Insulin resistance assessed by estimated glucose disposal rate and risk of incident cardiovascular diseases among individuals without diabetes: findings from a nationwide, population based, prospective cohort study

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: June 6, 2024

Abstract Background Recent studies have suggested that insulin resistance (IR) contributes to the development of cardiovascular diseases (CVD), and estimated glucose disposal rate (eGDR) is considered be a reliable surrogate marker IR. However, most existing evidence stems from involving diabetic patients, potentially overstating effects eGDR on CVD. Therefore, primary objective this study examine relationship with incidence CVD in non-diabetic participants. Method The current analysis included individuals China Health Retirement Longitudinal Study (CHARLS) who were free diabetes mellitus but had complete data at baseline. formula for calculating was as follows: (mg/kg/min) = 21.158 − (0.09 × WC) (3.407 hypertension) (0.551 HbA1c) [WC (cm), hypertension (yes 1/no 0), HbA1c (%)]. categorized into four subgroups according quartiles (Q) eGDR. Crude hazard ratios (HRs) 95% confidence intervals (CIs) computed investigate association between incident CVD, lowest quartile (indicating highest grade resistance) serving reference. Additionally, multivariate adjusted restricted cubic spine (RCS) employed dose–response relationship. Results We 5512 participants study, mean age 58.2 ± 8.8 years, 54.1% female. Over median follow-up duration 79.4 months, 1213 cases, including 927 heart disease 391 stroke, recorded. RCS curves demonstrated significant linear all outcomes (all P non-linearity > 0.05). After adjustment, lower levels founded significantly associated higher risk Compared Q1 eGDR, HRs (95% CIs) those Q2 4 0.88 (0.76 1.02), 0.69 (0.58 0.82), 0.66 (0.56 0.79). When assessed continuous variable, per 1.0-SD increase 17% (HR: 0.83, CI: 0.78 0.89) subgroup analyses indicating smoking status modified ( interaction 0.012). Moreover, mediation revealed obesity partly mediated association. incorporating basic model considerably improve predictive ability Conclusion A level found increased among This suggests may serve promising preferable predictor intervention target

Language: Английский

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Diagnostic and prognostic value of triglyceride glucose index: a comprehensive evaluation of meta-analysis

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: Aug. 23, 2024

The present umbrella review aims to collate and summarize the findings from previous meta-analyses on Triglyceride Glucose (TyG) Index, providing insights clinicians, researchers, policymakers regarding usefulness of this biomarker in various clinical settings. A comprehensive search was conducted PubMed, Scopus, Web Science up April 14, 2024, without language restrictions. AMSTAR2 checklist assessed methodological quality included meta-analyses. Statistical analyses were performed using Comprehensive Meta-Analysis (CMA) software. total 32 studies finally included. results revealed significant associations between TyG index health outcomes. For kidney outcomes, a high significantly associated with an increased risk contrast-induced nephropathy (CIN) (OR = 2.24, 95% CI: 1.82–2.77) chronic disease (CKD) (RR 1.46, 1.32–1.63). High type 2 diabetes mellitus (T2DM) 3.53, 2.74–4.54), gestational (GDM) 2.41, 1.48–3.91), diabetic retinopathy (DR) 2.34, 1.31–4.19). Regarding metabolic diseases, higher patients obstructive sleep apnea (OSA) (SMD 0.86, 0.57–1.15), syndrome (MD 0.83, 0.74–0.93), non-alcoholic fatty liver (NAFLD) 2.36, 1.88–2.97) compared those these conditions. In cerebrovascular dementia 1.14, 1.12–1.16), cognitive impairment 2.31, 1.38–3.86), ischemic stroke 1.37, 1.22–1.54). cardiovascular showed heart failure (HF) (HR 1.21, 1.12–1.30), atrial fibrillation (AF) 1.22, 0.57–1.87), hypertension (HTN) 1.52, 1.25–1.85). is promising for screening predicting medical conditions, particularly related insulin resistance disorders. However, heterogeneity suggest need further high-quality research confirm refine utility index.

Language: Английский

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Joint association of TyG index and high sensitivity C-reactive protein with cardiovascular disease: a national cohort study

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: May 7, 2024

Both the triglyceride-glucose (TyG) index, as a surrogate marker of insulin resistance, and systemic inflammation are predictors cardiovascular diseases; however, little is known about coexposures relative contributions TyG index to diseases. Using nationally representative data from China Health Retirement Longitudinal Study (CHARLS), we conducted longitudinal analyses evaluate joint mutual associations high-sensitivity C-reactive protein (hsCRP) with events in middle-aged older Chinese population.

Language: Английский

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Comparison of triglyceride glucose index and modified triglyceride glucose indices in prediction of cardiovascular diseases in middle aged and older Chinese adults

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: May 29, 2024

Abstract Background Triglyceride and glucose (TyG) index, a surrogate marker of insulin resistance, has been validated as predictor cardiovascular disease. However, effects TyG-related indices combined with obesity markers on diseases remained unknown. We aimed to investigate the associations between TyG index modified new-onset disease time-dependent predictive capacity using national representative cohort. Methods This study is retrospective observational cohort data from China Health Retirement Longitudinal Study (CHARLS) 7 115 participants. The was calculated Ln [fasting triglyceride (mg/dL) × fasting (mg/dL)/2]. were developed combining body mass (BMI), waist circumference (WC) waist-to‐height ratio (WHtR). used adjusted Cox proportional hazards regression analyze association based hazard (HR) Harrell’s C‐index. Results Over 7-year follow‐up period, 2136 participants disease, including 1633 cases coronary heart 719 stroke. Compared lowest tertile group, HR (95% CI) for in highest TyG, TyG-BMI, TyG-WC, TyG-WHtR 1.215 (1.088–1.356), 1.073 (0.967–1.191), 1.078 (0.970–1.198), 1.112 (1.002–1.235), respectively. C‐indices onset higher than other indices. Similar results observed Conclusion TyG-WhtR significantly associated diseases, outperformed identify individuals at risk incident event.

Language: Английский

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Association between the triglyceride glucose-body mass index and future cardiovascular disease risk in a population with Cardiovascular-Kidney-Metabolic syndrome stage 0–3: a nationwide prospective cohort study

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: Aug. 7, 2024

The American Heart Association (AHA) has recently introduced the concept of Cardiovascular-Kidney-Metabolic (CKM) syndrome, which is result an increasing emphasis on interplay metabolic, renal and cardiovascular diseases (CVD). Furthermore, there substantial evidence a correlation between triglyceride glucose-body mass index (TyG-BMI ) CVD as assessment insulin resistance (IR). However, it remains unknown whether this exists in population with CKM syndrome.

Language: Английский

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The association between TyG index and cardiovascular mortality is modified by antidiabetic or lipid-lowering agent: a prospective cohort study

Cardiovascular Diabetology, Journal Year: 2025, Volume and Issue: 24(1)

Published: Feb. 7, 2025

Abstract Background The triglyceride-glucose (TyG) index is recognized as an alternative measure of insulin resistance (IR) and has been linked to the risks cardiovascular disease (CVD) mortality. This study aimed evaluate whether association between TyG CVD mortality influenced by use antidiabetic hypolipidemic agents, given their potential modifying effects on index. Methods Participants from National Health Nutrition Examination Survey (1999–2018) were included in study. Mortality outcomes tracked through linkage with Death Index records until December 31, 2019. Data medications (including prescribed insulin, diabetic pills, cholesterol-lowering agents) self-reported participants. Results A total 5,046 adults (representing 42,753,806 individuals, weighted mean age 61.08 years [SE: 0.24]; 49.35% female) analyzed. was significantly associated all-cause mortality, these associations modified agents ( p < 0.01). Significant interactions observed for after full adjustments (p-value interaction 0.05). Exposure-effect analysis revealed a U-shaped relationship levels participants using while linear positive not agents. Conclusions modify These findings suggest that future studies its should account Graphical abstract

Language: Английский

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Insulin resistance assessed by estimated glucose disposal rate and risk of atherosclerotic cardiovascular diseases incidence: the multi-ethnic study of atherosclerosis

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: Sept. 28, 2024

Language: Английский

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The additive effect of the stress hyperglycemia ratio on type 2 diabetes: a population-based cohort study

Cardiovascular Diabetology, Journal Year: 2025, Volume and Issue: 24(1)

Published: Jan. 6, 2025

The stress hyperglycemia ratio (SHR) has recently gained attention as a marker for acute hyperglycemia, which been linked to adverse clinical outcomes. However, its independent role in the development of type 2 diabetes (T2D) remains understudied. This cohort study aimed assess association between SHR and incidence T2D. included 8978 participants aged 45 or older, free at baseline, from China Health Retirement Longitudinal Study (CHARLS). Incident T2D up December 31, 2020, was primary outcome. Participants were divided into quartiles, Cox proportional hazards regression fine-gray competing risk models used SHR's with onset, adjusting fasting glucose HbA1c. mean age 59.0 ± 9.5 years, 51.5% women. Over follow-up 7.8 1084 developed analysis revealed that individuals highest quartile had significantly higher onset compared those lowest (HR 1.48, 95% CI 1.26–1.75, P trend < 0.001). Stratified analyses by sex, obesity, smoking showed consistent results. Adding HbA1c improved AUC prediction (DeLong Test, = 0.013). is independently associated incident T2D, suggesting potential use stratification beyond

Language: Английский

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Association between myosteatosis or sarcopenia based on abdominal CT and hypertension in systemic lupus erythematosus patients

Lipids in Health and Disease, Journal Year: 2025, Volume and Issue: 24(1)

Published: March 20, 2025

Hypertension and obesity are common in systemic lupus erythematosus (SLE) patients, with obesity-related changes potentially driving hypertension. However, the specific adiposity measures associated hypertension SLE patients remain unclear. This study assessed association between myosteatosis sarcopenia detected on abdominal CT patients. Mediators of were also investigated. was a retrospective involving enrolled from January 2017 to August 2023 who underwent at L3 level track based skeletal muscle mean radiodensity (SMD) index considered as binary continuous variables. The these body composition tested using logistic regression analyses, while mediation modeling used assess mediators. A total 279 adult (median age, 41.00 [30.00, 51.00] years; 245 women) included this study. (adjusted OR: 3.54; 95% CI: 1.18–10.61 for variable 1.31; 1.02–1.68 variable). No statistically significant observed 0.48; 95%CI: 0.23–1.01 0.95; 0.78–1.16 Mediation analyses revealed eGFR could mediate (considered variable) when taken alone (95% 0.0177–0.2765) or combination TyG 0.0032–0.0614). Myosteatosis may association.

Language: Английский

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Insulin resistance, coronary artery lesion complexity and adverse cardiovascular outcomes in patients with acute coronary syndrome

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: May 16, 2024

Abstract Background Insulin resistance (IR) is linked to both the complexity of coronary artery lesions and prognosis acute syndrome (ACS). However, precise extent this correlation its impact on adverse cardiovascular outcomes in ACS patients remain unclear. Therefore, study aims investigate intricate relationship between IR, lesion complexity, through a cohort design analysis. Method A total 986 with who underwent percutaneous intervention (PCI) were included IR was assessed using triglyceride-glucose (TyG) index, while evaluated SYNTAX score. Pearson’s coefficients utilized analyze correlations variables. The association TyG index score major events (MACEs) investigated Kaplan-Meier method, restricted cubic splines (RCS), adjusted Cox regression. Additionally, novel 2-stage regression method for survival data employed mediation analysis explore mediating outcomes, including MACEs unplanned revascularization. Results During median follow-up 30.72 months, 167 cases documented, 66 all-cause deaths (6.69%), 26 nonfatal myocardial infarctions (MIs) (2.64%), 99 revascularizations (10.04%). incidence MACEs, death, revascularization increased elevated Both (non-linear, P = 0.119) 0.004) displayed positive dose-response as illustrated by RCS curve. Following adjustment multiple factors, emerged significant predictors across population various subgroups. Mediation indicated that mediated 25.03%, 18.00%, 14.93%, 11.53% different models, respectively. Similar effects observed when endpoint defined Conclusion Elevated baseline associated higher risk ACS. Furthermore, partially outcomes.

Language: Английский

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