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Lodge M, Dykes R, Kennedy A. Regulation of Fructose Metabolism in Nonalcoholic Fatty Liver Disease. Biomolecules 2024; 14:845. [PMID: 39062559 PMCID: PMC11274671 DOI: 10.3390/biom14070845] [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: 06/17/2024] [Revised: 07/02/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
Elevations in fructose consumption have been reported to contribute significantly to an increased incidence of obesity and metabolic diseases in industrial countries. Mechanistically, a high fructose intake leads to the dysregulation of glucose, triglyceride, and cholesterol metabolism in the liver, and causes elevations in inflammation and drives the progression of nonalcoholic fatty liver disease (NAFLD). A high fructose consumption is considered to be toxic to the body, and there are ongoing measures to develop pharmaceutical therapies targeting fructose metabolism. Although a large amount of work has summarized the effects fructose exposure within the intestine, liver, and kidney, there remains a gap in our knowledge regarding how fructose both indirectly and directly influences immune cell recruitment, activation, and function in metabolic tissues, which are essential to tissue and systemic inflammation. The most recent literature demonstrates that direct fructose exposure regulates oxidative metabolism in macrophages, leading to inflammation. The present review highlights (1) the mechanisms by which fructose metabolism impacts crosstalk between tissues, nonparenchymal cells, microbes, and immune cells; (2) the direct impact of fructose on immune cell metabolism and function; and (3) therapeutic targets of fructose metabolism to treat NAFLD. In addition, the review highlights how fructose disrupts liver tissue homeostasis and identifies new therapeutic targets for treating NAFLD and obesity.
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Affiliation(s)
| | | | - Arion Kennedy
- Department of Molecular and Structural Biochemistry, North Carolina State University, 128 Polk Hall Campus, Box 7622, Raleigh, NC 27695, USA
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Li C, Xu J. Negative correlation between metabolic score for insulin resistance index and testosterone in male adults. Diabetol Metab Syndr 2024; 16:113. [PMID: 38783379 PMCID: PMC11112955 DOI: 10.1186/s13098-024-01353-5] [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: 12/17/2023] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Insulin resistance (IR) is strongly correlated with the decreased deficiency of testosterone levels in males. The metabolic score for insulin resistance (METS-IR) index is regarded as an innovative measure for the assessment on IR. The research aims to explore the correlation between the METS-IR index and the testosterone levels in males. METHODS In this study, a cross-sectional design was made through the data obtained from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2020. Besides, the METS-IR index was derived from serum triglyceride levels, fasting plasma glucose, HDL-C and BMI. RESULTS A total of 2082 participants were included in the final analysis. After controlling for confounding variables, it was found that METS-IR was independently and negatively correlated with testosterone levels (β = -3.88, 95% CI = -4.49, -3.27, P < 0.001). As shown by the generalized smooth curve fitting, METS-IR had a linear correlation with testosterone levels without threshold or saturation effects, which was consistently observed across all subgroups through stratified analysis (all P > 0.05). As revealed by the analysis on the ROC curve, the area under the curve (AUC) for the METS-IR index (0.732, 95% CI = 0.705, 0.760) was significantly larger than that of homeostatic model assessment of insulin resistance (HOMA-IR), TG/HDL ratio, triglyceride-glucose index (TyG) and body mass index (BMI). CONCLUSION The findings suggest a negative relationship between the METS-IR index and the testosterone levels in male adults. Furthermore, the METS-IR index demonstrates superior predictive ability for testosterone deficiency in comparison to HOMA-IR, TG/HDL ratio, TyG and BMI.
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Affiliation(s)
- ChunMei Li
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng District, Wenzhou, Zhejiang Province, China
| | - Jing Xu
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng District, Wenzhou, Zhejiang Province, China.
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Kuo TC, Lu YB, Yang CL, Wang B, Chen LX, Su CP. Association of insulin resistance indicators with hepatic steatosis and fibrosis in patients with metabolic syndrome. BMC Gastroenterol 2024; 24:26. [PMID: 38195414 PMCID: PMC10775571 DOI: 10.1186/s12876-023-03095-6] [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: 09/05/2023] [Accepted: 12/13/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND To investigate the association of four insulin resistance (IR) indicators with hepatic steatosis and fibrosis in patients with metabolic syndrome (MetS), as well as to compare the diagnostic value of these indicators in identifying hepatic steatosis and fibrosis in individuals with MetS. METHODS This cross-sectional study used the data from the National Health and Nutrition Examination Survey 2017-2018. IR indicators included homeostasis model assessment of IR (HOMA-IR), triglyceride/glucose (TyG) index, triglyceride glucose-waist-to-height ratio (TyG-WHtR), and metabolic score for IR (METS-IR). The main endpoints of this study were hepatic steatosis and hepatic fibrosis. Weighted univariate and multivariate logistic regression models were employed to evaluate the association between four IR indicators and both hepatic steatosis, hepatic fibrosis. The efficacy of various IR indicators in the detection of hepatic steatosis and hepatic fibrosis were assessed using receiver operating characteristics curve (ROC). RESULTS A total of 876 participants with MetS were enrolled. Among the participants, hepatic steatosis was observed in 587 MetS individuals, while hepatic fibrosis was identified in 151 MetS individuals. In multivariate logistic regression model, HOMA-IR, TyG, TyG-WHtR, and METS-IR were related to the increased odd of hepatic steatosis. Additionally, HOMA-IR, TyG-WHtR, and METS-IR were associated with increased odd of hepatic fibrosis. According to the ROC analysis, the area under the curve (AUC) of the TyG-WHtR (AUC = 0.705, 95%CI: 0.668-0.743) was higher than HOMA-IR (AUC = 0.693, 95%CI: 0.656-0.730), TyG (AUC = 0.627, 95%CI: 0.587-0.666), and METS-IR (AUC = 0.685, 95%CI: 0.648-0.722) for identifying hepatic steatosis of MetS patients. Likewise, TyG-WHtR was also higher than HOMA-IR, TyG, and METS-IR for identifying hepatic fibrosis of MetS patients. CONCLUSION HOMA-IR, TyG-WHtR, and METS-IR may be associated with the risk of hepatic steatosis and fibrosis among the U.S. adult population with MetS. In addition, TyG-WHtR may have a good predictive value for hepatic steatosis and hepatic fibrosis.
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Affiliation(s)
- Tzu-Chia Kuo
- Department of Chinese Medicine, Xiamen Chang Gung Hospital, No.123 Xiafei Road, Haicang District, Xiamen, 361022, Fujian, China.
| | - Yang-Bor Lu
- Department of Digestive Diseases, Xiamen Chang Gung Hospital, Xiamen, 361022, Fujian, China
| | - Chieh-Lun Yang
- Department of Nephrology, Xiamen Chang Gung Hospital, Xiamen, 361022, Fujian, China
| | - Bin Wang
- Department of Chinese Medicine, Xiamen Chang Gung Hospital, No.123 Xiafei Road, Haicang District, Xiamen, 361022, Fujian, China
| | - Lin-Xin Chen
- Department of Chinese Medicine, Xiamen Chang Gung Hospital, No.123 Xiafei Road, Haicang District, Xiamen, 361022, Fujian, China
| | - Ching-Ping Su
- Department of Chinese Medicine, Xiamen Chang Gung Hospital, No.123 Xiafei Road, Haicang District, Xiamen, 361022, Fujian, China
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Ramírez-Manent JI, López-González ÁA, Tomás-Gil P, Riutord-Sbert P, Garrido-Sepulveda L, Vicente-Herrero MT. Relationship between Abdominal Volume Index and Body Adiposity Index and Scales of Insulin Resistance and Metabolic Syndrome. Diagnostics (Basel) 2023; 13:3356. [PMID: 37958252 PMCID: PMC10649100 DOI: 10.3390/diagnostics13213356] [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: 09/20/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Introduction, objectives: Obesity is a global health problem with a great negative impact on health. Among the pathologies caused by obesity are insulin resistance and metabolic syndrome, which constitute an increasingly common health problem in both developed and developing countries. The aim of this study was to examine the relationship between two scales that assess obesity-based on hip circumference-and metabolic syndrome (MetS) and insulin resistance risk scales as predictors of these alterations. MATERIALS, METHODS A descriptive, cross-sectional study was carried out on 193,462 workers from different Spanish regions and work groups between January 2019 and September 2021. Abdominal volume index (AVI) and body adiposity index (BAI) were evaluated to assess obesity and its association with insulin resistance using three risk scales (TyG index, Triglycerides/HDL, and METS-IR), while their association with metabolic syndrome was determined using the NCEP ATP III, IDF, and JIS models. RESULTS The results of the ROC curves to determine the predictive value of BAI and AVI in relation to the three criteria evaluated to calculate MetS in all instances presented a higher area under the curve (AUC) for AVI. The high values of AVI stand out for predicting MetS when applying the IDF criteria. The cut-off point in women was 13.70 with a Youden index of 0.802, whereas in men, the cut-off point was set at 17.59 with a Youden index of 0.672. Regarding the relationship of BAI and AVI with insulin resistance risk scales for both sexes, the AUC only revealed high values when using the METS-IR formula for both AVI and BAI. The AVI cut-off points to predict high values of insulin resistance risk scales in women were established at 13.12 with a Youden index of 0.722. In men, the cut-off point was 17.59, with a Youden index of 0.626. The BAI cut-off points in women were set at 33.88 with a Youden index of 0.748. In men, the cut-off point was 27.91, with a Youden index of 0.598. CONCLUSIONS AVI demonstrated its value as a predictor of metabolic syndrome while exclusively applying the IDF criteria. AVI and BAI demonstrated their value as predictors of high values of insulin resistance risk scales only in the case of METS-IR. This predictive value is also higher in women.
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Affiliation(s)
- José Ignacio Ramírez-Manent
- ADEMA-Health Group, IUNICS University of Balearic Islands, 07009 Palma, Spain; (J.I.R.-M.); (P.T.-G.); (P.R.-S.); (M.T.V.-H.)
- Faculty of Medicine, University of the Balearic Islands, 07009 Palma, Spain
- Institut d’Investigació Sanitària de les Illes Balears (IDISBA), Balearic Islands Health Research Institute Foundation, 07004 Palma, Spain
- General Practitioner Department, Balearic Islands Health Service, 07003 Palma, Spain
| | - Ángel Arturo López-González
- ADEMA-Health Group, IUNICS University of Balearic Islands, 07009 Palma, Spain; (J.I.R.-M.); (P.T.-G.); (P.R.-S.); (M.T.V.-H.)
| | - Pilar Tomás-Gil
- ADEMA-Health Group, IUNICS University of Balearic Islands, 07009 Palma, Spain; (J.I.R.-M.); (P.T.-G.); (P.R.-S.); (M.T.V.-H.)
| | - Pere Riutord-Sbert
- ADEMA-Health Group, IUNICS University of Balearic Islands, 07009 Palma, Spain; (J.I.R.-M.); (P.T.-G.); (P.R.-S.); (M.T.V.-H.)
| | | | - María Teofila Vicente-Herrero
- ADEMA-Health Group, IUNICS University of Balearic Islands, 07009 Palma, Spain; (J.I.R.-M.); (P.T.-G.); (P.R.-S.); (M.T.V.-H.)
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Wang M, Dai Z, Zhang X, Xu X, Sun Y, Gong F, Qin B, Wang J, Liu B, Tang H, Li T, Zhang J, Wang J, Chen W, Ma L, Han Z, Liu D. The metabolic score for insulin resistance as a predictor of clinical outcome in stroke patients treated by intravenous thrombolysis. Neurol Sci 2023; 44:3587-3594. [PMID: 37202593 DOI: 10.1007/s10072-023-06848-z] [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: 04/23/2023] [Accepted: 05/08/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND AND PURPOSE Insulin resistance is associated with clinical outcomes among patients with ischemic stroke. We aimed to investigate the association between metabolic score for insulin resistance (METS-IR) and clinical outcomes in stroke patients treated by intravenous thrombolysis (IVT). METHODS We recruited participants treated with IVT from a prospective registry including 3 stroke centers. Poor outcome was defined as a modified Rankin scale score ≥ 3 points at 90 days after the index stroke. We performed logistic regression models to investigate the association between METS-IR and the risk of poor outcome. We used the receiver operative characteristic to assess the discriminative ability and the restricted cubic spline to explore the relationship between METS-IR and the poor outcome. RESULTS This study enrolled a total of 1074 patients (median age, 68; 63.8% male). Three hundred sixty (33.5%) patients had poor outcome after IVT. METS-IR was associated with the risk of the poor outcome with the increase of confounding factors in models (odds ratio [OR], 1.078; 95% confidence interval [CI], 1.058-1.099; P < 0.001). The area under the curve for METS-IR for predicting the poor outcome was 0.790 (95% CI, 0.761-0.819). The restricted cubic spline revealed an increasing and non-linear association between METS-IR and the poor outcome (P for non-linearity < 0.001). CONCLUSION Our study found that METS-IR was associated with an increased risk of poor outcome after IVT. Further studies are warranted to investigate the efficacy of anti-diabetic agents regarding IR on clinical outcomes after IVT.
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Affiliation(s)
- Mingzhe Wang
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 528 Zhang-Heng Road, Pu-Dong New Area, Shanghai, 201203, China
| | - Zheng Dai
- Department of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, Jiangsu Province, 214023, China
| | - Xiaohao Zhang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Xiaochen Xu
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 528 Zhang-Heng Road, Pu-Dong New Area, Shanghai, 201203, China
| | - Yan Sun
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 528 Zhang-Heng Road, Pu-Dong New Area, Shanghai, 201203, China
| | - Fan Gong
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 528 Zhang-Heng Road, Pu-Dong New Area, Shanghai, 201203, China
| | - Baofeng Qin
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 528 Zhang-Heng Road, Pu-Dong New Area, Shanghai, 201203, China
| | - Jun Wang
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 528 Zhang-Heng Road, Pu-Dong New Area, Shanghai, 201203, China
| | - Bin Liu
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 528 Zhang-Heng Road, Pu-Dong New Area, Shanghai, 201203, China
| | - Haiyan Tang
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 528 Zhang-Heng Road, Pu-Dong New Area, Shanghai, 201203, China
| | - Tingting Li
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 528 Zhang-Heng Road, Pu-Dong New Area, Shanghai, 201203, China
| | - Jinsi Zhang
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 528 Zhang-Heng Road, Pu-Dong New Area, Shanghai, 201203, China
| | - Jiecheng Wang
- Department of Encephalopathy, Qinghai Provincial Hospital of Traditional Chinese Medicine, Xining, 810000, Qinghai Province, China
| | - Wenjie Chen
- Department of Neurology, Nanping People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Nanping, 353000, Fujian Province, China
| | - Ling Ma
- Department of Encephalopathy, Qinghai Provincial Hospital of Traditional Chinese Medicine, Xining, 810000, Qinghai Province, China
| | - Zhenxiang Han
- Department of Neurology and Rehabilitation, Seventh People's Hospital of Shanghai University of TCM, 200137, No 358 Datong Road, Shanghai, 200137, China.
| | - Dezhi Liu
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 528 Zhang-Heng Road, Pu-Dong New Area, Shanghai, 201203, China.
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Xiang Q, Xu H, Zhan J, Lu S, Li S, Wang Y, Wang Y, He J, Ni Y, Li L, Liu Y, Liu Y. Reply to Mahat, R.K.; Rathore, V. Comment on "Xiang et al. Association between the Triglyceride-Glucose Index and Vitamin D Status in Type 2 Diabetes Mellitus. Nutrients 2023, 15, 639". Nutrients 2023; 15:4069. [PMID: 37764852 PMCID: PMC10535357 DOI: 10.3390/nu15184069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/06/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
We are pleased to see that Mahat and Rathore [...].
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Affiliation(s)
- Qunyan Xiang
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Q.X.); (H.X.); (J.Z.); (S.L.); (Y.W.); (Y.W.); (J.H.); (Y.N.); (L.L.); (Y.L.)
- Institute of Aging and Age-Related Disease Research, Central South University, Changsha 410011, China
| | - Hui Xu
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Q.X.); (H.X.); (J.Z.); (S.L.); (Y.W.); (Y.W.); (J.H.); (Y.N.); (L.L.); (Y.L.)
- Institute of Aging and Age-Related Disease Research, Central South University, Changsha 410011, China
| | - Junkun Zhan
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Q.X.); (H.X.); (J.Z.); (S.L.); (Y.W.); (Y.W.); (J.H.); (Y.N.); (L.L.); (Y.L.)
- Institute of Aging and Age-Related Disease Research, Central South University, Changsha 410011, China
| | - Shuzhen Lu
- Department of Nursing, Hunan Normal University School of Medicine, Changsha 410013, China;
| | - Shuang Li
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Q.X.); (H.X.); (J.Z.); (S.L.); (Y.W.); (Y.W.); (J.H.); (Y.N.); (L.L.); (Y.L.)
- Institute of Aging and Age-Related Disease Research, Central South University, Changsha 410011, China
| | - Yanjiao Wang
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Q.X.); (H.X.); (J.Z.); (S.L.); (Y.W.); (Y.W.); (J.H.); (Y.N.); (L.L.); (Y.L.)
- Institute of Aging and Age-Related Disease Research, Central South University, Changsha 410011, China
| | - Yi Wang
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Q.X.); (H.X.); (J.Z.); (S.L.); (Y.W.); (Y.W.); (J.H.); (Y.N.); (L.L.); (Y.L.)
- Institute of Aging and Age-Related Disease Research, Central South University, Changsha 410011, China
| | - Jieyu He
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Q.X.); (H.X.); (J.Z.); (S.L.); (Y.W.); (Y.W.); (J.H.); (Y.N.); (L.L.); (Y.L.)
- Institute of Aging and Age-Related Disease Research, Central South University, Changsha 410011, China
| | - Yuqing Ni
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Q.X.); (H.X.); (J.Z.); (S.L.); (Y.W.); (Y.W.); (J.H.); (Y.N.); (L.L.); (Y.L.)
- Institute of Aging and Age-Related Disease Research, Central South University, Changsha 410011, China
| | - Linsen Li
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Q.X.); (H.X.); (J.Z.); (S.L.); (Y.W.); (Y.W.); (J.H.); (Y.N.); (L.L.); (Y.L.)
- Institute of Aging and Age-Related Disease Research, Central South University, Changsha 410011, China
| | - Yiyang Liu
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Q.X.); (H.X.); (J.Z.); (S.L.); (Y.W.); (Y.W.); (J.H.); (Y.N.); (L.L.); (Y.L.)
- Institute of Aging and Age-Related Disease Research, Central South University, Changsha 410011, China
| | - Youshuo Liu
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Q.X.); (H.X.); (J.Z.); (S.L.); (Y.W.); (Y.W.); (J.H.); (Y.N.); (L.L.); (Y.L.)
- Institute of Aging and Age-Related Disease Research, Central South University, Changsha 410011, China
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Pan L, Zou H, Meng X, Li D, Li W, Chen X, Yang Y, Yu X. Predictive values of metabolic score for insulin resistance on risk of major adverse cardiovascular events and comparison with other insulin resistance indices among Chinese with and without diabetes mellitus: Results from the 4C cohort study. J Diabetes Investig 2023; 14:961-972. [PMID: 37132055 PMCID: PMC10360377 DOI: 10.1111/jdi.14024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/06/2023] [Accepted: 04/14/2023] [Indexed: 05/04/2023] Open
Abstract
AIMS/INTRODUCTION To investigate the relationship between the metabolic score for insulin resistance (METS-IR) index and major adverse cardiac events (MACEs) and to compare its ability to predict MACEs with other IR indices including homeostatic model assessment for IR (HOMA-IR) and triglyceride glucose (TyG) index-related parameters. MATERIALS AND METHODS We conducted a cohort study enrolling 7,291 participants aged ≥40 years. Binary logistic regression and restricted cubic splines were performed to determine the association between METS-IR and MACEs, and the receiver operating curve (ROC) was utilized to compare the predictive abilities of IR indices and to determine the optimal cut-off points. RESULTS There were 348 (4.8%) cases of MACEs during a median follow-up of 3.8 years. Compared with participants with a METS-IR in the lowest quartile, the multivariate-adjusted RRs and 95% CIs for participants with a METS-IR in the highest quartile were 1.47 (1.05-2.77) in all participants, 1.42 (1.18-2.54) for individuals without diabetes, and 1.75 (1.11-6.46) for individuals with diabetes. Significant interactions were found between the METS-IR and the risk of MACEs by sex in all participants and by age and sex in individuals without diabetes (all P values for interaction < 0.05). In the ROC analysis, the METS-IR had a higher AUC value than other indices for predicting MACEs in individuals with diabetes and had a comparable or higher AUC than other indices for individuals without diabetes. CONCLUSIONS The METS-IR can be an effective clinical indicator for identifying MACEs, as it had superior predictive power when compared with other IR indices in individuals with diabetes.
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Affiliation(s)
- Limeng Pan
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Huajie Zou
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Division of Endocrinology, Department of Internal MedicineThe Affiliated Hospital of Qinghai UniversityXiningChina
| | - Xiaoyu Meng
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Danpei Li
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Wenjun Li
- Computer Center, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Xi Chen
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Yan Yang
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
| | - Xuefeng Yu
- Division of Endocrinology, Department of Internal Medicine, Tongji HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Branch of National Clinical Research Center for Metabolic DiseasesWuhanChina
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Lee JH, Park K, Lee HS, Park HK, Han JH, Ahn SB. Correspondence on Editorial regarding "Screening and prediction of nonalcoholic fatty liver disease using a peripheral insulin resistance index: Potential benefits and limitations". Clin Mol Hepatol 2023; 29:185-187. [PMID: 36353767 PMCID: PMC9845667 DOI: 10.3350/cmh.2022.0375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jun-Hyuk Lee
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea,Department of Medicine, Graduate School of Hanyang University, Seoul, Korea
| | - Kyongmin Park
- Department of Medicine, Graduate School of Hanyang University, Seoul, Korea,Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Korea
| | - Hoon-Ki Park
- Department of Medicine, Graduate School of Hanyang University, Seoul, Korea,Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jee Hye Han
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea,Corresponding author : Jee Hye Han Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, 68 Hangeulbiseok-ro, Nowon-gu, Seoul 01830, Korea Tel: +82-2-970-8518, Fax: +82-2-970-8862, E-mail:
| | - Sang Bong Ahn
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea,Corresponding author : Jee Hye Han Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, 68 Hangeulbiseok-ro, Nowon-gu, Seoul 01830, Korea Tel: +82-2-970-8518, Fax: +82-2-970-8862, E-mail:
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Lee JH, Park K, Lee HS, Park HK, Han JH, Ahn SB. Correspondence on Letter regarding "The usefulness of metabolic score for insulin resistance for the prediction of incident non-alcoholic fatty liver disease in Korean adults". Clin Mol Hepatol 2023; 29:179-181. [PMID: 36417890 PMCID: PMC9845672 DOI: 10.3350/cmh.2022.0409] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jun-Hyuk Lee
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea,Department of Medicine, Graduate School of Hanyang University, Seoul, Korea
| | - Kyongmin Park
- Department of Medicine, Graduate School of Hanyang University, Seoul, Korea,Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Korea
| | - Hoon-Ki Park
- Department of Medicine, Graduate School of Hanyang University, Seoul, Korea,Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jee Hye Han
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea,Corresponding author : Jee Hye Han Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, 68 Hangeulbiseok-ro, Nowon-gu, Seoul 01830, Korea Tel: +82-2-970-8518, Fax: +82-2-970-8862, E-mail:
| | - Sang Bong Ahn
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea,Corresponding author : Jee Hye Han Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, 68 Hangeulbiseok-ro, Nowon-gu, Seoul 01830, Korea Tel: +82-2-970-8518, Fax: +82-2-970-8862, E-mail:
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Lee HW. Letter regarding "The usefulness of metabolic score for insulin resistance for the prediction of incident non-alcoholic fatty liver disease in Korean adults". Clin Mol Hepatol 2023; 29:169-170. [PMID: 36353764 PMCID: PMC9845673 DOI: 10.3350/cmh.2022.0384] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Hye Won Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea,Insitute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea,Liver Center, Severance Hospital, Seoul, Korea,Corresponding author : Hye Won Lee Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea Tel: +82-2-2228-2288, Fax: +82-2-2227-7860, E-mail:
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Kim SS, Cheong JY. Screening and prediction of nonalcoholic fatty liver disease using a peripheral insulin resistance index: Potential benefits and limitations. Clin Mol Hepatol 2022; 28:802-805. [PMID: 36102114 PMCID: PMC9597231 DOI: 10.3350/cmh.2022.0249] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/06/2022] [Indexed: 01/05/2023] Open
Affiliation(s)
- Soon Sun Kim
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Jae Youn Cheong
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea,Corresponding author : Jae Youn Cheong Department of Gastroenterology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon 16499, Korea Tel: +82-31-219-6939, Fax: +82-31-219-7820, E-mail:
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Triglyceride-Glucose Index May Predict Renal Survival in Patients with IgA Nephropathy. J Clin Med 2022; 11:jcm11175176. [PMID: 36079108 PMCID: PMC9456599 DOI: 10.3390/jcm11175176] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 11/28/2022] Open
Abstract
Background: The triglyceride−glucose (TyG) index is a simple, novel and reliable surrogate marker of insulin resistance. However, evidence for the prognostic impact of an elevated TyG index on IgA nephropathy (IgAN) is limited. Therefore, we evaluated the relationship between the TyG index and the risk of renal progression in IgAN. Method: This cohort study involved biopsy-proven IgAN between January 2009 and December 2018 in West China Hospital, in which patients were assigned to two groups based on the cut-off value of TyG using receiver operating characteristic (ROC) curves. A 1:1 matched-pair analysis was established to optimize the bias in IgAN by propensity score matching (PSM). The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The composite endpoint was defined by eGFR decreased ≥50% of the baseline level, end-stage kidney disease (ESKD), renal transplantation and/or death. Univariable and multivariable Cox proportional hazard models were applied to confirm the predictive value of the optimal marker. Results: Before PSM, a total of 1210 participants were ultimately included. During a median follow-up period of 55.8 months (range 37.20−79.09 months), 129 participants progressed to the composite endpoint (10.7%). After PSM, 366 patients were enrolled in the matched cohort, of whom 34 (9.3%) patients reached the endpoints. Based on the cut-off value of the TyG index, patients were divided into the low TyG index group (TyG ≤ 8.72, n = 690) and the high TyG index group (TyG > 8.72, n = 520). Further analysis demonstrated that a higher TyG index was significantly associated with a higher risk of reaching composite endpoints in IgAN patients in both the unmatched and matched cohorts (before PSM: HR 2.509, 95% CI 1.396−4.511, p = 0.002; after PSM: HR 2.654, 95% CI 1.299−5.423, p = 0.007). Conclusion: A high TyG index is associated with a higher risk of renal progression.
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Cai X, Hu J, Zhu Q, Wang M, Liu S, Dang Y, Hong J, Li N. Relationship of the metabolic score for insulin resistance and the risk of stroke in patients with hypertension: A cohort study. Front Endocrinol (Lausanne) 2022; 13:1049211. [PMID: 36545329 PMCID: PMC9760826 DOI: 10.3389/fendo.2022.1049211] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/17/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND The current status of the dose-response relationship between the metabolic score for insulin resistance (METS-IR) and new-onset stroke in hypertensive patients and its subtypes is unclear. This study aimed to determine the association between METS-IR and incident stroke and its subtypes within a cohort of Chinese hypertensive patients. METHODS A total of 14032 hospitalized patients with hypertension from January 1, 2010, to December 31, 2021, were included in this retrospective cohort study. Cox models and restricted cubic splines were applied to determine the association between METS-IR and the risk of stroke. RESULTS During a median follow-up of 4.80 years, 1067 incident stroke cases occurred. Patients in the highest quartile group of METS-IR levels exhibited a higher risk of stroke (HR, 1.80; 95% CI, 1.50-2.17) and ischemic stroke (HR, 1.96; 95% CI, 1.60-2.42) than those in the lowest quartile group. However, no significant associations were observed between METS-IR and the risk of hemorrhagic stroke. Restricted cubic spline analysis suggested a nearly J-shaped association between METS-IR and risk of stroke and ischemic stroke (P for nonlinearity < 0.001). METS-IR did produce a significant improvement in the C statistic when added to the basic model (from 0.637 to 0.664, P < 0.001). Notably, the addition of METS-IR to the basic model resulted in a significant improvement in predicting incident total stroke and ischemic stroke. CONCLUSIONS This cohort study suggests a relationship between METS-IR and the risk of stroke and ischemic stroke. Further studies are required to elucidate the underlying mechanisms.
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