Juan Zhang
- Health Management Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Yu-Mei Liu
- Health Management Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Ling-Yun Geng
- Health Management Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Li-Ying Guan
- Health Management Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Xiao-Hong Li
- Health Management Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
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Baek W, Lee JW, Lee HS, Han D, Choi SY, Chun EJ, Han HW, Park SH, Sung J, Jung HO, Lee H, Chang HJ. Concurrent smoking and alcohol consumers had higher triglyceride glucose indices than either only smokers or alcohol consumers: a cross-sectional study in Korea. Lipids Health Dis 2021; 20:49. [PMID: 33975592 PMCID: PMC8111749 DOI: 10.1186/s12944-021-01472-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 04/20/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The triglyceride glucose (TyG) index is a noninsulin-based marker for insulin resistance (IR) in general practice. Although smoking and heavy drinking have been regarded as major risk factors for various chronic diseases, there is limited evidence regarding the combined effects of smoking and alcohol consumption on IR. This study aimed to investigate the relationship between the TyG index and smoking and alcohol consumption using two Korean population-based datasets. METHODS This study included 10,568 adults in the Korean National Health and Nutrition Examination Survey (KNHANES) and 9586 adults in the Korean Initiatives on Coronary Artery Calcification (KOICA) registry datasets. Multivariate logistic analysis was conducted to explore the relationship between smoking and alcohol consumption and the TyG index. To assess the predictive value of smoking and alcohol consumption on high TyG index, the area under the curve (AUC) were compared and net reclassification improvement (NRI) and integrated discrimination improvement (IDI) analyses were derived. RESULTS The combined effect of smoking and alcohol consumption was an independent risk factor of a higher TyG index in the KNHANES (adjusted odds ratio: 4.33, P < .001) and KOICA (adjusted odds ratio: 1.94, P < .001) datasets. Adding smoking and alcohol consumption to the multivariate logistic models improved the model performance for the TyG index in the KNHANES (AUC: from 0.817 to 0.829, P < .001; NRI: 0.040, P < .001; IDI: 0.017, P < .001) and KOICA (AUC: from 0.822 to 0.826, P < .001; NRI: 0.025, P = .006; IDI: 0.005, P < .001) datasets. CONCLUSIONS Smoking and alcohol consumption were independently associated with the TyG index. Concurrent smokers and alcohol consumers were more likely to have a TyG index that was ≥8.8 and higher than the TyG indices of non-users and those who exclusively consumed alcohol or smoking tobacco.
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Affiliation(s)
- Wonhee Baek
- Department of Nursing, Yonsei University Graduate School, Seoul, Republic of Korea.,Department of Nursing, Kyungnam University College of Health Sciences, Changwon, Republic of Korea
| | - Ji-Won Lee
- Department of Family Medicine, Yonsei University College of Medicine Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Donghee Han
- Department of Imaging and Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Su-Yeon Choi
- Division of Cardiology, Seoul National University Healthcare System Gangnam Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Ju Chun
- Department of Radiology, Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Hae-Won Han
- Department of Internal Medicine, Gangnam Heartscan Clinic, Seoul, Republic of Korea
| | - Sung Hak Park
- Department of Radiology, Gangnam Heartscan Clinic, Seoul, Republic of Korea
| | - Jidong Sung
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Heart Stroke and Vascular Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Hae Ok Jung
- Division of Cardiology, Cardiovascular Center, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyangkyu Lee
- Department of Nursing, Yonsei University Graduate School, Seoul, Republic of Korea. .,Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Hyuk-Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea.
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Tarantino G, Crocetto F, Di Vito C, Creta M, Martino R, Pandolfo SD, Pesce S, Napolitano L, Capone D, Imbimbo C. Association of NAFLD and Insulin Resistance with Non Metastatic Bladder Cancer Patients: A Cross-Sectional Retrospective Study. J Clin Med 2021; 10:jcm10020346. [PMID: 33477579 PMCID: PMC7831331 DOI: 10.3390/jcm10020346] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/09/2021] [Accepted: 01/13/2021] [Indexed: 01/28/2023] Open
Abstract
Among risk factors (apart from smoking) likely involved in bladder cancer (BCa), metabolic syndrome (MS), obesity and type 2 diabetes mellitus (T2DM) have been explored with contrasting results. In spite of these studies, there is little data on the association between nonalcoholic fatty liver disease (NAFLD), its main driver, i.e., insulin resistance (IR), and BCa. Implanting a cross-sectional retrospective study we tried to investigate both NAFLD and IR prevalence in a hospital based population of BCa patients. We studied laboratory data from 204 patients with histologically confirmed non metastatic BCa and 50 subjects with no BCa, but with bladder diseases (no Ca BD). We evaluated the presence of NAFLD by the triglycerides/glucose Index (TyG Index), using a cut-off of 0.59 and by the Aspartate Aminotransferase/Alanine Aminotransferase AST/ALT ratio. IR was assessed by the same TyG Index (cut-off 4.68) and the triglycerides/High-Density Lipoprotein HDL ratio (cut-off 2.197). The diagnosis of impaired fasting glucose (IFG), condition of prediabetes, as well as that of T2DM was assessed according to canonical guidelines. The TyG Index predicted NAFLD presence in both groups (p = 0.000), but the BCa group showed a major percentage of NAFLD cases with respect to no Ca BD group (59% versus 40%). A greater proportion of IR (47%) in BCa group than in no Ca BD one (37%) was evidenced by the TyG Index with its median value significantly different (p = 0.0092). This high rate of IR in the BCa group was confirmed by the triglycerides/HDL ratio (p = 0.02). Prediabetes and T2DM were more prevalent in the BCa group than no Ca BD group (p = 0.024). In this study a consistent NAFLD presence was found in BCa patients. This is an important comorbidity factor that deserves further consideration in prospective studies. The higher prevalence of NAFLD, IR, prediabetes and T2DM in the BCa group evidences the need that these disorders should be reckoned as adjunct factors that could impact on this cancerous disease.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II Medical School, Via S. Pansini 5, 80131 Naples, Italy
- Correspondence:
| | - Felice Crocetto
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Concetta Di Vito
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Massimiliano Creta
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Raffaele Martino
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Savio Domenico Pandolfo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Salvatore Pesce
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Luigi Napolitano
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
| | - Domenico Capone
- Clinical Pharmacology Consultant, Via Volturno 27, 80026 Naples, Italy;
| | - Ciro Imbimbo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Via S. Pansini 5, 80131 Naples, Italy; (F.C.); (C.D.V.); (M.C.); (R.M.); (S.D.P.); (S.P.); (L.N.); (C.I.)
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Association between Triglyceride-Glucose Index and Type 2 Diabetes Mellitus in the Japanese Population: A Secondary Analysis of a Retrospective Cohort Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2947067. [PMID: 33490240 PMCID: PMC7787715 DOI: 10.1155/2020/2947067] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/23/2022]
Abstract
Triglyceride-glucose index (TyG index) is associated with type 2 diabetes mellitus (T2DM), but research on this relationship is limited in Japan. The purpose of this study was to evaluate the correlation between TyG index and the risk of T2DM in the Japanese population. Here, 12732 participants were selected from the NAGALA study (NAfld in the Gifu Area, Longitudinal Analysis) conducted between 2004 and 2015 for a retrospective cohort analysis. The association between TyG index and T2DM was assessed using the Cox proportional-hazard model. Subgroup analyses were conducted according to age, sex, smoking status, alcohol consumption, waist circumference, BMI, and follow-up duration. The formula for TyG index was expressed as ln [fasting triglyceride level (mg/dL) × fasting plasma glucose level (mg/dL)/2]. After follow-up, 150 (1.18%) patients developed T2DM. After adjusting for potential confounders, a linear relationship was observed between TyG and the risk of T2DM. After adjusting for age, sex, BMI, waist circumference, HDL-cholesterol, total cholesterol, systolic blood pressure, regular exercise, smoking status, and alcohol consumption, TyG index, as a continuous variable, was associated with an increased risk of T2DM (adjusted hazard ratio (aHR), 1.79; 95% confidence interval (95% CI), 1.25-2.57). Compared with the first quartile of TyG index, subjects in the fourth quartile were 2.33-fold more likely to develop T2DM (aHR 2.33, 95% CI 1.09-4.96; P for trend 0.0224). Subgroup analyses showed that the association between TyG index and incident T2DM stably existed in different subgroups according to the variables tested. Therefore, TyG index was linearly related to the risk of incident T2DM in the Japanese population and may be used as a monitoring tool.
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Banitalebi E, Mardaniyan Ghahfarrokhi M, Faramarzi M, Earnest CP. Sprint interval training vs. combined aerobic + resistance training in overweight women with type 2 diabetes. J Sports Med Phys Fitness 2020; 61:712-724. [PMID: 33269876 DOI: 10.23736/s0022-4707.20.11105-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Aerobic and resistance training have known efficacy for treating type2 diabetes (T2D). Less is known about interval training in this population. We examined the effects of sprint interval (SIT) and combined aerobic + resistance (COMB) training on HbA1C and (Primary Outcome) in participants with T2D. Secondary outcomes included HOMA-IR and standard clinical chemistries. Exploratory/Tertiary included immerging cardiovascular disease risk indices. METHODS Participants (N.=52; 45-60y, BMI>30kg/m2, HbA1c, ≥6.5%) were randomly assigned to either SIT (N.=17), COMB (N.=17) or usual care control (Control, N.=18) for 10-weeks. Data were analyzed by ANOVA and effect sizes estimated using Cohen's D (CD). RESULTS We observed significant reductions in HbA1c for SIT (-1.82%, 95% CI, -2.50, -1.14) and COMB (-1.24%, 95% CI, -2.19, -0.29), but not Control (0.02%, 95% CI, -0.67, 0.71). Secondary outcome analysis demonstrated significant reductions in HOMA-IR for SIT (-4.89, 95% CI, -6.94, -2.83) and COMB training (-2.90, 95% CI, -5.00, -0.79), but not Control (-0.44, 95% CI, -3.44, 2.46). Effect size estimates and accompanying confidence interval bound were deemed "large" for HBA1c and moderate-to-large for HOMA-IR. Non-significant changes for the Control group were deemed "trivial." Both analyses were significant vs. Control. Similar patterns were observed for most standard laboratory measures and tertiary outcomes. CONCLUSIONS Our results demonstrated that SIT and COMBO training are effective exercise training regimens in overweight women with T2D independently of changes in body mass.
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Affiliation(s)
- Ebrahim Banitalebi
- Department of Sport Sciences, University of Shahrekord, Shahrekord, Iran
| | | | - Mohammad Faramarzi
- Department of Sport Sciences, University of Shahrekord, Shahrekord, Iran
| | - Conrad P Earnest
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
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Chen CL, Liu L, Lo K, Huang JY, Yu YL, Huang YQ, Feng YQ. Association Between Triglyceride Glucose Index and Risk of New-Onset Diabetes Among Chinese Adults: Findings From the China Health and Retirement Longitudinal Study. Front Cardiovasc Med 2020; 7:610322. [PMID: 33330672 PMCID: PMC7728664 DOI: 10.3389/fcvm.2020.610322] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 11/02/2020] [Indexed: 12/14/2022] Open
Abstract
The triglyceride glucose (TyG) index has been proposed to be a surrogate of insulin resistance. In the present study, we aimed to examine the relationship between TyG index and the risk of incident diabetes in middle-age and older adults in China using nationally representative data from the China Health and Retirement Longitudinal Study 2011-2015. Information on socio-demographics, medical background, anthropometric measurement, and laboratory information were collected. The association between TyG index and diabetes was examined by Cox proportional hazards models and restricted cubic spline regression, and the results were presented in hazard ratio (HR) with 95% confidence interval (CI). Subgroup analyses were also conducted to examine potential interactions between demographics and TyG index. Among 7,428 participants, 791 (10.6%) of them developed diabetes over 3.4 years of follow-up. The multivariate HR for every SD increment in TyG index was 1.22 (95% CI, 1.14-1.31). When comparing to the lowest quartile of TyG index, the multivariate HRs for new-onset diabetes were 1.22 (0.96-1.54) for Q2, 1.61 (1.28-2.01) for Q3, and 1.73 (1.38-2.16) for Q4 (P for trend <0.001). The restricted cubic spline regression also showed a linear association. No interaction was found between subgroup variables and the association between TyG index and the risk of diabetes. In conclusion, higher TyG index associated with the elevated risk of new-onset diabetes in middle-aged and older adults.
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Affiliation(s)
- Chao-lei Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lin Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Kenneth Lo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Epidemiology, Centre for Global Cardiometabolic Health, Brown University, Providence, RI, United States
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, China
| | - Jia-yi Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yu-ling Yu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yu-qing Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ying-qing Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Hong S, Han K, Park CY. The triglyceride glucose index is a simple and low-cost marker associated with atherosclerotic cardiovascular disease: a population-based study. BMC Med 2020; 18:361. [PMID: 33234146 PMCID: PMC7687762 DOI: 10.1186/s12916-020-01824-2] [Citation(s) in RCA: 138] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/22/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The triglyceride glucose (TyG) index is an inexpensive clinical surrogate marker for insulin resistance. However, the relationship between TyG index and atherosclerotic cardiovascular disease (CVD) remains unclear. We evaluated the relationship between TyG index and CVD using a large-scale population dataset from the National Health Information Database (NHID). METHODS We performed a retrospective observational cohort study of 5,593,134 persons older than 40 years from 2009 to 2017 using the NHID. We divided the participants into TyG index quartiles. Outcome variables were stroke, myocardial infarction, and both. The incidence of outcomes was estimated for each TyG quartile over the total follow-up period. All outcomes were analyzed by Cox proportional hazards regression analysis while controlling for baseline covariates. RESULTS During 8.2 years of mean follow-up, stroke was diagnosed in 89,120 (1.59%), MI in 62,577 (1.12%), and both stroke and MI in 146,744 (2.62%) participants. Multivariate-adjusted hazard ratios (HRs) for patients in the highest TyG index quartile demonstrated that these patients were at higher risk for stroke (HR = 1.259; 95% confidence interval [CI] 1.233-1.286), for MI (HR = 1.313; 95% CI 1.28-1.346), and for both (HR = 1.282; 95% CI 1.261-1.303) compared with participants in the lowest TyG index quartile. These effects were independent of age, sex, smoking, alcohol consumption, physical activity, body mass index, systolic blood pressure, and total cholesterol. CONCLUSIONS In our large population study, TyG index, a simple measure reflecting insulin resistance, was potentially useful in the early identification of individuals at high risk of experiencing a cardiovascular event.
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Affiliation(s)
- Sangmo Hong
- Department of Internal Medicine, Guri Hospital, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Cheol-Young Park
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Pyung-Dong, Jongro-Gu, Seoul, 03181, Republic of Korea.
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Barzegar N, Tohidi M, Hasheminia M, Azizi F, Hadaegh F. The impact of triglyceride-glucose index on incident cardiovascular events during 16 years of follow-up: Tehran Lipid and Glucose Study. Cardiovasc Diabetol 2020; 19:155. [PMID: 32993633 PMCID: PMC7526412 DOI: 10.1186/s12933-020-01121-5] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/12/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND To investigate whether the Triglyceride-Glucose index (TyG-index) is associated with increased risk of cardiovascular diseases (CVD)/coronary heart disease (CHD). METHODS A total of 7521 Iranians aged ≥ 30 years (male = 3367) were included in the study. Multivariate Cox regression analyses (adjusted for age, gender, waist circumference, body mass index, educational level, smoking status, physical activity, family history of CVD, type 2 diabetes, hypertension, low and high density lipoprotein cholesterol, and lipid lowering drugs) were used to assess the risk of incident CVD/CHD across quintiles and for 1-standard deviation (SD) increase in the TyG-index. The cut off point for TyG-index was assessed by the minimum value of [Formula: see text]. We also examined the added value of the TyG-index in addition to the Framingham risk score when predicting CVD. RESULTS During follow-up, 1084 cases of CVD (male = 634) were recorded. We found a significant trend of TyG-index for incident CVD/CHD in multivariate analysis (both Ps for tend ≤ 0.002). Moreover, a 1-SD increase in TyG-index was associated with significant risk of CVD/CHD in multivariate analysis [1.16 (1.07-1.25) and 1.19 (1.10-1.29), respectively]. The cut-off value of TyG-index for incident CVD was 9.03 (59.2% sensitivity and 63.2% specificity); the corresponding value of TyG-index for incident CHD was 9.03 (60.0% sensitivity and 62.8% specificity), respectively. Although no interaction was found between gender and TyG-index for CVD/CHD in multivariate analysis (both Ps for interaction > 0.085), the significant trend of TyG-index was observed only among females for incident CVD (P = 0.035). A significant interaction was found between age groups (i.e. ≥ 60 vs < 60 years) and TyG-index for CVD outcomes in the multivariate model (P-value for interaction = 0.046). Accordingly, a significant association between the TyG-index and outcomes was found only among the younger age group. Among the population aged < 60 the addition of TyG-index to the Framingham risk score (FRS) did not show improvement in the predictive ability of the FRS, using integrated discrimination improvement. CONCLUSION The TyG-index is significantly associated with increased risk of CVD/CHD incidence; this issue was more prominent among the younger population. However, adding TyG-index to FRS does not provide better risk prediction for CVD.
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Affiliation(s)
- Niloofar Barzegar
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24 Aarabi St. Velenjak, P.O. Box: 19395-4763, Tehran, Iran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24 Aarabi St. Velenjak, P.O. Box: 19395-4763, Tehran, Iran.
| | - Mitra Hasheminia
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24 Aarabi St. Velenjak, P.O. Box: 19395-4763, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24 Aarabi St. Velenjak, P.O. Box: 19395-4763, Tehran, Iran
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Hu C, Zhang J, Liu J, Liu Y, Gao A, Zhu Y, Zhao Y. Discordance between the triglyceride glucose index and fasting plasma glucose or HbA1C in patients with acute coronary syndrome undergoing percutaneous coronary intervention predicts cardiovascular events: a cohort study from China. Cardiovasc Diabetol 2020; 19:116. [PMID: 32703284 PMCID: PMC7379768 DOI: 10.1186/s12933-020-01091-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/15/2020] [Indexed: 02/07/2023] Open
Abstract
Background Previous studies have investigated the relationship of the triglyceride glucose (TyG) index with the incidence of cardiovascular events. However, to date, there have been no studies comparing the predictive values of fasting plasma glucose (FPG), glycosylated hemoglobin A (HbA1C) and the TyG index for the risk of cardiovascular events. This study aimed to use discordance analysis to evaluate and compare the effectiveness of FPG, HbA1C and the TyG index to predict the risk of cardiovascular events. Methods Patients diagnosed with acute coronary disease (ACS) undergoing percutaneous coronary intervention (PCI) were enrolled in this study. The TyG index was computed using the following formula: ln [fasting triglycerides (mg/dL) × FPG (mg/dL)/2]. We categorized patients into 4 concordance/discordance groups. Discordance was defined as a TyG index equal to or greater than the median and an FPG or HbA1C less than the median, or vice versa. The primary outcome was the composite of death, nonfatal myocardial infarction, nonfatal stroke and unplanned repeat revascularization. A Cox proportional hazards regression model was performed to estimate the risk of cardiovascular events according to the concordance/discordance groups. Sensitivity analysis was performed on each patient group divided into high or low categories for HbA1C or FPG and were repeated according to diabetes status. Results In total, 9285 patients were included in the final statistical analysis (male: 75.3%, age: 59.9 ± 10.05 years, BMI: 26.2 ± 9.21 kg/m2, diabetes: 43.9% and dyslipidemia: 76.8%). The medians defining concordance/discordance were 6.19 mmol/L for FPG, 6.1% for HbA1C and 8.92 for the TyG index. The TyG index was strongly related to triglycerides and HDL-C (r = 0.881 and -0.323, respectively; both P < 0.001). During the 17.4 ± 2.69 months of follow-up, there were 480 (5.1%) incident cardiovascular events. Among patients with a lower HbA1C or FPG, 15.6% and 16.3%, respectively, had a discordantly high TyG index and a greater risk of cardiovascular events compared with patients with a concordantly low TyG index after full adjustment (HR: 1.92, 95% CI 1.33–2.77; HR: 1.89, 95% CI 1.38–2.59; for HbA1C and FPG, respectively). Repeat risk estimation using high or low categories for FPG or HbA1C and diabetes status confirmed the results. Conclusions Patients with a discordantly high TyG index had a significantly greater risk of cardiovascular events regardless of diabetes status. The TyG index might be a better predictor of cardiovascular risk than FPG or HbA1C for patients with ACS undergoing PCI. This discordance may support better cardiovascular risk management regardless of diabetes status.
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Affiliation(s)
- Chengping Hu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China
| | - Jianwei Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China
| | - Jinxing Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China
| | - Yan Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China
| | - Ang Gao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China
| | - Yong Zhu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China
| | - Yingxin Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China.
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Zhu B, Wang J, Chen K, Yan W, Wang A, Wang W, Gao Z, Tang X, Yan L, Wan Q, Luo Z, Qin G, Chen L, Mu Y. A high triglyceride glucose index is more closely associated with hypertension than lipid or glycemic parameters in elderly individuals: a cross-sectional survey from the Reaction Study. Cardiovasc Diabetol 2020; 19:112. [PMID: 32664945 PMCID: PMC7362407 DOI: 10.1186/s12933-020-01077-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 07/02/2020] [Indexed: 12/29/2022] Open
Abstract
Background Both lipid and glucose abnormalities are associated with hypertension (HTN). However, it is unclear whether the triglyceride-glucose (TyG) index is associated with HTN. Therefore the aim of this study is to investigate the association of the TyG index and HTN and to compare the discriminative power of the TyG index, lipid, glycemic parameters for the risk of HTN in elderly individuals. Methods The present study was nested in a longitudinal (REACTION) study from May 2011 to December 2011, which was designed to demonstrate the association of abnormal glucose metabolism with the risk of cancer in the Chinese population. In total, 47,808 participants were recruited in this cross-sectional study. The TyG index was divided into five groups: the < 20% group, the 20–39% group, the 40–59% group, the 60–79% group and the ≥ 80% group, according to quintile division of the subjects. Three multivariate logistic regression models were used to evaluate the association between the TyG vs. lipid parameters, glycemic parameters and HTN. Results Multivariate logistic regression analysis shows that compared with lipid and glycemic parameters, the TyG index remains significantly associated with HTN in either total subjects or subjects separated into men and women (odds ratio (OR) 1.33, 95% confidence interval (CI) 1.18–1.51, p < 0.0001 in total subjects; OR 1.39, 95% CI 1.11–1.74, p = 0.0042 in men; OR 1.28, 95% CI 1.11–1.49, p = 0.0010 in women). In a stratified analysis, an elevated TyG index is significantly associated with HTN in the subgroup of the oldest age (≥ 65) (OR 1.67, 95% CI 1.30–2.14, p < 0.0001), as well as with obesity (Body mass index (BMI) ≥ 28 kg/m2) (OR 1.85, 95% CI 1.29–2.66, p = 0.0009) or lower estimated glomerular filtration rate (eGFR) (< 90 mL/(min·1.73 m2)) (OR 1.72, 95% CI 1.33–2.21, p < 0.0001). Conclusion The TyG index is significantly associated with HTN and shows the superior discriminative ability for HTN compared with lipid and glycemic parameters in the Chinese elderly population.
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Affiliation(s)
- Binruo Zhu
- Medicine School of Nankai University, Tianjin, China.,Department of Endocrinology, Chinese PLA General Hospital, 28 Fu Xing Road, Beijing, 100853, People's Republic of China
| | - Jie Wang
- Medicine School of Nankai University, Tianjin, China.,Department of Endocrinology, Chinese PLA General Hospital, 28 Fu Xing Road, Beijing, 100853, People's Republic of China
| | - Kang Chen
- Department of Endocrinology, Chinese PLA General Hospital, 28 Fu Xing Road, Beijing, 100853, People's Republic of China
| | - Wenhua Yan
- Department of Endocrinology, Chinese PLA General Hospital, 28 Fu Xing Road, Beijing, 100853, People's Republic of China
| | - Anping Wang
- Department of Endocrinology, Chinese PLA General Hospital, 28 Fu Xing Road, Beijing, 100853, People's Republic of China
| | - Weiqing Wang
- Shanghai National Research Centre for Endocrine and Metabolic Diseases, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhengnan Gao
- Dalian Central Hospital, Dalian, Liaoning, China
| | - Xulei Tang
- First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Li Yan
- Zhongshan University Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, China
| | - Qin Wan
- Southwest Medical University Affiliated Hospital, Luzhou, Sichuan, China
| | - Zuojie Luo
- First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Guijun Qin
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lulu Chen
- Wuhan Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yiming Mu
- Medicine School of Nankai University, Tianjin, China. .,Department of Endocrinology, Chinese PLA General Hospital, 28 Fu Xing Road, Beijing, 100853, People's Republic of China.
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Simental-Mendía LE, Gamboa-Gómez CI, Aradillas-García C, Rodríguez-Morán M, Guerrero-Romero F. The triglyceride and glucose index is a useful biomarker to recognize glucose disorders in apparently healthy children and adolescents. Eur J Pediatr 2020; 179:953-958. [PMID: 32016604 DOI: 10.1007/s00431-020-03570-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/27/2019] [Accepted: 01/08/2020] [Indexed: 12/15/2022]
Abstract
It has been suggested that the triglyceride and glucose (TyG) index is an early indicator for type 2 diabetes (T2D) in adults. Thus, the aim of this study was to evaluate whether the TyG index is useful in the screening of glucose disorders (GD) in apparently healthy children and adolescents. Eligible participants were apparently healthy children and adolescents. Individuals with new diagnosis of GD were allocated into the study groups with impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and T2D. Participants with normal glucose tolerance (NGT) were the control group. In total, 1872 children and adolescents were enrolled and allocated into the study groups. Diagnosis of NGT, IFG, IGT, and T2D was established in 1541 (82.3%), 256 (13.7%), 66 (3.5%), and 9 (0.4%) children, respectively. In girls, the best cutoff points of the TyG index for identifying IFG, IGT, and T2D were 4.51 (sensitivity 59.8%, specificity 59.8%), 4.55 (sensitivity 63.0%, specificity 64.3%), and 4.63 (sensitivity 75.0%, specificity 74.6%), respectively; and in boys were 4.52 (sensitivity 62.8%, specificity 64.2%), 4.54 (sensitivity 71.8%, specificity 65.1%), and 4.82 (sensitivity 91.0%, specificity 990.6%), respectively.Conclusion: Our results suggest that the TyG index may be a useful tool for screening GD in healthy children and adolescents.What is Known:• Prevalence of prediabetes and type 2 diabetes is increasing worldwide among young adults and adolescents.• Elevated fasting glucose and triglyceride concentrations have been recognized as independent risk factors for type 2 diabetes.What is New:• The TyG index exhibited highest sensitivity and specificity to detect impaired fasting glucose, impaired glucose tolerance, and type 2 diabetes.• The TyG index may be a useful tool for the screening of glucose disorders in apparently healthy children and adolescents.
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Affiliation(s)
- Luis E Simental-Mendía
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, Canoas 100, Col. Los Angeles, 34067, Durango, DGO, Mexico
| | - Claudia I Gamboa-Gómez
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, Canoas 100, Col. Los Angeles, 34067, Durango, DGO, Mexico
| | - Celia Aradillas-García
- Hormone Laboratory, Faculty of Medicine, University of San Luis Potosí, San Luis Potosí, Mexico
| | - Martha Rodríguez-Morán
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, Canoas 100, Col. Los Angeles, 34067, Durango, DGO, Mexico
| | - Fernando Guerrero-Romero
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, Canoas 100, Col. Los Angeles, 34067, Durango, DGO, Mexico.
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46
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Amini MR, Shahinfar H, Babaei N, Davarzani S, Ebaditabar M, Djafarian K, Clark CCT, Shab-Bidar S. Association of Dietary Patterns with Visceral Adiposity, Lipid Accumulation Product, and Triglyceride-Glucose Index in Iranian Adults. Clin Nutr Res 2020; 9:145-156. [PMID: 32395444 PMCID: PMC7192667 DOI: 10.7762/cnr.2020.9.2.145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 12/14/2022] Open
Abstract
In the present study, we sought to examine the association between dietary patterns (DPs) and visceral adiposity, lipid accumulation product (LAP), and triglyceride-glucose index. This cross-sectional study was conducted on adults aged between 18–45 years old who lived in Tehran, Iran, between February 2017 and December 2018 (n = 270). DPs were derived using principal component analysis. We used analysis of variance to examine differences in continues variables across tertiles of major DPs. Subsequently, for the modeling of these relationships, and also considering the possible effect of the confounding factors, multivariate regression was used. Three DPs were identified: healthy pattern, mixed pattern, and western pattern, respectively. Compared with individuals in the lowest category of mixed pattern, those in the highest category had lower fasting blood sugar (96.26 ± 11.57 vs. 101 ± 28.66, p = 0.01). A significant association was found between healthy pattern, after adjustment for potential confounders, and odds of LAP; such that individuals in the top category of healthy pattern score were 71% less likely to have a high LAP compared with those in the lowest category (odds ratio, 0.29; 95% confidence interval, 0.10–0.81). We found that adherence to a healthy DP was associated with decreased LAP. To confirm the veracity of these findings, more studies should be conducted.
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Affiliation(s)
- Mohammad Reza Amini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Hossein Shahinfar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Nadia Babaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Samira Davarzani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Mojdeh Ebaditabar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Cain C T Clark
- Centre for Sport, Exercise, and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
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Shang J, Yu D, Cai Y, Wang Z, Zhao B, Zhao Z, Simmons D. The triglyceride glucose index can predict newly diagnosed biopsy-proven diabetic nephropathy in type 2 diabetes: A nested case control study. Medicine (Baltimore) 2019; 98:e17995. [PMID: 31725665 PMCID: PMC6867726 DOI: 10.1097/md.0000000000017995] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Insulin resistance is usually a key factor in the development of type 2 diabetes. The triglyceride glucose (TyG) index is a marker of insulin resistance which is also implicated in the risk of nephropathy among people with type 2 diabetes. This study aimed to examine associations and potential thresholds between TyG index and the risk of newly diagnosed biopsy-proven diabetic nephropathy in people with type 2 diabetes. A nested case-control study incorporating 950 incident biopsy-proven diabetic nephropathy cases and age, gender matched 4750 patients with treated type 2 diabetes as controls selected by risk-set sampling method was implemented. The dose-response association between TyG index with subsequent risk of newly diagnosed biopsy-proven diabetic nephropathy after adjustment for age, gender, blood pressure, and other major cardiovascular risk factors were examined by conditional logistic regression model. A non-linear relationship was identified between TyG index and the risk of newly diagnosed biopsy-proven diabetic nephropathy with a potential threshold of TyG at 9.05-9.09. Similar relationships with the same threshold were also found in the analyses by fasting glucose and triglyceride levels. TyG index might be a prognostic factor in predicting newly development of biopsy-proven diabetic nephropathy among patients with treated type 2 diabetes. In people with type 2 diabetes, TyG index above 9.05-9.09 could be a prognostic threshold to identify individuals at high risk of diabetic nephropathy. Further replication studies are warranted.
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Affiliation(s)
- Jin Shang
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Dahai Yu
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Yamei Cai
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Zheng Wang
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Bin Zhao
- The Second Division of Internal Medicine, Kejing Community Health Centre, Jiyuan, China
| | - Zhanzheng Zhao
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - David Simmons
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
- Western Sydney University, Campbelltown, Sydney, Australia
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48
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Zhang Y, He P, Li Y, Zhang Y, Li J, Liang M, Wang G, Tang G, Song Y, Wang B, Liu C, Liu L, Cui Y, Wang X, Huo Y, Xu X, Qin X. Positive association between baseline brachial-ankle pulse wave velocity and the risk of new-onset diabetes in hypertensive patients. Cardiovasc Diabetol 2019; 18:111. [PMID: 31462258 PMCID: PMC6714437 DOI: 10.1186/s12933-019-0915-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/19/2019] [Indexed: 12/14/2022] Open
Abstract
Background There is no clearly defined temporal relationship between arterial stiffness and diabetes. We aimed to investigate the prospective association between baseline brachial–ankle pulse wave velocity (baPWV) and the risk of new-onset diabetes during follow-up, and examined whether there were effect modifiers, in hypertensive patients. Methods We included 2429 hypertensive patients with all the pertinent data but without diabetes at the baseline, who were part of the China Stroke Primary Prevention Trial (CSPPT), a randomized, double-blind, actively controlled trial conducted in 32 communities in Anhui and Jiangsu provinces in China. The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose (FG) ≥ 126.0 mg/dL at the exit visit. Results During a median follow-up duration of 4.5 years, 287 (11.8%) participants developed diabetes. There was a significant positive association between baseline baPWV and the risk of new-onset diabetes (per SD increment; OR, 1.33; 95% CI 1.13, 1.56). Consistently, when baPWV was assessed as quartiles, a significantly higher risk of new-onset diabetes was found in participants in quartiles 2–4 (≥ 15.9 m/s; OR, 1.80; 95% CI 1.22, 2.65) compared with those in quartile 1 (< 15.9 m/s). The positive association was consistent in participants with (per SD increment; OR, 1.29; 95% CI 1.06, 1.56) or without (per SD increment; OR, 1.40; 95% CI 1.15, 1.71) impaired fasting glucose (IFG, FG ≥ 100.8 and < 126.0 mg/dL, P-interaction = 0.486). Conclusions In this sample of hypertensive patients, we found a significant positive association between baseline baPWV and the risk of new-onset diabetes. Clinical trial registration Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008
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Affiliation(s)
- Yuanyuan Zhang
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Panpan He
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Youbao Li
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Min Liang
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Guobao Wang
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Genfu Tang
- Health Management College, Anhui Medical University, Hefei, 230032, China
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China.,Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Chengzhang Liu
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
| | - Yimin Cui
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, E4132, Baltimore, MD, 21205-2179, USA
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Xiping Xu
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China. .,Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China.
| | - Xianhui Qin
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
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Yan Z, Yu D, Cai Y, Shang J, Qin R, Xiao J, Zhao B, Zhao Z, Simmons D. Triglyceride Glucose Index Predicting Cardiovascular Mortality in Chinese Initiating Peritoneal Dialysis: A Cohort Study. Kidney Blood Press Res 2019; 44:669-678. [PMID: 31315123 DOI: 10.1159/000500979] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 04/22/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Insulin resistance (IR) is increased among people with end-stage renal disease (ESRD). The Triglyceride glucose (TyG) index is a marker of IR and is also associated with the prognosis of cardiovascular disease among patients initiating peritoneal dialysis (PD). This study was aimed at examining the associations between TyG index and cardiovascular deaths in patients initiating PD. METHODS AND RESULTS Three thousand fifty-four patients initiating PD between 2007 and 2014 were included in a prospective cohort derived from Henan PD Registry, TyG index alongside other baseline characteristics were measured when ESRD patients initiated PD. Logistic regression adjusting for age, gender, and major cardiovascular risk factors estimated the association between TyG index and subsequent cardiovascular mortality within 2 years since the initiation of PD. RESULTS TyG index was positively associated with cardiovascular mortality: adjusted incidence rates ratio (95% CI) comparing the highest vs. lowest TyG index quartile was 2.32 (2.12-2.55) in all, 2.22 (2.01-2.46) in those with body mass index (BMI) <25 kg/m2, and 2.82 (2.24-3.54) in those with BMI ≥25 kg/m2, respectively. Linear dose-response relationships were revealed in all and by BMI. CONCLUSIONS TyG index might be a prognostic factor in predicting cardiovascular mortality among patients initiating PD.
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Affiliation(s)
- Zechen Yan
- Department of Urology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Dahai Yu
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.,Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, United Kingdom
| | - Yamei Cai
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Jin Shang
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Rui Qin
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Jing Xiao
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Bin Zhao
- The Second Division of Internal Medicine, Kejing Community Health Centre, Jiyuan, China
| | - Zhanzheng Zhao
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China,
| | - David Simmons
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.,Western Sydney University, Campbelltown, Sydney, New South Wales, Australia
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50
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Ahn N, Baumeister SE, Amann U, Rathmann W, Peters A, Huth C, Thorand B, Meisinger C. Visceral adiposity index (VAI), lipid accumulation product (LAP), and product of triglycerides and glucose (TyG) to discriminate prediabetes and diabetes. Sci Rep 2019; 9:9693. [PMID: 31273286 PMCID: PMC6609728 DOI: 10.1038/s41598-019-46187-8] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 06/20/2019] [Indexed: 11/08/2022] Open
Abstract
The present study evaluated the ability of the visceral adiposity index (VAI), the lipid accumulation product (LAP), and product of triglycerides and glucose (TyG), three novel, insulin resistance-related markers, to discriminate prediabetes/diabetes in the general German population. Altogether 2,045 Germans (31-72 years, 53.3% women) without known diabetes and a history of Myocardial Infarction (MI)/stroke from the Cooperative Health Research in the Region of Augsburg (KORA) F4 Study were eligible. The discriminatory accuracy of the markers for oral glucose tolerance test (OGTT)-defined prediabetes/diabetes according to the American Diabetes Association (ADA) criteria was assessed by the area under the receiver operating characteristic (ROC) curve (AUC). The Youden Index (YI) was used to determine optimal cut-off values, and a non-parametric ROC regression was used to examine whether the discriminatory accuracy varied by sex and age. 365 men (38.2%) and 257 women (23.6%) were newly diagnosed with prediabetes/diabetes. AUCs for TyG, LAP and VAI were 0.762 (95% CI 0.740-0.784), 0.743 (95% CI 0.720-0.765), and 0.687 (95% CI 0.662-0.712), respectively. The optimal cut-off values for the LAP and TyG were 56.70 and 8.75 in men, and 30.40 and 8.53 in women. In conclusion, TyG and LAP provide good discrimination of persons with prediabetes/diabetes.
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Affiliation(s)
- Nayeon Ahn
- Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T Augsburg, Augsburg, Germany.
- The Institute of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University of Munich, Munich, Germany.
| | - Sebastian E Baumeister
- Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T Augsburg, Augsburg, Germany
| | - Ute Amann
- Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T Augsburg, Augsburg, Germany
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Cornelia Huth
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Christa Meisinger
- Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T Augsburg, Augsburg, Germany
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
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