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Caimi G, Urso C, Brucculeri S, Lo Presti R, Carlisi M. Calculated whole blood viscosity in non-diabetic subjects with asymptomatic carotid atherosclerosis: How insulin resistance may affect blood viscosity. Clin Hemorheol Microcirc 2024:CH221422. [PMID: 38905035 DOI: 10.3233/ch-221422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2024]
Abstract
BACKGROUND AND OBJECTIVE Asymptomatic atherosclerosis is an important early marker of vascular damage and, among its risk factors, hemorheological alterations play an important role. PATIENTS AND METHODS In a cohort of 85 non-diabetic subjects with asymptomatic carotid atherosclerosis (ACA), we have measured whole blood viscosity (cWBV) according to the haematocrit and plasma fibrinogen level. The cWBV distinguish the subgroup of ACA subjects with 3-5 cardiovascular risk factors (CRFs) from that with 1-2 CRFs and the same behavior is present for haematocrit and plasma fibrinogen level. Therefore, we divided the whole group of ACA subjects according to the medians of the four surrogate indexes with an insulin resistance degree of TG/HDL-C, TyG, VAI and LAP. RESULTS The analysis of the correlation between cWBV and each index of insulin resistance has shown that no correlation is present in the whole group and in the group of ACA subjects with 1-2 CRFs, while in the subgroup with 3-5 CRFs there is a positive correlation between cWBV with TG/HDL-C and TyG at a low degree of statistical significance. CONCLUSIONS The date underline that subjects with this clinical condition have an unaltered evaluation of the cWBV compared to the other indices.
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Affiliation(s)
- G Caimi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy
| | - C Urso
- Fondazione Istituto "G. Giglio" Cefalù, Palermo, Italy
| | - S Brucculeri
- Fondazione Istituto "G. Giglio" Cefalù, Palermo, Italy
| | - R Lo Presti
- Department of Psychology, Educational Science and Human Movement, Università degli Studi di Palermo, Palermo, Italy
| | - M Carlisi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy
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Zhao L, Cui M, Li Y, Li Y, Miao R, Wang J, Zhou H. Correlation between obesity and early vascular aging in middle-aged and young adult health check-up populations. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2024; 49:408-416. [PMID: 38970515 PMCID: PMC11208404 DOI: 10.11817/j.issn.1672-7347.2024.230361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Indexed: 07/08/2024]
Abstract
OBJECTIVES The obesity rate among middle-aged and young adults in China is increasing annually, and the incidence of cardiovascular diseases is becoming more prevalent in younger populations. However, it has not yet been reported whether obesity is associated with early vascular aging (EVA). This study aims to explore the correlation between obesity and EVA in middle-aged and young adult health check-up populations, providing a reference for the prevention of cardiovascular diseases. METHODS A total of 15 464 middle-aged and young adults aged 18-59 who completed brachial-ankle pulse wave velocity (baPWV) test in the Third Xiangya Hospital of Central South University from January to December 2020 were included. Among them, 1 965 individuals with normal blood pressure and no cardiovascular risk factors were selected as the healthy population. The baPWV thresholds for determining EVA in each age group for males and females were calculated based on the baPWV values of the healthy population. The number and percentage of individuals meeting the EVA criteria in the middle-aged and young adult health check-up populations were statistically analyzed by age and gender. The differences in obesity indicators [visceral adiposity index (VAI), body mass index (BMI), waist circumference (WC)] between the EVA and non-EVA groups for males and females were compared. Using EVA as the dependent variable, VAI, BMI, and WC were included as independent variables in a Logistic model to analyze the correlation between each obesity indicator and EVA before and after adjusting for other influencing factors. Furthermore, the correlation between each obesity indicator and EVA in each age group was analyzed. RESULTS In the health check-up populations, the detection rate of EVA in different age groups was 1.65%-10.92% for males, and 1.16%-10.50% for females, the detection rate of EVA increased with age in both males and females. Except for the 40-<50 age group, the EVA detection rate was higher in males than in females in all other age groups. Regardless of gender, obesity indicators VAI, BMI, and WC were significantly higher in the EVA group than in the non-EVA group (all P<0.01). Before and after adjusting for other influencing factors, VAI and WC were both correlated with EVA (both P<0.05). BMI was a risk factor for EVA before adjusting for other influencing factors (P<0.01), but after adjustment, the correlation between BMI and EVA was not statistically significant (P=0.05). After adjusting for other influencing factors, the correlation between VAI and EVA was statistically significant in the 18-<40 and 50-<60 age groups (both P<0.05), while the correlation between BMI and WC with EVA was not statistically significant (both P>0.05). In the 40-<50 age group, the correlation between VAI and BMI with EVA was not statistically significant (both P>0.05), but the correlation between WC and EVA was statistically significant (P<0.01). CONCLUSIONS VAI is closely related to the occurrence of EVA in middle-aged and young adults aged 18-<40 and 50-<60 years, while WC is closely related to the occurrence of EVA in those aged 40-<50 years.
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Affiliation(s)
- Linlin Zhao
- Medical Center of Health Management, Third Xiangya Hospital, Central South University, Changsha 410013.
| | - Man Cui
- Medical Department, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250001, China
| | - Yapei Li
- Medical Center of Health Management, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Ying Li
- Medical Center of Health Management, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Rujia Miao
- Medical Center of Health Management, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Jiangang Wang
- Medical Center of Health Management, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Hui Zhou
- Medical Center of Health Management, Third Xiangya Hospital, Central South University, Changsha 410013.
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Li YQ, Zhang LY, Zhao YC, Xu F, Hu ZY, Wu QH, Li WH, Li YN. Vascular endothelial growth factor B improves impaired glucose tolerance through insulin-mediated inhibition of glucagon secretion. World J Diabetes 2023; 14:1643-1658. [DOI: 10.4239/wjd.v14.i11.1643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/11/2023] [Accepted: 09/06/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Impaired glucose tolerance (IGT) is a homeostatic state between euglycemia and hyperglycemia and is considered an early high-risk state of diabetes. When IGT occurs, insulin sensitivity decreases, causing a reduction in insulin secretion and an increase in glucagon secretion. Recently, vascular endothelial growth factor B (VEGFB) has been demonstrated to play a positive role in improving glucose metabolism and insulin sensitivity. Therefore, we constructed a mouse model of IGT through high-fat diet feeding and speculated that VEGFB can regulate hyperglycemia in IGT by influencing insulin-mediated glucagon secretion, thus contributing to the prevention and cure of prediabetes.
AIM To explore the potential molecular mechanism and regulatory effects of VEGFB on insulin-mediated glucagon in mice with IGT.
METHODS We conducted in vivo experiments through systematic VEGFB knockout and pancreatic-specific VEGFB overexpression. Insulin and glucagon secretions were detected via enzyme-linked immunosorbent assay, and the protein expression of phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) was determined using western blot. Further, mRNA expression of forkhead box protein O1, phosphoenolpyruvate carboxykinase, and glucose-6 phosphatase was detected via quantitative polymerase chain reaction, and the correlation between the expression of proteins was analyzed via bioinformatics.
RESULTS In mice with IGT and VEGFB knockout, glucagon secretion increased, and the protein expression of PI3K/AKT decreased dramatically. Further, in mice with VEGFB overexpression, glucagon levels declined, with the activation of the PI3K/AKT signaling pathway.
CONCLUSION VEGFB/vascular endothelial growth factor receptor 1 can promote insulin-mediated glucagon secretion by activating the PI3K/AKT signaling pathway to regulate glucose metabolism disorders in mice with IGT.
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Affiliation(s)
- Yu-Qi Li
- Department of Pathophysiology, School of Basic Medicine, Binzhou Medical University, Yantai 264000, Shandong Province, China
| | - Lu-Yang Zhang
- Department of Rheumatology and Immunology, Yantaishan Hospital, Yantai 264000, Shandong Province, China
| | - Yu-Chi Zhao
- Department of Surgery, Yantaishan Hospital, Yantai 264000, Shandong Province, China
| | - Fang Xu
- Department of Pathophysiology, School of Basic Medicine, Binzhou Medical University, Yantai 264000, Shandong Province, China
| | - Zhi-Yong Hu
- School of Public Health and Management, Binzhou Medical University, Yantai 264000, Shandong Province, China
| | - Qi-Hao Wu
- The First School of Clinical Medicine, Binzhou Medical University, Yantai 264000, Shandong Province, China
| | - Wen-Hao Li
- Department of Pathophysiology, School of Basic Medicine, Binzhou Medical University, Yantai 264000, Shandong Province, China
| | - Ya-Nuo Li
- Department of Pathophysiology, School of Basic Medicine, Binzhou Medical University, Yantai 264000, Shandong Province, 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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Thomas TS, Dunderdale C, Lu MT, Walpert AR, Shen G, Young MCH, Torriani M, Chu JT, Haptu HH, Manandhar M, Wurcel A, Adler GK, Grinspoon SK, Srinivasa S. Visceral Adiposity Index as a Measure of Cardiovascular Disease in Persons With Human Immunodeficiency Virus. Open Forum Infect Dis 2023; 10:ofad398. [PMID: 37559752 PMCID: PMC10407462 DOI: 10.1093/ofid/ofad398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
Background Persons with well-treated human immunodeficiency virus (HIV) demonstrate a 2-fold higher risk of cardiovascular disease (CVD), which may be related to excess visceral adipose tissue (VAT). The visceral adiposity index (VAI) is a score to approximate VAT by combining biochemical measures with anthropometrics without quantification by imaging. We evaluated VAI in association with cardiometabolic factors among persons with HIV (PWH). Methods Forty-five PWH on antiretroviral therapy and virologically controlled with increased abdominal VAT (VAT area >110 cm2 on CT) and no known CVD were included. VAI was calculated using standard sex-specific formulas. Coronary plaque was assessed using coronary CT angiography. Results Participants were predominantly male (73%), white (53%), and non-Hispanic (84%), with a mean age of 55 (standard deviation, 7) years. Among PWH, median VAI was calculated to be 4.9 (interquartile range [IQR], 2.8-7.3). Log VAI correlated with log VAT (r = 0.59, P < .0001) and anthropometric measures (body mass index: r = 0.36, P = .02; waist circumference: r = 0.43, P = .004; waist-to-hip ratio: r = 0.33, P = .03). Participants with coronary plaque had a higher VAI compared to those without coronary plaque (median, 5.3 [IQR, 3.4-10.5] vs 2.8 [IQR, 1.8-5.0]; P = .004). VAI (area under the curve = 0.760, P = .008) performed better than the atherosclerotic CVD risk score to predict the presence of plaque in receiver operating characteristic analyses. Conclusions VAI may be a useful biomarker of metabolic dysfunction and increased CVD risk that may occur with VAT accumulation in PWH. Clinical Trials Registration NCT02740179.
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Affiliation(s)
- Teressa S Thomas
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Carolyn Dunderdale
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Michael T Lu
- Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Allie R Walpert
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Grace Shen
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Michele C H Young
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Martin Torriani
- Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jacqueline T Chu
- Division of Infectious Diseases, Mass General Brigham and Harvard Medical School, Boston, Massachusetts, USA
| | - Hanna H Haptu
- Division of Infectious Diseases, Mass General Brigham and Harvard Medical School, Boston, Massachusetts, USA
| | - Monica Manandhar
- Division of Infectious Diseases, Mass General Brigham and Harvard Medical School, Boston, Massachusetts, USA
| | - Alysse Wurcel
- Division of Infectious Diseases, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Gail K Adler
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Steven K Grinspoon
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Suman Srinivasa
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Zhao W, Ma X, Ju J, Zhao Y, Wang X, Li S, Sui Y, Sun Q. Association of visceral adiposity index with asymptomatic intracranial arterial stenosis: a population-based study in Shandong, China. Lipids Health Dis 2023; 22:64. [PMID: 37198613 DOI: 10.1186/s12944-023-01831-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/09/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The visceral adiposity index (VAI), as a composite indictor to evaluate visceral adipose function, has been demonstrated to be correlated with atherosclerosis. The study objective was to explore the association between asymptomatic intracranial arterial stenosis (aICAS) and VAI in Chinese rural dwellers. METHODS The cross-sectional study consisted of 1942 participants ≥ 40 years old who were living in Pingyin County, Shandong Province and free from history of clinical stroke and transient ischemic attack. The aICAS in the study was diagnosed by transcranial doppler ultrasound combined with magnetic resonance angiography. The multivariate logistic regression models were deployed to explore the correlation of VAI with aICAS, and receiver operating characteristic (ROC) curve were plotted to compare the performance of models. RESULTS The participants with aICAS comparing to those without had a significantly higher VAI. After adjusting for confounding factors including age, hypertension, DM, sex, drinking habit, LDL-C, hsCRP, and smoking habit, the VAI-Tertile 3 (vs. VAI-Tertile 1) was positively associated with aICAS (OR, 2.15; 95% CI, 1.25-3.65; P = 0.005). The VAI-Tertile 3 was still markedly associated with aICAS among the underweight and normal weight (BMI ≤ 23.9 kg/m2) participants (OR, 3.17; 95% CI, 1.15-8.71; P = 0.026) with an AUC = 0.684. A similar relationship between VAI and aICAS was obtained among the participants with no abdominal obesity (WHR < 1, OR, 2.03; 95% CI, 1.14-3.62; P = 0.017). CONCLUSIONS The possible correlation between VAI and aICAS was found to be positive for the first time among Chinese rural residents over 40 years old. A higher VAI was found to be significantly associated with aICAS among the participants who were underweight or normal weight, and these results may provide additional risk stratification information for aICAS.
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Affiliation(s)
- Weihua Zhao
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Xiaotong Ma
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, Jinan, Shandong, 250021, P.R. China
| | - Jiachen Ju
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, Jinan, Shandong, 250021, P.R. China
| | - Yuanyuan Zhao
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, Jinan, Shandong, 250021, P.R. China
| | - Xiang Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, Jinan, Shandong, 250021, P.R. China
| | - Shan Li
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, Jinan, Shandong, 250021, P.R. China
| | - Yanling Sui
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, Jinan, Shandong, 250021, P.R. China
| | - Qinjian Sun
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, Jinan, Shandong, 250021, P.R. China.
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Sun J, Meng X, Huang H, Jing J, Pan Y, Mei L, Jin A, Wang Y, Wei T, Cai X. Higher visceral adiposity index and lipid accumulation product in relation to increased risk of atherosclerotic burden in community-dwelling older adults. Exp Gerontol 2023; 174:112115. [PMID: 36758647 DOI: 10.1016/j.exger.2023.112115] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/02/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND AND AIMS Visceral adiposity index (VAI) and lipid accumulation product (LAP), as anthropometric indices, have been applied to predict the risk of cardiovascular diseases (CVD). However, few studies investigated the correlation between these two indicators and cardio-cerebro-vascular atherosclerosis in community populations. Our study was to explore the association of VAI and LAP with coronary, intracranial and extracranial atherosclerosis in a community-based asymptomatic middle-aged and older population. METHODS Participants without a history of CVD in the study of PRECISE (Polyvascular Evaluation for Cognitive Impairment and Vascular Events) were included. The sex-special indicators of VAI and LAP were calculated and stratified by the tertiles. The presence of plaque and coronary segmental stenosis score (SSS) were assessed by coronary computed tomography (CTA), as well as intracranial and extracranial atherosclerotic burden were evaluated by high-resolution magnetic resonance imaging (HR-MRI), respectively. Binary or ordinal logistic regression was conducted to assess the association between each of the indexes and the presence and burden of atherosclerosis. RESULTS A total of 2875 subjects were included in the final analysis. The mean age was 60.9 ± 6.6 years and 1329 (46.2 %) participants were males. Compared with the first tertile of VAI, the higher tertile was associated with the presence of plaques (T3 vs T1, OR, 1.49, 95%CI, 1.12-1.98, for males; OR, 1.64, 95%CI, 1.24-2.17, for females) and atherosclerotic burden (T3 vs T1, adjusted cOR, 1.63, 95%CI, 1.24-2.14, for males; adjusted cOR, 1.70, 95%CI, 1.29-2.24, for females) in major coronary arteries. A similar association was found for LAP. VAI level has presented an association with the extracranial atherosclerotic plaques (T3 vs T1, OR, 1.34, 95%CI, 1.02-1.77) and burden (T3 vs T1, adjusted cOR 1.32, 95 % CI 1.00-1.73) only in females. Whereas, for intracranial atherosclerosis, the results failed to show any statistically significant association. CONCLUSIONS Among community-dwelling asymptomatic older adults, VAI and LAP were associated with the presence and burden of coronary atherosclerotic plaques, while VAI presented a weaker significant association with extracranial atherosclerosis in females.
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Affiliation(s)
- Jingping Sun
- Department of Neurology, the Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China; Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Huifen Huang
- Department of Neurology, the Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China; Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China
| | - Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Lerong Mei
- Department of Neurology, the Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China; Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China
| | - Aoming Jin
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Tiemin Wei
- Department of Cardiology, the Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China.
| | - Xueli Cai
- Department of Neurology, the Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China; Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China.
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Khazaal MS, Hamdan FB, Al-Mayah QS. Nicotine dependence and visceral adiposity as risk factors for the development and severity of carotid artery stenosis. J Med Life 2023; 16:463-470. [PMID: 37168312 PMCID: PMC10165523 DOI: 10.25122/jml-2022-0252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/13/2023] [Indexed: 05/13/2023] Open
Abstract
Nicotine dependence (ND) and visceral adiposity are emerging as independent risk factors for cardiovascular diseases, including carotid artery stenosis (CAS). This study aimed to determine the relationship between ND and the contribution of abdominal fat to the onset of CAS, which is indicated by a luminal narrowing of at least 60% as determined by duplex and/or Doppler ultrasound. We prospectively collected data from 60 patients with CAS and 60 age- and gender-matched healthy subjects. The Fagerström Test for Nicotine Dependence (FTND), a common research tool, was used in the study. The original questionnaire was designed to gather social and demographic data. Anthropometric measurements, visceral adiposity index (VAI), and lipid accumulation products (LAP) were used to assess obesity. Most patients showed a high or mild-moderate degree of ND: 46.67% and 35%, respectively. The median visceral adiposity index (VAI) and lipid accumulation product (LAP) in patients was 3.92 and 32.83, respectively. Prolonged smoking duration, increased intensity, and high ND are hallmarks of CAS patients.
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Affiliation(s)
| | - Farqad Bader Hamdan
- Department of Physiology, College of Medicine, Al-Nahrain University, Baghdad, Iraq
| | - Qasim Sharhan Al-Mayah
- Medical Research Unit, College of Medicine, Al-Nahrain University, Baghdad, Iraq
- Corresponding Author: Qasim Sharhan Al-Mayah, Medical Research Unit, College of Medicine, Al-Nahrain University, Baghdad, Iraq. E-mail:
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Derivation and Validation of a New Visceral Adiposity Index for Predicting Short-Term Mortality of Patients with Acute Ischemic Stroke in a Chinese Population. Brain Sci 2023; 13:brainsci13020297. [PMID: 36831840 PMCID: PMC9954352 DOI: 10.3390/brainsci13020297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/20/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
The visceral adiposity index (VAI) is related to the occurrence of various cardiometabolic diseases, atherosclerosis, and stroke. However, few studies have analyzed the impact on the short-term prognosis of stroke. We assessed the effect of VAI on short-term prognoses in patients with acute ischemic stroke through a retrospective cohort study of 225 patients with acute stroke who were admitted to the neurological intensive care unit of our hospital. We collected metabolic indicators (blood pressure, fasting glucose, lipids), National Institutes of Health Stroke Scale (NIHSS) scores, symptomatic intracranial hemorrhage, and other disease evaluation indicators on 197 patients who were screened for inclusion. VAI was calculated by using baseline data (sex, height, weight, waist circumference (WC)). We assessed functional recovery according to modified Rankin scale scores after 90 days. The receiver operating characteristic (ROC) curve was used to calculate the VAI cutoff value that affects short-term outcomes. A nomogram that can predict the risk of short-term mortality in patients with acute ischemic stroke was drawn. In total, 28 patients died within 90 days. Those patients had higher VAI (p = 0.000), higher triglyceride (TG) (p = 0.020) and NIHSS scores (p = 0.000), and lower high-density lipoprotein cholesterol (HDL-C) (p = 0.000) than patients who survived. VAI had higher predictive value of short-term mortality than did body mass index (BMI), body fat mass index (BFMI), and WC. VAI and NIHSS scores were independent risk factors for the short-term mortality of patients with stroke. Patients with a VAI > 2.355 had a higher risk of short-term mortality. VAI has a predictive value higher than that of traditional metabolic indicators such as BMI, BFMI, and WC. The nomogram, composed of NIHSS, VAI, HDL-C, and TG, may predict the short-term mortality of cerebral infarction patients.
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Kara Z, Demir AN, Sulu C, Durcan E, Uysal S, Turan H, Özkaya HM, Evliyaoğlu SO, Ercan O, Gönen MS. Visceral Adiposity Index as an Indicator of Cardiometabolic Risk in Patients with Congenital Adrenal Hyperplasia. Metab Syndr Relat Disord 2023; 21:35-40. [PMID: 36576499 DOI: 10.1089/met.2022.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: To evaluate the cardiometabolic risk in patients with CAH (21 (OH) enzyme deficiency) on the basis of the visceral adiposity index (VAI), which indicates dysfunction of the visceral adipose tissue (VAT). Materials and Methods: A total of 41 patients and 38 body mass index (BMI), age, and gender-matched healthy controls (HC) were included. The patients' and HCs' age, gender, waist circumference (WC), BMI information and total cholesterol (TC), high-density lipoprotein (HDL), triglyceride (TG) values, smoking, and medication history were obtained from medical charts. Weight, height, WC, and blood pressure levels were measured. Patients' and HCs' BMI, Framingham risk scores (FRS), VAI and Ferriman-Gallwey scores were calculated. The patients' and HCs' age, gender TC, HDL, and TG, androstenedione, dehydroepiandrosterone sulfate (DHEASO4), 17 hydroxyprogesterone (17(OH)P) values, smoking, and medication history were obtained from medical charts. Body fat and muscle mass levels were measured with Tanita T 6360. Results: Gender distribution, mean age, and BMI of patients with CAH were 34/7, 30 ± 8, 27 ± 5.4; HC subjects 30/8, 30 ± 6, 27 ± 3.8 (P = 0.9, 0.6, 0.9, respectively). The VAI values of patients with a diagnosis of CAH 3.7 (2.3-6.9) were found to be significantly higher than those of HC patients 2.5 (1.8-3.9; P = 0.02). The mean glucocorticoid doses of the patients were 17 ± 9 mg/day. The glucocorticoid dose level was determined as independent risk factor on the FRS (P = 0.03, β = 0.04) and VAI (P = 0.018, β = 0.17). Conclusion: Glucocorticoid dose optimization should be done more carefully to improve metabolic and cardiovascular outcomes in CAH patients.
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Affiliation(s)
- Zehra Kara
- Department of Endocrinology, Metabolism and Diabetes and Cerrahpasa Medical Faculty, University of İstanbul-Cerrahpasa, Istanbul, Turkey
| | - Ahmet Numan Demir
- Department of Endocrinology, Metabolism and Diabetes and Cerrahpasa Medical Faculty, University of İstanbul-Cerrahpasa, Istanbul, Turkey
| | - Cem Sulu
- Department of Endocrinology, Metabolism and Diabetes and Cerrahpasa Medical Faculty, University of İstanbul-Cerrahpasa, Istanbul, Turkey
| | - Emre Durcan
- Department of Endocrinology, Metabolism and Diabetes and Cerrahpasa Medical Faculty, University of İstanbul-Cerrahpasa, Istanbul, Turkey
| | - Serhat Uysal
- Department of Endocrinology, Metabolism and Diabetes and Cerrahpasa Medical Faculty, University of İstanbul-Cerrahpasa, Istanbul, Turkey
| | - Hande Turan
- Department of Pediatric Endocrinology, Cerrahpasa Medical Faculty, University of İstanbul-Cerrahpasa, Istanbul, Turkey
| | - Hande Mefkure Özkaya
- Department of Endocrinology, Metabolism and Diabetes and Cerrahpasa Medical Faculty, University of İstanbul-Cerrahpasa, Istanbul, Turkey
| | - Saadet Olcay Evliyaoğlu
- Department of Pediatric Endocrinology, Cerrahpasa Medical Faculty, University of İstanbul-Cerrahpasa, Istanbul, Turkey
| | - Oya Ercan
- Department of Pediatric Endocrinology, Cerrahpasa Medical Faculty, University of İstanbul-Cerrahpasa, Istanbul, Turkey
| | - Mustafa Sait Gönen
- Department of Endocrinology, Metabolism and Diabetes and Cerrahpasa Medical Faculty, University of İstanbul-Cerrahpasa, Istanbul, Turkey
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Caimi G, Urso C, Brucculeri S, Amato C, Lo Presti R, Carlisi M. Leukocyte subtypes, gelatinases, and their tissue inhibitors in a group of subjects with asymptomatic carotid atherosclerosis. Clin Hemorheol Microcirc 2022; 82:37-51. [PMID: 35599473 PMCID: PMC9741743 DOI: 10.3233/ch-221380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In a cohort of subjects with asymptomatic carotid atherosclerosis (ACA), we have evaluated the neutrophil and lymphocyte count and their ratio (NLR), the gelatinases (MMP-2 and MMP-9) and their tissue inhibitors (TIMP-1 and TIMP-2). At baseline, no difference was observed between ACA subjects and subject control group regarding neutrophil and lymphocyte count while was evident in ACA subjects a significant increase in MMP-2, MMP-9 and TIMP-2 associated to a significant decrease in TIMP-1. Dividing the ACA according to the number of cardiovascular risk factors (CRFs) we have observed an increase in lymphocyte count in the subgroup with 3-5 CRFs. Evaluating the leukocyte subtypes according to all the surrogate markers of insulin resistance has been noted, in the subgroups that exceed the medians of these markers, a significant increase in neutrophil and lymphocyte count without any variation of the NLR. Effecting the same evaluation for the MMP/TIMP pattern we observed, instead, that the same subgroups tend to show a decrease in MMP-2 and an increase in MMP-9. No difference instead for TIMP-1 and TIMP-2. The abnormality of the MMP/TIMP pattern, bearing in mind the cardiometabolic clustering present in this cohort of ACA subjects, would induce to use drugs able not only to cure the cardiometabolic risk factors but also to influence the MMP/TIMP profile.
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Affiliation(s)
- Gregorio Caimi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy,Corresponding author: Gregorio Caimi, Via Leonardo Da Vinci, 52, 90145, Palermo, Italy. E-mails: ;
| | - C. Urso
- Fondazione Istituto “G. Giglio” Cefalù, Palermo, Italy
| | - S. Brucculeri
- Fondazione Istituto “G. Giglio” Cefalù, Palermo, Italy
| | - C. Amato
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy
| | - R. Lo Presti
- Department of Psychology, Educational Science and Human Movement, Università degli Studi di Palermo, Palermo, Italy
| | - M. Carlisi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy
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Cui C, He C, Sun Q, Xu Z, Li Q, Yue S, Liu J, Wang L, Wang H. Association between visceral adiposity index and incident stroke: Data from the China Health and Retirement Longitudinal Study. Nutr Metab Cardiovasc Dis 2022; 32:1202-1209. [PMID: 35260305 DOI: 10.1016/j.numecd.2022.01.031] [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: 12/04/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Visceral adiposity index (VAI), an indicator of visceral fat, is associated with metabolic health and arterial stiffness. However, studies correlating VAI and stroke are limited. This study aimed to explore the association between VAI and incident stroke in the Chinese population. METHODS AND RESULTS We retrospectively analysed the data of 9127 individuals enrolled in the China Health and Retirement Longitudinal Study. The first survey of the study was conducted during 2011-2012 and the individuals were followed up until Survey 4 (2017-2018). Multivariable-adjusted Cox regression models were used to evaluate the association between VAI and stroke. The mean age of the study population was 59.3 ± 9.5 years and 4938 (54.1%) participants were women. During the median follow-up of 5.2 [1.0-7.0] years, 833 (9.1%) participants developed stroke, and the cumulative incidence of stroke increased with increasing quartiles of VAI (8.6%, 8.7%, 9.2%, and 10.0%). Compared to those in the first quartile of VAI, individuals in the fourth quartile had an increased risk of stroke (adjusted hazard ratio, 1.45; 95% CI, 1.15-1.75). The results were stable in several sensitivity analyses. CONCLUSION Our findings suggest a positive association between VAI and incident stroke in the Chinese population.
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Affiliation(s)
- Cancan Cui
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Chengyan He
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Qichao Sun
- Imaging and Nuclear Medicine, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Zhonghang Xu
- Department of Gastrointestinal Surgery, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Qianyu Li
- Department of Nephrology, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Siqi Yue
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Jinhua Liu
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Liqiang Wang
- Endoscopy Center, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Hai Wang
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
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13
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Wu Z, Yu S, Kang X, Liu Y, Xu Z, Li Z, Wang J, Miao X, Liu X, Li X, Zhang J, Wang W, Tao L, Guo X. Association of visceral adiposity index with incident nephropathy and retinopathy: a cohort study in the diabetic population. Cardiovasc Diabetol 2022; 21:32. [PMID: 35209907 PMCID: PMC8876445 DOI: 10.1186/s12933-022-01464-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background The association between visceral adiposity index (VAI) and diabetic complications has been reported in cross-sectional studies, while the effect of VAI on complication development remains unclear. This study aims to evaluate the longitudinal association of VAI and Chinese VAI (CVAI) with the incidence of diabetic nephropathy and retinopathy using a Chinese cohort. Methods A total of 8 948 participants with type 2 diabetes from Beijing Health Management Cohort were enrolled during 2013–2014, and followed until December 31, 2019. Nephropathy was confirmed by urine albumin/creatinine ratio and estimated glomerular filtration rate; retinopathy was diagnosed using fundus photograph. Results The mean (SD) age was 53.35 (14.66) years, and 6 154 (68.8%) were men. During a median follow-up of 4.82 years, 467 participants developed nephropathy and 90 participants developed retinopathy. One-SD increase in VAI and CVAI levels were significantly associated with an increased risk of nephropathy, and the adjusted hazard ratios (HR) were 1.127 (95% CI 1.050–1.210) and 1.165 (95% CI 1.003–1.353), respectively. On contrary, VAI and CVAI level were not associated with retinopathy after adjusting confounding factors. Conclusion VAI and CVAI are independently associated with the development of nephropathy, but not retinopathy in Chinese adults with diabetes. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01464-1.
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Affiliation(s)
- Zhiyuan Wu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China.,Centre for Precision Health, Edith Cowan University, Perth, Australia
| | - Siqi Yu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China
| | | | - Yue Liu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China
| | - Zongkai Xu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China
| | - Zhiwei Li
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China
| | - Jinqi Wang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China
| | - Xinlei Miao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China
| | - Xiangtong Liu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - Jingbo Zhang
- Beijing Physical Examination Center, Beijing, China
| | - Wei Wang
- Centre for Precision Health, Edith Cowan University, Perth, Australia
| | - Lixin Tao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China.
| | - Xiuhua Guo
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China. .,Centre for Precision Health, Edith Cowan University, Perth, Australia.
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Cai X, Li N, Hu J, Wen W, Yao X, Zhu Q, Heizhati M, Hong J, Sun L, Tuerxun G, Zhang D, Luo Q. Nonlinear Relationship Between Chinese Visceral Adiposity Index and New-Onset Myocardial Infarction in Patients with Hypertension and Obstructive Sleep Apnoea: Insights from a Cohort Study. J Inflamm Res 2022; 15:687-700. [PMID: 35140499 PMCID: PMC8819537 DOI: 10.2147/jir.s351238] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/15/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose We aimed to investigate the relationship between the Chinese visceral adiposity index (CVAI) and the risk of new-onset myocardial infarction (MI) in patients with hypertension and obstructive sleep apnoea (OSA) and to inspect possible modifiers of the effect. Methods The Cox regression model was used to evaluate the relationship between baseline CVAI and risk of new-onset MI. A generalized additive model was used to identify the nonlinear relationship. Besides, we conducted subgroup analyses and interaction tests. Results A total of 2177 patients with hypertension and OSA undergoing polysomnography were enrolled in this study. During a median follow-up period of 87 months, 82 participants developed new-onset MI. Overall, CVAI was positively related to the risk of new-onset MI (per 1 SD increase; HR = 1.54, 95% CI: 1.28–1.85). In multivariable-adjusted models, the risk of new-onset MI increased with quartiles of CVAI, with an HR of 3.64 (95% CI: 1.94–6.83) for quartile 4 compared with quartile 1. The generalized additive model and smoothed curve fit revealed a nonlinear relationship between CVAI and risk of new-onset MI with an inflection point of approximately 112. None of the stratification variables had a significant effect on the relationship between CVAI and new-onset MI. Similar outcomes were observed in the sensitivity analysis. The addition of CVAI significantly improved reclassification and discrimination over the conventional model, with a category-free NRI of 0.132 (95% CI 0.021 to 0.236, P = 0.021) and an IDI of 0.012 (95% CI 0.005 to 0.023, P < 0.001). Conclusion This study demonstrated a nonlinear relationship between CVAI and the risk of new-onset MI in patients with hypertension and OSA. Higher CVAI was significantly associated with the risk of new-onset MI when CVAI was ≥112.
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Affiliation(s)
- Xintian Cai
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Nanfang Li
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Correspondence: Nanfang Li, Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China, Email
| | - Junli Hu
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Wen Wen
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Xiaoguang Yao
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Qing Zhu
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Mulalibieke Heizhati
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Jing Hong
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Le Sun
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Guzailinuer Tuerxun
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Delian Zhang
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Qin Luo
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
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Jiang K, Luan H, Pu X, Wang M, Yin J, Gong R. Association Between Visceral Adiposity Index and Insulin Resistance: A Cross-Sectional Study Based on US Adults. Front Endocrinol (Lausanne) 2022; 13:921067. [PMID: 35937809 PMCID: PMC9353944 DOI: 10.3389/fendo.2022.921067] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/22/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Visceral obesity index (VAI) is an empirical mathematical model used to evaluate the distribution and function of fat. Some studies have shown that VAI may be associated with the development of insulin resistance. In view of the differences in insulin resistance among different ethnic groups, this study attempts to analyze the special relationship between VAI and insulin resistance in American adults. METHODS We conducted a cross-sectional study through NHANES database. A total of 27309 patients over the age of 18 from the United States took part in the survey. It was divided into two groups: the IR-positive group and the IR-negative group. The association of VAI with IR was evaluated by logistic regression analyses mainly, including univariate analysis, multivariate regression analysis, curve fitting analysis and subgroup analysis. RESULTS The results showed that in the full-adjusted model, there is a strong positive association between VAI level and insulin resistance (OR: 1.28 (1.2~1.37), P<0.001) and there is a threshold effect. CONCLUSIONS This study suggests that higher VAI levels are associated with insulin resistance. VAI index may be used as a predictor of insulin resistance.
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Affiliation(s)
- Kai Jiang
- Department of Cardiovascular Medicine, The Bozhou Hospital Affiliated to Anhui Medical University, Bozhou, China
| | - Hong Luan
- Department of Cardiovascular Medicine, People’s Hospital of Ningxia Hui Autonomous Region, YinChuan, China
| | - Xiaolu Pu
- Medical College of Qinghai University, Xining, China
| | | | - Jiahui Yin
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
- *Correspondence: Rongpeng Gong, ; ; Jiahui Yin,
| | - Rongpeng Gong
- Medical College of Qinghai University, Xining, China
- *Correspondence: Rongpeng Gong, ; ; Jiahui Yin,
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Wang L, Yi Z. Obesity paradox and aging: Visceral Adiposity Index and all-cause mortality in older individuals: A prospective cohort study. Front Endocrinol (Lausanne) 2022; 13:975209. [PMID: 36299458 PMCID: PMC9589042 DOI: 10.3389/fendo.2022.975209] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The relationship between body mass index (BMI) and mortality in older adults diminished. It is necessary to examine other factors that may accurately predict mortality in older adults. The visceral adiposity index (VAI) is an uncomplicated marker specific to the gender that incorporates anthropometric data and lipid profiles. VAI has been proposed as a marker of visceral adipose tissue dysfunction and of the related cardiometabolic risk. The aim of this study was to evaluate the link of VAI with all-cause mortality among the elderly. METHODS The present prospective cohort study included data from 1999 to 2014 provided by the National Health and Nutrition Examination Survey (NHANES) in the United States. NHANES participants at or above the age of 65 were included. Data collection was carried out by taking face-to-face interviews, mobile-physical examinations, and lab tests. From the start of the survey to the end of December 2015, mortality-related follow-up statistics are available. The shape of the link between VAI and all-cause mortality was investigated using a restricted cubic spline model. Univariate- and multivariate-adjusted Cox proportional hazard models were estimated for VAI, and the results were presented as regression coefficients and 95% confidence intervals (CI). RESULTS The 82,091 NHANES participants represented 442.2 million non-institutionalized residents of the United States. A total of 11,173 older individuals (representing 23.3 million; aged 73.4 ± 5.8 years; 56.3% women, 82.7% non-Hispanic Whites, 6.8% non-Hispanic Blacks, and 3.3% Mexican Americans) were included in the study. During the 80-month follow-up period, 4466 fatalities were reported, including 825 deaths from cancer, 867 from heart disease, and 211 from cerebrovascular disease. The restricted cubic spline model demonstrated a robust J-shaped link between VAI and all-cause mortality, revealing a significant decrease in risk within the lower range of VAI, which attained the lowest risk close to 1.7. With VAI greater than 1.7, the risk of mortality increased with the increase of VAI (P for non-linearity = 0.025). In the multivariate-adjusted model, the risk of all-cause mortality was 0.73 (0.56-0.97) and 1.05 (1.01-1.09) in participants with VAI less than 1.7 and VAI greater than or equal to 1.7, respectively. CONCLUSION This investigation is a population-based cohort study with high sample sizes and a long-term in older individuals follow-up that showed a J-shaped link between VAI levels and all-cause mortality. Understanding the independent roles of VAI in the relationship between BMI and mortality is crucial to understanding the obesity paradox phenomenon.
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Affiliation(s)
- Lei Wang
- Department of Cardiology, Aerospace Center Hospital, Beijing, China
| | - Zhong Yi
- Department of Geriatric Medicine, Aerospace Center Hospital, Beijing, China
- *Correspondence: Zhong Yi,
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Zhao Q, Cheng YJ, Xu YK, Zhao ZW, Liu C, Sun TN, Zhou YJ. Visceral Adiposity Index Plays an Important Role in Prognostic Prediction in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome and Type 2 Diabetes Mellitus Undergoing Percutaneous Coronary Intervention. Front Cardiovasc Med 2021; 8:735637. [PMID: 34869637 PMCID: PMC8636737 DOI: 10.3389/fcvm.2021.735637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Visceral adiposity index (VAI), a surrogate marker of adiposity and insulin resistance, has been demonstrated to be significantly related to cardiovascular disease. It remains indistinct whether VAI predicts adverse prognosis after percutaneous coronary intervention (PCI) for patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and type 2 diabetes mellitus (T2DM). Methods: A total of 798 participants who met the enrollment criteria were finally brought into this study. VAI was determined by waist circumference, body mass index, fasting triglyceride, and high-density lipoprotein cholesterol as previously reported. Adverse prognosis included all-cause death, non-fatal myocardial infarction, non-fatal ischemic stroke, and ischemia-driven revascularization, the composite of which was defined as the primary endpoint. Results: Higher VAI maintained as a significant and independent risk predictor for the primary endpoint, regardless of the adjustment for the various multivariate models [hazard ratio (95% CI) for fully adjusted model: 2.72 (2.02-3.68), p < 0.001]. The predictive value of VAI was further confirmed in sensitivity analysis where VAI was taken as a continuous variate. There was a dose-response relationship of VAI with the risk of the primary endpoint (p for overall association < 0.001). Moreover, the ability of VAI on the prediction of the primary endpoint was consistent between subgroups stratified by potential confounding factors (all p for interaction > 0.05). VAI exhibited a significant incremental effect on risk stratification for the primary endpoint beyond existing risk scores, expressed as increased Harrell's C-index, significant continuous net reclassification improvement, and significant integrated discrimination improvement. Conclusion: VAI is a significant indicator for predicting worse prognosis and plays an important role in risk stratification among patients with NSTE-ACS and T2DM undergoing elective PCI. The present findings require further large-scale, prospective studies to confirm.
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Affiliation(s)
| | | | | | | | | | | | - Yu-Jie Zhou
- Clinical Center for Coronary Heart Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
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18
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Wang J, Jin X, Chen K, Yan W, Wang A, Zhu B, Wang W, Gao Z, Tang X, Yan L, Wan Q, Luo Z, Qin G, Chen L, Mu Y. Visceral adiposity index is closely associated with urinary albumin-creatinine ratio in the Chinese population with prediabetes. Diabetes Metab Res Rev 2021; 37:e3424. [PMID: 33245203 DOI: 10.1002/dmrr.3424] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/16/2020] [Accepted: 11/06/2020] [Indexed: 11/09/2022]
Abstract
AIMS Visceral obesity is a major health issue and is a risk factor for an atherogenic state. Visceral obesity has been reported to be a crucial link between albuminuria and cardiovascular diseases (CVD). This study attempted to explore the association between visceral obesity and albuminuria in prediabetic individuals. METHODS This cross-sectional study included 24871 prediabetic participants over 40 years of age from seven centres across China (REACTION study). The visceral adiposity index (VAI) was determined based on the measurements of anthropometric indices and lipid parameters. Increased albuminuria was defined as a urinary albumin-creatinine ratio (UACR) ≥30 mg/g, indicating kidney damage. Propensity score matching was used to reduce bias, and a multiple logistic regression model was performed to evaluate the association between visceral obesity and albuminuria in the population with prediabetes. RESULTS Participants with increased UACR exhibited increased VAI, age, blood pressure, triglycerides, poor glycaemic control, CVD events, and decreased estimated glomerular filtration rate (eGFR). Multiple logistic regression analysis demonstrated that VAI quartiles were positively associated with an increased risk of albuminuria (Q2: odds rate [OR]: 1.10, 95% confidence intervals [CI] 0.96-1.25; Q3: OR: 1.16, 95% CI 1.01-1.32; Q4: OR: 1.26, 95% CI 1.10-1.44, p for trend = 0.001). Stratified analysis revealed that the association of VAI level with increased albuminuria risk also occurred in people who were young, women, overweight or obese, with poor control of blood pressure, and eGFR ≥90 ml/min per 1.73 m2 . CONCLUSIONS Visceral obesity assessed by VAI is significantly associated with increased UACR in a Chinese population with prediabetes.
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Affiliation(s)
- Jie Wang
- Medicine School of Nankai University, Nankai, Tianjin, China
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Xinye Jin
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Kang Chen
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Wenhua Yan
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Anping Wang
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Binruo Zhu
- Medicine School of Nankai University, Nankai, Tianjin, China
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Weiqing Wang
- Shanghai National Research Centre for Endocrine and Metabolic Diseases, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhengnan Gao
- Dalian Central Hospital, Dalian, Liaoning, China
| | - Xulei Tang
- First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Li Yan
- Zhongshan University Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, China
| | - Qin Wan
- Southwest Medical University Affiliated Hospital, Luzhou, Sichuan, China
| | - Zuojie Luo
- First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Guijun Qin
- First Affiliated Hospital of Zhengzhou University, Zhenzhou, Henan, China
| | - Lulu Chen
- Wuhan Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yiming Mu
- Medicine School of Nankai University, Nankai, Tianjin, China
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
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19
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Karatas S, Beysel S. Visceral Adiposity Index, Triglyceride/High-Density Lipoprotein Ratio, and Lipid Accumulation Product Index to Discriminate Metabolic Syndrome Among Adult Type 1 Diabetes Patients. Metab Syndr Relat Disord 2021; 19:507-512. [PMID: 34283922 DOI: 10.1089/met.2021.0047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: Obesity and metabolic syndrome (MetS) are growing problems in type 1 diabetic patients; these can influence clinical complications and also treatment regimens. Visceral adipose tissue inflammation plays an important role in cardiovascular complications. Visceral adiposity index (VAI), lipid accumulation product index (LAP), and triglyceride (TG)/high-density lipoprotein (HDL) ratio have been strongly correlated with insulin resistance and visceral adipose tissue amount in previous studies. Therefore, this study aimed to investigate and compare the usefulness of these indices to detect MetS in patients with type 1 diabetes mellitus (T1DM). Materials and Methods: Patients with T1DM and gender- and age-matched controls were included in this cross-sectional study. MetS was defined using both International Diabetes Federation (IDF), World Health Organization (WHO), and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. T1DM patients were divided into two groups according to the IDF criteria. VAI, LAP, and TG/HDL ratio were calculated for all patients. Groups were compared accordingly. Results: One hundred twenty-six patients with T1DM were included in the study. Increased VAI was observed in association with MetS. Patients with MetS (32.2%) had the highest VAI than healthy controls (8.21 ± 8.86; 3.49 ± 2.73, respectively, P < 0.01). For determining MetS in type 1 diabetes, the cutoff value of VAI was 2.65 [area under the curve (AUC) = 0.837, sensitivity 80.0%, specificity 72.8%], LAP was 27.57 (AUC = 0.842, sensitivity 80.0%, specificity74.0%), TG/HDL ratio was 2.18 (AUC = 0.826, sensitivity 75.0%, specificity 74.0%), each P < 0.001. Conclusions: MetS becomes increasingly common in T1DM. VAI, LAP, and TG/HDL ratio were useful for predicting MetS in patients with T1DM.
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Affiliation(s)
- Savas Karatas
- Endocrinology and Metabolism Department, Istanbul Research and Education Hospital, Istanbul, Turkey
| | - Selvihan Beysel
- Endocrinology and Metabolism Department, Afyonkarahisar Saglik Bilimleri University, Afyonkarahisar, Turkey
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20
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Svarovskaya AV, Garganeeva AA. Anthropometric indices obesity and cardiometabolic risk: is there a link? КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Adipose tissue is currently regarded as a key organ for excess dietary lipids, which determine whether the body will maintain normal homeostasis or whether inflammation and insulin resistance will develop. In recent years, there is more information about novel prognostic models — the visceral adiposity index and the lipid accumulation product. The aim of this review was to analyze the results of studies examining the relationship between various indices of obesity and cardiometabolic risk. We analyzed 105 literature sources, 53 of which were ruled out, becausethe processes of interest were not described in detail or included anassessment of the relationship of various obesity indices with metabolic parameters. The results obtained indicate the advisability of using novel obesity indices, which have a good predictive ability and are simple and convenient to use. It is necessary to use additional methods of anthropometric and clinical examination in order to assess the metabolic phenotype of obesity, which will make it possible to stratify patients by the level of cardiometabolic risk.
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Affiliation(s)
- A. V. Svarovskaya
- Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences
| | - A. A. Garganeeva
- Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences
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21
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Sasaki N, Maeda R, Ozono R, Nakano Y, Higashi Y. Association of Flow Parameters and Diameter in the Common Carotid Artery with Impaired Glucose Metabolism. J Atheroscler Thromb 2021; 29:654-666. [PMID: 34011802 PMCID: PMC9135665 DOI: 10.5551/jat.62790] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Diameter, intima-media thickness (IMT), and flow parameters, including resistance index (RI) and pulsatility index (PI), in the common carotid artery (CCA) are markers of arterial remodeling, atherosclerosis, and vascular resistance, respectively. We investigated the differences among these markers in association with plasma glucose level, serum insulin level, and insulin resistance in participants without cardiovascular disease. METHODS CCA parameters (including the CCA interadventitial diameter and mean IMT at the time of 75-g oral glucose tolerance testing) were assessed in 4218 participants. RI and PI were assessed in 3380 of these participants. To assess plasma glucose and serum immunoreactive insulin profiles during oral glucose tolerance testing, we used the total areas under the curves (AUCglu and AUCins, respectively). We used the homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda index to assess insulin resistance. Insulin secretion was assessed with the HOMA-β. RESULTS AUCglu was significantly associated with CCA interadventitial diameter (β=0.048, P<0.001), RI (β=0.144, P<0.001), and PI (β=0.103, P<0.001) but not with mean IMT. AUCins (β=-0.064, P<0.001) and HOMA-β (β=-0.054, P<0.001) were significantly and negatively associated with CCA interadventitial diameter, but not with mean IMT. Both HOMA-IR and Matsuda index were significantly associated with RI and PI. CONCLUSIONS These findings indicate that all CCA parameters except IMT are associated with impaired glucose metabolism in patients without cardiovascular disease.
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Affiliation(s)
- Nobuo Sasaki
- Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council
| | - Ryo Maeda
- Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council
| | - Ryoji Ozono
- Department of General Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
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22
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Kundel V, Lehane D, Ramachandran S, Fayad Z, Robson P, Shah N, Mani V. Measuring Visceral Adipose Tissue Metabolic Activity in Sleep Apnea Utilizing Hybrid 18F-FDG PET/MRI: A Pilot Study. Nat Sci Sleep 2021; 13:1943-1953. [PMID: 34737662 PMCID: PMC8560175 DOI: 10.2147/nss.s327341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/18/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Visceral adipose tissue (VAT) is proinflammatory and is associated with cardiovascular (CV) disease. We investigated the relationship between obstructive sleep apnea (OSA) and visceral adipose tissue (VAT) metabolic activity in a pilot group of patients using positron-emission tomography/magnetic resonance imaging (PET/MRI) with 18F-fluorodeoxyglucose (FDG) tracer as a novel marker of adipose tissue inflammation. PATIENTS AND METHODS We analyzed patients from an ongoing study, recruiting those with newly diagnosed, untreated OSA (Respiratory Disturbance Index [RDI] ≥ 5), using home sleep apnea testing (WatchPAT-200 Central-Plus). PET/MRI scans were acquired before continuous positive airway pressure (CPAP)-initiation, and after 3 months of CPAP therapy. Adipose tissue metabolic activity (18F-FDG-uptake) was measured using standardized uptake values (SUV) within the adipose tissue depots. The primary outcome was VAT SUVmean, and secondary outcomes included VAT volume, and subcutaneous adipose tissue (SAT) volume/SUVmean. Reproducibility and reliability of outcome measures were analyzed using intraclass correlation coefficients (ICC). Multivariable linear regression was used to evaluate the association between OSA and primary/secondary outcomes. RESULTS Our analytical sample (n = 16) was 81% male (mean age 47 ± 15 years, mean BMI of 29.9 ± 4.8kg/m2). About 56% had moderate to severe OSA (mean RDI 23 ± 6 events/hour), and 50% were adherent to CPAP. We demonstrated excellent inter/intra-rater reliability and reproducibility for the primary and secondary outcomes. Patients with moderate-to-severe OSA had a higher VAT SUV mean compared to those with mild OSA (0.795 ± 0.154 vs 0.602 ± 0.19, p = 0.04). OSA severity was positively associated with VAT SUVmean (primary outcome), adjusted for age and BMI (B [SE] = 0.013 ± 0.005, p = 0.03). Change in VAT volume was inversely correlated with CPAP adherence in unadjusted analysis (B [SE] = -48.4 ± 18.7, p = 0.02). CONCLUSION Derangements in VAT metabolic activity are implicated in adverse cardiometabolic outcomes and may be one of the key drivers of CV risk in OSA. Our results are hypothesis-generating, and suggest that VAT should be investigated in future studies using multi-modal imaging to understand its role as a potential mediator of adverse cardiometabolic risk in OSA.
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Affiliation(s)
- Vaishnavi Kundel
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniel Lehane
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Sarayu Ramachandran
- Department of Radiology, BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Zahi Fayad
- Department of Radiology, BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Philip Robson
- Department of Radiology, BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Neomi Shah
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Venkatesh Mani
- Department of Radiology, BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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23
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The Use of Visceral Adiposity Index to Predict Diabetes Remission in Low BMI Chinese Patients After Bariatric Surgery. Obes Surg 2020; 31:805-812. [PMID: 33063158 DOI: 10.1007/s11695-020-05034-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Visceral Adiposity Index (VAI) is considered to be a reliable indicator for evaluation of visceral adipose dysfunction and cardiovascular disease risk. However, no previous studies have reported the VAI variation after bariatric surgery and the predictive effect of preoperative VAI on diabetes remission. The aim of this study is to evaluate whether preoperative VAI is useful to predict diabetes remission in low BMI Chinese patients after bariatric surgery. METHODS Eighty-seven type 2 diabetes mellitus patients with BMI < 35 kg/m2 underwent bariatric surgery from May 2010 to March 2018 in our hospital. VAI, glycolipid metabolic parameters, and anthropometric variables were measured before and 4 years after surgery. Complete remission was defined as follows: HbA1c < 6%, FPG < 5.6 mmol/L, achieved without anti-diabetic medication. Analysis included using binary logistic regression to identify predictors and ROC curves to determine clinically useful cutoff values. RESULTS Seventy-four patients (85.1%) underwent Roux-en-Y gastric bypass (RYGB), while the remaining 13 patients (14.9%) underwent sleeve gastrectomy (SG). Patients' weight, glycemic control, and lipid profiles were improved significantly after surgery (p < 0.05). Complete remission of T2DM was found in 35 patients (40.2%) 1 year after surgery. VAI decreased from baseline 4.41 to 1.74 in 3 months after surgery (p < 0.05) and showed a downward trend over the period from 6 months to 4 years. Patients with complete remission had a significantly shorter duration of diabetes, lower HbA1c level, and higher VAI, in comparison to those without remission. Binary logistics regression and ROC curves analysis confirm that VAI, HbA1c, and duration of diabetes can predict diabetes remission after bariatric surgery, and the VAI of 4.46 is a useful threshold for predicting surgical efficacy. CONCLUSION VAI is a significant predictor of diabetes remission for lower BMI patients with T2DM following bariatric surgery in China. The VAI of 4.46 is a useful threshold for predicting surgical efficacy. Multi-center and larger prospective studies are needed to confirm our findings.
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24
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Nam KW, Kwon HM, Jeong HY, Park JH, Kwon H, Jeong SM, Kim HJ. Visceral adiposity index is associated with silent brain infarct in a healthy population. Sci Rep 2020; 10:17271. [PMID: 33057150 PMCID: PMC7566629 DOI: 10.1038/s41598-020-74454-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/30/2020] [Indexed: 12/17/2022] Open
Abstract
Visceral adiposity index (VAI) has been associated with various cardio-metabolic diseases; however, there is limited information about its association with cerebrovascular diseases. In this study, we evaluated the relationship between VAI and silent brain infarct (SBI). We evaluated a consecutive series of healthy volunteers over the age of 40 between January 2006 and December 2013. SBI was defined as an asymptomatic, well-defined lesion with a diameter ≥ 3 mm with the same signal characteristics as the cerebrospinal fluid. VAI was calculated using sex-specific equations as described in previous studies. A total of 2596 subjects were evaluated, and SBI was found in 218 (8%) participants. In multivariable analysis, VAI (adjusted odds ratio [aOR] = 1.30; 95% confidence interval [CI] 1.03-1.66; P = 0.030) remained a significant predictor of SBI after adjustment for confounders. The close relationship between VAI and SBI was prominent only in females (aOR = 1.44; 95% CI 1.00-2.07; P = 0.048). In the evaluation between VAI and the burden of SBI, VAI showed a positive dose-response relationship with the number of SBI lesions (P for trend = 0.037). High VAI was associated with a higher prevalence and burden of SBI in a neurologically healthy population.
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Affiliation(s)
- Ki-Woong Nam
- Departments of Neurology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
| | - Hyung-Min Kwon
- Department of Neurology, Seoul National University College of Medicine and Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea.
| | - Han-Yeong Jeong
- Departments of Neurology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
| | - Jin-Ho Park
- Departments of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
| | - Hyuktae Kwon
- Departments of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - Su-Min Jeong
- Departments of Family Medicine, Seoul National University College of Medicine and Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hyun-Jin Kim
- National Cancer Control Institute, National Cancer Center, Goyang, South Korea
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25
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Yu Y, Zhang FL, Yan XL, Zhang P, Guo ZN, Yang Y. Visceral adiposity index and cervical arterial atherosclerosis in northeast China: a population based cross-sectional survey. Eur J Neurol 2020; 28:161-171. [PMID: 32896952 DOI: 10.1111/ene.14513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/31/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE The burden of cervical arterial atherosclerosis, which is an important risk factor of stroke, is huge in China. The visceral adiposity index (VAI) is a convenient index that is related to a series of metabolic abnormalities and a variety of diseases, including cerebrovascular diseases. This study aimed to explore the relationship between VAI and cervical arterial atherosclerosis. METHODS This cross-sectional study used the multistage stratified random cluster sampling method to acquire a representative sample of residents aged ≥40 in the general population of northeast China. All participants completed a detailed questionnaire and provided blood samples. Cervical vascular ultrasound was performed by experienced ultrasound doctors. VAI was calculated by a well-established formula and analyzed by quartiles (Q1-Q4). RESULTS A total of 3688 people aged ≥40 years who underwent cervical arterial ultrasound were finally included, amongst whom 3.2% had increased intima-media thickness (IMT), 48.6% had carotid plaque and 4.0% had cervical artery stenosis (CAS). After adjusting for several parameters, little statistical significance was found between VAI and increased IMT; compared with the VAI-Q1 group, the VAI-Q2, VAI-Q3 and VAI-Q4 groups were more likely to have CAS [odds ratio (OR) 2.01, 95% confidence interval (CI) 1.17-3.43; OR 1.82, 95% CI 1.05-3.15; OR 1.79, 95% CI 1.03-3.12] and the VAI-Q3 and VAI-Q4 groups were at greater risk of carotid plaque (OR 1.30, 95% CI 1.05-1.62; OR 1.34, 95% CI 1.07-1.67). CONCLUSIONS The VAI was related to carotid plaque and CAS in the general population that is older than 40 years.
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Affiliation(s)
- Y Yu
- Stroke Center, Department of Neurology, First Hospital of Jilin University, Changchun, China.,Neuroscience Center, Department of Neurology, First Hospital of Jilin University, Changchun, China.,Clinical Trial and Research Center for Stroke, Department of Neurology, First Hospital of Jilin University, Changchun, China
| | - F-L Zhang
- Stroke Center, Department of Neurology, First Hospital of Jilin University, Changchun, China.,Neuroscience Center, Department of Neurology, First Hospital of Jilin University, Changchun, China.,Clinical Trial and Research Center for Stroke, Department of Neurology, First Hospital of Jilin University, Changchun, China
| | - X-L Yan
- Stroke Center, Department of Neurology, First Hospital of Jilin University, Changchun, China.,Neuroscience Center, Department of Neurology, First Hospital of Jilin University, Changchun, China.,Clinical Trial and Research Center for Stroke, Department of Neurology, First Hospital of Jilin University, Changchun, China
| | - P Zhang
- Stroke Center, Department of Neurology, First Hospital of Jilin University, Changchun, China.,Neuroscience Center, Department of Neurology, First Hospital of Jilin University, Changchun, China.,Clinical Trial and Research Center for Stroke, Department of Neurology, First Hospital of Jilin University, Changchun, China
| | - Z-N Guo
- Stroke Center, Department of Neurology, First Hospital of Jilin University, Changchun, China.,Neuroscience Center, Department of Neurology, First Hospital of Jilin University, Changchun, China.,Clinical Trial and Research Center for Stroke, Department of Neurology, First Hospital of Jilin University, Changchun, China
| | - Y Yang
- Stroke Center, Department of Neurology, First Hospital of Jilin University, Changchun, China.,Neuroscience Center, Department of Neurology, First Hospital of Jilin University, Changchun, China.,Clinical Trial and Research Center for Stroke, Department of Neurology, First Hospital of Jilin University, Changchun, China
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26
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Katsiki N, Mikhailidis DP. Diabetes and carotid artery disease: a narrative review. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1280. [PMID: 33178812 PMCID: PMC7607073 DOI: 10.21037/atm.2019.12.153] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Diabetes mellitus (DM) has been linked to an increased prevalence and severity of carotid artery disease, as well as polyvascular disease. Carotid disease is also associated with obesity and abnormal peri-organ and intra-organ fat (APIFat) deposition (i.e., excess fat accumulation in several organs such as the liver, heart and vessels). In turn, DM is associated with APIFat. The coexistence of these comorbidities confers a greater risk of vascular events. Clinicians should also consider that carotid bruits may predict cardiovascular risk. DM has been related to a greater risk of adverse outcomes after carotid endarterectomy or stenting. Whether modifying risk factors (e.g., glycaemia and dyslipidaemia) in DM patients can improve the outcomes of these procedures needs to be established. Furthermore, DM is a risk factor for contrast-induced acute kidney injury (CI-AKI). The latter should be recorded in DM patients undergoing carotid stenting since it can influence both short- and long-term outcomes. From a pathophysiological perspective, functional changes in the carotid artery may precede morphological ones. Furthermore, carotid plaque characteristics are increasingly being studied in terms of vascular risk stratification and monitoring short-term changes attributed to treatment. The present narrative review discusses the recent (2019) literature on the associations between DM and carotid artery disease. Physicians and vascular surgeons looking after patients with carotid disease and DM should consider these links that may influence outcomes. Further research in this field is also needed to optimise the treatment of such patients.
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Affiliation(s)
- Niki Katsiki
- Diabetes Center, Division of Endocrinology and Metabolism, First Department of Internal Medicine, AHEPA University Hospital, Medical School Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, UK.,Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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27
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de Medeiros SF, de Medeiros MAS, Barbosa BB, Yamamoto MMW. The Role of Visceral Adiposity Index as Predictor of Metabolic Syndrome in Obese and Nonobese Women with Polycystic Ovary Syndrome. Metab Syndr Relat Disord 2020; 19:18-25. [PMID: 32845813 DOI: 10.1089/met.2020.0045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: To evaluate anthropometric-metabolic biomarkers as predictors of metabolic syndrome (MS) in women with polycystic ovary syndrome (PCOS) with and without obesity. Methods: This was an observational cross-sectional study. Patients were classified as nonobese-PCOS (body mass index, BMI <30 kg/m2, n = 385), and obese-PCOS (BMI ≥30 kg/m2, n = 261). The anthropometric parameters waist circumference, waist/hip ratio, lean body mass, fat body mass, visceral adiposity index (VAI), lipid accumulating product, and biomarkers of glucose and lipid metabolisms were compared between groups. Binominal logistic regression analyses were performed to identify predictors of MS. Results: Obesity was diagnosed in 40% of all PCOS women (P < 0.001). Blood pressure and anthropometric abnormalities were significantly more frequent in obese-PCOS women (P < 0.001, for all comparisons). Glucose metabolism markers were higher in obese-PCOS compared with nonobese-PCOS (P < 0.001, for all comparisons). High-density lipoprotein cholesterol was lower in obese group than in nonobese group (1.26 mM vs. 1.08 mM, P < 0.001). MS was found in 23 of 385 (6%) nonobese-PCOS and in 116 of 261 (44.4%) obese-PCOS (P < 0.001). VAI was the best predictor of MS in both nonobese-PCOS (OR = 4.1, 95% CI 1.5-11.1) and obese-PCOS (OR = 12.9, 95% CI 5.7-29.0). Conclusions: MS is more prevalent in PCOS women with obesity. VAI was the strongest predictor of MS in both obese and nonobese PCOS women, and can be applied in clinical practice for early detection of risk for MS and precocious intervention in women with PCOS, particularly in obese women.
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Affiliation(s)
- Sebastião Freitas de Medeiros
- Department of Gynecology and Obstetrics, Medical School, Federal University of Mato Grosso, Cuiabá, Brazil.,Department of Gynecology and Obstetrics, Tropical Institute of Reproductive Medicine, Cuiabá, Brazil
| | | | - Bruna Barcelo Barbosa
- Department of Gynecology and Obstetrics, Tropical Institute of Reproductive Medicine, Cuiabá, Brazil
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Sung HH, Park CE, Gi MY, Cha JA, Moon AE, Kang JK, Seong JM, Lee JH, Yoon H. The association of the visceral adiposity index with insulin resistance and beta-cell function in Korean adults with and without type 2 diabetes mellitus. Endocr J 2020; 67:613-621. [PMID: 32161204 DOI: 10.1507/endocrj.ej19-0517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This study was conducted to assess the association of the visceral adiposity index (VAI) with insulin resistance and beta cell function in Korean adults with and without type 2 diabetes mellitus. The study was carried out using data from the 2015 Korean National Health and Nutrition Examination Survey (KNHANES VI-3) and included 4,922 adults, aged 20 or older. There were several key findings in the present study. First, in subjects without type 2 diabetes mellitus, homeostasis model assessment of insulin resistance (HOMA-IR) (p < 0.001) and beta cell function (HOMA-B) (p < 0.001), insulin (p < 0.001), fasting blood glucose (FBG) (p < 0.001), and metabolic syndrome (MetS) score (p < 0.001) were positively associated with quartiles of VAI. Second, in subjects with type 2 diabetes mellitus, HOMA-IR (p = 0.038), FBG (p = 0.007), and MetS score (p < 0.001) were positively associated with quartiles of VAI, but associations with HOMA-B (p = 0.879) and insulin (p = 0.104) were not significant. In conclusions, the visceral adiposity index is positively associated with insulin resistance and beta cell function in Korean adults without type 2 diabetes mellitus. The visceral adiposity index is positively associated with insulin resistance but not beta cell function in Korean adults with type 2 diabetes mellitus.
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Affiliation(s)
- Hyun Ho Sung
- Department of Clinical Laboratory Science, Dongnam Health University, Suwonsi, Gyeonggi-do, 16328, South Korea
| | - Chang Eun Park
- Department of Biomedical Laboratory Science, Namseoul University, Cheonan-si, Chungcheongnam-do, 31020, South Korea
| | - Mi Young Gi
- Department of Nursing, Christian College of Nursing, Gwangju, 61662, South Korea
| | - Ju Ae Cha
- Department of Nursing, Chunnam Techno University, Gokseong-gun, Jeollanam-do, 57500, South Korea
| | - Ae Eun Moon
- Department of Dental Hygiene, Honam University, Gwangju, 62399, South Korea
| | - Jae Kook Kang
- Department of Dental Hygiene, Honam University, Gwangju, 62399, South Korea
| | - Jeong Min Seong
- Department of Dental Hygiene, College of Health Science, Kangwon National University, Samcheok-si, Gangwon-do, 25949, South Korea
| | - Jun Ho Lee
- Department of Clinical Laboratory Science, Wonkwang Health Science University, Iksan-si, Jeollabuk-do, 54538, South Korea
| | - Hyun Yoon
- Department of Clinical Laboratory Science, Wonkwang Health Science University, Iksan-si, Jeollabuk-do, 54538, South Korea
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Bagyura Z, Kiss L, Lux Á, Csobay-Novák C, Jermendy ÁL, Polgár L, Szelid Z, Soós P, Merkely B. Association between coronary atherosclerosis and visceral adiposity index. Nutr Metab Cardiovasc Dis 2020; 30:796-803. [PMID: 32127334 DOI: 10.1016/j.numecd.2020.01.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 12/29/2019] [Accepted: 01/29/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS Visceral obesity is a marker of dysfunctional adipose tissue and ectopic fat infiltration. Many studies have shown that visceral fat dysfunction has a close relationship with cardiovascular disease. For a better identification of visceral adiposity dysfunction, the visceral adiposity index (VAI) is used. Coronary artery calcium score (CACS) is known to have a strong correlation with the total plaque burden therefore provides information about the severity of the coronary atherosclerosis. CACS is a strong predictor of cardiac events and it refines cardiovascular risk assessment beyond conventional risk factors. Our aim was to evaluate the association between VAI and CACS in an asymptomatic Caucasian population. METHODS AND RESULTS Computed tomography scans of 460 participants were analyzed in a cross-sectional, voluntary screening program. A health questionnaire, physical examination and laboratory tests were also performed. Participants with a history of cardiovascular disease were excluded from the analysis. Mean VAI was 1.41 ± 0.07 in men and 2.00 ± 0.15 in women. VAI showed a positive correlation with total coronary calcium score (r = 0.242) in males but not in females. VAI was stratified into tertiles by gender. In males, third VAI tertile was independently associated with CACS>100 (OR: 3.21, p = 0.02) but not with CACS>0 after the effects of conventional risk factors were eliminated. CONCLUSION VAI tertiles were associated with calcium scores and the highest VAI tertile was an independent predictor for the presence of CACS>100 in males but not in females.
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Affiliation(s)
- Zsolt Bagyura
- Heart and Vascular Center, Semmelweis University, Városmajor utca 68, Budapest, H-1122, Hungary.
| | - Loretta Kiss
- Heart and Vascular Center, Semmelweis University, Városmajor utca 68, Budapest, H-1122, Hungary
| | - Árpád Lux
- Heart and Vascular Center, Semmelweis University, Városmajor utca 68, Budapest, H-1122, Hungary
| | - Csaba Csobay-Novák
- Heart and Vascular Center, Semmelweis University, Városmajor utca 68, Budapest, H-1122, Hungary
| | - Ádám L Jermendy
- Heart and Vascular Center, Semmelweis University, Városmajor utca 68, Budapest, H-1122, Hungary
| | - Lívia Polgár
- Heart and Vascular Center, Semmelweis University, Városmajor utca 68, Budapest, H-1122, Hungary
| | - Zsolt Szelid
- Heart and Vascular Center, Semmelweis University, Városmajor utca 68, Budapest, H-1122, Hungary
| | - Pál Soós
- Heart and Vascular Center, Semmelweis University, Városmajor utca 68, Budapest, H-1122, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Városmajor utca 68, Budapest, H-1122, Hungary
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Randrianarisoa E, Lehn-Stefan A, Krier J, Böhm A, Heni M, Hrabě De Angelis M, Fritsche A, Häring HU, Stefan N, Staiger H. AMPK Subunits Harbor Largely Nonoverlapping Genetic Determinants for Body Fat Mass, Glucose Metabolism, and Cholesterol Metabolism. J Clin Endocrinol Metab 2020; 105:5568228. [PMID: 31512724 DOI: 10.1210/clinem/dgz020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/29/2019] [Accepted: 09/04/2019] [Indexed: 02/13/2023]
Abstract
CONTEXT Adenosine monophosphate (AMP)-activated protein kinase (AMPK) is a heterotrimeric enzyme and central regulator of cellular energy metabolism. The impact of single nucleotide polymorphisms (SNPs) in all 7 AMPK subunit genes on adiposity, glucose metabolism, and lipid metabolism has not yet been systematically studied. OBJECTIVE To analyze the associations of common SNPs in all AMPK genes, and of different scores thereof, with adiposity, insulin sensitivity, insulin secretion, blood glucose, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, total cholesterol, and triglycerides. STUDY DESIGN AND METHODS A cohort of 2789 nondiabetic participants from the Tübingen Family study of type 2 diabetes, metabolically characterized by oral glucose tolerance test and genotyped by genome-wide SNP array, was analyzed. RESULTS We identified 6 largely nonoverlapping SNP sets across 4 AMPK genes (PRKAA1, PRKAA2, PRKAG2, PRKAG3) associated with adiposity, insulin sensitivity, insulin secretion, blood glucose, total/LDL cholesterol, or HDL cholesterol, respectively. A genetic score of body-fat-increasing alleles revealed per-allele effect sizes on body mass index (BMI) of +0.22 kg/m2 (P = 2.3 × 10-7), insulin sensitivity of -0.12 × 1019 L2/mol2 (P = 9.9 × 10-6) and 2-hour blood glucose of +0.02 mmol/L (P = 0.0048). Similar effects on blood glucose were observed with scores of insulin-sensitivity-reducing, insulin-secretion-reducing and glucose-raising alleles, respectively. A genetic cholesterol score increased total and LDL cholesterol by 1.17 mg/dL per allele (P = 0.0002 and P = 3.2 × 10-5, respectively), and a genetic HDL score decreased HDL cholesterol by 0.32 mg/dL per allele (P = 9.1 × 10-6). CONCLUSIONS We describe largely nonoverlapping genetic determinants in AMPK genes for diabetes-/atherosclerosis-related traits, which reflect the metabolic pathways controlled by the enzyme. Formation of trait-specific genetic scores revealed additivity of allele effects, with body-fat-raising alleles reaching a marked effect size. (J Clin Endocrinol Metab XX: 0-0, 2019).
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Affiliation(s)
- Elko Randrianarisoa
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, 72076 Tübingen, Germany
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany
| | - Angela Lehn-Stefan
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, 72076 Tübingen, Germany
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany
| | - Johannes Krier
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, 72076 Tübingen, Germany
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany
| | - Anja Böhm
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, 72076 Tübingen, Germany
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
| | - Martin Heni
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, 72076 Tübingen, Germany
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
| | - Martin Hrabě De Angelis
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany
- Institute of Experimental Genetics, Helmholtz Center Munich, 85764 Neuherberg, Germany
- Chair of Experimental Genetics, Technical University Munich, 85764 Neuherberg, Germany
| | - Andreas Fritsche
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, 72076 Tübingen, Germany
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
| | - Hans-Ulrich Häring
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, 72076 Tübingen, Germany
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
| | - Norbert Stefan
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, 72076 Tübingen, Germany
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
| | - Harald Staiger
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, 72076 Tübingen, Germany
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany
- Institute of Pharmaceutical Sciences, Department of Pharmacy and Biochemistry, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
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Can Visceral Adiposity Index Serve as a Simple Tool for Identifying Individuals with Insulin Resistance in Daily Clinical Practice? ACTA ACUST UNITED AC 2019; 55:medicina55090545. [PMID: 31470593 PMCID: PMC6780575 DOI: 10.3390/medicina55090545] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 08/14/2019] [Accepted: 08/24/2019] [Indexed: 01/14/2023]
Abstract
Background and objectives: The visceral adiposity index (VAI), estimating visceral adiposity dysfunction through a simple formula, could serve as a useful tool for identifying individuals at higher cardiometabolic risk. Its relationship with insulin resistance (IR), assessed using the homeostasis model assessment of IR (HOMA-IR), and metabolic syndrome (MetS) components remains unclear. The study aimed to investigate the association of VAI with both HOMA-IR and MetS. Materials and Methods: After undergoing anthropometric and biochemical studies, 783 individuals were divided into three groups according to a number of present MetS components. The VAI cut-offs signaling MetS and HOMA-IR were determined by maximizing the sum of the sensitivity and specificity. Correlation analysis was performed to explore the associations between VAI and other tested parameters. A logistic stepwise regression analysis was applied to identify statistically significant determinants of HOMA-IR. Given the variability of reference values, two thresholds of HOMA-IR were applied, namely 2.0 and 3.8. Results: VAI increased significantly between the groups with a rising number of MetS components. The VAI cut-off for MetS was 2.37, with a sensitivity of 0.86 and a specificity of 0.78. The same cut-off point identified subjects with HOMA-IR = 3.8, with a sensitivity of 0.79 and a specificity of 0.66. The VAI cut-off for HOMA-IR = 2.0 was 1.89, with a sensitivity of 0.74 and a specificity of 0.68. The strongest correlations of VAI were noted with HOMA-IR (r = 0.51) and insulin (r = 0.49), respectively, while the strongest correlation of HOMA-IR was with waist circumference (r = 0.54). Not one of the routine parameters was a significant predictor in the regression analysis. Conclusions: The obtained results show an existing association of VAI with HOMA-IR. The high sensitivity and specificity of the cut-offs may allow the application of VAI in common clinical practice.
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