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Karaaslan H, Inan H, Turkmen AT, Altintas I, Uyar N, Eren MA. Comparison of triglyceride-glucose index and anthropometric obesity indices in predicting severe grades of hepatic steatosis in nonalcoholic fatty liver disease among non-diabetic obese individuals. HEPATOLOGY FORUM 2024; 5:113-119. [PMID: 39006142 PMCID: PMC11237241 DOI: 10.14744/hf.2023.2023.0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/09/2023] [Accepted: 11/27/2023] [Indexed: 07/16/2024]
Abstract
Background and Aim The triglyceride glucose index (TyG) has been proposed as a promising indicator of both insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD). However, the efficacy of the TyG index in predicting NAFLD has not been adequately studied, particularly in obese individuals. Materials and Methods We analyzed 190 morbidly obese individuals. The TyG index, anthropometric obesity indices, homeostatic model assessment (HOMA-IR), and biochemical parameters were compared. NAFLD was diagnosed by hepatic ultrasonography and classified into four grades (0, 1, 2, and 3). Individuals in grades 2 and 3 are considered to have severe steatosis, while those in grades 0 and 1 do not. Results The area under the curve (AUC) values of the TyG index, body mass index, neck circumferences, waist-to-hip ratio, and HOMA-IR did not differ significantly in predicting severe steatosis (0.640, 0.742, 0.725, 0.620, and 0.624 respectively). However, the AUC values of waist circumference and alanine aminotransferase provided better predictions than the TyG index (0.782, 0.744, and 0.640 respectively). Conclusion The TyG index is highly effective in predicting both the presence and severity of NAFLD. However, it did not outperform simple obesity indices in predicting NAFLD and its severity in obese patients.
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Affiliation(s)
- Huseyin Karaaslan
- Department of Endocrinology, Harran University School of Medicine, Sanliurfa, Turkiye
| | - Hasan Inan
- Department of Internal Medicine, Harran University School of Medicine, Sanliurfa, Turkiye
| | - Alper Tunga Turkmen
- Department of Radiology, Harran University School of Medicine, Sanliurfa, Turkiye
| | - Ismail Altintas
- Department of Internal Medicine, Harran University School of Medicine, Sanliurfa, Turkiye
| | - Nida Uyar
- Department of Endocrinology, Harran University School of Medicine, Sanliurfa, Turkiye
| | - Mehmet Ali Eren
- Department of Endocrinology, Harran University School of Medicine, Sanliurfa, Turkiye
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Gou R, Dou D, Tian M, Chang X, Zhao Y, Meng X, Li G. Association between triglyceride glucose index and hyperuricemia: a new evidence from China and the United States. Front Endocrinol (Lausanne) 2024; 15:1403858. [PMID: 39010899 PMCID: PMC11246899 DOI: 10.3389/fendo.2024.1403858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/14/2024] [Indexed: 07/17/2024] Open
Abstract
Background Hyperuricemia (HUA) is a glo\bal public health problem. The etiology of HUA is complex and efficient and accurate assessment metrics are still lacking when conducting large-scale epidemiologic screening. The aim of this study was to evaluate the association of the triglyceride glucose (TyG) index, TyG-body mass index (BMI), TyG-waist-to-height ratio (WHtR) with the risk of HUA. Methods Based on data collected from the National Health and Nutrition Examination Survey (NHANES) in the United States and the China Health and Aging Longitudinal Study (CHARLS) in China, a total of 14,286 U.S. adults and 4,620 Chinese adults were included in the analysis. The study examined the levels of TyG, TyG-BMI, TyG-WHtR, and TyG-WC. Multivariate logistic regression was utilized to investigate the relationships between these variables and hyperuricemia (HUA), separately. Additionally, the study used restricted cubic splines (RCS) to explore the linear associations of TyG, TyG-BMI, TyG-WHtR, TyG-WC, and HUA, separately. Results The NHANES results showed that TyG [Q2, 1.58(1.26, 1.98); Q3, 2.36 (1.94, 2.88); Q4, 3.21 (2.61, 3.94)], TyG-BMI [Q2, 2.14 (1.74, 2.65); Q3, 3.38 (2.74, 4.17); Q4, 6.70 (5.55, 8.02)], TyG-WHtR [Q2, 1.92 (1.56, 2.36); Q3, 3.14 (2.56, 3.85); Q4, 6.28 (5.12, 7.69)], TyG-WC [Q2, 2.32 (1.85, 2.90); Q3, 3.51 (2.84, 4.34); Q4, 7.32 (5.95, 9.02)] were identified as risk factors for hyperuricemia (HUA). Similarly, the CHARLS results, when fully adjusted for covariates, indicated that TyG [Q4, 2.36 (1.08, 5.15)], TyG-BMI [Q3, 2.60 (1.05, 6.41); Q4, 3.70 (1.64, 8.32)], TyG-WHtR (Q4, 2.84 (1.23, 6.55), TyG-WC [Q4, 2.85 (1.23, 6.5)] were also risk factors for HUA. The predictive ability of each indicator for the risk of developing HUA was stronger in women than in men. Furthermore, there was an observed nonlinear relationship between TyG, TyG-BMI, TyG-WHtR, TyG-WC, and HUA in both the NHANES and CHARLS datasets (P-nonlinearity < 0.05). Conclusion These findings suggest that TyG, TyG-BMI, TyG-WHtR and TyG-WC are associated with an increased risk of HUA. They are potential indicators for screening HUA status in the general population in China and the United States.
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Affiliation(s)
- Ruoyu Gou
- School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Danni Dou
- School of Basic Medicine, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Mi Tian
- School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Xiaoyu Chang
- School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Yonggang Zhao
- School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Xin Meng
- School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Guanghua Li
- School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
- School of Basic Medicine, Ningxia Medical University, Yinchuan, Ningxia, China
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Han AL, Lee HK, Shin SR. Diagnostic Performance of Insulin Resistance Indices for Identifying Metabolic Dysfunction-Associated Fatty Liver Disease. Metab Syndr Relat Disord 2024; 22:402-409. [PMID: 38574322 DOI: 10.1089/met.2023.0276] [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] [Indexed: 04/06/2024] Open
Abstract
Background/objectives: Insulin resistance (IR) plays an important role in metabolic dysfunction-associated fatty liver disease (MAFLD) pathogenesis. A modified triglyceride-glucose (TyG) index, including TyG-body mass index (TyG-BMI) and TyG-waist circumference (TyG-WC), has been introduced to represent IR. This study aimed to investigate the diagnostic abilities of IR indices in MAFLD, in which fatty liver was diagnosed using computed tomography (CT). Subjects/methods: We retrospectively analyzed the clinical data and images of 852 adults aged ≥19 years who underwent abdominal CT. MAFLD was diagnosed based on the appearance of fatty liver on CT alongside at least one of the following three criteria: being overweight or obese, at least two metabolic risk abnormalities, and/or diabetes mellitus. IR indices were calculated by examining the following variables: homeostasis model assessment-IR, TyG index, TyG-BMI, TyG-WC, and visceral adiposity index. The diagnostic accuracy was evaluated using the area under the receiver operating characteristic curve. Results: For all patients, the area under the curve (AUC) of the TyG index, TyG-BMI, and TyG-WC were 0.834, 0.938, and 0.942, respectively. In men, the AUC of the TyG index, TyG-BMI, and TyG-WC were 0.812, 0.928, and 0.934, respectively. In women, the AUC of the TyG index was 0.841, and TyG-BMI and TyG-WC were 0.940 and 0.953, respectively. The AUC values tended to increase in the following order: TyG index < TyG-BMI < TyG-WC. Women showed a higher AUC than men in all items, and the TyG-WC of women showed the highest value with AUC 0.953 (95% confidence interval [CI]: 0.892-1.000, P < 0.0001). The AUC of the TyG index was 0.858 (95% CI: 0.828-0.888, P < 0.0001). Conclusions: In conclusion, TyG-WC is a powerful surrogate marker for identifying MAFLD in clinical settings.
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Affiliation(s)
- A Lum Han
- Department of Family Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Hee Kyung Lee
- Department of Family Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Sae Ron Shin
- Department of Family Medicine, Wonkwang University Hospital, Iksan, Korea
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Wu Z, Huang K, Bao S, Zhang X, Li J, Kong W, Shi Y, Xie Y. The association of triglyceride-glucose-waist circumference with metabolic associated fatty liver disease and the severity of liver steatosis and fibrosis in American adults: a population-based study. Scand J Gastroenterol 2024; 59:561-569. [PMID: 38235548 DOI: 10.1080/00365521.2024.2305268] [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: 07/31/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND The global obesity pandemic has led to an alarming rise in the prevalence of metabolic-associated fatty liver disease (MAFLD), making it a substantial clinical and economic burden on society. Early detection and effective treatment of MAFLD are imperative to mitigate its impact. METHODS This cross-sectional study was conducted involving 4634 adults from the National Health and Nutrition Examination Surveys (NHANES) 2017-2018 cycle. Transient elastography (TE) was used to diagnose MAFLD and assess the extent of liver steatosis and fibrosis. Multivariate logistic regression models were utilized to examine the association between the triglyceride and glucose index-waist circumference (TyG-WC) and the risk of MAFLD, liver fibrosis, and steatosis. RESULTS A positive association between TyG-WC and MAFLD persisted across all three models: model1: OR = 8.44, 95% CI: 6.85-10.38 (unadjusted), model2: OR = 8.28, 95% CI: 6.53-10.50 (partially adjusted), and model3: OR = 7.98, 95% CI: 4.11-15.46 (fully adjusted). Further investigation through interaction and stratified analysis revealed that this association was more pronounced in the non-obese and Non-Hispanic White persons groups. Moreover, a non-linear relationship analysis unveiled threshold and saturation effects between TyG-WC and MAFLD. Specifically, a TyG-WC value of approximately 600 may represent the threshold effect for MAFLD risk, while 1200 may signify the saturation effect of MAFLD risk. Finally, a robust correlation between TyG-WC and the severity of liver steatosis and fibrosis was found. CONCLUSIONS The findings suggest that the TyG-WC index exhibits excellent predictive value for MAFLD in the general American population.
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Affiliation(s)
- Zhouxiao Wu
- Health Science Center, Ningbo University, Ningbo, Zhejiang, China
- Department of Infectious Diseases, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- Department of Hepatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Kai Huang
- Department of General Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Sizeng Bao
- Department of Nephrology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Xiangyu Zhang
- Department of Nephrology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Jingwen Li
- Department of Infectious Diseases, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- Department of Hepatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Weiliang Kong
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Yanmei Shi
- Department of Infectious Diseases, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- Department of Hepatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Yilian Xie
- Department of Infectious Diseases, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- Department of Hepatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
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Mijangos-Trejo A, Gómez-Mendoza R, Ramos-Ostos MH, Castro-Narro G, Uribe M, Juárez-Hernández E, López-Méndez I. Diagnostic Accuracy of the Triglyceride-Glucose Index (TyG), TyG Body Mass Index, and TyG Waist Circumference Index for Liver Steatosis Detection. Diagnostics (Basel) 2024; 14:762. [PMID: 38611675 PMCID: PMC11011440 DOI: 10.3390/diagnostics14070762] [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: 02/17/2024] [Revised: 03/28/2024] [Accepted: 03/31/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The triglyceride-glucose index (TyG) and a combination of body mass index (BMI) and waist circumference (WC) have been proposed as predictive scores for liver steatosis (LS). The aim of this study was to determine the diagnostic accuracy of these indices compared with controlled attenuation parameters (CAPs) and other predictive scores of LS. METHODS A retrospective analysis of patients who attended a check-up unit in 2021 was performed. LS was determined by CAP. Anthropometric and biochemical parameters for calculating TyG, TyG-BMI, TyG-WC, fatty liver index, and hepatic steatosis index were obtained. ROC curve was used to establish the best cut-off point of each TyG index for LS detection. The accuracy was determined for all patients, as well as for overweight and diabetic patients. RESULTS Medical records of 855 patients with a median age of 48 [IQR, 44-54] years and a BMI of 25.7 [IQR 23.4-28.1] kg/m2 were included. According to CAP, LS prevalence was 31.8% (n = 272). TyG-BMI and TyG-WC show better AUCs compared with CAP (0.82, 0.81), FLI (0.96, both), and HSI (0.93, 0.85). For diabetic patients, TyG-WC shows an AUC of 0.70. Meanwhile, TyG-BMI shows better accuracy (0.75) compared with CAP. CONCLUSIONS TyG-BMI and TyG-WC showed a superior predictive accuracy for detecting LS compared with the TyG index.
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Affiliation(s)
- Alejandra Mijangos-Trejo
- Gastroenterology and Obesity Unit, Medica Sur Clinic & Foundation, Mexico City 14050, Mexico; (A.M.-T.); (R.G.-M.); (M.U.)
| | - Raúl Gómez-Mendoza
- Gastroenterology and Obesity Unit, Medica Sur Clinic & Foundation, Mexico City 14050, Mexico; (A.M.-T.); (R.G.-M.); (M.U.)
| | | | - Graciela Castro-Narro
- Transplants and Hepatology Unit, Medica Sur Clinic & Foundation, Mexico City 14050, Mexico;
| | - Misael Uribe
- Gastroenterology and Obesity Unit, Medica Sur Clinic & Foundation, Mexico City 14050, Mexico; (A.M.-T.); (R.G.-M.); (M.U.)
| | - Eva Juárez-Hernández
- Translational Research Unit, Medica Sur Clinic & Foundation, Mexico City 14050, Mexico
| | - Iván López-Méndez
- Transplants and Hepatology Unit, Medica Sur Clinic & Foundation, Mexico City 14050, Mexico;
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Song K, Kim HS, Chae HW. Nonalcoholic fatty liver disease and insulin resistance in children. Clin Exp Pediatr 2023; 66:512-519. [PMID: 36634667 PMCID: PMC10694550 DOI: 10.3345/cep.2022.01312] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/19/2022] [Accepted: 12/29/2022] [Indexed: 01/11/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD), a spectrum of liver diseases characterized by excessive fat accumulation, is the leading cause of chronic liver disease. The global prevalence of NAFLD is increasing in both adults and children. In Korea, the prevalence of pediatric NAFLD increased from 8.2% in 2009 to 12.1% in 2018 according to a national surveillance study. For early screening of pediatric NAFLD, laboratory tests including aspartate aminotransferase and alanine aminotransferase; biomarkers including hepatic steatosis index, triglyceride glucose index, and fibrosis-4 index; and imaging studies including ultrasonography and magnetic resonance imaging are required. Insulin resistance plays a major role in the pathogenesis of NAFLD, which promotes insulin resistance. Thus, the association between NAFLD and insulin resistance, diabetes mellitus, and metabolic syndrome has been reported in many studies. This review addresses issues related to the epidemiology and investigation of NAFLD as well as the association between NAFLD and insulin resistance and metabolic syndrome with focus on pediatric NAFLD.
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Affiliation(s)
- Kyungchul Song
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Ho-Seong Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
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Wang M, Chang M, Shen P, Wei W, Li H, Shen G. Application value of triglyceride-glucose index and triglyceride-glucose body mass index in evaluating the degree of hepatic steatosis in non-alcoholic fatty liver disease. Lipids Health Dis 2023; 22:186. [PMID: 37924128 PMCID: PMC10623715 DOI: 10.1186/s12944-023-01954-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/21/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND The elevation of TyG is considered an important factor in promoting the progression of non-alcoholic fatty liver disease (NAFLD), but its impact on the degree of liver steatosis remains unclear. This study aims to explore the relationship between TyG and TyG-related indices, such as triglyceride glucose-body mass index (TyG-BMI), with the degree of liver fat accumulation. METHODS From January 2021 to March 2022, 1171 participants underwent health check-ups, and all underwent FibroScan transient elastography. The analysis focused on identifying the factors that contribute to the onset of NAFLD and the degree of hepatic steatosis. RESULTS The predictive value of TyG-BMI (OR = 1.039, 95% CI 1.031-1.046) in triggering NAFLD development was greater than that of TyG alone. The areas under the curve for TyG-BMI and TyG were calculated at 0.808 and 0.720, respectively. TyG-BMI (OR = 1.034, P < 0.001) was identified as a main independent factor affecting hepatic steatosis severity. With each incremental increase in TyG-BMI, the likelihood of experiencing an increase in the extent of hepatic steatosis was 1.034 times higher than that of the preceding unit. CONCLUSIONS The TyG-BMI showed higher accuracy in predicting NAFLD than did the TyG, and was more closely linked to the severity of hepatic steatosis. Therefore, it can be included as a parameter in health management centers and should be widely used to screen and evaluate patients with NAFLD.
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Affiliation(s)
- Mengyuan Wang
- Department of Health Management Center, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Mingxing Chang
- Department of Health Management Center, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Peipu Shen
- Department of Health Management Center, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wei Wei
- Department of Health Management Center, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Huayao Li
- Department of Health Management Center, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Guifang Shen
- Department of Health Management Center, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
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Liu Z, Deng B, Huang Q, Tu R, Yu F, Xia J, Feng J. Comparison of seven surrogate insulin resistance indexes for predicting the prevalence of carotid atherosclerosis in normal-weight individuals. Front Public Health 2023; 11:1241523. [PMID: 37719743 PMCID: PMC10501451 DOI: 10.3389/fpubh.2023.1241523] [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: 06/16/2023] [Accepted: 08/18/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction The aim of this study was to assess the correlation between surrogate insulin resistance (IR) indexes and carotid atherosclerosis (CA) in normal-weight populations, as well as compared their ability to predict CA. Method A total of 26,795 middle-aged and older adult individuals with normal body weights were included. Triglyceride-glucose index (TyG), TyG-body mass index, TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), visceral adiposity index, Chinese VAI (CVAI) and lipid accumulation product (LAP) were determined using established formulas. The associations between these surrogate indexes and CA were assessed using logistic regression models and restricted cubic spline (RCS) analysis. Receiver operating characteristic curves were utilized to compare the performance of these indexes for predicting CA. Result The levels of all seven surrogate indexes of IR were significantly higher in normal-weight individuals with CA than in those without CA (p < 0.001). In the full-adjusted model, only CVAI, TyG-WC, TyG-WHtR and LAP were significantly associated with CA, with the adjusted odds ratios (95% CI) of CA being 1.25 (1.20-1.30), 1.18 (1.14-1.23), 1.20 (1.16-1.25) and 1.25 (1.18-1.32) for each one standard deviation increase in CVAI, TyG-WC, TyG-WHtR and LAP, respectively. RCS analysis revealed a significant increase in the prevalence of CA among normal-weight individuals with CVAI >89.83, LAP >28.91, TyG-WHtR >4.42 and TyG-WC >704.93. The area under the curve for CVAI was significantly greater than for other indexes (p < 0.001). Conclusion CVAI, TyG-WC, TyG-WHtR and LAP were independently associated with the prevalence of CA. Specifically, CVAI may be the most appropriate predictor of CA in normal-weight individuals.
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Affiliation(s)
- Zeyu Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bi Deng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qin Huang
- Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Ruxin Tu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fang Yu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jian Xia
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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He X, Huang X, Qian Y, Sun T. A non-linear relationship between triglyceride glucose waist circumference and nonalcoholic fatty liver disease in a Japanese population: a secondary analysis. Front Endocrinol (Lausanne) 2023; 14:1188214. [PMID: 37484966 PMCID: PMC10361614 DOI: 10.3389/fendo.2023.1188214] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/08/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Nonalcoholic fatty liver disease (NAFLD) is a common metabolic disorder associated with insulin resistance (IR). Triglyceride glucose waist circumference (TyG-WC) is a novel index of IR that reflects both visceral fat and hepatic steatosis. However, it is not known whether TyG-WC and NAFLD exhibit a nonlinear relationship in Japanese subjects with normal plasma glucose level. Thus, we examined the relationship between TyG-WC and NAFLD, in addition to determining the threshold level of TyG-WC associated with NAFLD. Methods A secondary analysis was performed based on a previous study that extracted medical examination records from Murakami Memorial Hospital between 2004 and 2015 in order to detect chronic diseases and their risk factors. TyG-WC was determined at baseline. NAFLD is the dependent variable. Univariate and multivariate logistic regression models were used to evaluate the risk of NAFLD incidence. Based on the smoothing plot, a two-piecewise linear regression model was used to examine the threshold effect of TyG-WC on NAFLD. A subgroup analysis was carried out in order to study other factors that may influence the association between TyG-WC and NAFLD. Results 14,280 met the criteria for inclusion in the current secondary analysis. The adjusted OR (95% CI) for NAFLD in all subjects was 1.007 (95% CI 1.006-1.009, P < 0.001). The relationship between TyG-WC and NAFLD in Japanese subjects with normal plasma glucose level is nonlinear. TyG-WC is positively associated with NAFLD when TyG-WC is ranged between 480 and 800. In subgroup analyses, there was a significant interaction between BMI and TyG-WC associated NAFLD risk (P for interaction <0.001). Discussion The relationship between TyG-WC and NAFLD is nonlinear. TyG-WC is positively associated with NAFLD when TyG-WC is ranged between 480 and 800. There is potential clinical significance for the TyG-WC in identifying groups at high risk for NAFLD in subjects with normal plasma glucose level.
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Affiliation(s)
- Xiaojie He
- Department of Health Management Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xinyue Huang
- School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yafang Qian
- Department of Health Management Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ting Sun
- Department of Health Management Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Kuang M, Yang R, Huang X, Wang C, Sheng G, Xie G, Zou Y. Assessing temporal differences in the predictive power of baseline TyG-related parameters for future diabetes: an analysis using time-dependent receiver operating characteristics. J Transl Med 2023; 21:299. [PMID: 37138277 PMCID: PMC10158224 DOI: 10.1186/s12967-023-04159-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/25/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND It is known that measuring the triglyceride glucose (TyG) index and TyG-related parameters [triglyceride glucose-body mass index (TyG-BMI), triglyceride glucose-waist circumference (TyG-WC), and triglyceride glucose-waist to height ratio (TyG-WHtR)] can predict diabetes; this study aimed to compare the predictive value of the baseline TyG index and TyG-related parameters for the onset of diabetes at different future periods. METHODS We conducted a longitudinal cohort study involving 15,464 Japanese people who had undergone health physical examinations. The subject's TyG index and TyG-related parameters were measured at the first physical examination, and diabetes was defined according to the American Diabetes Association criteria. Multivariate Cox regression models and time-dependent receiver operating characteristic (ROC) curves were constructed to examine and compare the risk assessment/predictive value of the TyG index and TyG-related parameters for the onset of diabetes in different future periods. RESULTS The mean follow-up period of the current study cohort was 6.13 years, with a maximum of 13 years, and the incidence density of diabetes was 39.88/10,000 person-years. In multivariate Cox regression models with standardized hazard ratios (HRs), we found that both the TyG index and TyG-related parameters were significantly and positively associated with diabetes risk and that the TyG-related parameters were stronger in assessing diabetes risk than the TyG index, with TyG-WC being the best parameter (HR per SD increase: 1.70, 95% CI 1.46, 1.97). In addition, TyG-WC also showed the highest predictive accuracy in time-dependent ROC analysis for diabetes occurring in the short-term (2-6 years), while TyG-WHtR had the highest predictive accuracy and the most stable predictive threshold for predicting the onset of diabetes in the medium- to long-term (6-12 years). CONCLUSIONS These results suggest that the TyG index combined with BMI, WC, and WHtR can further improve its ability to assess/predict the risk of diabetes in different future periods, where TyG-WC was not only the best parameter for assessing diabetes risk but also the best risk marker for predicting future diabetes in the short-term, while TyG-WHtR may be more suitable for predicting future diabetes in the medium- to long-term.
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Affiliation(s)
- Maobin Kuang
- Medical College of Nanchang University, Nanchang, 330006, Jiangxi, China
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Ruijuan Yang
- Medical College of Nanchang University, Nanchang, 330006, Jiangxi, China
- Department of Endocrinology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Xin Huang
- Medical College of Nanchang University, Nanchang, 330006, Jiangxi, China
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Chao Wang
- Medical College of Nanchang University, Nanchang, 330006, Jiangxi, China
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Guotai Sheng
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Guobo Xie
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China.
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China.
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11
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The Diagnostic and Prognostic Value of the Triglyceride-Glucose Index in Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD): A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14234969. [PMID: 36500999 PMCID: PMC9741077 DOI: 10.3390/nu14234969] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Metabolic dysfunction-associated fatty liver disease (MAFLD) has been related to a series of harmful health consequences. The triglyceride-glucose index (TyG index) appears to be associated with MAFLD. However, no consistent conclusions about the TyG index and incident MAFLD have been reached. PubMed, MEDLINE, Web of Science, EMBASE and the Cochrane Library were searched. Sensitivities, specificities and the area under the receiver operating characteristic (AUC) with a random-effects model were used to assess the diagnostic performance of the TyG index in NAFLD/MAFLD participants. Potential threshold effects and publication bias were evaluated by Spearman’s correlation and Deeks’ asymmetry test, respectively. A total of 20 studies with 165725 MAFLD participants were included. The summary receiver operator characteristic (SROC) curve showed that the sensitivity, specificity and AUC were 0.73 (0.69−0.76), 0.67 (0.65, 0.70) and 0.75 (0.71−0.79), respectively. Threshold effects (r = 0.490, p < 0.05) were confirmed to exist. Subgroup analyses and meta-regression showed that some factors including country, number of samples, age and disease situation were the sources of heterogeneity (p < 0.05). Our meta-analysis suggests that the TyG index can diagnose and predict MAFLD patients with good accuracy. The number of studies remains limited, and prospective studies are needed.
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12
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Beran A, Ayesh H, Mhanna M, Wahood W, Ghazaleh S, Abuhelwa Z, Sayeh W, Aladamat N, Musallam R, Matar R, Malhas SE, Assaly R. Triglyceride-Glucose Index for Early Prediction of Nonalcoholic Fatty Liver Disease: A Meta-Analysis of 121,975 Individuals. J Clin Med 2022; 11:jcm11092666. [PMID: 35566790 PMCID: PMC9102411 DOI: 10.3390/jcm11092666] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 12/12/2022] Open
Abstract
Insulin resistance (IR) is a major contributor to the pathogenesis of nonalcoholic fatty liver disease (NAFLD). The triglyceride-glucose (TyG) index has recently gained popularity for the assessment of IR and NAFLD due to its ease of acquisition and calculation. Therefore, we conducted this systematic review and meta-analysis to summarize the existing studies in the literature and provide a quantitative assessment of the significance of the TyG index in predicting the incidence of NAFLD. A comprehensive literature search in PubMed, EMBASE, and Web of Science databases from inception until 25 March 2022 was conducted. Published observational studies that evaluated the association between TyG index and NAFLD among the adult population and reported the hazard ratio (HR) or odds ratio (OR) for this association after multivariate analysis were included. The random-effects model was used as the primary statistical analysis model in the estimation of pooled ORs and HRs with the corresponding confidence intervals (CIs). A total of 17 observational studies, including 121,975 participants, were included. For studies analyzing the TyG index as a categorical variable, both pooled OR (6.00, CI 4.12–8.74) and HR (1.70, CI 1.28–2.27) were significant for the association between TyG index and incident NAFLD. For studies analyzing the TyG index as a continuous variable, pooled OR (2.25, CI 1.66–3.04) showed similar results. Consistent results were obtained in subgroup analyses according to the study design, sample size, ethnicity, and diabetic status. In conclusion, our meta-analysis demonstrates that a higher TyG index is associated with higher odds of NAFLD. TyG index may serve as an independent predictive tool to screen patients at high risk of NAFLD in clinical practice, especially in primary care settings. Patients with a high TyG index should be referred for a liver ultrasound and start intense lifestyle modifications. However, further large-scale prospective cohort studies are necessary to validate our findings.
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Affiliation(s)
- Azizullah Beran
- Department of Internal Medicine, University of Toledo, Toledo, OH 43606, USA; (H.A.); (M.M.); (S.G.); (Z.A.); (W.S.); (S.-E.M.); (R.A.)
- Correspondence: ; Tel.: +1-469-348-1347
| | - Hazem Ayesh
- Department of Internal Medicine, University of Toledo, Toledo, OH 43606, USA; (H.A.); (M.M.); (S.G.); (Z.A.); (W.S.); (S.-E.M.); (R.A.)
| | - Mohammed Mhanna
- Department of Internal Medicine, University of Toledo, Toledo, OH 43606, USA; (H.A.); (M.M.); (S.G.); (Z.A.); (W.S.); (S.-E.M.); (R.A.)
| | - Waseem Wahood
- Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Davie, FL 33314, USA;
| | - Sami Ghazaleh
- Department of Internal Medicine, University of Toledo, Toledo, OH 43606, USA; (H.A.); (M.M.); (S.G.); (Z.A.); (W.S.); (S.-E.M.); (R.A.)
| | - Ziad Abuhelwa
- Department of Internal Medicine, University of Toledo, Toledo, OH 43606, USA; (H.A.); (M.M.); (S.G.); (Z.A.); (W.S.); (S.-E.M.); (R.A.)
| | - Wasef Sayeh
- Department of Internal Medicine, University of Toledo, Toledo, OH 43606, USA; (H.A.); (M.M.); (S.G.); (Z.A.); (W.S.); (S.-E.M.); (R.A.)
| | - Nameer Aladamat
- Department of Neurology, University of Toledo, Toledo, OH 43606, USA;
| | - Rami Musallam
- Department of Internal Medicine, St. Vincent Charity Medical Center, Cleveland, OH 44115, USA;
| | - Reem Matar
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA;
| | - Saif-Eddin Malhas
- Department of Internal Medicine, University of Toledo, Toledo, OH 43606, USA; (H.A.); (M.M.); (S.G.); (Z.A.); (W.S.); (S.-E.M.); (R.A.)
| | - Ragheb Assaly
- Department of Internal Medicine, University of Toledo, Toledo, OH 43606, USA; (H.A.); (M.M.); (S.G.); (Z.A.); (W.S.); (S.-E.M.); (R.A.)
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13
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Song K, Lee HW, Choi HS, Park G, Lee HS, Kim SJ, Lee M, Suh J, Kwon A, Kim HS, Chae HW. Comparison of the Modified TyG Indices and Other Parameters to Predict Non-Alcoholic Fatty Liver Disease in Youth. BIOLOGY 2022; 11:biology11050685. [PMID: 35625413 PMCID: PMC9138077 DOI: 10.3390/biology11050685] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022]
Abstract
Simple Summary Non-alcoholic fatty liver disease (NAFLD) is associated with cardio-metabolic risk factors, including obesity, dyslipidemia, insulin resistance, and hepatic cirrhosis. The increasing prevalence of NAFLD among youths has become a public health concern. However, studies about reliable markers for assessing NAFLD in youths are limited. Thus, we investigated the markers including the triglycerides-glucose (TyG) index, modified TyG indices, hepatic steatosis index (HSI), aspartate transaminase-to-platelet ratio index (APRI), and modified APRIs for the prediction of NAFLD. This study demonstrated that the modified TyG indices, APRI-body mass index standard deviation score, and HSI are strongly associated with NAFLD in children and adolescents. Thus, these markers may be useful for identifying youths who require hepatic ultrasonography and early treatment. Abstract We investigated the modified triglycerides-glucose (TyG) indices and other markers for non-alcoholic fatty liver disease (NAFLD) in 225 participants aged 10–19 years, and the participants were divided into subgroups according to their NAFLD grade. We performed logistic regression analysis and calculated the odds ratios (ORs) with 95% confidence intervals (CIs) of tertiles 2 and 3 for each parameter, with those of tertile 1 as a reference. The area under the receiver operating characteristic (ROC) curve was calculated to compare the parameters for identifying NAFLD. TyG and modified indices, aspartate transaminase-to-platelet ratio index (APRI)-body mass index (BMI), APRI-BMI standard deviation score (SDS), APRI waist-to-hip ratio, fibrosis-4 index (FIB)-4, and hepatic steatosis index (HSI) were higher in participants with NAFLD than in those without NAFLD. The ORs and 95% CIs for NAFLD progressively increased across tertiles of each parameter. TyG and modified TyG indices, FIB-4, HSI, and modified APRIs, except APRI waist-to-height ratio, predicted NAFLD significantly through ROC curves. Modified TyG indices, APRI-BMI SDS, and HSI were superior to the other markers for NAFLD prediction. Modified TyG indices, APRI-BMI SDS, and HSI appear to be useful for assessing NAFLD in youths.
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Affiliation(s)
- Kyungchul Song
- Department of Pediatrics, Severance Children’s Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (K.S.); (H.W.L.); (S.J.K.); (M.L.); (J.S.); (A.K.); (H.-S.K.)
| | - Hae Won Lee
- Department of Pediatrics, Severance Children’s Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (K.S.); (H.W.L.); (S.J.K.); (M.L.); (J.S.); (A.K.); (H.-S.K.)
| | - Han Saem Choi
- Department of Pediatrics, International St. Mary’s Hospital, Catholic Kwandong University, Incheon 22711, Korea;
| | - Goeun Park
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 03722, Korea; (G.P.); (H.S.L.)
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 03722, Korea; (G.P.); (H.S.L.)
| | - Su Jin Kim
- Department of Pediatrics, Severance Children’s Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (K.S.); (H.W.L.); (S.J.K.); (M.L.); (J.S.); (A.K.); (H.-S.K.)
| | - Myeongseob Lee
- Department of Pediatrics, Severance Children’s Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (K.S.); (H.W.L.); (S.J.K.); (M.L.); (J.S.); (A.K.); (H.-S.K.)
| | - Junghwan Suh
- Department of Pediatrics, Severance Children’s Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (K.S.); (H.W.L.); (S.J.K.); (M.L.); (J.S.); (A.K.); (H.-S.K.)
| | - Ahreum Kwon
- Department of Pediatrics, Severance Children’s Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (K.S.); (H.W.L.); (S.J.K.); (M.L.); (J.S.); (A.K.); (H.-S.K.)
| | - Ho-Seong Kim
- Department of Pediatrics, Severance Children’s Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (K.S.); (H.W.L.); (S.J.K.); (M.L.); (J.S.); (A.K.); (H.-S.K.)
| | - Hyun Wook Chae
- Department of Pediatrics, Severance Children’s Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (K.S.); (H.W.L.); (S.J.K.); (M.L.); (J.S.); (A.K.); (H.-S.K.)
- Correspondence: ; Tel.: +82-2-2019-3350; Fax: +82-2-393-9118
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14
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Ling Q, Chen J, Liu X, Xu Y, Ma J, Yu P, Zheng K, Liu F, Luo J. The triglyceride and glucose index and risk of nonalcoholic fatty liver disease: A dose-response meta-analysis. Front Endocrinol (Lausanne) 2022; 13:1043169. [PMID: 36743937 PMCID: PMC9892833 DOI: 10.3389/fendo.2022.1043169] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The triglyceride and glucose (TyG) index is associated with the risk of nonalcoholic fatty liver disease (NAFLD), but the dose-response relationship between them is still unknown. We conducted a comprehensive meta-analysis to study the dose-response association between the TyG index and the risk of NAFLD. METHODS We systematically searched the Cochrane Library, PubMed, and Embase databases until July 2022 for relevant studies. The robust error meta-regression method was used to investigate the dose-response association between the TyG index and NAFLD. Summary relative risks (ORs) and 95% CIs were estimated by using a random-effects model. RESULTS A total of 4 cohort and 8 cross-sectional studies were included, with 28,788 NAFLD cases among the 105,365 participants. A positive association for the risk of NAFLD was observed for each additional unit of the TyG index with a linear association (p=0.82), and the summary OR was 2.84 (95% CI, 2.01-4.01). In the subgroup analyses, a stronger association of the TyG index with NAFLD was shown in females than in males (men: OR=2.97, 95% CI 2.55-3.46, women: OR=4.80, 95% CI 3.90-5.90, Psubgroup<0.001). CONCLUSION The TyG index may be a novel independent risk factor for NAFLD beyond traditional risk factors. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero, identifier (CRD42022347813).
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Affiliation(s)
- Qin Ling
- Department of Cardiology, the Affiliated Ganzhou Hospital of Nanchang University, Jiangxi, China
- The Second Clinical Medical College of Nanchang University, Jiangxi, China
| | - Jiawei Chen
- Department of Cardiology, the Affiliated Ganzhou Hospital of Nanchang University, Jiangxi, China
- The Second Clinical Medical College of Nanchang University, Jiangxi, China
| | - Xiao Liu
- Department of Cardiology, the Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yi Xu
- Department of Cardiology, the Affiliated Ganzhou Hospital of Nanchang University, Jiangxi, China
- The Second Clinical Medical College of Nanchang University, Jiangxi, China
| | - Jianyong Ma
- Department of Pharmacology and Systems Physiology, University of Cinnati College of Medicine, Cincinnati, OH, United States
| | - Peng Yu
- Department of Endocrine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Kai Zheng
- Medical Care Strategic Customer Department, China Merchants Bank Shenzhen Branch, Shenzhen, China
| | - Fuwei Liu
- Department of Cardiology, the Affiliated Ganzhou Hospital of Nanchang University, Jiangxi, China
- *Correspondence: Jun Luo, ; Fuwei Liu,
| | - Jun Luo
- Department of Cardiology, the Affiliated Ganzhou Hospital of Nanchang University, Jiangxi, China
- *Correspondence: Jun Luo, ; Fuwei Liu,
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15
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Hu J, Cai X, Li N, Zhu Q, Wen W, Hong J, Zhang D, Yao X, Luo Q, Sun L. Association Between Triglyceride Glucose Index-Waist Circumference and Risk of First Myocardial Infarction in Chinese Hypertensive Patients with Obstructive Sleep Apnoea: An Observational Cohort Study. Nat Sci Sleep 2022; 14:969-980. [PMID: 35615442 PMCID: PMC9126228 DOI: 10.2147/nss.s362101] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/06/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to investigate the association between triglyceride glucose index-waist circumference (TyG-WC) and the risk of first myocardial infarction (MI) in Chinese hypertensive patients with obstructive sleep apnoea (OSA). METHODS This study was an observational cohort study. A total of 2224 Chinese hypertensive patients with OSA without a history of MI were included in this study. Hazard ratio (HR) and 95% confidence interval (CI) were estimated using multivariable Cox proportion hazard models. A generalized additive model was used to identify nonlinear relationships. Additionally, we performed hierarchical analysis and test for interaction. RESULTS During a median follow-up of 7.15 years, 85 incidents of MI developed. Overall, there was a positive association between TyG-WC and the risk of first MI. In the multivariable-adjusted model, the risk of MI increased with quartiles of the TyG-WC, the HR in quartile 4 versus quartile 1 was 4.29. A generalized additive model and a smooth curve fitting showed that there existed a similar J-shaped association between TyG-WC and the risk of first MI, with an inflection point at about 785. CONCLUSION Elevated levels of the baseline TyG-WC are associated with an increased risk of first MI. This finding indicates that the TyG-WC might be useful to identify the high risk of first MI in Chinese hypertensive patients with OSA.
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Affiliation(s)
- Junli Hu
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Xintian Cai
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Nanfang Li
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Qing Zhu
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Wen Wen
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Jing Hong
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Delian Zhang
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Xiaoguang Yao
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Qin Luo
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Le Sun
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
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