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Shin J, Bressler J, Grove ML, Brown M, Selvin E, Pankow JS, Fornage M, Morrison AC, Sarnowski C. DNA methylation markers of insulin resistance surrogate measures in the Atherosclerosis Risk in Communities (ARIC) study. Epigenetics 2025; 20:2498857. [PMID: 40327844 PMCID: PMC12064056 DOI: 10.1080/15592294.2025.2498857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Revised: 04/03/2025] [Accepted: 04/21/2025] [Indexed: 05/08/2025] Open
Abstract
Insulin resistance (IR) is a risk factor for cardiovascular diseases and type 2 diabetes. Associations between DNA methylation (DNAm) and IR have been less studied in African ancestry (AA) populations than those of European ancestry (EA). We aimed to identify associations between whole blood DNAm and IR in up to 1,811 AA and 964 EA participants from the Atherosclerosis Risk in Communities (ARIC) study. We quantified IR using three surrogate measures: the homeostasis model assessment of insulin resistance (HOMA-IR), the triglyceride-glucose index (TyG), and the triglyceride glucose-body mass index (TyG-BMI). We used ancestry-stratified linear regression models to conduct epigenome-wide association studies of IR, adjusting for batch effects and relevant covariates. Among 484,436 tested CpG sites, 39 were significantly associated with IR, of which 31% (10 in AA and two in EA) were associated with TyG-BMI and not previously reported for IR or related traits. These include a positive association at cg18335991-SEMA7A in AA. SEMA7A inhibits adipogenesis of preadipocytes and lipogenesis of mature adipocytes. DNAm levels at cg18335991 have been reported to be negatively associated with SEMA7A expression in blood. After additionally adjusting for smoking and drinking status, 15 of the 39 significant CpG sites remained significant or suggestive. Our study identified novel IR-associated CpG sites, contributing to a broader understanding of the epigenetic mechanisms underlying IR in diverse populations.
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Affiliation(s)
- Jeewoen Shin
- Human Genetics Center, Department of Epidemiology, University of Texas Health Science Center at Houston, Houston, School of Public Health, TX, USA
| | - Jan Bressler
- Human Genetics Center, Department of Epidemiology, University of Texas Health Science Center at Houston, Houston, School of Public Health, TX, USA
| | - Megan L. Grove
- Human Genetics Center, Department of Epidemiology, University of Texas Health Science Center at Houston, Houston, School of Public Health, TX, USA
| | - Michael Brown
- Human Genetics Center, Department of Epidemiology, University of Texas Health Science Center at Houston, Houston, School of Public Health, TX, USA
| | - Elizabeth Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - James S. Pankow
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Myriam Fornage
- Human Genetics Center, Department of Epidemiology, University of Texas Health Science Center at Houston, Houston, School of Public Health, TX, USA
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Alanna C. Morrison
- Human Genetics Center, Department of Epidemiology, University of Texas Health Science Center at Houston, Houston, School of Public Health, TX, USA
| | - Chloé Sarnowski
- Human Genetics Center, Department of Epidemiology, University of Texas Health Science Center at Houston, Houston, School of Public Health, TX, USA
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Hu B, Yu D, Guo G, Wan F, Liu H. Impact of triglyceride glucose - Body mass index on depression risk in Chinese middle-aged and elderly adults: Evidence from a large-scale study. Physiol Behav 2025; 296:114931. [PMID: 40287002 DOI: 10.1016/j.physbeh.2025.114931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2025] [Revised: 04/13/2025] [Accepted: 04/23/2025] [Indexed: 04/29/2025]
Abstract
BACKGROUND Current literature lacks evidence to characterize the relationship between the triglyceride glucose - body mass index (TyG-BMI) and depression. Therefore, this study aimed to elucidate the potential association between TyG-BMI and depression risk in a Chinese middle-aged and elderly population. METHODS The study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011, which included 17,708 participants. We used multifactorial logistic regression modeling to investigate the relationship between TyG-BMI and depression in Chinese adults, using smoothed curve fitting to assess the nonlinear relationship between them. In addition, we performed sensitivity and subgroup analyses to verify the robustness of the results. RESULTS A total of 9328 participants were included in our study, After adjusting for all potential covariates, participants with higher levels of TyG-BMI had a lower risk of depression compared to Q1, the adjusted OR (95 % CI) values were Q2 (OR: 0.84, 95 % CI: 0.74-0.96, p = 0.009), Q3 (OR: 0.75, 95 % CI: 0.65-0.86, p < 0.001), and Q4 (OR: 0.67, 95 % CI: 0.57-0.79, p < 0.001). The association between TyG-BMI and depression exhibited an L-shaped curve (nonlinear, p = 0.004). When TyG-BMI <200, Increased TyG-BMI was associated with a significantly lower risk of depression (OR = 0.87 [95 %CI:0.82-0.93], p < 0.001). However, there was no association between TyG-BMI and depression when TyG-BMI ≥200 (OR = 0.96 [95 %CI:0.91-1.02], p = 0.22). CONCLUSION The connection between TyG-BMI and depression in Chinese adults is L-shaped, with an inflection point around 200.
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Affiliation(s)
- Bohong Hu
- Department of Neurology, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China
| | - Dandan Yu
- Department of Electrocardiogram, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China
| | - Guixiang Guo
- Department of Neurology, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China
| | - Fangchao Wan
- Department of Neurology, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China.
| | - Hongjuan Liu
- Department of Neurology, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China.
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Kim JS, Choi JH, Shin SR, Han AL. Association between insulin resistance indices and prevalence of knee osteoarthritis using the Korean National health and examination survey. Sci Rep 2025; 15:18195. [PMID: 40415118 DOI: 10.1038/s41598-025-91526-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 02/20/2025] [Indexed: 05/27/2025] Open
Abstract
Knee osteoarthritis (OA) is associated with high insulin resistance, particularly in individuals with metabolic syndrome and type 2 diabetes. In this cross-sectional study, we aimed to explore the relationship between insulin resistance indices and the prevalence of knee OA using data from 4,209 participants of the 2009-2010 Korea National Health and Nutrition Examination Survey. We used several insulin resistance indices in our analysis: Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), triglyceride-glucose (TyG) index, TyG-body mass index (TyG_BMI), TyG-waist circumference (TyG_WC), and visceral adiposity index (VAI). Without adjusting for confounding variables, the TyG_index increased the risk of knee OA by 1.056. After adjusting for confounders, the risk increased significantly by 1.082. Similarly, the TyG_BMI, TyG_WC, and VAI showed significant associations with knee OA. However, the association between HOMA-IR and knee OA was not significant. BMI (with and without confounding variable adjustments) was significantly associated with knee OA, whereas no significant associations were found for hypertension, dyslipidemia, diabetes, or WC. These results suggest that insulin resistance indices, particularly TyG-related indices, are significantly associated with knee OA. This highlights the potential benefits of managing knee OA in the context of metabolic syndrome, which is often associated with increased insulin resistance.
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Affiliation(s)
- Jung Sik Kim
- Department of Family Medicine, Wonkwang University Hospital, Sinyong-dong 344-2, Iksan, 54538, Jeollabuk- do, Republic of Korea
| | - Jae Hoon Choi
- Department of Family Medicine, Wonkwang University Hospital, Sinyong-dong 344-2, Iksan, 54538, Jeollabuk- do, Republic of Korea
| | - Sae Ron Shin
- Department of Family Medicine, Wonkwang University Hospital, Sinyong-dong 344-2, Iksan, 54538, Jeollabuk- do, Republic of Korea
| | - A Lum Han
- Department of Family Medicine, Wonkwang University Hospital, Sinyong-dong 344-2, Iksan, 54538, Jeollabuk- do, Republic of Korea.
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Yan R, Zhang J, Ma H, Wu Y, Fan Y. Potential of seven insulin resistance indicators as biomarkers to predict infertility risk in U.S. women of reproductive age: a cross-sectional study. Reprod Biol Endocrinol 2025; 23:77. [PMID: 40413481 DOI: 10.1186/s12958-025-01416-w] [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: 03/13/2025] [Accepted: 05/13/2025] [Indexed: 05/27/2025] Open
Abstract
BACKGROUND Insulin resistance(IR) is a key mechanism underlying both obesity and metabolic syndrome, with significant implications for the onset and progression of female infertility. This study systematically examines the associations between seven insulin resistance indicators and the risk of infertility in U.S. women of reproductive age, while also evaluating the diagnostic value of these indicators in predicting infertility. METHOD This cross-sectional study analyzed data from the 2013-2018 National Health and Nutrition Examination Survey (NHANES) to explore the relationship between seven insulin resistance indicators and infertility risk. The indicators included the Metabolic Score for Insulin Resistance (METS-IR), Triglyceride-Glucose Index (TyG), Triglyceride-Glucose-Waist Circumference (TyG-WC), Triglyceride-Glucose-Body Mass Index (TyG-BMI), Triglyceride-Glucose-Waist-to-Height Ratio (TyG-WHtR), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and Triglyceride/High-Density Lipoprotein Ratio (TG/HDL). Receiver Operating Characteristic (ROC) curves were used to assess the diagnostic accuracy of each insulin resistance indicator in predicting infertility. Additionally, smooth curve fitting and threshold effect analysis were employed to further explore the relationship between insulin resistance indicators with high diagnostic efficacy and infertility. RESULTS This study included 1,100 women aged 20-45, of whom 140 (12.61%) were diagnosed with infertility. The results revealed significant positive correlations between METS-IR, TyG-BMI, TyG-WC, TyG-WHtR, and infertility risk. Specifically, as TyG-WC and TyG-WHtR levels increased, the risk of infertility rose linearly, while METS-IR and TyG-BMI exhibited a nonlinear positive association with infertility risk. No significant correlations were observed between TyG, HOMA-IR, TG/HDL, and infertility. Finally, ROC curve analysis indicated that METS-IR outperformed the other six insulin resistance indicators in predicting infertility risk. CONCLUSION METS-IR, TyG-BMI, TyG-WC, and TyG-WHtR are significantly associated with the risk of infertility in U.S. women of reproductive age, with METS-IR demonstrating the highest predictive power. These findings suggest that METS-IR may have substantial clinical utility in evaluating infertility risk.
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Affiliation(s)
- Ruihua Yan
- Department of Obstetrics and Gynecology, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, China
| | - Jiao Zhang
- Department of Obstetrics and Gynecology, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, China
| | - Hongyun Ma
- Department of Obstetrics and Gynecology, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, China
| | - Yang Wu
- Department of Obstetrics and Gynecology, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, China
| | - Yang Fan
- Department of Obstetrics and Gynecology, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, China.
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Cheng Y, Wu S, Chen S, Wu Y. Association of body mass index combined with triglyceride-glucose index in cardiovascular disease risk: a prospective cohort study. Sci Rep 2025; 15:17687. [PMID: 40399481 PMCID: PMC12095778 DOI: 10.1038/s41598-025-02342-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2025] [Accepted: 05/13/2025] [Indexed: 05/23/2025] Open
Abstract
Previous studies have mainly explored the effects of body mass index (BMI) and triglyceride-glucose index (TyG index) on cardiovascular disease (CVD) separately or by examining the composite parameter (TyG-BMI) formed by multiplying the two and its association with CVD. However, few studies have investigated the combined effect of BMI categories and the TyG index on CVD. This study aimed to determine the association of BMI categories combined with the TyG index in new-onset CVD. A total of 94,002 participants were included from the Kailuan study. Their BMI combined with the TyG index was categorized into six groups: Low-BMI/Low-TyG, Middle-BMI/Low-TyG, High-BMI/Low-TyG, Low-BMI/High-TyG, Middle-BMI/High-TyG, and High-BMI/High-TyG. A multifactorial Cox proportional hazards model was used to analyze the longitudinal association between BMI combined with the TyG index and new-onset CVD events. During a follow-up period of 15.95 ± 3.59 years, 9791 new CVD events were recorded. After adjusting for confounding factors such as sex, age, smoking, drinking, physical activity, systolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, uric acid, high-sensitivity C-reactive protein, antihypertensive drugs, hypoglycemic drugs, and lipid-lowering drugs, Cox regression analysis showed that the risk of CVD events was 52% higher in the High-BMI/High-TyG group (HR: 1.52; 95% CI 1.42-1.64) compared to the Low-BMI/Low-TyG group. The combination of high BMI (≥ 28.0) and high TyG index (> 8.58) significantly increases individual CVD risk. This study suggests that the combination of BMI and the TyG index may better help identify individuals at risk of developing CVD.
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Affiliation(s)
- Yu Cheng
- School of Public Health, North China University of Science and Technology, Tangshan, 063210, China
- Kailuan General Hospital, Tangshan, 063000, China
| | - Shouling Wu
- Kailuan General Hospital, Tangshan, 063000, China
| | - Shuohua Chen
- Kailuan General Hospital, Tangshan, 063000, China
| | - Yuntao Wu
- Kailuan General Hospital, Tangshan, 063000, China.
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Pan W, Ji TF, Hu BT, Yang J, Lu L, Wei J. Association between triglyceride glucose body mass index and 1 year all cause mortality in stage 4 CKM syndrome patients. Sci Rep 2025; 15:17019. [PMID: 40379745 PMCID: PMC12084581 DOI: 10.1038/s41598-025-01549-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2025] [Accepted: 05/07/2025] [Indexed: 05/19/2025] Open
Abstract
The triglyceride-glucose body mass index (TyG-BMI) is acknowledged as a dependable surrogate biomarker for the evaluation of insulin resistance (IR). Current research indicates a significant correlation between TyG-BMI and the risk of subsequent cardiovascular events in individuals diagnosed with cardiovascular-kidney-metabolic syndrome (CKM) at stages 0-3. Nevertheless, the prognostic significance of TyG-BMI in patients with CKM stage 4 has not been extensively investigated, and there is a paucity of evidence available on this topic. The study utilized patient data from the Medical Information Mart for Intensive Care (MIMIC-IV) database, categorizing the data into quartiles based on the TyG-BMI index. The primary outcomes of interest were all-cause mortality at 180 days and at one year. To assess the relationship between the TyG-BMI index and these outcomes in patients diagnosed with stage 4 CKM, a Cox proportional hazards model was employed. Additionally, a restricted cubic splines(RCS) model was applied to further investigate the associations between the TyG-BMI index and the specified outcomes. A total of 1,885 patients participated in the study, with 62.49% of the cohort being male. The all-cause mortality rates were recorded at 30.50% at 180 days and 35.12% at one year. Analysis using a multivariate Cox proportional hazards model revealed that an increase in the TyG-BMI index was significantly correlated with a reduction in the risk of all-cause mortality at both the 180-day and one-year marks. Specifically, for each standard deviation increase in the TyG-BMI index, the risk of all-cause mortality decreased by 17% within 180 days (HR = 0.83, 95% CI: 0.76-0.91) and by 21% within one year (HR = 0.79, 95% CI: 0.71-0.87). Furthermore, regression analysis utilizing RCS indicated a linear decrease in all-cause mortality rates associated with increasing TyG-BMI index values over both the 180-day and one-year periods (P for nonlinearity = 0.171 and P for nonlinearity = 0.141, respectively). In patients diagnosed with stage 4 CKM syndrome, a reduced TyG-BMI index was found to be significantly correlated with a heightened risk of all-cause mortality within both 180 days and one year. Consequently, the TyG-BMI index may be utilized as an effective instrument for risk stratification and prognostic assessment in this patient population.
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Affiliation(s)
- Wen Pan
- Department of Cardiovascular Internal Medicine, The Second Affiliated Hospital of Xi 'an Jiaotong University, Xi 'an, China
| | - Teng-Fei Ji
- Department of Cardiovascular Internal Medicine, The Second Affiliated Hospital of Xi 'an Jiaotong University, Xi 'an, China
| | - Bing-Tao Hu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Xi 'an Jiaotong University, Xi 'an, China
| | - Jing Yang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Xi 'an Jiaotong University, Xi 'an, China
| | - Lei Lu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Xi 'an Jiaotong University, Xi 'an, China
| | - Jin Wei
- Department of Cardiovascular Internal Medicine, The Second Affiliated Hospital of Xi 'an Jiaotong University, Xi 'an, China.
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Usatiuc LO, Pop RM, Adrian S, Pârvu M, Țicolea M, Uifălean A, Vălean D, Gavrilaș LI, Csilla-Enikő S, Leopold LF, Ranga F, Cătoi FA, Pârvu AE. Multitargeted Effects of Plantago ovata Ethanol Extract in Experimental Rat Streptozotocin-Induced Diabetes Mellitus and Letrozole-Induced Polycystic Ovary Syndrome. Int J Mol Sci 2025; 26:4712. [PMID: 40429855 PMCID: PMC12111918 DOI: 10.3390/ijms26104712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2025] [Revised: 05/09/2025] [Accepted: 05/10/2025] [Indexed: 05/29/2025] Open
Abstract
Polycystic ovary syndrome (PCOS), a common and multifactorial endocrine disorder in reproductive-aged women, is strongly associated with insulin resistance (IR) and type 2 diabetes mellitus (T2DM), and also affects up to one in four women with type 1 diabetes mellitus (T1DM). The current study explored the potential of Plantago ovata (P. ovata) seed ethanol extract (POEE) to modulate oxidative stress (OS), inflammatory responses, metabolic profiles, and hormonal levels in rat Streptozotocin (STZ)-induced DM and Letrozole (LET)-induced PCOS. Phytochemical analysis measured total phenolic content (TPC) and total flavonoid content (TFC) using HPLC-DAD-ESI MS for compound identification. POEE's antioxidant activity was evaluated in vitro through DPPH, H2O2, FRAP, and NO scavenging assays. Rats received POEE, metformin, or Trolox (TX) for 10 days. PCOS confirmation was achieved via ultrasound and histopathology. Serum levels of OS markers (TOS, TAC, OSI, MDA, AOPP, 8-OHdG, NO, 3-NT, AGEs, and SH), inflammatory markers (NF-κB, IL-1β, IL-18, Gasdermin D, and IL-10), metabolic parameters (fasting blood glucose, lipid profile, and liver enzymes), and hormone levels (LH, FSH, estrogen, testosterone, and insulin) were assessed. Additionally, the Triglyceride-Glucose index (TyG) and HOMA-IR were calculated. POEE had a medium content of polyphenols and a good in vitro antioxidant effect. In vivo, POEE administration in diabetic rats led to a reduction in OS markers and an increase in antioxidant levels, alongside decreases in inflammatory cytokines, blood glucose levels, and transaminase activity and improvements in lipid profile. In the PCOS model, POEE treatment effectively reduced total OS and lowered levels of LH, FSH, and testosterone, while elevating estrogen concentrations and reducing insulin resistance. These therapeutic effects were dose-dependent, with higher doses producing more pronounced outcomes, comparable to those observed with metformin and TX treatment.
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Affiliation(s)
- Lia-Oxana Usatiuc
- Pathophysiology, Department 2—Functional Sciences, Faculty of Medicine,“Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (L.-O.U.); (M.Ț.); (A.U.); (F.A.C.); (A.E.P.)
| | - Raluca Maria Pop
- Pharmacology, Toxicology and Clinical Pharmacology, Department 2—Functional Sciences, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Surd Adrian
- Pediatric Surgery and Orthopedics, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Marcel Pârvu
- Department of Taxonomy, Faculty of Biology and Geology, “Babes-Bolyai” University, 400012 Cluj-Napoca, Romania;
| | - Mădălina Țicolea
- Pathophysiology, Department 2—Functional Sciences, Faculty of Medicine,“Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (L.-O.U.); (M.Ț.); (A.U.); (F.A.C.); (A.E.P.)
| | - Ana Uifălean
- Pathophysiology, Department 2—Functional Sciences, Faculty of Medicine,“Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (L.-O.U.); (M.Ț.); (A.U.); (F.A.C.); (A.E.P.)
| | - Dan Vălean
- Surgery Department, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Laura-Ioana Gavrilaș
- Faculty of Nursing and Health Sciences, Department 2, “Iuliu Hațieganu” University of Medicine and Pharmacy, 23 Marinescu Street, 400337 Cluj-Napoca, Romania;
| | - Szabo Csilla-Enikő
- First Pediatric Clinic, Department of Mother and Child, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Loredana Florina Leopold
- Faculty of Food Science and Technology, University of Agricultural Sciences and Veterinary Medicine, 3–5 Calea Mănăștur, 400372 Cluj-Napoca, Romania; (L.F.L.); (F.R.)
| | - Floricuța Ranga
- Faculty of Food Science and Technology, University of Agricultural Sciences and Veterinary Medicine, 3–5 Calea Mănăștur, 400372 Cluj-Napoca, Romania; (L.F.L.); (F.R.)
| | - Florinela Adriana Cătoi
- Pathophysiology, Department 2—Functional Sciences, Faculty of Medicine,“Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (L.-O.U.); (M.Ț.); (A.U.); (F.A.C.); (A.E.P.)
| | - Alina Elena Pârvu
- Pathophysiology, Department 2—Functional Sciences, Faculty of Medicine,“Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (L.-O.U.); (M.Ț.); (A.U.); (F.A.C.); (A.E.P.)
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Sun C, Niu XL, Zeng LX. The association between triglyceride glucose-body mass index and mortality in critically ill patients with respiratory failure: insights from ICU data. Sci Rep 2025; 15:16153. [PMID: 40341139 PMCID: PMC12062496 DOI: 10.1038/s41598-025-00254-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Accepted: 04/28/2025] [Indexed: 05/10/2025] Open
Abstract
Respiratory failure (RF) lead to high mortality rates and extended hospital stays in intensive care unit (ICU). The Triglyceride-Glucose (TyG) index, a reliable surrogate marker for insulin resistance (IR), predicted adverse outcomes in various diseases. Combining weight-related indices like body mass index (BMI) with TyG to form the TyG-BMI enhanced the assessment of IR and its impact on patient outcomes. However, the association between TyG-BMI and outcomes in patients with RF remained underexplored. This study retrospectively analyzed data from the MIMIC-IV database, focusing on critically ill patients with RF. From an initial cohort of 19,429 patients, 2177 met the inclusion criteria and were divided into quartiles based on TyG-BMI values. Key clinical information was collected within the first 24 h of ICU admission, including demographics, lab results, vital signs, and scoring systems such as SAPS II and SOFA. Primary outcome was 28-day, secondary outcomes were 180-day and 1-year mortality. Data were analyzed using multivariable Cox regression models, Kaplan-Meier survival curves, and restricted cubic splines to assess the nonlinear relationship between TyG-BMI and mortality. The study found significant differences in baseline characteristics across TyG-BMI quartiles. Kaplan-Meier survival curves indicated a higher survival probability for patients in the lowest TyG-BMI quartile (Q1) compared to higher quartiles (Q2-Q4). Adjusted hazard ratios demonstrated a nonlinear association between higher TyG-BMI values and increased mortality risk at all three time points. The RCS-derived cut-off value of 269 for TyG-BMI was identified as a significant threshold, with higher TyG-BMI values correlating with lower mortality risks. Subgroup analyses reinforced these findings across different patient demographics and clinical profiles. Higher TyG-BMI was associated to lower short-term and long-term mortality, suggesting a potential protective effect. These findings highlighted the importance of the TyG-BMI as a robust prognostic marker, providing valuable insights for improving treatment strategies for patients with RF.
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Affiliation(s)
- Ce Sun
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiao-Li Niu
- Shenzhen Bao'an Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Li-Xiong Zeng
- Department of Cardiology, The Third Xiangya Hospital of Central South University, Changsha, China.
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Chen IW, Wang WT, Wu JY, Yu CH, Chang YJ, Hung KC. Diagnostic performance of the triglyceride-glucose index in predicting occurrence of cancer: a meta-analysis. Front Oncol 2025; 15:1532253. [PMID: 40416870 PMCID: PMC12098037 DOI: 10.3389/fonc.2025.1532253] [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: 01/08/2025] [Accepted: 04/16/2025] [Indexed: 05/27/2025] Open
Abstract
Objective This meta-analysis aimed to evaluate the diagnostic performance of the triglyceride-glucose (TyG) index in predicting cancer occurrence. Method A comprehensive literature search was conducted in Embase, Medline, Cochrane Library, and Google Scholar from inception to July 2024. Observational studies reporting the diagnostic efficacy of the TyG index in predicting cancer occurrence using ROC curve analysis were included. Pooled sensitivity, specificity, and area under the summary receiver operating characteristic (SROC) curve were calculated using a bivariate random-effects model. Results Eleven studies with 46,658 participants were included. Patients with cancer had a significantly higher TyG index than those without cancer (mean difference: 0.34, 95% CI: 0.23-0.45). The pooled sensitivity and specificity of the TyG index for predicting cancer occurrence were 0.68 (95% CI: 0.62-0.74) and 0.65 (95% CI: 0.54-0.74), respectively. The area under the SROC curve was 0.72 (95% CI: 0.68-0.75), indicating good discriminatory ability. Subgroup analysis of female participants yielded similar results, with an AUC of 0.73 (95% CI: 0.69-0.77). Conclusion The TyG index demonstrates good discriminatory ability and may have potential as an adjunct screening tool to help identify individuals at a higher risk of developing cancer. However, this should be interpreted alongside other established risk factors, as many confounding factors (including cancer type, genetic predisposition, and other malignancy risk factors) must be considered. Further research is needed to establish optimal cut-off values, which likely vary across different cancer types, and to investigate their diagnostic accuracy in diverse populations. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42024573712.
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Affiliation(s)
- I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Wei-Ting Wang
- Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
| | - Chia-Hung Yu
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Ying-Jen Chang
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
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Xu H, Xie J, Niu H, Cai X, He P. Associations between triglyceride-glucose body mass index and all-cause mortality in ICU patients with sepsis and acute heart failure. BMC Cardiovasc Disord 2025; 25:359. [PMID: 40346499 PMCID: PMC12063255 DOI: 10.1186/s12872-025-04804-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2025] [Accepted: 04/28/2025] [Indexed: 05/11/2025] Open
Abstract
BACKGROUND The triglyceride‒glucose body mass index (TyG-BMI) has been recognized as a significant predictor of cardiovascular disease risk and plays a crucial role in assessing insulin resistance. However, the correlation between the TyG-BMI and clinical outcomes in patients with sepsis and acute heart failure (AHF) has not been sufficiently explored. This study aimed to investigate the associations between TyG-BMI and clinical outcomes in patients with sepsis and AHF. METHODS We conducted a retrospective analysis of ICU-admitted patients via data from the MIMIC-IV database. Multivariable logistic regression, sensitivity analysis, and restricted cubic spline (RCS) models were used to assess the relationship between TyG-BMI and all-cause mortality. K‒M survival analysis and Boruta analysis were employed to evaluate the predictive value of the TyG-BMI. Subgroup analyses considered the effects of age, sex, ethnicity, and comorbidities. RESULTS Among the 1,729 patients, a higher TyG-BMI was associated with lower all-cause mortality at 90 and 180 days. Each standard deviation increase in the TyG-BMI was linked to 0.2% and 0.3% reductions in 90-day and 180-day all-cause mortality, respectively. Kaplan‒Meier analysis revealed significantly lower all-cause mortality in patients with higher TyG-BMIs (P < 0.0001). The RCS model revealed a nonlinear relationship between the TyG-BMI and mortality. Boruta analysis identified the TyG-BMI as an important clinical feature. Sensitivity analyses revealed that the association remained significant after patients with myocardial infarction, malignancies, or missing data were excluded. The subgroup analysis revealed that for the 90-day and 180-day mortality rates, significant interactions were found only in the subgroup of patients with kidney diseases (P < 0.05). CONCLUSION The TyG-BMI may have potential value in predicting mortality in ICU patients with sepsis and AHF, supporting early risk assessment and clinical intervention. This study provides critical insights into patient prognosis.
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Affiliation(s)
- Heping Xu
- Department of Emergency Medicine, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, No. 19, Xiuhua Road, Xiuying District, Haikou City, Hainan Province, 570311, China.
| | - Jinyuan Xie
- Department of Emergency Medicine, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, No. 19, Xiuhua Road, Xiuying District, Haikou City, Hainan Province, 570311, China
| | - Huan Niu
- Department of Emergency Medicine, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, No. 19, Xiuhua Road, Xiuying District, Haikou City, Hainan Province, 570311, China
| | - Xiongwei Cai
- Department of Emergency Medicine, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, No. 19, Xiuhua Road, Xiuying District, Haikou City, Hainan Province, 570311, China
| | - Ping He
- Department of Emergency Medicine, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, No. 19, Xiuhua Road, Xiuying District, Haikou City, Hainan Province, 570311, China
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11
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Gao X, Chen T, Zhou F, Sun Y, Zhang J, Li X, Zhao W, Li Y, Shi Y, Niu K, Wang Y, Zhang Y, Zhang W. The association between different insulin resistance surrogates and all-cause mortality and cardiovascular mortality in patients with metabolic dysfunction-associated steatotic liver disease. Cardiovasc Diabetol 2025; 24:200. [PMID: 40346671 PMCID: PMC12065324 DOI: 10.1186/s12933-025-02758-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2025] [Accepted: 04/26/2025] [Indexed: 05/11/2025] Open
Abstract
BACKGROUND Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely associated with insulin resistance (IR). However, the prognostic value of different alternative IR surrogates in patients with MASLD remains unclear. This study aimed to evaluate the association between various IR indices and all-cause mortality and cardiovascular mortality in MASLD patients. METHODS A total of 8,753 adults aged ≥ 20 years with MASLD from the National Health and Nutrition Examination Survey (NHANES, 2003-2018) were included, and their mortality data were obtained from the National Death Index (NDI). Insulin resistance surrogates [including the triglyceride-glucose (TyG) index, TyG-body mass index (TyG-BMI), TyG-waist circumference index, TyG-waist-to-height ratio index, and Homeostatic Model Assessment for IR] were stratified into quartiles. Cox proportional hazards models, receiver operating characteristic (ROC) curve analysis, restricted cubic spline (RCS), mediation analyses, and subgroup analyses were used to explore the associations between these indices and all-cause mortality as well as cardiovascular mortality in MASLD patients. RESULTS During a median follow-up of 98 months, 1,234 deaths were observed, including 409 cardiovascular disease (CVD)-related deaths. In the fully adjusted model, higher quartiles of TyG-related indices were significantly associated with an increased risk of all-cause mortality in MASLD patients. Furthermore, the TyG-BMI index was associated with both all-cause mortality and CVD mortality [all-cause mortality: HR (95% CI) 2.84 (1.73-4.67), P < 0.001; CVD mortality: HR (95% CI) 5.32 (2.26-12.49), P < 0.001]. The RCS analyses indicated a U-shaped relationship between TyG-BMI and mortality, with a threshold value of 270.49. Subgroup analyses demonstrated that TyG-related indices had stronger associations with mortality in elderly MASLD patients. CONCLUSIONS Our findings highlight the prognostic value of IR indices, particularly TyG-BMI index, in predicting all-cause mortality and CVD mortality in MASLD patients.
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Affiliation(s)
- Xin Gao
- Hepatopancreatobiliary Center, The Second Affiliated Hospital of Nanjing Medical University, Jiangjiayuan 121, Nanjing, Jiangsu Province, China
| | - Tianyi Chen
- Hepatopancreatobiliary Center, The Second Affiliated Hospital of Nanjing Medical University, Jiangjiayuan 121, Nanjing, Jiangsu Province, China
| | - Feilong Zhou
- Hepatopancreatobiliary Center, The Second Affiliated Hospital of Nanjing Medical University, Jiangjiayuan 121, Nanjing, Jiangsu Province, China
| | - Yanmei Sun
- Hepatopancreatobiliary Center, The Second Affiliated Hospital of Nanjing Medical University, Jiangjiayuan 121, Nanjing, Jiangsu Province, China
| | - Jiaqi Zhang
- Hepatopancreatobiliary Center, The Second Affiliated Hospital of Nanjing Medical University, Jiangjiayuan 121, Nanjing, Jiangsu Province, China
| | - Xinhao Li
- Hepatopancreatobiliary Center, The Second Affiliated Hospital of Nanjing Medical University, Jiangjiayuan 121, Nanjing, Jiangsu Province, China
| | - Weijie Zhao
- Hepatopancreatobiliary Center, The Second Affiliated Hospital of Nanjing Medical University, Jiangjiayuan 121, Nanjing, Jiangsu Province, China
| | - Yunxin Li
- Hepatopancreatobiliary Center, The Second Affiliated Hospital of Nanjing Medical University, Jiangjiayuan 121, Nanjing, Jiangsu Province, China
| | - Yanlong Shi
- Hepatopancreatobiliary Center, The Second Affiliated Hospital of Nanjing Medical University, Jiangjiayuan 121, Nanjing, Jiangsu Province, China
| | - Kaiyi Niu
- Hepatopancreatobiliary Center, The Second Affiliated Hospital of Nanjing Medical University, Jiangjiayuan 121, Nanjing, Jiangsu Province, China
| | - Yizhu Wang
- Hepatopancreatobiliary Center, The Second Affiliated Hospital of Nanjing Medical University, Jiangjiayuan 121, Nanjing, Jiangsu Province, China
| | - Yewei Zhang
- Hepatopancreatobiliary Center, The Second Affiliated Hospital of Nanjing Medical University, Jiangjiayuan 121, Nanjing, Jiangsu Province, China.
- Department of Hepatobiliary Surgery, The Second Hospital of Shangdong University, Jinan, Shandong Province, China.
| | - Wei Zhang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
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Zeng X, Zhang Y, Xie X, Lan J, Li S. Triglyceride-glucose index predicts ventricular aneurysm formation in acute ST-segment elevation myocardial infarction. Front Endocrinol (Lausanne) 2025; 16:1423040. [PMID: 40405981 PMCID: PMC12094953 DOI: 10.3389/fendo.2025.1423040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 04/14/2025] [Indexed: 05/26/2025] Open
Abstract
Background The triglyceride-glucose (TyG) index has been confirmed to be a predictor of cardiovascular diseases. The present study aimed to assess the predictive value of TyG index for left ventricular aneurysm (LVA) formation and prognosis in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). Methods This prospective study included 991 patients with acute STEMI who underwent primary PCI. Multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were used to assess the predictive value of TyG index for LVA formation. Prognosis analysis was performed with cox proportional hazard regression. Results The prevalence of LVA was 14.4%. A higher TyG index was associated with a greater incidence of LVA (23.1% vs. 11.8%, P< 0.001). The TyG index was also higher in the LVA group than in the non-LVA group (9.4 ± 0.9 vs. 9.0 ± 0.8, P<0.001). Multivariable logistic regression analysis revealed that the TyG index was independently associated with the risk of LVA [odds ratio (OR)= 2.4, 95% confidence interval (CI)= 1.51-3.82, P< 0.001]. The predictive value of the TyG index remained significant even after cross-validation by dividing the study population into a training set (OR= 2.32, 95% CI= 1.24-4.35, P= 0.009) and validation set (OR= 3.19, 95% CI= 1.42-7.19, P= 0.005). Higher TyG index was correlated with increased risk of cardiac death (HR= 2.17, P= 0.04). The maximal length and width of LVA were significantly increased in patients with TyG index ≥ 9.68 compared with < 9.68 (P< 0.001). The discriminant power of TyG index for LVA was 0.742, which was superior to both triglyceride (C statistic= 0.666) and fasting blood glucose (C statistic= 0.613). The combination of TyG index, left ventricular ejection fraction, gensini score, and left anterior descending artery as the culprit vessel could significantly improve the predictive ability (C statistic= 0.908). Conclusions A higher TyG index was an independent predictor for LVA formation and increased risk of cardiac death in patients with STEMI who underwent primary PCI.
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Affiliation(s)
- Xiaobin Zeng
- Division of Cardiology, Panzhihua Central Hospital, Panzhihua, China
| | - Yanyu Zhang
- Clinical Laboratory, Panzhihua Central Hospital, Panzhihua, China
| | - Xiaoshuang Xie
- Division of Cardiology, Panzhihua Central Hospital, Panzhihua, China
| | - Jianjun Lan
- Division of Cardiology, Panzhihua Central Hospital, Panzhihua, China
| | - Shiyang Li
- Department of Geriatrics, Panzhihua Central Hospital, Panzhihua, China
- Department of Geriatrics, Panzhihua Central Hospital Affiliated to Dali University, Dali, China
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Jia F, Lu Y, Wen H, Tu J, Ning X, Wang J, Li P. Correlations Between TyG-Related Indices and Bone Health: A Cross-Sectional Study of Osteoporosis in a Rural Chinese Population. Diabetes Metab Syndr Obes 2025; 18:1445-1458. [PMID: 40356712 PMCID: PMC12067712 DOI: 10.2147/dmso.s505024] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2024] [Accepted: 04/22/2025] [Indexed: 05/15/2025] Open
Abstract
Background Osteoporosis (OP) is a major metabolic bone disease with significant health and socioeconomic impacts. The triglyceride-glucose (TyG) index and its derivatives, which reflect insulin resistance (IR), may play a role in bone metabolism. However, the relationship between TyG indices and OP is unclear. This study aimed to explore the association between TyG indices and OP in a low-income rural Chinese population. Methods This cross-sectional study was conducted in rural Tianjin, China, in 2020. Participants aged 60 years or older were included. Data were collected through interviews, including sociodemographic and clinical information, and physical examinations. Bone mineral density (BMD) of the femoral neck was measured using dual-energy X-ray absorptiometry (DXA). Multivariate regression models and restricted cubic spline (RCS) curves were used to assess the relationships between TyG indices and OP. Results A total of 437 individuals were included in the final analysis, with 38 diagnosed with osteoporosis (prevalence of 8.7%). After adjusting for all covariates, each 1-unit increase in triglyceride-glucose-body mass index (TyG-BMI) was associated with a 2% lower risk of osteoporosis, (OR: 0.98, 95% CI: 0.96-1.00, P=0.029), especially in women, individuals with hypertension, and non-diabetic populations. The OP risk of the fourth quartile (Q4) of the triglyceride-glucose-waist circumference (TyG-WC) index after correcting for all covariates is 5.58 times that of the first quartile (Q1)(OR: 5.58, 95% CI: 1.14-27.41, P=0.034). Linear regression showed a positive correlation between TyG-BMI and BMD, particularly in women, individuals under 70, and those with hypertension or non-hypertension, with the strongest correlation in the non-hypertensive group. Conclusion TyG-related indices are associated with OP, suggesting a potential role in the early prevention and management of osteoporosis in this population, ultimately improving public health outcomes.
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Affiliation(s)
- Fang Jia
- Department of Anesthesia, Tianjin Hospital, Tianjin, 300211, People’s Republic of China
| | - Yuting Lu
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin, 300070, People’s Republic of China
| | - Haotian Wen
- The First Clinical School of Southern Medical University, Guangzhou, Guangdong Province, 510515, People’s Republic of China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China
| | - Ping Li
- Department of Anesthesia, Tianjin Hospital, Tianjin, 300211, People’s Republic of China
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Deng W, Han Y, Deng Z. The relationship between longitudinal changes in triglyceride-glucose-body mass index and new-onset diabetes in middle-aged and elderly adults: Evidence from a nationwide Chinese cohort study. Diabetes Res Clin Pract 2025; 223:112127. [PMID: 40157610 DOI: 10.1016/j.diabres.2025.112127] [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: 12/04/2024] [Revised: 03/08/2025] [Accepted: 03/20/2025] [Indexed: 04/01/2025]
Abstract
OBJECTIVE This study investigates the association between changes in TyG-BMI and the risk of diabetes mellitus (DM) in middle-aged and elderly adults in China, as prior research has mainly focused on single baseline measurements. METHODS Data were obtained from CHARLS, a nationwide prospective cohort study. TyG-BMI changes (2011-2015) were analyzed using K-means clustering. Cox proportional hazards regression models assessed the relationship between TyG-BMI changes, cumulative TyG-BMI, and DM risk, with sensitivity and subgroup analyses ensuring robustness. RESULTS Compared to individuals with consistently low TyG-BMI (class 1), hazard ratios (HRs) for DM were 1.474, 2.250, and 3.142 for participants with moderately sustained and slowly increasing TyG-BMI (class 2), slowly increasing high level of TyG-BMI (class 3), and the highest and increasing TyG-BMI levels (class 4), respectively. △TyG-BMI2015-2011 (per 10-unit) yielded HRs of 1.064 for class 2, 1.108 for class 3, and 1.079 for class 4. Cumulative TyG-BMI (per 10-unit) had an HR of 1.029. CONCLUSION TyG-BMI changes and sustained exposure to high TyG-BMI levels are independently linked to increased DM risk. Monitoring long-term fluctuations in TyG-BMI could be an important strategy for preventing DM, and effectively controlling high TyG-BMI through various interventions may significantly reduce DM risk.
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Affiliation(s)
- Wangsheng Deng
- Department of Emergency Medicine, People's Hospital of Longhua, Shenzhen 518081 Guangdong Province, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035 Guangdong Province, China.
| | - Zhe Deng
- Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035 Guangdong Province, China.
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Mao W, Barge S, Luo Z, Yu W. Association of overactive bladder with all-cause and cardiovascular mortality in women: A propensity-matched NHANES study. BJUI COMPASS 2025; 6:e70022. [PMID: 40313594 PMCID: PMC12040721 DOI: 10.1002/bco2.70022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2025] [Revised: 04/08/2025] [Accepted: 04/12/2025] [Indexed: 05/03/2025] Open
Abstract
Objectives To examine the impact of overactive bladder (OAB) on all-cause and cardiovascular mortality in women in a real-world setting, and to examine the association of TyG-related indices with OAB. Methods Data on 6580 women aged ≥20 years were collected from the National Health and Nutrition Examination Survey (NHANES) database. Kaplan-Meier curves and Cox survival analysis were used to evaluate the association between OAB and all-cause and cardiovascular mortality. Biomarkers for metabolic syndrome were assessed for their association with OAB, including triglyceride-glucose (TyG) and TyG-related indices. The association between TyG-related indices and OAB was evaluated using restricted cubic splines (RCS), receiver operating characteristic (ROC) curves and multivariate logistic regression, with propensity score matching (PSM) employed to balance confounders between OAB and non-OAB groups. Results Kaplan-Meier curves showed that OAB was associated with a poorer prognosis, and multivariate Cox regression analyses indicated that OAB was an independent risk factor for both all-cause and cardiovascular mortality. RCS revealed a positive association between TyG-related indices and OAB. Both ROC curves and multivariate logistic regression analysis indicated that TyG-WHtR (TyG combined with waist-to-height ratio) was strongly associated with OAB, with a higher TyG-WHtR associated with an increased risk of OAB. The retrospective design and selection bias may be the potential limitations. Conclusions OAB is positively associated with all-cause and cardiovascular mortality in women. TyG-related indices are positively associated with OAB, with TyG-WHtR as the most effective index.
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Affiliation(s)
- Weipu Mao
- Department of Medicine, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA
| | - Sagar Barge
- Department of Medicine, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA
| | - Zhaobo Luo
- Department of Medicine, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA
| | - Weiqun Yu
- Department of Medicine, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA
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Yang Y, Guo L, Song S, Kong X, Zhao Y, Ma X, Wang X, Wang H, Sun Q. Association of the triglyceride glucose-waist height ratio with asymptomatic intracranial arterial stenosis. Lipids Health Dis 2025; 24:161. [PMID: 40301904 PMCID: PMC12039148 DOI: 10.1186/s12944-025-02562-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2025] [Accepted: 04/08/2025] [Indexed: 05/01/2025] Open
Abstract
BACKGROUND AND OBJECTIVE This study evaluated the associations of the triglyceride-glucose (TyG) index or its attendant parameters, known as reliable measures of insulin resistance, with asymptomatic intracranial arterial stenosis (aICAS), along with their value for distinguishing individuals with a notable aICAS burden. METHODS This study enrolled 2000 participants (aged ≥ 40 years) based on the Rose asymptomatic IntraCranial Artery Stenosis study. Transcranial Doppler ultrasound combined with magnetic resonance angiography was utilized to confirm aICAS. Logistic regression was applied to assess the associations between TyG or TyG-related indices (TyG-body mass index, TyG-waist circumference [TyG-WC], TyG-waist-to-hip ratio [TyG-WHR], or TyG-waist-to-height ratio [TyG-WHtR]) and aICAS. The diagnostic potential of them was investigated using receiver operating characteristic (ROC) analysis. RESULTS Among the 2000 participants, 146 (7.3%) had a diagnosis of aICAS. TyG-WC, TyG-WHR, or TyG-WHtR were independently related to the prevalence of aICAS (TyG-WC: OR 1.26, 95%CI 1.03-1.54; TyG-WHR: OR 1.29, 95%CI 1.07-1.55; TyG-WHtR: OR 1.25, 95%CI 1.04-1.51). ROC analysis disclosed that TyG-WHtR had significant superior performance in identifying aICAS compared with other parameters (all P < 0.05). Subgroup analysis revealed that higher TyG-WHtR values showed a positive association with a heightened prevalence of aICAS observed in elderly participants aged ≥ 65 years (OR 1.69, 95%CI 1.20-2.38), and hypertensive patients (OR 1.30, 95%CI 1.06-1.59). CONCLUSION The association of TyG-WHtR with aICAS showed that TyG-WHtR might be a more effective indicator for identifying populations with early-stage aICAS.
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Affiliation(s)
- Yumeng Yang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Liying Guo
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Shiqing Song
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Xianglong Kong
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yuanyuan Zhao
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiaotong Ma
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiang Wang
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Hailing Wang
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
| | - Qinjian Sun
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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17
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Que Z, Chen D, Cai H, Lan W, Huang Y, Rui G. Associations between insulin resistance and low back pain risk in US adults: a cross-sectional study. Front Med (Lausanne) 2025; 12:1538754. [PMID: 40357296 PMCID: PMC12066540 DOI: 10.3389/fmed.2025.1538754] [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: 12/03/2024] [Accepted: 04/09/2025] [Indexed: 05/15/2025] Open
Abstract
Background Insulin resistance is one of the major pathophysiological features of type 2 diabetes mellitus. Studies have revealed the association between type 2 diabetes mellitus and low back pain. However, few studies explored the relationship between insulin resistance and low back pain directly. Therefore, this study selected HOMA-IR, TyG, TyG-BMI, TyG-WC, and TyG-WtHR as indicators of insulin resistance to comprehensively investigate the association between insulin resistance and low back pain. Methods The data for this cross-sectional study were from NHANES. Multivariate logistic regression was used to assess the association of insulin resistance with low back pain, and the stability of the results was evaluated by stratified analysis. Results A total of 6,126 adult participants were included in the study, including 3,657 non-LBP participants and 2,469 LBP patients. All of these five indices showed significant association with low back pain after full adjustment for all covariates (Model 3), HOMA-IR [OR = 1.052, 95% CI (1.018, 1.087), p = 0.003], TyG [OR = 1.431, 95% CI (1.013, 2.021), p = 0.042], TyG-BMI [OR = 1.003, 95% CI (1.002, 1.005), p < 0.0001], TyG-WC [OR = 1.001, 95% CI (1.001, 1.002), p < 0.0001], TyG-WtHR [OR = 1.268, 95% CI (1.155, 1.393), p < 0.0001]. The relationship between insulin resistance and low back pain is stable in most stratified populations (p-interaction >0.05). Conclusion Insulin resistance is associated with an increased risk of low back pain. The HOMA-IR, TyG, TyG-WC, TyG-BMI, and TyG-WtHR all showed a stable correlation with low back pain. TyG-BMI, TyG-WC, and TyG-WtHR are more stable in their associations with low back pain than TyG alone.
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Affiliation(s)
- Zhiqiang Que
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Dingqiang Chen
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Huirong Cai
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Weibin Lan
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Yuxuan Huang
- Xiamen Key Laboratory of Clinical Efficacy and Evidence Studies of Traditional Chinese Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Gang Rui
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
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Li Z, Zhao Z, Zhang T, Yang X, Chen H, Yin X, Bai H, Liu X, Chang T, Zhang Y, Lu M. Association between triglyceride-glucose related indicators, genetic risk, and incident breast cancer among postmenopausal women in UK Biobank. BMC Cancer 2025; 25:781. [PMID: 40281472 PMCID: PMC12032665 DOI: 10.1186/s12885-025-13970-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Accepted: 03/19/2025] [Indexed: 04/29/2025] Open
Abstract
BACKGROUND The potential links between triglyceride-glucose (TyG) related indicators and breast cancer incidence after menopause have been less well studied, and the joint associations between genetic risk, TyG related indicators, and breast cancer are unknown. METHODS Simple surrogate indicators of insulin resistance including TyG, TyG-waist circumference (TyG-WC), TyG-waist to height ratio (TyG-WHtR), TyG-waist to hip ratio (TyG-WHR), TyG-body mass index (TyG-BMI). Genetic susceptibility in breast cancer was estimated by categorizing polygenic risk scores (PRS). For estimating the associations, we used Cox proportional hazards regression modeling. Correlation shapes were evaluated using restricted cubic splines (RCS). Mediation analyses for assessing the role of sex hormone-binding globulin (SHBG), C-reactive protein (CRP), testosterone, and glycosylated hemoglobin (HbA1c) in mediating the associations were conducted. RESULTS The study included 83,873 UK biobank participants who were followed for a median of 13.8 years, with 3,561 new cases of postmenopausal breast cancer. Genetic risk and TyG related indicators were monotonically related to breast cancer, with additive but not multiplicative interactions between them. The highest quartiles of TyG, TyG-WC, TyG-WHtR, TyG-WHR, and TyG-BMI were significantly associated with increased breast cancer risk with hazard ratio (95% confidence interval) were 1.12 (1.01-1.25), 1.35 (1.23-1.49), 1.16 (1.05-1.28), 1.22(1.12-1.33), and 1.31 (1.19-1.44), respectively. TyG-WC was nonlinearly linked to breast cancer (P for nonlinear = 0.006). Individuals with high genetic risk and high TyG related indicators exhibited a substantially elevated breast cancer risk by 4- to 5-fold compared with reference group. The associations were mainly mediated by SHBG, CRP, and testosterone, with mediation proportions ranging from 10.24% to 68.29%. CONCLUSIONS TyG related factors are linked to incident postmenopausal breast cancer, and the combined effects with genetic risk significantly optimize risk stratification. High levels of TyG related indicators may amplify the influence of genetic factors on postmenopausal breast cancer. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Zhen Li
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 107 Wenhua West Road, Jinan, Shandong, 250012, China
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
| | - Zengle Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 107 Wenhua West Road, Jinan, Shandong, 250012, China
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
| | - Tongchao Zhang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
- Clinical Research Center, Qilu Hospital of Shandong University, Jinan, China
| | - Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
- Clinical Research Center, Qilu Hospital of Shandong University, Jinan, China
| | - Hao Chen
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
- Clinical Research Center, Qilu Hospital of Shandong University, Jinan, China
| | - Xiaolin Yin
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
- Clinical Research Center, Qilu Hospital of Shandong University, Jinan, China
| | - Hao Bai
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
- Clinical Research Center, Qilu Hospital of Shandong University, Jinan, China
| | - Xinjie Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 107 Wenhua West Road, Jinan, Shandong, 250012, China
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
| | - Tongmin Chang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 107 Wenhua West Road, Jinan, Shandong, 250012, China
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
| | - Yuan Zhang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.
- Clinical Research Center, Qilu Hospital of Shandong University, Jinan, China.
| | - Ming Lu
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 107 Wenhua West Road, Jinan, Shandong, 250012, China.
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.
- Clinical Research Center, Qilu Hospital of Shandong University, Jinan, China.
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Li C, Liu X, Lv X, Zhou W, Fan G, Zhu F. The application of the triglyceride-glucose-body mass index (TyG-BMI) in predicting acute kidney injury in diabetic patients following coronary artery bypass grafting surgery. J Cardiothorac Surg 2025; 20:221. [PMID: 40281638 PMCID: PMC12023640 DOI: 10.1186/s13019-025-03455-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Accepted: 04/11/2025] [Indexed: 04/29/2025] Open
Abstract
BACKGROUND The triglyceride-glucose-body mass index (TyG-BMI), a marker for insulin resistance, is recognized for its predictive role in cardiovascular and metabolic diseases, including kidney disease. we explored the TyG-BMI index's association with postoperative kidney injury in coronary artery bypass grafting (CABG) patients, who are at an elevated risk for such complications, underscoring its potential as a predictor for acute kidney injury (AKI). METHODS This single-center, retrospective study included 126 patients. Patients were divided into AKI and non-AKI groups postoperatively according to the KDIGO classification criteria. Univariate logistic regression was used to screen for variables with significant differences (P < 0.01), and multiple multivariate regression models were constructed to analyze independent risk factors in the multivariate regression model and to analyze the value of TyG-BMI in predicting AKI in diabetic patients after CABG. RESULTS Compared to the non-AKI group, the AKI group had statistically significant differences in preoperative fasting triglycerides, preoperative fasting glucose, preoperative and postoperative creatinine levels, ICU stay duration, and TyG-BMI levels (P < 0.05). Based on the results of univariate regression analysis, a multivariate logistic regression model A was constructed using all significant variables, and a multivariate logistic regression model 2 was constructed using significant variables other than TyG-BMI. ROC analysis showed that model 2 had better predictive performance than model 1 (AUC = 0.836 vs. 0.766). A positive correlation was observed between TyG-BMI and AKI occurrence (Spearman's correlation coefficient: R = 0.33, P = 0.00019). CONCLUSION Elevated TyG-BMI levels are closely associated with AKI in diabetic patients after CABG. TyG-BMI has potentially predictive value for AKI in diabetic patients after CABG and may play a crucial role in risk stratification in clinical practice.
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Affiliation(s)
- Chen Li
- Department of Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Xiaobin Liu
- Department of Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Xingping Lv
- Department of Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Wei Zhou
- Department of Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Guoliang Fan
- Department of Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Feng Zhu
- Department of Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China.
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Sun Y, Deng W, Luo L, Chen M. Effect of Insulin Resistance on Prognosis of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with or Without Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2025; 18:1299-1309. [PMID: 40303385 PMCID: PMC12039837 DOI: 10.2147/dmso.s513652] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2024] [Accepted: 04/05/2025] [Indexed: 05/02/2025] Open
Abstract
Introduction This study aims to investigate the significance of insulin resistance (IR) markers in predicting 48-hour hemorrhagic transformation and 3-month poor prognosis in acute ischemic stroke (AIS) patients of intravenous thrombolysis (IVT), with or without type 2 diabetes mellitus (T2DM). Methods A total of 1352 patients with AIS treated with IVT between January 2019 and December 2023 were retrospectively reviewed. We analyzed the prognostic value of IR markers, including the triglyceride-glucose (TyG) index, triglyceride and body mass index (TYG-BMI), and the insulin resistance metabolic score (METS-IR), in AIS patients who received IVT with or without T2DM. The primary outcome was 48-hour hemorrhagic transformation and 3-month poor prognosis (modified Rankin Scale [mRS] ≥ 3). Results Among 1181 enrolled patients, 328 were diagnosed with T2DM, representing 27.8% of the cohort. T2DM group showed a higher proportion of poor prognosis (23% vs.11%, p < 0.001), but no significant difference in hemorrhagic transformation between the two groups. TyG index, TyG-BMI, and METS-IR all demonstrated predictive value for 3-month poor prognosis, with the TyG index showing the highest predictive accuracy [area under the curve (AUC): 0.848]. The optimal cutoff point for predicting poor prognosis was 7.409, with sensitivity of 0.762 and specificity of 0.855 (p < 0.001). However, all three indexes were limited in their ability to predict hemorrhagic transformation. Conclusion Elevated TyG index is an independent risk factor for 3-month poor prognosis in AIS patients of IVT with or without type T2DM, with the TyG index showing the highest predictive value. These findings provide a new understanding that IR can be used as a therapeutic target for AIS patients of IVT.
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Affiliation(s)
- Yanli Sun
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, People’s Republic of China
- Department of General Practice, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang City, Hubei Province, People’s Republic of China
| | - Wei Deng
- Department of Neurology, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang City, Hubei Province, People’s Republic of China
| | - Li Luo
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, People’s Republic of China
| | - Mingwei Chen
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, People’s Republic of China
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Yan S, Dong W, Niu Y, Song L, Pang P, Sun D, Zhang Y, Wang W, Hu H, Jin X, Zhang J, Luo Q, Sun D, Li H, Zhang Z, Qu Z, Zhu Q, Chen Y, Ning C, Fu S, Yang S, Wang S, He Y, Wang B, Zhao Y, Yang G, Chen X, Liu M, Chen Y. Associations of the triglyceride-glucose index and triglyceride-glucose/body mass index with all-cause mortality in Chinese centenarians. BMC Geriatr 2025; 25:266. [PMID: 40269748 PMCID: PMC12016446 DOI: 10.1186/s12877-025-05894-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Accepted: 03/27/2025] [Indexed: 04/25/2025] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index and triglyceride-glucose/body mass index (TyG-BMI) have been shown to be associated with cardiovascular and cerebrovascular disorders and the risk of death. The aim of this study was to explore the relationships of the TyG index and TyG-BMI with all-cause mortality among Chinese centenarians. METHODS Data from the China Hainan Centenarian Cohort Study (CHCCS) were analyzed. Eligible centenarians were divided into quartiles on the basis of their TyG and TyG-BMI indices. Kaplan‒Meier analysis was used to compare survival times across groups. The associations of the TyG index and TyG-BMI with all-cause mortality were investigated using restricted cubic splines (RCSs) and Cox proportional hazards regression models. Moreover, the concordance of the associations of the TyG index and TyG-BMI with all-cause mortality in different subgroups was further explored by subgroup analysis. RESULTS A total of 921 centenarian participants were included in this study. During a median follow-up of 29.70 months, 852 (92.5%) centenarians died. The results of the RCS analysis demonstrated that the TyG index and TyG-BMI were both linearly and negatively associated with all-cause mortality. Compared with that for the highest the TyG index and TyG-BMI quartile groups, higher risks of death were found for the lowest quartile groups (TyG Q1 vs. Q4, HR 1.27, 95% CI 1.03-1.56, P = 0.024; TyG-BMI Q1 vs. Q4, HR 1.60, 95% CI 1.30-1.96, P < 0.001). Centenarians with lower TyG index and TyG-BMI values had significantly greater mortality risks according to the Kaplan‒Meier analysis (log-rank P = 0.020, log-rank P < 0.001, respectively). Subgroup analysis demonstrated that blood pressure could influence the linear negative correlation between the TyG-BMI and all-cause mortality. CONCLUSION Both lower TyG and TyG-BMI indices were significantly associated with higher all-cause mortality in Chinese centenarians, whereas the TyG-BMI was superior to the TyG index in predicting the mortality risk of centenarians.
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Affiliation(s)
- Shiju Yan
- Department of Orthopedics, Hainan Hospital of Chinese PLA General Hospital, Hainan, Sanya, 572013, China
| | - Wenjing Dong
- Department of Endocrinology, Hainan Hospital of Chinese PLA General Hospital, Hainan, Sanya, 572013, China
- Chinese PLA Medical College, Beijing, 100039, China
| | - Yue Niu
- Senior Department of Nephrology, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Prevention and Treatment of Pan-vascular Diseases, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Beijing, 100853, China
| | - Lingyun Song
- Department of Endocrinology, Hainan Hospital of Chinese PLA General Hospital, Hainan, Sanya, 572013, China
| | - Ping Pang
- Department of Endocrinology, Hainan Hospital of Chinese PLA General Hospital, Hainan, Sanya, 572013, China
| | - Di Sun
- Department of Endocrinology, Hainan Hospital of Chinese PLA General Hospital, Hainan, Sanya, 572013, China
| | - Yue Zhang
- Department of Endocrinology, Hainan Hospital of Chinese PLA General Hospital, Hainan, Sanya, 572013, China
| | - Wei Wang
- Department of Endocrinology, Hainan Hospital of Chinese PLA General Hospital, Hainan, Sanya, 572013, China
| | - Hongyan Hu
- Department of Laboratory Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China
| | - Xinye Jin
- Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Academician Chen Xiangmei of Hainan Province Kidney Diseases Research Team Innovation Center, Sanya, 572013, China
| | - Jie Zhang
- Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Academician Chen Xiangmei of Hainan Province Kidney Diseases Research Team Innovation Center, Sanya, 572013, China
| | - Qing Luo
- Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Academician Chen Xiangmei of Hainan Province Kidney Diseases Research Team Innovation Center, Sanya, 572013, China
| | - Ding Sun
- Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Academician Chen Xiangmei of Hainan Province Kidney Diseases Research Team Innovation Center, Sanya, 572013, China
| | - Hao Li
- Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Academician Chen Xiangmei of Hainan Province Kidney Diseases Research Team Innovation Center, Sanya, 572013, China
| | - Zehao Zhang
- Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Academician Chen Xiangmei of Hainan Province Kidney Diseases Research Team Innovation Center, Sanya, 572013, China
| | - Zeyu Qu
- Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Academician Chen Xiangmei of Hainan Province Kidney Diseases Research Team Innovation Center, Sanya, 572013, China
| | - Qiao Zhu
- Central Laboratory, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China
| | - Yujian Chen
- Central Laboratory, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China
| | - Chaoxue Ning
- Central Laboratory, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China
| | - Shihui Fu
- Department of Cardiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China
| | - Shanshan Yang
- Department of Disease Prevention and Control, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shengshu Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yao He
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Bin Wang
- Senior Department of Nephrology, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Prevention and Treatment of Pan-vascular Diseases, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Beijing, 100853, China
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China
| | - Guoqing Yang
- Department of Endocrinology, Hainan Hospital of Chinese PLA General Hospital, Hainan, Sanya, 572013, China
| | - Xiangmei Chen
- Senior Department of Nephrology, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Prevention and Treatment of Pan-vascular Diseases, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Beijing, 100853, China.
| | - Miao Liu
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Yizhi Chen
- Senior Department of Nephrology, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Prevention and Treatment of Pan-vascular Diseases, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine(zyyzdxk-2023310), Beijing, 100853, China.
- Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Academician Chen Xiangmei of Hainan Province Kidney Diseases Research Team Innovation Center, Sanya, 572013, China.
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.
- Sanya Nephrology Medical Quality Control Center, Sanya, 572013, China.
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Shu MJ, Han F, Zhai FF, Zhang DD, Zhou LX, Ni J, Yao M, Cui LY, Peng B, Jin ZY, Zhang SY, Zhu YC. The association between long-term trajectories of insulin resistance and brain structural integrity in middle-aged and older adults. J Alzheimers Dis 2025:13872877251336333. [PMID: 40267302 DOI: 10.1177/13872877251336333] [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: 04/25/2025]
Abstract
BackgroundThe triglyceride-glucose (TyG) index is considered a robust surrogate for insulin resistance (IR). The relationship between the trajectory patterns of the TyG index and subsequent brain structure changes is still unclear.ObjectiveThis study investigates the relationship between 10-year trajectories of TyG-related indices and brain structural integrity in a 10-year follow-up.MethodsThis prospective study included 898 participants (mean age 55.6 years, 34.4% males) from the community-based Shunyi Study. IR was assessed using the TyG index, TyG-body mass index (BMI) index, TyG-waist circumference index, and TyG-waist-to-height ratio (WHtR) index. The group-based trajectory model was employed to identify the 10-year trajectories. Structural brain measurements included structural changes of the whiter matter (white matter hyperintensities (WMHs), fractional anisotropy, and mean diffusivity) and gray matter (brain parenchymal fraction (BPF), cortical thickness, and hippocampal volume). General linear models were utilized to examine the association between the trajectory patterns of TyG-related indices and brain structure.ResultsThree distinct trajectories of TyG-related indices were identified from 2013 to 2023. The high-level trajectory groups of TyG-related indices exhibited a greater volume of WMHs and were more susceptible to disruptions in white matter microstructural integrity. This association was most significant for the TyG-BMI and TyG-WHtR trajectory groups. No significant correlations were found for BPF and cortical thickness among the different TyG-related indices trajectories.ConclusionsThe findings suggest that long-term IR primarily damages brain white matter rather than causing structural changes in gray matter.
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Affiliation(s)
- Mei-Jun Shu
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Fei Han
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Fei-Fei Zhai
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Ding-Ding Zhang
- Department of Central Research Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Li-Xin Zhou
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Jun Ni
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Ming Yao
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Li-Ying Cui
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Bin Peng
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Zheng-Yu Jin
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Shu-Yang Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Yi-Cheng Zhu
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
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Zhang Z, Tan L. Association of insulin resistance-related indicators with cardiovascular disease in Chinese people with different glycemic states. Front Endocrinol (Lausanne) 2025; 16:1515559. [PMID: 40313486 PMCID: PMC12043448 DOI: 10.3389/fendo.2025.1515559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Accepted: 04/02/2025] [Indexed: 05/03/2025] Open
Abstract
Background This study compares the association of eight insulin resistance (IR)-related markers (triglyceride-glucose index (TyG), TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), triglycerides-to-high-density lipoprotein cholesterol ratio (TG/HDL), lipid accumulation product (LAP), visceral adiposity index (VAI), and estimated glucose disposal rate (eGDR)) with cardiovascular disease (CVD). Methods Spearman's coefficients were used for correlations between IR-related markers. Predictive capacities were evaluated using receiver operating characteristic (ROC) curve analysis, Akaike Information Criterion, and Bayesian Information Criterion were calculated. Multivariable-adjusted Cox regression models and restricted cubic spline (RCS) analysis were performed to explore associations between IR-related markers and CVD. Results In Pearson correlation analysis, TyG-WC and TyG-WHtR had a correlation coefficient of 0.95, while TG/HDL ratio and VAI had a correlation coefficient of 0.97. Regarding predictive capacity across different glycemic states, eGDR showed the best performance among the 8 IR-related markers, particularly in predicting stroke. According to Cox regression analysis, with each unit increase in TyG, TyG-BMI, TyG-WC, and TyG-WHtR, the risk of heart disease increased by 24.1%, 0.4%, 0.1%, and 17.56%, respectively; and the risk of stroke increased by 69.3%, 0.6%, 0.2%, and 36.5%, respectively. Additionally, TG/HDL ratio, VAI, and LAP exhibited nonlinear associations with heart disease and stroke risk. For each unit increase in eGDR, the risks of heart disease and stroke decreased by 21% and 14.2%, respectively. Conclusion eGDR is the most effective marker for predicting CVD, especially stroke, across all glycemic states. Modified TyG indices provide better predictive value than TyG alone.
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Affiliation(s)
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
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Woodiwiss AJ, Norton GR, Libhaber CD, Sareli P, Dessein PHC. Differential Association Between Ten Indices of Insulin Resistance and End-Organ Damage in a Community of African Ancestry in Africa. J Clin Med 2025; 14:2703. [PMID: 40283533 PMCID: PMC12027772 DOI: 10.3390/jcm14082703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2025] [Revised: 04/07/2025] [Accepted: 04/11/2025] [Indexed: 04/29/2025] Open
Abstract
Objective: Various insulin resistance (IR) indices have been developed to assess cardiovascular (CVS) risk. We compared the association between ten IR indices and cardiac, renal, and vascular end-organ measures in a predominantly young (age 45.0 ± 18.3 years) South African Black population. Methods: We assessed the relationships between ten IR indices (homeostatic model assessment for IR [HOMA-IR], quantitative insulin sensitivity check index [QUICKI], metabolic score for IR [METS-IR], triglyceride-glucose index [TyG], TyG-body mass index [TyG-BMI], TyG-waist circumference [TyG-WC], TyG-waist-to-height ratio [TyG-WHtR], triglyceride to high-density cholesterol concentration [TyG-HDL], lipid accumulation product [LAP], visceral adiposity index [VAI]) and end-organ measures in 779 community participants of African ancestry. Results: HOMA-IR and QUICKI were the only IR indices consistently associated with end-organ measures (left ventricular [LV] mass index, p ≤ 0.005; LV relative wall thickness, p < 0.0001; early-to-late mitral velocity, p ≤ 0.01; E/e', p ≤ 0.002; e', p < 0.0001; pulse wave velocity, p = 0.036 (HOMA-IR only); glomerular filtration rate [GFR], p < 0.0001), independent of confounders. Furthermore, HOMA-IR was consistently higher, and QUICKI lower, in those with compared to those without end-organ damage (LV hypertrophy [p ≤ 0.03], concentric LV [p < 0.03], and reduced GFR [p ≤ 0.008]), independent of confounders. Importantly, the associations between HOMA-IR or QUICKI and end-organ measures were independent of additional CVS risk factors, including adiposity measures, and were replicated in the participants without diabetes mellitus (n = 669) and in the participants without high blood pressure (n = 505). Conclusions: In a predominantly young community of African ancestry, of ten recommended IR indices, only HOMA-IR and QUICKI were consistently associated with end-organ damage independent of CVS risk factors.
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Affiliation(s)
- Angela J. Woodiwiss
- Cardiovascular Pathophysiology and Genomics Research Unit, Department of Physiology, School of Biomedical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa (P.H.C.D.)
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Tarantino G, Imbimbo C, Ferro M, Bianchi R, La Rocca R, Lucarelli G, Lasorsa F, Busetto GM, Finati M, Pastore AL, Al Salhi Y, Fuschi A, Terracciano D, Giampaglia G, Falabella R, Barone B, Fusco F, Del Giudice F, Crocetto F. Which Surrogate Marker of Insulin Resistance Among Those Proposed in the Literature Better Predicts the Presence of Non-Metastatic Bladder Cancer? J Clin Med 2025; 14:2636. [PMID: 40283465 PMCID: PMC12027915 DOI: 10.3390/jcm14082636] [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: 03/06/2025] [Revised: 03/25/2025] [Accepted: 04/09/2025] [Indexed: 04/29/2025] Open
Abstract
Background: Recent evidence has shown that insulin resistance (IR), a hallmark of nonalcoholic fatty liver disease, predicts bladder cancer (BC) presence. However, the best surrogate marker of IR in predicting BC is still unclear. This study examined the relationships among ten surrogate markers of IR and the presence of BC. Methods: Data from 209 patients admitted to two urology departments from September 2021 to October 2024 were retrospectively analyzed. Individuals (median age 70 years) were divided into two groups (123 and 86 patients, respectively) based on the presence/absence after cystoscopy/TURB of non-metastatic BC. Univariate logistic regression was used to determine the relationships between groups, and the following IR parameters: Triglyceride-Glucose (TyG) index, TyG-BMI, HOMA-IR HOMAB, MetS-IR, Single Point Insulin Sensitivity Estimator, Disposition Index, non-HDL/HDL, TG/HDL-C ratio and Lipoprotein Combine Index. Stepwise logistic regressions were carried out to evaluate the significant predictions and LASSO regression to confirm any significant variable(s). The predictive value of the index test for coexistent BC was evaluated using receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC). Results: The univariate analysis revealed that the TyG index and MetS-IR were associated with the BC presence. Specifically, the associations of the TyG index and MetS-IR were more significant in participants =/> 65 years old. In multivariate analysis, the stepwise logistic regression, evaluating the most representative variables at univariate analysis, revealed a prediction of BC by only TyG index (OR 2.51, p = 0.012), confirmed by LASSO regression, with an OR of 3.13, p = 0.004). Assessing the diagnostic reliability of TyG, it showed an interesting predictive value for the existence of BC (AUC = 0.60; 95% CI, 0.51-0.68, cut-off 8.50). Additionally, a restricted cubic spline model to fit the dose-response relationship between the values of the index text (TyG) and the BC evidenced the presence of a non-linear association, with a high predictive value of the first knot, corresponding to its 10th percentile. The decision curve analysis confirmed that the model (TyG) has utility in supporting clinical decisions. Conclusions: Compared to other surrogate markers of IR, the TyG index is effective in identifying individuals at risk for BC. A TyG threshold of 8.5 was highly sensitive for detecting BC subjects and may be suitable as an auxiliary diagnostic criterion for BC in adults, mainly if less than 65 years old.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (C.I.); (R.L.R.); (G.G.); (F.C.)
| | - Matteo Ferro
- Unit of Urology, Department of Health Science, University of Milan, ASST Santi Paolo e Carlo, 20172 Milan, Italy; (M.F.); (R.B.)
| | - Roberto Bianchi
- Unit of Urology, Department of Health Science, University of Milan, ASST Santi Paolo e Carlo, 20172 Milan, Italy; (M.F.); (R.B.)
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (C.I.); (R.L.R.); (G.G.); (F.C.)
| | - Giuseppe Lucarelli
- Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy (F.L.)
| | - Francesco Lasorsa
- Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy (F.L.)
| | - Gian Maria Busetto
- Department of Urology and Renal Transplantation, University of Foggia, 71122 Foggia, Italy; (G.M.B.); (M.F.)
| | - Marco Finati
- Department of Urology and Renal Transplantation, University of Foggia, 71122 Foggia, Italy; (G.M.B.); (M.F.)
| | - Antonio Luigi Pastore
- Department of Urology, Sapienza University of Rome, 04100 Latina, Italy; (A.L.P.); (Y.A.S.); (A.F.)
| | - Yazan Al Salhi
- Department of Urology, Sapienza University of Rome, 04100 Latina, Italy; (A.L.P.); (Y.A.S.); (A.F.)
| | - Andrea Fuschi
- Department of Urology, Sapienza University of Rome, 04100 Latina, Italy; (A.L.P.); (Y.A.S.); (A.F.)
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Gaetano Giampaglia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (C.I.); (R.L.R.); (G.G.); (F.C.)
| | | | - Biagio Barone
- Department of Urology, Ospedale San Paolo, ASL NA1 Centro, 80147 Naples, Italy;
| | - Ferdinando Fusco
- Division of Urology, Department of Surgical Sciences, AORN Sant’Anna e San Sebastiano, 81100 Caserta, Italy;
| | | | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (C.I.); (R.L.R.); (G.G.); (F.C.)
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Tian J, Dong Y, Xu Z, Ke J, Xu H. Association between triglyceride glucose-body mass index and 365-day mortality in patients with critical coronary heart disease. Front Endocrinol (Lausanne) 2025; 16:1513898. [PMID: 40255500 PMCID: PMC12006011 DOI: 10.3389/fendo.2025.1513898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2024] [Accepted: 03/17/2025] [Indexed: 04/22/2025] Open
Abstract
Objectives The aim of this study was to analyze the association between TyG-BMI and 365-day mortality in critically ill patients with CHD. Methods Patient data were extracted from the MIMIC-IV database. All patients were categorized into 3 groups based on TyG-BMI index: Low TyG-BMI index group, Medium TyG-BMI index group, and High TyG-BMI index group. Outcomes included primary and secondary outcomes, with the primary outcome being 365-day mortality and the secondary outcomes being hospital survival, intensive care unit (ICU) survival, and 28-day, 90-day, and 180-day mortality. The Kaplan-Meier survival curves were used to compare the outcomes of the three groups. The relationship between TyG-BMI index and 365-day mortality was assessed using multivariate Cox proportional risk regression models and restricted cubic spline curves (RCS). Results 889 critically ill patients with CHD were analyzed. Among them, 600 (67.50%) were male patients with a mean age of 68.37 years and 289 (32.50%) were female patients with a mean age of 73.91 years. Patients with a medium TyG-BMI index had the best 365-day prognostic outcome and the highest survival rate compared with patients in the Low and High TyG-BMI index groups [201 (67.68%) vs. 166 (56.08%), 188 (63.51%); P=0.013]. After fully adjusted modeling analysis, the hazard ratio (HR) for 365-day mortality was found to be 0.71 (95% CI 0.54-0.93, P=0.012) for the Medium TyG-BMI index group. Meanwhile, RCS analysis showed an L-shaped relationship between TyG-BMI index and 365-day mortality. Conclusions The TyG-BMI index is significantly associated with 365-day mortality in patients with severe CHD.
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Affiliation(s)
| | | | | | | | - Hongyang Xu
- Department of Critical Care Medicine, The Affiliated Wuxi People’s Hospital of
Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, Jiangsu, China
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Song Z, Miao X, Liu S, Hu M, Xie X, Sun Y, Leng S. Associations between cardiometabolic indices and the onset of metabolic dysfunction-associated steatotic liver disease as well as its progression to liver fibrosis: a cohort study. Cardiovasc Diabetol 2025; 24:154. [PMID: 40181314 PMCID: PMC11969729 DOI: 10.1186/s12933-025-02716-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2025] [Accepted: 03/27/2025] [Indexed: 04/05/2025] Open
Abstract
BACKGROUND This study sought to examine the associations between cardiometabolic indices and the onset of metabolic dysfunction-associated steatotic liver disease (MASLD) as well as its progression to liver fibrosis. METHODS This study comprised 25,366 subjects aged 18 years and older, free of MASLD at baseline, from the Dalian Health Management Cohort (DHMC). Cardiometabolic indices include cardiometabolic index (CMI), atherogenic index of plasma (AIP), triglyceride glucose (TyG), triglyceride glucose-body mass index (TyG-BMI), triglyceride glucose-waist circumference (TyG-WC) and triglyceride glucose-waist height ratio (TyG-WHtR). All participants were categorized into quartile groups based on cardiometabolic indices. Cox proportional hazards regression models and restricted cubic splines were employed to examine the relationship between cardiometabolic indices and the incidence of MASLD as well as its progression to liver fibrosis, and analyses were performed between different subgroups. Mediation analysis was employed to explore how obesity and inflammation serve as mediators in the connection between cardiometabolic indices and MASLD. To evaluate the predictive ability of cardiometabolic indices for the onset of MASLD, the time-dependent receiver operating characteristic (ROC) curve was utilized. RESULTS A total of 5378 (21.2%) individuals developed MASLD during the follow-up period of 82,445 person-years. Multivariates Cox regression analyses showed that participants in the highest quartile of cardiometabolic indices had greater risk of MASLD than those in the lowest quartile (CMI: HR = 6.11, 95% CI 5.45-6.86; AIP: HR = 4.58, 95% CI 4.11-5.10; TyG: HR = 3.55, 95% CI 3.21-3.92; TyG-BMI: HR = 13.55, 95% CI 11.80-15.57; TyG-WC: HR = 12.52, 95% CI 10.93-14.34; TyG-WHtR: HR = 11.37, 95% CI 9.96-12.98). TyG-BMI (HR = 1.36, 95% CI 1.18-1.57), but not other cardiometabolic indices, was associated with liver fibrosis. Mediation analysis indicated that BMI mediated 40.4%, 33.2%, 36.5%, - 10.4%, 37.4%, 48.5% of the associations between CMI, AIP, TyG, TyG-BMI, TyG-WC, TyG-WHtR and MASLD. Time-dependent ROC curves demonstrated that TyG-BMI had a superior predictive ability for MASLD onset compared to other indicators. CONCLUSIONS The risk of developing MASLD increases as the level of cardiometabolic indices increases. Obesity may serve as a mediating factor in the aforementioned association. TyG-BMI showed the strongest association with the onset of MASLD and its progression to liver fibrosis, proved to be outperformed other cardiometabolic indicators, and could be the best clinical non-invasive biomarker for early screening of MASLD and liver fibrosis.
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Affiliation(s)
- Ziping Song
- Health Management Center, The Second Hospital of Dalian Medical University, No.467, Zhongshan Road, Dalian, 116023, China
- Department of Gastroenterology, The Second Hospital of Dalian Medical University, Dalian, 116023, Liaoning, China
| | - Xinlei Miao
- Health Management Center, The Second Hospital of Dalian Medical University, No.467, Zhongshan Road, Dalian, 116023, China
| | - Shuang Liu
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Manling Hu
- Department of Gastroenterology, The Second Hospital of Dalian Medical University, Dalian, 116023, Liaoning, China
| | - Xiaoling Xie
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Yuting Sun
- Department of Gastroenterology, The Second Hospital of Dalian Medical University, Dalian, 116023, Liaoning, China
| | - Song Leng
- Health Management Center, The Second Hospital of Dalian Medical University, No.467, Zhongshan Road, Dalian, 116023, China.
- Department of Gastroenterology, The Second Hospital of Dalian Medical University, Dalian, 116023, Liaoning, China.
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Weng J, Dong W, Liao R, Zheng Y, Fang X, You J, Wang Z, Zuo Y, Chen X, Peng X. High triglyceride-to-high-density lipoprotein cholesterol ratio predicts poor prognosis in new-onset heart failure: a retrospective study. BMC Cardiovasc Disord 2025; 25:251. [PMID: 40175907 PMCID: PMC11963554 DOI: 10.1186/s12872-025-04706-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2025] [Accepted: 03/25/2025] [Indexed: 04/04/2025] Open
Abstract
BACKGROUND There is limited research on the relationship between the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio and outcomes in new-onset heart failure (HF). Therefore, this study aimed to explore the association between TG/HDL-C ratio and clinical outcomes in these patients. METHODS A retrospective cohort of 614 adults with new-onset HF hospitalized at The First Affiliated Hospital of Nanchang University between July 2021 and December 2022 was analyzed. The primary endpoint was major adverse cardiovascular events (MACE), defined as cardiovascular (CV) death and HF rehospitalizations within 12 months after discharge. Kaplan-Meier (K-M) curves, restricted cubic spline (RCS) analysis, and Cox regression evaluated the association between TG/HDL-C ratio and MACE risk. RESULTS Patients were divided into four quartiles (Quartile 1, 2,3 and 4) based on their TG/HDL-C ratios. The mean age was 68.94 ± 14.34 years, with 59.12% male. The mean left ventricular ejection fraction (LVEF) was 46.59 ± 10.89%, with 45.11% having an LVEF ≤ 40%. During the 12-month follow-up, 156 patients experienced MACE, comprising 18 CV deaths and 138 HF rehospitalizations. The Quartile 4 group had the highest MACE risk incidence compared to other groups (P < 0.001). K-M analysis confirmed that the Quartile 4 group was associated with an increased cumulative incidence of MACE, HF rehospitalization, and CV death (all P < 0.001). RCS analysis revealed a positive nonlinear relationship between the TG/HDL-C ratio and MACE risk (P for nonlinear = 0.026), with a sharp risk increase above a ratio of 1.08. After adjustment, TG/HDL-C ratio was independently associated with MACE (HR: 1.44, 95% CI: 1.29-1.60). Compared to Quartile 1, adjusted HRs were significantly higher in Quartiles 2, 3, and 4 (all P < 0.005). CONCLUSIONS The TG/HDL-C ratio is independently associated with 12-month MACE risk in new-onset HF patients. It may serve as a simple, cost-effective marker to improve early risk stratification and guide closer monitoring and tailored management in this high-risk population.
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Affiliation(s)
- Junfei Weng
- The 1 st affiliated hospital, Jiangxi Medical College, Nanchang University, No. 461, Bayi Avenue, Nanchang City, 330006, Jiangxi Province, People's Republic of China
- The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwaizheng Street, Donghu District, Nanchang City, 330006, Jiangxi Province, People's Republic of China
| | - Wei Dong
- The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwaizheng Street, Donghu District, Nanchang City, 330006, Jiangxi Province, People's Republic of China
| | - Ruichun Liao
- The 1 st affiliated hospital, Jiangxi Medical College, Nanchang University, No. 461, Bayi Avenue, Nanchang City, 330006, Jiangxi Province, People's Republic of China
- The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwaizheng Street, Donghu District, Nanchang City, 330006, Jiangxi Province, People's Republic of China
| | - Yaofu Zheng
- The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwaizheng Street, Donghu District, Nanchang City, 330006, Jiangxi Province, People's Republic of China
| | - Xu Fang
- The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwaizheng Street, Donghu District, Nanchang City, 330006, Jiangxi Province, People's Republic of China
| | - Jiaxiang You
- The 1 st affiliated hospital, Jiangxi Medical College, Nanchang University, No. 461, Bayi Avenue, Nanchang City, 330006, Jiangxi Province, People's Republic of China
- The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwaizheng Street, Donghu District, Nanchang City, 330006, Jiangxi Province, People's Republic of China
| | - Zhichao Wang
- The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwaizheng Street, Donghu District, Nanchang City, 330006, Jiangxi Province, People's Republic of China
| | - Yingbing Zuo
- The 1 st affiliated hospital, Jiangxi Medical College, Nanchang University, No. 461, Bayi Avenue, Nanchang City, 330006, Jiangxi Province, People's Republic of China
- The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwaizheng Street, Donghu District, Nanchang City, 330006, Jiangxi Province, People's Republic of China
| | - Xuanying Chen
- The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwaizheng Street, Donghu District, Nanchang City, 330006, Jiangxi Province, People's Republic of China
| | - Xiaoping Peng
- The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwaizheng Street, Donghu District, Nanchang City, 330006, Jiangxi Province, People's Republic of China.
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Shoier NO, Ghareib SA, Kothayer H, Alsemeh AE, El-Sayed SS. Vitamin D3 mitigates myopathy and metabolic dysfunction in rats with metabolic syndrome: the potential role of dipeptidyl peptidase-4. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2025; 398:3697-3715. [PMID: 39356321 PMCID: PMC11978688 DOI: 10.1007/s00210-024-03439-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 09/06/2024] [Indexed: 10/03/2024]
Abstract
Metabolic syndrome is associated with vitamin D3 deficiency. This work aims to examine the efficacy of vitamin D3 in inhibiting MetS-induced myopathy and to determine whether the beneficial effects of vitamin D3 are mediated by the inhibition of dipeptidyl peptidase-4 (DPP-4). An in silico study investigated the potential effectiveness of vitamin D3 on the inhibition of the DPP-4 enzyme. An in vitro assay of the DPP-4 inhibitory effect of vitamin D3 was performed. In vivo and over 12 weeks, both diet (with 3% salt) and drinking water (with 10% fructose) were utilized to induce MetS. In the seventh week, rats received either vitamin D3, vildagliptin, a combination of both, or vehicles. Serum lipids, adipokines, glycemic indices, and glucagon-like peptide-1 (GLP-1), muscular glucose transporter type-4 (GLUT-4) content, DPP-4, adenosine monophosphate kinase (AMPK) activities, and Sudan Black B-stained lipids were assessed. Muscular reactive oxygen species (ROS), caspase-3, and desmin immunostaining were used to determine myopathy. MetS-induced metabolic dysfunction was ameliorated by vitamin D3, which also reduced intramuscular glycogen and lipid accumulation. This is demonstrated by the attenuation of MetS-induced myopathy by vitamin D3, decreased oxidative stress, increased desmin immuno-expression, and caspase-3 activity. Our in silico data demonstrated that vitamin D3 is capable of inhibiting DPP-4, which is further supported by biochemical findings. Vitamin D3 increased serum GLP-1, muscular AMPK activity, and GLUT-4 content, whereas the levels of muscular ROS were decreased in MetS. Vildagliptin and its combination with vitamin D3 yielded comparable results. It is suggested that the DPP-4 inhibitory potential of vitamin D3 is responsible for the amelioration of MetS-induced metabolic changes and myopathy.
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Affiliation(s)
- Nourhan O Shoier
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Salah A Ghareib
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Hend Kothayer
- Medicinal Chemistry Department, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Amira Ebrahim Alsemeh
- Human Anatomy and Embryology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Shaimaa S El-Sayed
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt.
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Li M, Gao L, Liu Y, Zheng Y, Chen L, Wang Y, Zhang W. Relationship between insulin resistance surrogates and bone mineral density in postmenopausal women. Climacteric 2025; 28:154-161. [PMID: 39903513 DOI: 10.1080/13697137.2025.2455164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 12/03/2024] [Accepted: 12/30/2024] [Indexed: 02/06/2025]
Abstract
OBJECTIVE This study aimed to investigate the association between four insulin resistance (IR) surrogates and bone mineral density (BMD) and whether IR surrogates could be risk factors for osteoporosis (OP) in Chinese non-diabetic postmenopausal individuals. METHODS Four non-insulin-based surrogates including triglyceride glucose (TyG), triglyceride glucose with body mass index (TyG-BMI), triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C) and the metabolic score for insulin resistance (METS-IR) index were calculated. All individuals underwent dual-energy X-ray absorptiometry for measurement of BMD. Pearson correlation analysis was employed to evaluate the correlations between IR indices and BMD. Subsequently, logistic regression analysis was performed to investigate the relationship between these indices and OP while the receiver-operating characteristic curve was used to assess the predictive values for OP. RESULTS Both TyG-BMI and the METS-IR index were significantly positively associated with BMD. As TyG-BMI and the METS-IR index increased, the prevalence of OP decreased. After adjusting confounding factors, the fourth quartile of TyG-BMI and the METS-IR index showed significantly decreased odds ratio of 0.304 and 0.352, respectively, for OP with respect to its first quartile value. The area under the curve of TyG-BMI and the METS-IR index was 0.616 and 0.605, respectively. CONCLUSIONS IR surrogates TyG-BMI and the METS-IR index were positively associated with BMD and may be protective factors for OP in Chinese non-diabetic postmenopausal women.
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Affiliation(s)
- Min Li
- Department of Endocrinology, Hebei Medical University Third Hospital, Shijiazhuang City, China
| | - Lei Gao
- Department of Radiology, Hebei Medical University Third Hospital, Shijiazhuang City, China
| | - Ying Liu
- Department of Radiology, Hebei Medical University Third Hospital, Shijiazhuang City, China
| | - Yongli Zheng
- Department of Radiology, Hebei Medical University Third Hospital, Shijiazhuang City, China
| | - Luyao Chen
- Department of Endocrinology, Hebei Medical University Third Hospital, Shijiazhuang City, China
| | - Yan Wang
- Department of Endocrinology, Hebei Medical University Third Hospital, Shijiazhuang City, China
| | - Wei Zhang
- Department of Radiology, Hebei Medical University Third Hospital, Shijiazhuang City, China
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Bai W, Chen H, Wan H, Ye X, Ling Y, Xu J, Guo X, He J. Association between the triglyceride glucose-body roundness index and the incidence of cardiovascular disease among Chinese middle and old-aged adults: a nationwide prospective cohort study. Acta Diabetol 2025:10.1007/s00592-025-02499-y. [PMID: 40167638 DOI: 10.1007/s00592-025-02499-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Accepted: 03/22/2025] [Indexed: 04/02/2025]
Abstract
AIM Previous studies have suggested that the triglyceride glucose (TyG) index and body roundness index (BRI) are indicators of insulin resistance (IR) and are associated with the incidence of cardiovascular disease (CVD) among middle and old-aged adults. BRI is considered a more accurate indicator of the proportion of body fat and visceral fat than body mass index (BMI). However, it remains unclear whether the combined use of the TyG index and BRI, specifically the triglyceride glucose-body roundness index (TyG-BRI), is associated with the incidence of CVD among Chinese middle and old-aged adults. METHODS Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). The TyG-BRI index was computed using baseline measurements of triglycerides, fasting blood glucose, waist circumference, and height. Cox proportional hazards regression and restricted cubic spline (RCS) regression analyses were applied to assess the association between the TyG-BRI index and incident CVD (defined as cardiac events or stroke). RESULTS A total of 8,113 Chinese adults participated in this study, with a median age of 58 years, including 56.3% males. The fully adjusted Cox regression analysis revealed that individuals in the highest quartile (Q4) of the TyG-BRI index had a 59.1% increased risk of developing incident CVD compared to those in the lowest quartile (HR, 1.591 [95% CI, 1.330-1.902]). The TyG-BRI index showed a significant linear association with CVD incidence (P for nonlinearity = 0.447, P < 0.001). This association persisted after conducting subgroup and sensitivity analyses. CONCLUSIONS This study introduced a novel TyG-BRI index, which integrated IR and body roundness as a comprehensive indicator, demonstrating its strong and independent association with increased CVD risk in a Chinese nationwide cohort. Our findings provide new insights into the interaction between metabolic dysfunction and cardiovascular risk, suggesting that the TyG-BRI index could serve as a practical tool for targeted preventive interventions.
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Affiliation(s)
- Wangyang Bai
- School of Medicine, Tongji University, Shanghai, China
| | - Hangqi Chen
- School of Medicine, Tongji University, Shanghai, China
| | - Huiqin Wan
- School of Medicine, Tongji University, Shanghai, China
| | - Xiaofei Ye
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Yi Ling
- College of Basic Medical Sciences, Naval Medical University, Shanghai, China
| | - Jinfang Xu
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Xiaojing Guo
- Department of Health Statistics, Naval Medical University, Shanghai, China.
| | - Jia He
- School of Medicine, Tongji University, Shanghai, China.
- Department of Health Statistics, Naval Medical University, Shanghai, China.
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Bian K, Hou C, Jin H, Feng X, Peng M, Zhao X, Yuan X, Sun W, Feng H, Xu G. Association between Triglyceride-Glucose indices and ischemic stroke risk across different glucose metabolism statuses. Diabetes Res Clin Pract 2025; 222:112064. [PMID: 40010673 DOI: 10.1016/j.diabres.2025.112064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Revised: 01/14/2025] [Accepted: 02/21/2025] [Indexed: 02/28/2025]
Abstract
BACKGROUND Triglyceride-glucose (TyG) related indices, including TyG, TyG-body mass index (TyG-BMI), and TyG-waist circumference (TyG-WC), have been identified as promising biomarkers for assessing insulin resistance (IR), a known risk factor for ischemic stroke. While previous research has highlighted the relevance of these indices in various metabolic disorders, their predictive utility for ischemic stroke across different glucose metabolic statuses has not been extensively explored. METHOD This study utilized data from the UK Biobank, analyzing 392,733 participants free from ischemic stroke at baseline, categorized into normal glucose, prediabetes, and diabetes groups based on American Diabetes Association criteria. TyG-related indices were computed using baseline measures of fasting blood glucose and triglycerides. Participants were followed for a median of 14.68 years to assess the incidence of ischemic stroke. Cox proportional hazards models adjusted for demographic and clinical covariates were used to explore the associations between TyG indices and stroke risk. RESULTS Over the follow-up period, 8033 participants experienced an ischemic stroke. Higher TyG-related indices were associated with an increased stroke risk in all glucose metabolism groups, with the strongest associations observed in the prediabetes and normal glucose groups. The risk of stroke increased progressively across quartiles of TyG, TyG-BMI, and TyG-WC indices. The analysis revealed that each unit increase in the TyG index significantly elevated stroke risk in diabetic individuals, while TyG-BMI and TyG-WC indices showed significant predictive power in the prediabetes and normal glucose groups. CONCLUSION TyG-related indices, particularly TyG-BMI and TyG-WC, are effective in predicting the risk of ischemic stroke, especially among individuals with prediabetes and normal glucose levels. These findings underscore the utility of TyG indices as tools for early detection and preventive strategies in stroke risk management across various states of glucose metabolism.
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Affiliation(s)
- Keyu Bian
- Department of Neurology, Wujin TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Changzhou, Jiangsu 213100, China; Department of Neurology, Jinling Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; Department of Neurology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Chao Hou
- Department of Neurology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210002, China
| | - Huafeng Jin
- Department of Neurology, Wujin TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Changzhou, Jiangsu 213100, China
| | - Xiaoli Feng
- Department of Neurology, Wujin TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Changzhou, Jiangsu 213100, China
| | - Min Peng
- Department of Neurology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China; Department of Neurology, First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Xingqi Zhao
- Department of Neurology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China; Department of Neurology, First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Xiangling Yuan
- Department of Neurology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China; Guangxi University of Traditional Chinese Medicine, Nanning, Guangxi, China
| | - Wen Sun
- Department of Neurology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Haixing Feng
- Department of Neurology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China; Department of Neurology, First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.
| | - Gelin Xu
- Department of Neurology, Jinling Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; Department of Neurology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China; Department of Neurology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210002, China; Department of Neurology, First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.
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Ding C, Lu R, Kong Z, Huang R. Exploring the triglyceride-glucose index's role in depression and cognitive dysfunction: Evidence from NHANES with machine learning support. J Affect Disord 2025; 374:282-289. [PMID: 39805501 DOI: 10.1016/j.jad.2025.01.051] [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: 03/22/2024] [Revised: 01/07/2025] [Accepted: 01/09/2025] [Indexed: 01/16/2025]
Abstract
BACKGROUND Depression and cognitive impairments are prevalent among older adults, with evidence suggesting potential links to obesity and lipid metabolism disturbances. This study investigates the relationships between the triglyceride-glucose (TyG) index, body mass index (BMI), depression, and cognitive dysfunction in older adults, leveraging data from the NHANES survey and employing machine learning techniques. METHODS We analysed 1352 participants aged 60-79 from the 2011-2014 NHANES dataset, who underwent cognitive function testing, depression assessments, and TyG index measurements. Multivariate linear regression and subgroup analyses were conducted to examine associations between the TyG index and depression/cognitive impairment. Machine learning models evaluated the importance of predictive factors for depression, while Mendelian randomization (MR) was employed to explore the causal relationship between BMI and depression/cognitive function. RESULTS The TyG index was negatively associated with cognitive function scores and positively associated with depression scores in adjusted models (p < 0.001). In fully adjusted subgroup analyses, among obese individuals (BMI ≥ 28), a 100-unit increase in the TyG index was linked to a 3.79-point decrease in depression scores. Machine learning models (Xgboost, AUC = 0.960) identified BMI, TyG-BMI, gender, and comorbidities (e.g., asthma, stroke, emphysema) as key determinants of depression. MR analyses revealed a negative association between BMI and depression risk [OR: 0.9934; 95 % CI (0.9901-0.9968), p = 0.0001] and cognitive dysfunction risk [OR: 0.8514; 95 % CI (0.7929-0.9143), p < 0.05]. No evidence of heterogeneity or pleiotropy was detected. LIMITATIONS Depression and cognitive impairments were self-reported, potentially introducing bias. The observed associations may be influenced by unmeasured confounders, necessitating further research into the underlying mechanisms. CONCLUSIONS Our findings reveal associations between the TyG index and psychocognitive health in older adults. While these results highlight lipid metabolism as a potential factor in depression and cognitive dysfunction, further studies are needed to validate these findings and explore underlying mechanisms.
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Affiliation(s)
- Chao Ding
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Renjie Lu
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhiyu Kong
- South China University of Technology, Guangzhou, China
| | - Rong Huang
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Sergi D, Spaggiari R, Dalla Nora E, Angelini S, Castaldo F, Omenetto A, Stifani G, Sanz JM, Passaro A. HOMA-IR and TyG index differ for their relationship with dietary, anthropometric, inflammatory factors and capacity to predict cardiovascular risk. Diabetes Res Clin Pract 2025; 222:112103. [PMID: 40107622 DOI: 10.1016/j.diabres.2025.112103] [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: 01/29/2025] [Revised: 03/10/2025] [Accepted: 03/13/2025] [Indexed: 03/22/2025]
Abstract
BACKGROUND HOMA-IR and the triglyceride-glucose index (TyG index) are surrogate indexes of insulin resistance. However, it remains to elucidate how HOMA-IR and the TyG index compare for their relationship with cardiometabolic health. AIM This study aimed at comparing HOMA-IR and the TyG index with regard to their relationship with anthropometric, dietary and inflammatory factors as well as ability to predict cardiovascular risk. METHODS 438 subjects aged 55-80 years, underwent anthropometric, metabolic and nutritional characterisation. Spearman's correlation coefficient was used to evaluate the association between the parameters of interest. Predictors of HOMA-IR, the TyG index and the 10-year risk of cardiovascular events were investigated using stepwise multivariable regression analysis. RESULTS HOMA-IR and TyG index correlated positively with body mass index, waist circumference, fat mass, systolic and diastolic blood pressure, interleukin-18 and C-reactive protein. However, only HOMA-IR correlated with dietary factors. After adjusting for age and sex, waist circumference and interleukin-18 were stronger predictors of HOMA-IR compared to the TyG index. Instead, the TyG index, but not HOMA-IR, emerged as a predictor of cardiovascular risk. CONCLUSIONS The TyG index represents a better predictor of cardiovascular risk compared to HOMA-IR which, instead, exhibits a stronger relationship with anthropometric, inflammatory and nutritional variables.
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Affiliation(s)
- Domenico Sergi
- Department of Translational Medicine, University of Ferrara 44121 Ferrara, Italy
| | - Riccardo Spaggiari
- Department of Translational Medicine, University of Ferrara 44121 Ferrara, Italy
| | - Edoardo Dalla Nora
- Department of Translational Medicine, University of Ferrara 44121 Ferrara, Italy
| | - Sharon Angelini
- Department of Translational Medicine, University of Ferrara 44121 Ferrara, Italy
| | - Fabiola Castaldo
- Department of Translational Medicine, University of Ferrara 44121 Ferrara, Italy
| | - Alice Omenetto
- Department of Translational Medicine, University of Ferrara 44121 Ferrara, Italy
| | - Gabriella Stifani
- Department of Translational Medicine, University of Ferrara 44121 Ferrara, Italy
| | - Juana Maria Sanz
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara 44121 Ferrara, Italy.
| | - Angelina Passaro
- Department of Translational Medicine, University of Ferrara 44121 Ferrara, Italy
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Li C, Lin Q, Wan C, Li L. Nonlinear relationships between the triglyceride glucose-body mass index and cardiovascular disease in middle-aged and elderly women from NHANES (1999-2018). Sci Rep 2025; 15:10953. [PMID: 40164755 PMCID: PMC11958736 DOI: 10.1038/s41598-025-95677-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2025] [Accepted: 03/24/2025] [Indexed: 04/02/2025] Open
Abstract
This study aims to investigate the relationship between the triglyceride-glucose body mass index (TyG-BMI) and cardiovascular disease (CVD) among middle-aged and elderly women, using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2018. TyG-BMI was calculated as Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2] × BMI. After applying the sampling weights from NHANES, the study sample of 6,343 participants is representative of approximately 59,174,898 American women. We categorized TyG-BMI into quartiles, using Q3 as the reference group. In the crude model, Q4 exhibited a 40% increased odds of CVD (odds ratio [OR] = 1.40, 95% confidence interval [CI] 1.09-1.79, P = 0.009). In the fully adjusted model, the increased odds of CVD for Q4 relative to Q3 was 39% (OR = 1.39, 95% CI 1.06-1.82, P = 0.019). Further analysis using restricted cubic splines (RCS) and threshold effect analysis confirmed a nonlinear relationship between them. Below a TyG-BMI threshold of 260, there was no significant association with CVD odds. However, above 260, each 10-unit increase in TyG-BMI was associated with a 2.4% increase in CVD odds in this demographic. Sensitivity analyses confirmed the stability of the results.
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Affiliation(s)
- Chunxue Li
- Department of Cardiovascular, The Second Hospital of Jilin University, No.218, Zi Qiang Street, Nanguan Zone, Changchun, 130041, Jilin, China
| | - Qiuxia Lin
- Department of Cardiovascular, The Second Hospital of Jilin University, No.218, Zi Qiang Street, Nanguan Zone, Changchun, 130041, Jilin, China
| | - Chunli Wan
- Department of Cardiovascular, The Second Hospital of Jilin University, No.218, Zi Qiang Street, Nanguan Zone, Changchun, 130041, Jilin, China
| | - Lin Li
- Department of Cardiovascular, The Second Hospital of Jilin University, No.218, Zi Qiang Street, Nanguan Zone, Changchun, 130041, Jilin, China.
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Wang Y, Chen B, Zang C, Hou J. Association between cumulative average triglyceride glucose-body mass index and the risk of CKD onset. Front Endocrinol (Lausanne) 2025; 16:1525078. [PMID: 40230478 PMCID: PMC11994409 DOI: 10.3389/fendo.2025.1525078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Accepted: 03/10/2025] [Indexed: 04/16/2025] Open
Abstract
Background Chronic kidney disease (CKD) has become a significant global public health challenge, which was reported to be highly correlated with the triglyceride glucose-body mass index (TyG-BMI). Nevertheless, literature exploring the association between changes in the TyG-BMI and CKD incidence is scant, with most studies focusing on individual values of the TyG-BMI. We aimed to investigate whether cumulative average in the TyG-BMI were associated with CKD incidence. Methods Data in our study were obtained from the China Health and Retirement Longitudinal Study (CHARLS), which is an ongoing nationally representative prospective cohort study. The exposure was the cumulative average TyG-BMI from 2011 to 2015. The TyG-BMI was calculated by the formula ln [TG (mg/dl) × FBG (mg/dl)/2] × BMI (kg/m2), and the cumulative average TyG-BMI was calculated as follows: (TyG-BMI2011+ TyG-BMI2015)/2. Logistic regressions were used to determine the association between different quartiles of cumulative average TyG-BMI and CKD incidence. Meanwhile, restricted cubic spline was applied to examine the potential nonlinear association of the cumulative average TyG-BMI and CKD incidence. In addition, subgroup analysis was used to test the robustness of results. Results Of the 6117 participants (mean [SD] age at baseline, 58.64 [8.61] years), 2793 (45.7%) were men. During the 4 years of follow-up, 470 (7.7%) incident CKD cases were identified. After adjusting for potential confounders, compared to the participants in the lowest quartile of cumulative average TyG-BMI, participants in the 3rd and 4th quartile had a higher risk of CKD onset. The ORs and 95%CIs were [1.509(1.147, 1.990)] and [1.452(1.085, 1.948)] respectively. In addition, restricted cubic spline showed the cumulative average TyG-BMI had a liner association (p-nonlinear = 0.139). Conclusions The cumulative average in the TyG-BMI was independently associated with the risk of CKD in middle-aged and older adults. Monitoring long-term changes in the TyG-BMI may assist with the early identification of individuals at high risk of CKD.
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Affiliation(s)
| | | | | | - Jie Hou
- Department of Nephrology, the First Hospital of Jilin University, Changchun, Jilin, China
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Zhang Y, Tang Y, Xu L, Fang L, Li X, Mao W, Liu T. Effect of limb ischemic preconditioning on the indirect index of insulin resistance in maintenance hemodialysis patients. BMC Cardiovasc Disord 2025; 25:238. [PMID: 40158091 PMCID: PMC11954303 DOI: 10.1186/s12872-025-04677-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Accepted: 03/17/2025] [Indexed: 04/01/2025] Open
Abstract
BACKGROUND Poor prognosis of maintenance hemodialysis (MHD) patients, including cardiovascular disease (CVD) and protein-energy wasting (PEW), is strongly associated with insulin resistance (IR). Previous studies have revealed that limb ischemic preconditioning (LIPC), as an intervention, is effective in reducing inflammation and oxidative stress levels in patients. The aim of this study was to elucidate the effects of LIPC on IR indirect indices, inflammation and oxidative stress indices, and to further explore the potential mechanisms of LIPC in reducing IR indices. METHODS A retrospective analysis was performed on 62 patients with MHD who had previously undergone limb ischemia preconditioning (LIPC) or sham surgery (Sham). General clinical and laboratory data were collected. Furthermore, to assess the IR status of MHD patients, the following indices were employed: triglyceride-glucose index (TyG), triglyceride-glucose body mass index (TyG-BMI), triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C), and metabolic score of insulin resistance (METS-IR). Inflammation and oxidative stress indicators included high-sensitivity C-reactive protein (hs-CRP), hs-CRP /albumin ratio (CAR), serum malondialdehyde (MDA) and superoxide dismutase (SOD). Mediation analysis was conducted using Model 4 in the SPSS PROCESS macro version 4.1. RESULTS Following a four-week experiment, hs-CRP (15.46 ± 3.60 vs. 10.53 ± 5.42, p < 0.001), CAR (0.39 ± 0.10 vs. 0.26 ± 0.13, p < 0.001) and MDA (8.46(6.71,9.85) vs. 5.99(5.11,7.89), p = 0.001) indices were significantly decreased in the MHD patients of the LIPC group, whereas SOD indices (215.07(180.27,286.45) vs. 267.76(228.32,319.54), p = 0.012) were significantly higher. Only hs-CRP (-4.93 ± 5.68 vs. 0.16 ± 5.39, p = 0.001) and CAR (-0.14 ± 0.14 vs. -0.001 ± 0.15, p = 0.001) were significantly different in the LIPC group compared to the Sham group. In contrast, the changes in MDA (p = 0.058) and SOD (p = 0.107) were not statistically significant between groups. The intra- and inter-group differences in the four indirect indices of IR were significant (p < 0.05). The heatmap revealed a notable correlation between the changes in hs-CRP and CAR levels and the changes in the IR indirect indices. In addition, The mediation model showed that the inflammatory indicators hs-CRP played a partial mediating role in the improvement of IR indices (TyG-BMI) by LIPC. CONCLUSION LIPC has an excellent ability to inhibit inflammation and peroxidation. In addition, in MHD patients, inflammation plays a significant role in the process of LIPC improving IR index.
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Affiliation(s)
- Yu Zhang
- Department of Nephrology, The Second People's Hospital of Changzhou, Third Affiliated Hospital of Nanjing Medical University, Changzhou, 213003, China
| | - Yushang Tang
- Department of Nephrology, The Second People's Hospital of Changzhou, Third Affiliated Hospital of Nanjing Medical University, Changzhou, 213003, China
| | - Linfang Xu
- Department of Nephrology, The Second People's Hospital of Changzhou, Third Affiliated Hospital of Nanjing Medical University, Changzhou, 213003, China
| | - Li Fang
- Department of Nephrology, The Second People's Hospital of Changzhou, Third Affiliated Hospital of Nanjing Medical University, Changzhou, 213003, China
| | - Xiaoping Li
- Department of Nephrology, The Second People's Hospital of Changzhou, Third Affiliated Hospital of Nanjing Medical University, Changzhou, 213003, China
| | - Wenbin Mao
- Department of Nephrology, The Second People's Hospital of Changzhou, Third Affiliated Hospital of Nanjing Medical University, Changzhou, 213003, China
| | - Tongqiang Liu
- Department of Nephrology, The Second People's Hospital of Changzhou, Third Affiliated Hospital of Nanjing Medical University, Changzhou, 213003, China.
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Tamini S, Bondesan A, Caroli D, Marazzi N, Sartorio A. The Ability of the Triglyceride-Glucose (TyG) Index and Modified TyG Indexes to Predict the Presence of Metabolic-Associated Fatty Liver Disease and Metabolic Syndrome in a Pediatric Population with Obesity. J Clin Med 2025; 14:2341. [PMID: 40217790 PMCID: PMC11989838 DOI: 10.3390/jcm14072341] [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: 03/10/2025] [Revised: 03/25/2025] [Accepted: 03/27/2025] [Indexed: 04/14/2025] Open
Abstract
Background: Metabolic-associated fatty liver disease (MASLD) and metabolic syndrome (MetS) are increasingly prevalent among children and adolescents with obesity, posing significant long-term metabolic and cardiovascular risks. Non-invasive identification of at-risk individuals is crucial for a timely intervention. This study aimed to evaluate the diagnostic performance of the triglyceride-glucose (TyG) index and its modified versions, TyG-body mass index (TyG-BMI) and TyG-waist circumference (TyG-WC), in predicting MASLD and MetS in a large cohort of children and adolescents with obesity. Methods: A total of 758 children and adolescents with obesity (454 females, 304 males; mean age 14.8 ± 2.1 years; mean BMI 37.9 ± 6.2 kg/m2) were included. MASLD was diagnosed via ultrasonography, while MetS was defined using International Diabetes Federation criteria. TyG, TyG-WC, and TyG-BMI were calculated for all participants. Receiver operating characteristic (ROC) curves were generated to assess the diagnostic accuracy of these indexes, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: MASLD was detected in 38.9% of participants, with a higher prevalence in males (p < 0.0001). MetS was present in 27.8% of the cohort, with higher prevalence in males (p < 0.0001). Among the indexes, TyG-WC exhibited the highest sensitivity for MASLD (77.6%), whereas TyG-BMI had the highest specificity (63.3%). In predicting MetS, all three indexes performed better than for MASLD, with TyG demonstrating the highest PPV (54.5%) and TyG-BMI the highest NPV (87.5%). Predictive performance was lower in males than females, potentially due to sex-specific differences in fat distribution and metabolic response. Conclusions: TyG, TyG-WC, and TyG-BMI are promising, non-invasive tools for identifying children and adolescents with obesity at risk for MASLD and MetS. The superior sensitivity of TyG-WC and the high specificity of TyG-BMI highlight the value of incorporating anthropometric parameters into metabolic screening. Integrating these indexes into routine clinical practice may enhance early detection, allowing for timely intervention and personalized management strategies, ultimately reducing the long-term burden of metabolic and liver diseases in pediatric populations.
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Affiliation(s)
- Sofia Tamini
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo-Verbania, Italy; (A.B.); (D.C.); (N.M.); (A.S.)
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Wang F, Ren H, Zhao W, Liu Y, Chen A. Analysis of the efficacy of the ZJU index and triglyceride‒glucose product index in identifying obstructive sleep apnea hypoventilation syndrome in patients with metabolic syndrome. Hormones (Athens) 2025:10.1007/s42000-025-00643-5. [PMID: 40116990 DOI: 10.1007/s42000-025-00643-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Accepted: 03/11/2025] [Indexed: 03/23/2025]
Abstract
PURPOSE Metabolic syndrome (MS) and obstructive sleep apnea-hypopnea syndrome (OSAHS) are associated with an increased risk of cardiometabolic disease. The coexistence of OSAHS and metabolic disorders is common, but research on how to recognize OSAHS and how OSAHS risk exacerbates metabolic disorders is limited. This study aimed to analyze the correlations of the ZJU index and triglyceride‒glucose (TyG) index with OSAHS in MS patients and to investigate the ability to use the ZJU index and TyG-related indices to assess the presence and severity of OSAHS in MS patients. METHODS This retrospective study included 216 MS patients with perfect polysomnographic monitoring (PSG), who were categorized into MS combined with OSAHS (n = 142) and MS alone (n = 74) groups according to the sleep monitoring results. The MS combined with OSAHS group was further categorized into mild (n = 55), moderate (n = 34), and severe (n = 53) groups according to the apnea hypopnea index (AHI). The general clinical data, clinical biochemical indices, AHI, mean oxygen saturation (MSaO2), lowest oxygen saturation (LSaO2), and longest apnea duration were collected from all the included subjects. Composite indices such as the ZJU, TyG, and TyG-BMI indices were calculated. The differences in each metabolic index among the different groups were analyzed; logistic regression analysis was used to compare the correlations between each parameter and OSAHS, and the efficacy of each parameter in identifying OSAHS in the MS population was evaluated by receiver operating characteristic (ROC) curves. RESULTS The ZJU, TyG, and TyG-BMI indices were associated with OSAHS after adjusting for sex, age, history of hypertension, history of diabetes, and history of smoking (all P < 0.05). The odds ratios for the ZJU, TyG, and TyG-BMI indices were 1.472 (1.293-1.674), 9.811 (3.916-24.582), and 1.032 (1.020-1.044), respectively. The ZJU, TyG, and TyG-BMI indices are effective predictors of the occurrence of OSAHS in MS patients, and their cutoff values could be used for early screening of OSAHS. The ZJU index was the strongest predictor of OSAHS, (area under the curve 0.829, 95% CI 0.771-0.888), with an optimal cutoff value of 38.940. CONCLUSIONS The ZJU, TyG, and TyG-BMI indices are novel, valid, and practical indicators for early screening of OSAHS risk in MS patients.
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Affiliation(s)
- Fang Wang
- Department of Endocrinology and Metabolism, Lanzhou University Second Hospital, Lanzhou, Gansu, 730000, China
- The Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Huimin Ren
- Department of Endocrinology and Metabolism, Lanzhou University Second Hospital, Lanzhou, Gansu, 730000, China
- The Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Wenfei Zhao
- Department of Endocrinology and Metabolism, Lanzhou University Second Hospital, Lanzhou, Gansu, 730000, China
- The Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Yifan Liu
- The Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Airong Chen
- Department of Endocrinology and Metabolism, Lanzhou University Second Hospital, Lanzhou, Gansu, 730000, China.
- The Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu, 730000, China.
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Tang H, Huang J, Zhang X, Chen X, Yang Q, Luo N, Lin H, Hong J, Wu S, Tian C, Lin M, Tang J, Wen J, Chen P, Jiang L, Zhang Y, Yi K, Tan X, Chen Y. Association between triglyceride glucose-body mass index and the trajectory of cardio-renal-metabolic multimorbidity: insights from multi-state modelling. Cardiovasc Diabetol 2025; 24:133. [PMID: 40119385 PMCID: PMC11929281 DOI: 10.1186/s12933-025-02693-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2025] [Accepted: 03/17/2025] [Indexed: 03/24/2025] Open
Abstract
BACKGROUND Although some studies have examined the association between the triglyceride glucose-body mass index (TyG-BMI) and cardiovascular outcomes in the cardio-renal-metabolic (CRM) background, none have explored its role in the progression of CRM multimorbidity. In addition, prior research is limited by small sample sizes and a failure to account for the competitive effects of other CRM diseases. METHODS In this study, data obtained from the large-scale, prospective UK Biobank cohort were used. CRM multimorbidity was defined as the new-onset of ischemic heart disease, type 2 diabetes mellitus, or chronic kidney disease during follow-up. Multivariable Cox regression was used to analyse the independent association between TyG-BMI and each CRM multimorbidity (first, double, or triple CRM diseases). The C-statistic was calculated for each model, and a restricted cubic spline was applied to assess the dose-response relationship. A multi-state model was used to investigate the association between TyG-BMI and the trajectory of CRM multimorbidity (from baseline [without CRM disease] to the first CRM disease, the first CRM disease to double disease, and double disease to triple disease), with disease-specific analyses. RESULTS This study included 349,974 participants, with a mean age of 56.05 (standard deviation [SD], 8.08), 55.93% of whom were female. Over a median follow-up of approximately 14 years, 56,659 (16.19%) participants without baseline CRM disease developed at least one CRM disease, including 8451 (14.92%) who progressed to double CRM disease and 789 (9.34%) who further developed triple CRM disease. In the crude model, each SD increase in TyG-BMI was associated with a 47% higher risk of the first CRM disease, a 72% higher risk of double CRM disease, and a 95% higher risk of triple CRM disease, with C-statistics of 0.625, 0.694, and 0.764, respectively. Multi-state model analysis showed a 32% increased risk of new CRM disease, a 24% increased risk of progression to double CRM disease, and a 23% increased risk of further progression for those with double CRM diseases. TyG-BMI was significantly associated with the onset of all individual first CRM diseases (except for stroke) and with the transition to double CRM disease. Significant interactions were also observed, but TyG-BMI remained significantly associated with CRM multimorbidity across subgroups. Sensitivity analyses, including varying time intervals for entering states and an expanded CRM definition (including atrial fibrillation, heart failure, peripheral vascular disease, obesity, and dyslipidaemia), confirmed these findings. CONCLUSION TyG-BMI remarkably influences the onset and progression of CRM multimorbidity. Incorporating it into CRM multimorbidity prevention and management could have important public health implications.
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Affiliation(s)
- Haoxian Tang
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515000, Guangdong, China
| | - Jingtao Huang
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Xuan Zhang
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Bone and Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Xiaojing Chen
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Qinglong Yang
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Urology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Nan Luo
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Psychiatry, Shantou University Mental Health Center, Shantou, Guangdong, China
| | - Hanyuan Lin
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Urology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Jianan Hong
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515000, Guangdong, China
| | - Shiwan Wu
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515000, Guangdong, China
| | - Cuihong Tian
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515000, Guangdong, China
| | - Mengyue Lin
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515000, Guangdong, China
| | - Junshuang Tang
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515000, Guangdong, China
| | - Jiasheng Wen
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515000, Guangdong, China
| | - Pan Chen
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515000, Guangdong, China
| | - Liwen Jiang
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515000, Guangdong, China
| | - Youti Zhang
- Department of Cardiology, Jiexi People's Hospital, Jieyang, Guangdong, China
| | - Kaihong Yi
- Department of Medical Quality Management, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xuerui Tan
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515000, Guangdong, China.
- Human Phenome Institute of Shantou University Medical College, Guangdong Engineering Research Centre of Human Phenome, Chemistry and Chemical Engineering Guangdong Laboratory, Shantou, 515063, Guangdong, China.
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515000, Guangdong, China.
| | - Yequn Chen
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515000, Guangdong, China.
- Human Phenome Institute of Shantou University Medical College, Guangdong Engineering Research Centre of Human Phenome, Chemistry and Chemical Engineering Guangdong Laboratory, Shantou, 515063, Guangdong, China.
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, 515000, Guangdong, China.
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Abdollahpour N, Seifi N, Arabi AAA, Shahri NSS, Ferasati A, Moghadam HK, Esmaily H, Ferns GA, Ghayour-Mobarhan M. The association between dietary acid load and indices of insulin resistance. Sci Rep 2025; 15:9392. [PMID: 40102445 PMCID: PMC11920251 DOI: 10.1038/s41598-024-77262-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 10/21/2024] [Indexed: 03/20/2025] Open
Abstract
The role of diet-induced acid-base imbalance in insulin resistance (IR) and related cardiometabolic abnormalities has attracted considerable attention. This study sought to investigate the association between dietary acid load and IR indices among Iranian adults. The study included 6,531 participants, with dietary acid load estimated using a validated questionnaire which comprised 65 food frequency items. The IR indices assessed included: Triglyceride to high-density lipoprotein (TG: HDL), Metabolic score for insulin resistance (METS-IR), Triglyceride Glucose-Body mass index (TyG-BMI), Triglyceride glucose (TyG), and Triglyceride glucose-waist circumference (TyG-WC). The results revealed that all IR indices were significantly higher in participants positioned in the top tertiles of dietary acid load as opposed to those in the lowest, with a notable increasing trend (p < 0.001). Using a crude model, there was a significant positive association between TG: HDL, TyG, TyG-WC, TyG-BMI, and METS-IR with dietary acid load (p < 0.001). However, in the fully adjusted model, only TyG and TyG-WC remained significant (OR=1.16, 95% CI: 1.04-1.30, and OR=1.69, 95% CI: 1.51-1.90, respectively). In summary dietary acid load is significantly associated with IR indices, with TyG-WC showing the strongest relationship.
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Affiliation(s)
- Niloufar Abdollahpour
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Najmeh Seifi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | - Ali Ferasati
- Varastegan Institute for Medical Sciences, Mashhad, Iran
| | | | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Department of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, UK
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, 99199-91766, Iran.
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Lang Y, Song X, Chen Y, Mei H, Wu C, Zhang R, Xue C. Association between the indicators of insulin resistance and periodontitis: a study using data from the National Health and Nutrition Examination Survey 2009-2014. BMC Oral Health 2025; 25:404. [PMID: 40108596 PMCID: PMC11924845 DOI: 10.1186/s12903-025-05752-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 03/04/2025] [Indexed: 03/22/2025] Open
Abstract
BACKGROUND The rising obesity rates are accompanied by an increasing prevalence of insulin resistance (IR) associated with obesity. To ascertain the best index for replacing IR, this study aimed to investigate the possible association between IR, which was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and the triglyceride-glucose (TyG) index and its derived indexes and periodontitis. METHODS The association between the indicators of IR and periodontitis was assessed via multivariate-adjusted logistic regression analyses using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2014. In addition, subgroup analyses and receiver operating characteristic curve analyses were conducted to explore possible influencing factors. RESULTS Our study encompassed 1,588 participants, and 41.0% were diagnosed with periodontitis. Based on the multivariate logistic regression analysis, a higher TyG-waist-to-height ratio (WHtR) (odds ratio [OR] = 1.14, 95% confidence interval [CI]: 1.02-1.27, P = 0.0244) and HOMA-IR score (OR = 1.00, 95% CI: 1.00-1.00, P = 0.0028) were associated with an increased risk of periodontitis. Conversely, the TyG index, TyG-adjusted for body mass index, and TyG-adjusted for waist circumference (WC) were not associated with periodontitis. According to further subgroup analyses and interaction result analyses, sex affected the association between the TyG index, TyG-WC, and TyG-WHtR and periodontitis (P < 0.05 for interaction). Moreover, the influence of age regulated the association between periodontitis and both TyG and HOMA-IR score. In terms of diagnostic accuracy, the area under the receiver operating characteristic curve analysis revealed that HOMA-IR score and TyG-WHtR slightly outperformed the TyG index, TyG-body mass index, and TyG-WC. Thus, they can be robust markers for assessing IR-related periodontitis risk. CONCLUSION A consistent and positive association was found between HOMA-IR score and TyG-WHtR and the odds of periodontitis prevalence. Hence, HOMA-IR score and TyG-WHtR were significantly associated with periodontitis in this cross-sectional study. However, prospective studies are needed to determine whether higher TyG-waist-to-height ratio and HOMA-IR score can predict the occurrence of periodontitis.
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Affiliation(s)
- Yiyuan Lang
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
- The Third Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Xin Song
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yan Chen
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Han Mei
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
- The Third Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chengyu Wu
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Rui Zhang
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Changao Xue
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
- The Third Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China.
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El-Sehrawy AAMA, Khachatryan LG, Kubaev A, Rekha MM, Rab SO, Kaur M, Singh M, Srivastava M, Kadhim AJ, Zwamel AH. Triglyceride-glucose index: a potent predictor of metabolic risk factors and eating behavior patterns among obese individuals. BMC Endocr Disord 2025; 25:71. [PMID: 40098017 PMCID: PMC11917143 DOI: 10.1186/s12902-025-01887-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 02/20/2025] [Indexed: 03/19/2025] Open
Abstract
BACKGROUND The strong potential of triglyceride to glucose index (TyG) in prediction of metabolic abnormalities is well identified in numerous disease including diabetes, metabolic syndrome and kidney disorders. However, no study is available to assess its validity and association with metabolic phenotype among obese individuals. In the current study, we aimed to evaluate the TyG index, its validity and association with metabolic parameters among obese individuals. METHODS AND MATERIALS In the current cross-sectional study, 300 obese individuals were enrolled. Their demographic, anthropometric measurements were done and laboratory parameters including serum lipids, glycemic markers and insulin resistance were evaluated. Blood pressure was also measured with standard methods. The TyG index was calculated as the ln (fasting triglyceride level [mg/dL] × fasting glucose level [mg/dL]/2). Eating pattern was measured with three factor eating behavior questionnaire (TFEQ). Receiver operator characteristic curve was used to assess the TyG validity. RESULTS Subjects at the higher TyG tertile had higher waist o hip ratio (WHR) and eating disorder compared with lowest tertiles. Also, those at the highest tertiles had significantly higher total cholesterol (TC), triglyceride (TG), and fasting blood sugar (FBS), and lower high density lipoprotein cholesterol (HDL). According to the ROC curve analysis for various metabolic parameters, TyG demonstrated the highest area under curve (AUC) value of 0.838 compared with other metabolic parameters in identification of metabolic syndrome. CONCLUSION The current study provides valuable insights into the relationship between TyG index, metabolic parameters, and eating behaviors among obese individuals.
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Affiliation(s)
| | - Lusine G Khachatryan
- Department of Pediatric Diseases, N.F. Filatov Clinical Institute of Children's Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Aziz Kubaev
- Department of Maxillofacial Surgery, Samarkand State Medical University, 18 Amir Temur Street, Samarkand, 140100, Uzbekistan.
| | - M M Rekha
- Department of Chemistry and Biochemistry, School of Sciences, JAIN (Deemed to be University), Bangalore, Karnataka, India
| | - Safia Obaidur Rab
- Central Labs, King Khalid University, AlQura'a, P.O. Box 960, AlQura'a, Abha, Saudi Arabia
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Mandeep Kaur
- Department of Sciences, Vivekananda Global University, Jaipur, Rajasthan, 303012, India
| | - Manmeet Singh
- Department of Applied Sciences, Chandigarh Engineering College, Chandigarh Group of Colleges- Jhanjeri, Mohali, Punjab, 140307, India
| | - Manish Srivastava
- Department of Endocrinology, National Institute of Medical Sciences, NIMS University Rajasthan, Jaipur, India
| | - Abed J Kadhim
- Department of Medical Engineering, Al-Nisour University College, Baghdad, Iraq
| | - Ahmed Hussein Zwamel
- Medical Laboratory Technique College, the Islamic University, Najaf, Iraq
- Medical Laboratory Technique College, The Islamic University of Al Diwaniyah, Al Diwaniyah, Iraq
- Medical Laboratory Technique College, The Islamic University of Babylon, Babylon, Iraq
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Zhao L, Zheng L, Wang R, Gong X, Wu Y, Han S, Liu L, Xue M. Association between triglyceride glucose combined with body mass index and hypertension in the NHANES 2017 to 2020. Sci Rep 2025; 15:9092. [PMID: 40097561 PMCID: PMC11914623 DOI: 10.1038/s41598-025-93723-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Accepted: 03/10/2025] [Indexed: 03/19/2025] Open
Abstract
Triglyceride glucose-body mass index (TyG-BMI), as a new surrogate index for evaluating insulin resistance (IR), has rarely been studied with the incidence rate of hypertension (HTN). This study aims to explore the correlation between TyG-BMI and HTN in American adults, to find a cost-effective and convenient marker to guide early prevention of HTN. We performed this cross-sectional study based on the NHANES database from 2017 to 2020. A multivariate logistic regression model was used to analyze the correlation between TyG-BMI and the prevalence of HTN. Additionally, stratified analysis was performed to test the robustness of the results. 3,069 eligible participants were included in our study (48.8% male, mean age 50.0 ± 17.2 years), and multivariate logistic regression analysis showed that TyG-BMI was maintained positively correlated with HTN after fully adjusting covariates. For every 10-unit increase in the TyG-BMI, the risk of HTN increases by 4.3% (95% CI: 1.007-1.08, P = 0.018). When TyG-BMI was represented as a Quartile, the relationship between TyG-BMI and increased risk of HTN remained significant, which were statistically significant for each model. Stratified analyses suggested that the correlation between TyG-BMI and HTN was more pronounced in those aged 60 years or older (P < 0.05). The correlation between TyG-BMI and HTN remained stable in all strata except the age subgroup (P > 0.05). TyG-BMI is significantly associated with HTN among American adults. Early monitoring of TyG-BMI may help to monitor early the risk of hypertension.
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Affiliation(s)
- Lin Zhao
- Xiyuan Hospital, National Clinical Research Center for Chinese Medicine Cardiology, Academy of Chinese Medical Sciences, Beijing, China
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liying Zheng
- Xiyuan Hospital, National Clinical Research Center for Chinese Medicine Cardiology, Academy of Chinese Medical Sciences, Beijing, China
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Rumeng Wang
- Xiyuan Hospital, National Clinical Research Center for Chinese Medicine Cardiology, Academy of Chinese Medical Sciences, Beijing, China
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiao Gong
- Xiyuan Hospital, National Clinical Research Center for Chinese Medicine Cardiology, Academy of Chinese Medical Sciences, Beijing, China
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanyan Wu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Senfu Han
- Xiyuan Hospital, National Clinical Research Center for Chinese Medicine Cardiology, Academy of Chinese Medical Sciences, Beijing, China
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Leshun Liu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Mei Xue
- Xiyuan Hospital, National Clinical Research Center for Chinese Medicine Cardiology, Academy of Chinese Medical Sciences, Beijing, China.
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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Gong L, Su M, Xu JH, Peng ZF, Du L, Chen ZY, Liu YZ, Chan LC, Huang YL, Chen YT, Huang FY, Piao CL. Cross-sectional study of the association between triglyceride glucose-body mass index and obstructive sleep apnea risk. World J Diabetes 2025; 16:98519. [PMID: 40093293 PMCID: PMC11885970 DOI: 10.4239/wjd.v16.i3.98519] [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: 06/28/2024] [Revised: 09/10/2024] [Accepted: 12/27/2024] [Indexed: 01/21/2025] Open
Abstract
BACKGROUND The triglyceride glucose-body mass index (TyG-BMI) is a novel indicator of insulin resistance (IR). Obstructive sleep apnea (OSA) is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep; however, the relationship between these two conditions remains unexplored. We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA. AIM To assess the association between TyG-BMI and OSA in adults in the United States. METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018. TyG-BMI was calculated as Ln [triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2] × BMI. Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence. To identify potential nonlinear relationships, we combined Cox proportional hazard regression with smooth curve fitting. We also conducted sensitivity and subgroup analyses to verify the robustness of our findings. RESULTS We included 16794 participants in the final analysis. Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence. After adjusting for all covariates, TyG-BMI was positively correlated with the prevalence of OSA (odds ratio: 1.28; 95% confidence interval: 1.17, 1.40; P < 0.001); no significant nonlinear relationship was observed. Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes. The correlation between TyG-BMI and OSA was influenced by age, sex, smoking status, marital status, hypertensive stratification, and obesity; these subgroups played a moderating role between TyG-BMI and OSA. Even after adjusting for all covariates, there was a positive association between TYG-BMI and OSA prevalence. CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA. As TyG-BMI is an indicator of IR, managing IR may help reduce the risk of OSA.
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Affiliation(s)
- Li Gong
- Department of Diabetes, Shenzhen Bao'an Chinese Medicine Hospital Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
| | - Ming Su
- Department of Pneumology, Shenzhen Bao'an Chinese Medicine Hospital Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
| | - Jing-Han Xu
- Department of Endocrinology, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
| | - Zhen-Fei Peng
- Department of Diabetes, Shenzhen Bao'an Chinese Medicine Hospital Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
| | - Lin Du
- Department of Endocrinology, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
| | - Ze-Yao Chen
- Department of Endocrinology, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
| | - Yu-Zhou Liu
- Department of Diabetes, Shenzhen Bao'an Chinese Medicine Hospital Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
| | - Lu-Cia Chan
- Department of Endocrinology, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
| | - Yin-Luan Huang
- Department of Diabetes, Shenzhen Bao'an Chinese Medicine Hospital Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
| | - Yu-Tian Chen
- Department of Diabetes, Shenzhen Bao'an Chinese Medicine Hospital Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
| | - Feng-Yi Huang
- Department of Diabetes, Shenzhen Bao'an Chinese Medicine Hospital Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
| | - Chun-Li Piao
- Department of Endocrinology, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
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Liu MJ, Pei JY, Zeng C, Xing Y, Zhang YF, Tang PQ, Deng SM, Hu XQ. Triglyceride-glucose related indices as predictors for major adverse cardiovascular events and overall mortality in type-2 diabetes mellitus patients. World J Diabetes 2025; 16:101488. [PMID: 40093282 PMCID: PMC11885977 DOI: 10.4239/wjd.v16.i3.101488] [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: 09/16/2024] [Revised: 11/05/2024] [Accepted: 12/26/2024] [Indexed: 01/21/2025] Open
Abstract
BACKGROUND Recent studies have indicated that triglyceride glucose (TyG)-waist height ratio (WHtR) and TyG-waist circumference (TyG-WC) are effective indicators for evaluating insulin resistance. However, research on the association in TyG-WHtR, TyG-WC, and the risk and prognosis of major adverse cardiovascular events (MACEs) in type 2 diabetes mellitus (T2DM) cases are limited. AIM To clarify the relation in TyG-WHtR, TyG-WC, and the risk of MACEs and overall mortality in T2DM patients. METHODS Information for this investigation was obtained from Action to Control Cardiovascular Risk in Diabetes (ACCORD)/ACCORD Follow-On (ACCORDION) study database. The Cox regression model was applied to assess the relation among TyG-WHtR, TyG-WC and future MACEs risk and overall mortality in T2DM cases. The RCS analysis was utilized to explore the nonlinear correlation. Subgroup and interaction analyses were conducted to prove the robustness. The receiver operating characteristic curves were applied to analysis the additional predicting value of TyG-WHtR and TyG-WC. RESULTS After full adjustment for confounding variables, the highest baseline TyG-WHtR cohort respectively exhibited a 1.353-fold and 1.420-fold higher risk for MACEs and overall mortality, than the lowest quartile group. Similarly, the highest baseline TyG-WC cohort showed a 1.314-fold and 1.480-fold higher risk for MACEs and overall mortality, respectively. Each 1 SD increase in TyG-WHtR was significantly related to an 11.7% increase in MACEs and a 14.9% enhance in overall mortality. Each 1 SD increase in TyG-WC corresponded to an 11.5% in MACEs and a 16.6% increase in overall mortality. Including these two indexes in conventional models significantly improved the predictive power for MACEs and overall mortality. CONCLUSION TyG-WHtR and TyG-WC were promising predictors of MACEs and overall mortality risk in T2DM cases.
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Affiliation(s)
- Mao-Jun Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - Jun-Yu Pei
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - Cheng Zeng
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - Ying Xing
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - Yi-Feng Zhang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - Pei-Qi Tang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - Si-Min Deng
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - Xin-Qun Hu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
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Huang PC, Chen HC, Huang HB, Lin YL, Chang WT, Leung SH, Chen H, Chang JW. Mediating effects of insulin resistance on lipid metabolism with elevated paraben exposure in the general Taiwan population. Front Public Health 2025; 13:1416264. [PMID: 40161019 PMCID: PMC11949955 DOI: 10.3389/fpubh.2025.1416264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 02/25/2025] [Indexed: 04/02/2025] Open
Abstract
Introduction Parabens are commonly used to prevent bacteria from growing in cosmetics and foodstuffs. Parabens have been reported to influence hormone regulation, potentially leading to metabolic anomalies, including insulin resistance and obesity. However, there is a paucity of knowledge regarding the relationship between urinary paraben levels and lipid metabolism in the general Taiwanese population. Therefore, the objective of this study was to determine whether the mediating role of insulin resistance exists between paraben exposure and lipid metabolism. Methods We selected the data of 264 adult participants from a representative survey in five major Taiwan area in 2013. UPLC tandem mass spectrometry was used to examine four urine parabens: methyl- (MeP), ethyl- (EtP), propyl- (PrP) and butyl- (BuP). Blood samples were analyzed for concentrations of glucose and lipid metabolic indices using the DxI 800 immunoassay analyzer and immunoradiometric assay kit. The relationship between urinary paraben levels and metabolism indices were evaluated through a multiple linear regression analysis. Finally, a mediation analysis was employed to understand the underlying mechanism by which paraben exposure influences lipid metabolism through insulin resistance. Results The significant positive association between MeP exposure and Castelli risk index I (CRI-I; β = 0.05, p = 0.049) was found, and also exhibited the similar associations between EtP exposure and low-density lipoprotein cholesterol (β = 0.10, p = 0.001), total cholesterol (β = 0.06, p = 0.003), and non-HDL cholesterol (NHC; β = 0.08, p = 0.005). EtP exhibited a significant positive association with triglyceride BMI (TyG-BMI; β = 0.02, p = 0.040). Additionally, TyG-BMI was positively associated with CRI-I (β = 0.98, p < 0.001), CRI-II (β = 1.03, p < 0.001) and NHC (β = 0.63, p < 0.001). Moreover, insulin resistance served as mediators for the effects of EtP exposure on lipid metabolism indices. Discussion The results indicate that changes in insulin resistance mediated the relationship between urinary paraben and lipid metabolism. Large-scale epidemiological and animal studies are warranted to identify biological mechanisms underlying validate these relationships.
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Affiliation(s)
- Po-Chin Huang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsin-Chang Chen
- Department of Chemistry, Tunghai University, Taichung, Taiwan
| | - Han-Bin Huang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Lung Lin
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Wan-Ting Chang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Shih-Hao Leung
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsi Chen
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jung-Wei Chang
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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48
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Li B, Zhang Z, Sun C, Sun Y, Li J, Liu X. Association between TyG-BMI and BPH in a national prospective cohort study. Sci Rep 2025; 15:8743. [PMID: 40082448 PMCID: PMC11906792 DOI: 10.1038/s41598-024-81629-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 11/27/2024] [Indexed: 03/16/2025] Open
Abstract
This study aims to explore the relationship between the Triglyceride Glucose Body Mass Index (TyG-BMI) and the risk of developing benign prostatic hyperplasia (BPH). Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), we included 3301 men aged 45 and above. We analyzed the association between TyG-BMI and the risk of developing BPH using multivariable logistic regression and restricted cubic spline models. During the 4-year follow-up period, 268 cases of BPH were identified. There was a positive correlation between TyG-BMI and the risk of BPH (OR 1.22, 95% CI 1.08-1.38, p < 0.001), with a significant dose-response relationship (P < 0.001). Stratified analyses indicated that the impact of TyG-BMI on BPH risk was consistent across various subgroups. There is a linear positive correlation between TyG-BMI and the risk of developing BPH. Managing TyG-BMI levels may help reduce the risk of BPH.
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Affiliation(s)
- Bing Li
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhiqiang Zhang
- Graduate School of Tianjin Medical University, Tianjin Medical University, Tianjin, China
| | - Chao Sun
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Yaodong Sun
- Department of Cardiovascular surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Junping Li
- Department of Oncology, Zibo City Municipal Hospital, Zibo, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China.
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49
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Forouzesh P, Kheirouri S, Alizadeh M. Predicting hepatic steatosis degree in metabolic dysfunction-associated steatotic liver disease using obesity and lipid-related indices. Sci Rep 2025; 15:8612. [PMID: 40074727 PMCID: PMC11904216 DOI: 10.1038/s41598-024-73132-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 09/13/2024] [Indexed: 03/14/2025] Open
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease, represents a prevalent condition ranging from simple steatosis to advanced stages associated with liver cancer. Asymptomatic presentation in the majority of cases underscores the need for non-invasive, cost-effective methods to stratify degree of hepatic steatosis. This cross-sectional study aimed to assess the association between obesity and lipid-related indices with the degree of hepatic steatosis in MASLD patients. 150 individuals recently diagnosed with metabolic dysfunction-associated steatotic liver disease were recruited. Anthropometric measurements, including weight, height, and waist circumference (WC), were taken, alongside biochemical parameters such as alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglycerides (TG), high-density lipoprotein, low-density lipoprotein, and fasting plasma glucose, following a 12-h fasting period. Various indicators of obesity and lipid metabolism, including body mass index, waist-to-height ratio (WHtR), a body shape index, lipid accumulation product (LAP), triglyceride-glucose index (TyG), visceral adiposity index, and hepatic steatosis index (HSI), were calculated. The diagnosis of MASLD and degree of hepatic steatosis were established through abdominal ultrasound examination. Data analysis was performed utilizing SPSS version 22. All the investigated indices displayed an area under the curve (AUC) surpassing 0.5, implying a correlation with the degree of hepatic steatosis. Notably, TyG-WC, TyG-WHtR, LAP, and a cardiometabolic obesity index showed the highest AUC values (> 0.7), indicating a relatively strong association with degree of hepatic steatosis. Specifically, in females, TyG-WC (AUC = 0.797, 95% CI 0.712-0.882, threshold = 865.991), while in males, LAP (AUC = 0.746, 95% CI 0.593-0.899, threshold = 74.290), demonstrated the highest AUC values. TyG-WHtR, TyG-WC, and LAP exhibited significant correlations with the degree of hepatic steatosis. Given their non-invasive nature and easy measurement, they hold promise for potential clinical utility, pending validation in additional studies.
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Affiliation(s)
- Paniz Forouzesh
- Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Attar Nishabouri St., Tabriz, 5166614711, Iran.
| | - Sorayya Kheirouri
- Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Attar Nishabouri St., Tabriz, 5166614711, Iran
| | - Mohammad Alizadeh
- Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Attar Nishabouri St., Tabriz, 5166614711, Iran
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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50
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Li W, Ge C, Zhou J. Association between TyG-BMI and early-onset hypertension: evidence from NHANES. Sci Rep 2025; 15:8595. [PMID: 40074808 PMCID: PMC11903749 DOI: 10.1038/s41598-025-92159-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2024] [Accepted: 02/25/2025] [Indexed: 03/14/2025] Open
Abstract
Early-onset hypertension (EHT) is a growing concern due to its long-term cardiovascular risks. This study investigated the association between the triglyceride glucose-body mass index (TyG-BMI) and EHT in a nationally representative US sample. EHT was defined as physician-reported hypertension diagnosed before age 40. We used weighted logistic regression models to assess the association between TyG-BMI and EHT, adjusting for potential confounders. Mediation analysis was conducted to examine the role of oxidative stress and inflammation markers in this association. We analyzed data from 5193 adults with age under 40 years from the National Health and Nutrition Examination Survey (NHANES) 2009-2018.Participants with EHT had significantly higher TyG-BMI compared to those without EHT (P < 0.001). In multivariable analysis, the highest quartile of Ty-BMI was independently associated with 6.47-fold increased odds of EHT (OR: 6.47, 95% CI: 4.35-9.61) compared to the lowest quartile. This association remained significant across subgroups stratified by gender, race, and smoking status. Gamma-glutamyl transferase (GGT) and uric acid were identified as potential mediators. Higher TyG-BMI is significantly associated with EHT. TyG-BMI may serve as a readily available clinical tool for early identification and management of individuals at increased risk for EHT, facilitating timely interventions to mitigate long-term cardiovascular risks.
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Affiliation(s)
- Wushuang Li
- Department of Critical Care Medicine, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, 530021, Guangxi, China
| | - Chenliang Ge
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Jianyong Zhou
- Department of Critical Care Medicine, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, 530021, Guangxi, China.
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