scholarly journals The Triglyceride-Glucose Index, an Insulin Resistance Marker, Was Non-linear Associated With All-Cause and Cardiovascular Mortality in the General Population

2021 ◽  
Vol 7 ◽  
Author(s):  
Xiao-cong Liu ◽  
Guo-dong He ◽  
Kenneth Lo ◽  
Yu-qing Huang ◽  
Ying-qing Feng
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Cox Regression ◽  
Piecewise Linear ◽  
Threshold Value ◽  
Cardiovascular Death ◽  
Tyg Index ◽  
Significant Difference ◽  
Non Linear ◽  
The Relationship

Background: The triglyceride-glucose (TyG) index could serve as a convenient substitute of insulin resistance (IR), but epidemiological evidence on its relationship with the long-term risk of mortality is limited.Methods: Participants from the National Health and Nutrition Examination Survey during 1999–2014 were grouped according to TyG index (<8, 8–9, 9–10, >10). Cox regression was conducted to compute the hazard ratios (HRs) and 95% confidence interval (CI). Restricted cubic spline and piecewise linear regression were performed to detect the shape of the relationship between TyG index and mortality.Results: A total of 19,420 participants (48.9% men) were included. On average, participants were followed-up for 98.2 months, and 2,238 (11.5%) and 445 (2.3%) cases of mortality due to all-cause or cardiovascular disease were observed. After adjusting for confounders, TyG index was independently associated with an elevated risk of all-cause (HR, 1.10; 95% CI, 1.00–1.20) and cardiovascular death (HR, 1.29; 95% CI, 1.05–1.57). Spline analyses showed that the relationship of TyG index with mortality was non-linear (All non-linear P < 0.001), and the threshold value were 9.36 for all-cause and 9.52 for cardiovascular death, respectively. The HRs above the threshold point were 1.50 (95% CI, 1.29–1.75) and 2.35 (95% CI, 1.73–3.19) for all-cause and cardiovascular death. No significant difference was found below the threshold points (All P > 0.05).Conclusion: Elevated TyG index reflected a more severe IR and was associated with mortality due to all-cause and cardiovascular disease in a non-linear manner.

scholarly journals The triglyceride glucose index is a simple and low-cost marker associated with atherosclerotic cardiovascular disease: a population-based study

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Sangmo Hong ◽  
Kyungdo Han ◽  
Cheol-Young Park
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Large Scale ◽  
Large Population ◽  
Surrogate Marker ◽  
Cox Proportional Hazards ◽  
Atherosclerotic Cardiovascular Disease ◽  
Tyg Index ◽  
The Relationship

Abstract Background The triglyceride glucose (TyG) index is an inexpensive clinical surrogate marker for insulin resistance. However, the relationship between TyG index and atherosclerotic cardiovascular disease (CVD) remains unclear. We evaluated the relationship between TyG index and CVD using a large-scale population dataset from the National Health Information Database (NHID). Methods We performed a retrospective observational cohort study of 5,593,134 persons older than 40 years from 2009 to 2017 using the NHID. We divided the participants into TyG index quartiles. Outcome variables were stroke, myocardial infarction, and both. The incidence of outcomes was estimated for each TyG quartile over the total follow-up period. All outcomes were analyzed by Cox proportional hazards regression analysis while controlling for baseline covariates. Results During 8.2 years of mean follow-up, stroke was diagnosed in 89,120 (1.59%), MI in 62,577 (1.12%), and both stroke and MI in 146,744 (2.62%) participants. Multivariate-adjusted hazard ratios (HRs) for patients in the highest TyG index quartile demonstrated that these patients were at higher risk for stroke (HR = 1.259; 95% confidence interval [CI] 1.233–1.286), for MI (HR = 1.313; 95% CI 1.28–1.346), and for both (HR = 1.282; 95% CI 1.261–1.303) compared with participants in the lowest TyG index quartile. These effects were independent of age, sex, smoking, alcohol consumption, physical activity, body mass index, systolic blood pressure, and total cholesterol. Conclusions In our large population study, TyG index, a simple measure reflecting insulin resistance, was potentially useful in the early identification of individuals at high risk of experiencing a cardiovascular event.

scholarly journals A Decreased Level of Soluble Klotho Can Predict Cardiovascular Death in No or Mild Abdominal Aortic Calcification Hemodialysis Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Hong Cai ◽  
Xuying Zhu ◽  
Jiayue Lu ◽  
Minxia Zhu ◽  
Shang Liu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Regression Analysis ◽  
Mortality Rate ◽  
Cox Regression ◽  
Aortic Calcification ◽  
Multivariate Linear Regression Analysis ◽  
Kaplan Meier ◽  
Significant Difference ◽  
The Relationship ◽  
Cvd Mortality

Background: Soluble Klotho plays an important role in cardiovascular disease and death in chronic kidney disease (CKD). We assessed the relationship between serum soluble Klotho (sKL) level and outcome in MHD patients.Methods: Soluble Klotho was detected by ELISA. Cox regression analysis and Kaplan-Meier analysis showed the relationship between sKL and cardiovascular disease (CVD) mortality in maintenance hemodialysis (MHD) patients.Results: There were 45 cases (35.2%) of all-cause death and 36 cases (28.1%) of CVD mortality. Multivariate linear regression analysis showed that Log[iPTH] (γ = −0.224, P = 0.015) was an independent predictor of sKL level. Cox regression showed that lower sKL was associated with higher CVD mortality rate [OR = 0.401, 95% CI (0.183–0.867), P = 0.022]. Kaplan-Meier analysis showed that the CVD mortality rate increased significantly in patients with low sKL (P = 0.006). Compared with high sKL patients, low sKL patients with no or mild vascular calcification [aortic calcification score (AACs) ≤ 4] had no significant difference in all-cause mortality rate. The CVD mortality rate was significantly lower in high sKL patients (P = 0.004) than in those with low sKL. In the severe calcification group (AACs ≥ 5), all-cause and CVD mortality rates were similar between different sKL groups (P = 0.706 and 0.488, respectively). The area under the receiver-operating characteristic curve (AUC) of soluble Klotho for predicting the CVD in MHD patients with AACs ≤ 4 was 0.796 (0.647–0.946, P = 0.017), sensitivity was 0.921, and specificity was 0.50 for a cutoff value of 307.69 pg/ml.Conclusions: Lower sKL was associated with higher CVD mortality rate. Lower sKL concentration in MHD patients with no or mild calcification can predict CVD mortality.

scholarly journals The Profile of Timing Dialysis Initiation in Patients with End-stage Renal Disease in China: A Cohort Study

2020 ◽  
Vol 45 (2) ◽  
pp. 180-193
Author(s):  
Ying Liu ◽  
Luping Wang ◽  
Xianfeng Han ◽  
Yang Wang ◽  
Xuefeng Sun ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cox Regression ◽  
Mainland China ◽  
Dialysis Initiation ◽  
Significant Difference ◽  
Initiation Of Dialysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship

Background: Hemodialysis is the main approach for renal replacement therapy in patients with end-stage renal disease (ESRD) in China. The timing of dialysis initiation is one of the key factors influencing patient survival and prognosis. Over the past decade, the relationship between the timing of dialysis initiation and mortality has remained unclear in patients with ESRD in China. Methods: Patients who commenced maintenance hemodialysis from 2009 to 2014 from 24 hemodialysis centers in Mainland China were enrolled in the study (n = 1,674). Patients were divided into 2 groups based on the year they started hemodialysis (patients who started hemodialysis from 2009 to 2011, and patients who started hemodialysis from 2012 to 2014). Analysis of the yearly change in the estimated glomerular filtration rate (eGFR) at the initiation of dialysis was performed for the 2 groups. Meanwhile, the patients were divided into 3 groups based on their eGFR at the initiation of dialysis (<4, 4–8, and >8 mL/min/1.73 m2). For these 3 groups, the relationship between the eGFR at the start of dialysis and mortality were analyzed. Results: The average eGFRs were 5.68 and 5.94 mL/min/1.73 m2 for 2009–2011 and 2012–2014, respectively. Compared with the 2009–2011 group, the proportion of patients with diabetes in 2012–2014 increased from 26.7 to 37.7%. The prognosis of patients with different eGFRs at the start of dialysis was analyzed using Kaplan-Meier survival curves. After adjusting for confounding factors through a Cox regression model, no significant difference was demonstrated among the 3 groups (<4 mL/min/1.73 m2 was used as the reference, in comparison with 4–8 mL/min/1.73 m2 [p = 0.681] and >8 mL/min/1.73 m2 [p = 0.403]). Conclusion: In Mainland China, the eGFR at the start of dialysis did not change significantly over time from 2008 to 2014 and had no association with the mortality of patients with ESRD.

Could Be % MMEF and sGaw Determinant Diagnostic Parameters Between Partial Reversibility and Reversibility in Evaluating Short-Acting Bronchodilator Response?

2021 ◽  
Author(s):  
Gökhan Erdoğan ◽  
Elif Altuğ ◽  
Sacide Rana Işık ◽  
Levent Tabak
Keyword(s):  
Independent Predictor ◽  
Binary Logistic Regression ◽  
Threshold Value ◽  
Test Results ◽  
Binary Logistic Regression Model ◽  
Bronchodilator Response ◽  
Significant Difference ◽  
Post Hoc ◽  
The Relationship ◽  
Airway Conductance

INTRODUCTION: By examining the relationship between changes in maximum mild-expiratory flow( MMEF) and specific airway conductance(sGaw), parameters with the change in FEV1 when evaluating the spirometer test and the bronchodilator response, we investigated their diagnostic contribution to the bronchodilator response in those with partial responses to FEV1. METHODS: The retrospective study sample consists of data from 112 patients between Jun 1, 2019, and Feb 1, 2020 who applied to the pulmonary function laboratory with a pre-diagnosis of bronchial hyperreactivity as well as body plethysmography test performed together with the reversibility test. RESULTS: MMEF% and ▲sGaw were linearly correlated with ▲FEV1 (respectively r = 0.752; p <0.001, r = 0.611; p <0.001). While there was a significant difference between ▲MMEF% and ▲sGaw between reversible, partially reversible, and irreversible groups (P <0.001), there was no significant difference in ▲sGaw between partial reversible and reversible groups in post-hoc comparisons (P> 0.05). In the binary logistic regression model created between the partially reversible and reversible groups, demographic characteristics, MMEF% and ▲sGaw variables, ▲MMEF was an independent predictor [OR: 1.132; 95% CI (1.036-1.238), p = 0.006]. The 24% threshold for absolute reversibility or partial reversibility calculated with MMEF% was significant, indicating significance at 86.2% sensitivity and 80.8% specificity (AUC: 0.811, 95% CI: 0.686-0.936; p <0.001). This value we found defined 81% of the partially reversible group as reversible. DISCUSSION AND CONCLUSION: We observed that ▲sGaw alone didn' have a determinant contribution for determining reversibility in bronchodilator response, which showed partial reversibility with respect to FEV1 change. We believe that ▲MMEF% can be an independent predictor between these two groups and the calculated threshold value of 24% can be used as a criterion for determining the reversibility in cases where FEV1 is not determinant.

scholarly journals The relationship between the expression of PLIN3 and PLIN5 protein flowing endurance training in streptozotocin rats

2019 ◽  
Vol 21 (4) ◽  
pp. 194-199
Author(s):  
Mahdi Ghafari ◽  
Ebrahim Banitalebi ◽  
Mohamad Faramarzi
Keyword(s):  
Insulin Resistance ◽  
Endurance Training ◽  
High Intensity ◽  
Training Group ◽  
Control Group ◽  
High Intensity Training ◽  
Significant Difference ◽  
Post Hoc ◽  
The Relationship ◽  
Intensity Training

Background and aims: Intermuscular lipolysis disorder plays an important role in insulin resistance and diabetes mellitus and perilipin PLIN5 and PLIN3 are the key proteins in regulating muscle cellular lipolysis. Therefore, the purpose of this study was to examine the relationship between the expression of PLIN3 and PLIN5 protein following endurance training in streptozotocin (STZ) rats. Methods: A number of 24 male Wistar rats were randomly divided into low endurance training group (n = 8), high-intensity training group (n = 8), and control group (n = 8). Diabetes was induced in every rat by STZ injection. Three days after injection, the blood samples were taken from the cut tip of the tails of the mice and animals with blood glucose greater than 300 mg/dL were considered diabetic. The training program included eight weeks of aerobic training at different intensities. Training in high- and low-intensity groups included 22-25 and 5-8 m/min of training. Finally, one-way analysis of variance (ANOVA) and correlation was used to determine the significance of the differences between variables, followed by utilizing Tukey’s post-hoc test for significance. Results: The comparison between the groups by ANOVA showed significant differences in PLIN3 (P=0.0006) and PLIN5 (P=0.012). The results of Tukey post hoc test also demonstrated a statistical difference between the mean values of diabetic control group and high-intensity endurance group regarding PLIN3 (P=0.01) and PLIN5 (P=0.009), but no significant increase was observed in the lowintensity exercise group as compared to the control group (PLIN3, P=0.067 & PLIN5, P=0.44). As regards insulin resistance, there was a significant difference among the three groups (P=0.0001). Eventually, the result of the correlation between PLIN3 and PLIN5 showed similar enhancement by increasing the intensity (P=0.0026). Conclusion: According to research results, high-intensity endurance training increased the expression of PLIN3 and PLIN5 in diabetic specimens and PLIN3 and PLIN5 followed a similar increase pattern in high-intensity training

scholarly journals Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yinping Guo ◽  
Jing Zhao ◽  
Yi Zhang ◽  
Lingshan Wu ◽  
Zhiyuan Yu ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Platelet Reactivity ◽  
Multivariate Logistic Regression Analysis ◽  
Platelet Inhibition ◽  
Inhibition Rate ◽  
Stroke Patients ◽  
Tyg Index ◽  
Significant Difference

Abstract Aim Insulin resistance was reported to increase the risk of ischemic stroke, which can be assessed by the triglyceride glucose (TyG) index. However, it remains unclear whether the TyG index influences the platelet reactivity during the treatment of ischemic patients. Methods Ischemic stroke patients receiving dual antiplatelet therapy (DAPT) within 48 h onset were consecutively included. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The top quartile of TyG index was defined as insulin resistance. The platelet reactivity was assessed by thromboelastography. The platelet inhibition rate induced by arachidonic acid (AA) or adenosine diphosphate (ADP) was used to confirm the high residual on-treatment platelet reactivity (HRPR) to aspirin or clopidogrel, respectively. The association between TyG index and platelet reactivity was assessed by Kruskal–Wallis test. The independent risk factors of HRPR were determined by multivariate logistic regression analysis. Results A total of 1002 patients were included and divided into 4 groups by quartiles of the TyG index (< 2.02; 2.02–2.27; 2.27–2.52; ≥2.52). The findings demonstrated that the maximum intensity of the clot increased, but the AA-induced platelet inhibition rate decreased, depending on the TyG index quartiles. No significant difference was found in the ADP-induced platelet inhibition rate among groups. The prevalence of aspirin HRPR increased depending on the TyG index quartile. Unlike the non-insulin resistance group, the insulin resistance group was independently associated with aspirin HRPR (OR = 1.689, 95% CI 1.14 to 2.51, P = 0.009). Conclusions In acute ischemic stroke patients taking DAPT, the elevation of the TyG index is associated with enhanced platelet reactivity and higher prevalence of aspirin HRPR. Insulin resistance assessed by the TyG index could be an independent risk factor for aspirin HRPR.

scholarly journals Relationship Between Creatinine and Body Weight Ratio and Diabetes Mellitus in a Chinese Cohort Study

2021 ◽  
Author(s):  
Xinyu Wang ◽  
Zhuangsen Chen ◽  
Fan Yang ◽  
Xiaohan Ding ◽  
Changchun Cao ◽  
...  
Keyword(s):  
Body Weight ◽  
Missing Values ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Weight Ratio ◽  
Cox Proportional Hazards ◽  
Additive Models ◽  
Cox Regression Analysis ◽  
Non Linear ◽  
The Relationship

Abstract Background: Research on the relationship between Creatinine to Body Weight Ratios (Cre/BW ratios) and the prevalence of diabetes is still lacking. The aim of this study was to investigate the potential association between Cre/BW ratios and incident of diabetes in Chinese adults.Methods: This retrospective study was conducted in 199,526 patients from Rich Healthcare Group in China from 2010 to 2016. The participants were divided into quartiles of the Cre/BW ratios. Multivariate multiple imputation and dummy variables were used to handle missing values. Cox proportional-hazards regression was used to investigate the association of Cre/BW and diabetes. Generalized additive models(GAM) were used to identify non-linear relationships.Results: Of all participants,after handling missing values and adjustment for potential confounders, the multivariate Cox regression analysis results showed that Cre/BW ratios was inversely associated with diabetes risk( HR: 0.268; 95% CI:0.229 to 0.314, P < 0.00001).For men, the hazard ratios(HRs) of incident diabetes was 0.255(95%CI: 0.212-0.307);and for women HR= 0.297 (95%CI: 0.218-0.406).Moreover, sensitivity analysis confirmed the stability of the results. Furthermore, GAM revealed a saturation effect on the independent association between Cre/BW and incident of diabetes.Conclusions: This study demonstrated that increased Cre/BW is negatively correlated with incident of diabetes in Chinese for the first time. And we found that the relationship between Cre/BW and incident of diabetes was non-linear.

Abstract 13714: Clinical Utility of the Triglyceride-glucose Index Which is a Novel Marker of Insulin Resistance for Predicting the Neointimal Vulnerability After Everolimus-eluting Stent Implantation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Naotaka Akutsu ◽  
Riku Arai ◽  
Daisuke Fukamachi ◽  
Yasuo Okumura
Keyword(s):  
Insulin Resistance ◽  
Stent Implantation ◽  
Tyg Index ◽  
Index Group ◽  
Triglyceride Glucose Index ◽  
Coronary Angioscopy ◽  
High Insulin ◽  
Grade 3 ◽  
The Relationship

Introduction: Insulin resistance has been recognized as the cause of cardiovascular disease, but little is known about the influence of insulin resistance to neointimal characteristics after stent implantation. Hypothesis: The high triglyceride-glucose index (TyG index) has been reported to indirectly represent a high insulin resistance. It was hypothesized that in-stent neointimal characteristics in the high TyG index patients may be unstable more than the low TyG index patients. Methods: In 100 patients, we investigated the relationship between the neointimal characteristics and the TyG index using coronary angioscopy (CAS) and optical coherence tomography (OCT) during follow-up angiography after stent implantation. We divided into 2 groups according to the median value of TyG index (8.8). Results: The high TyG index group (n=48) had the higher yellow grade and the higher prevalence of yellow grade 3 by CAS than the low TyG index group (n=52). The prevalence of heterogeneous and layered patterns were more often observed by OCT in the high TyG index group than in the low TyG index group (Figure). Conclusions: The high TyG index strongly associated with neointimal vulnerability evaluating by CAS and OCT. The TyG index can be a useful predictor for the neointimal vulnerability after stent implantation.

scholarly journals An Approximate Analytic Solution to a Non-Linear ODE for Air Jet Velocity Decay through Tree Crops Using Piecewise Linear Emulations and Rectangle Functions

2019 ◽  
Vol 9 (24) ◽  
pp. 5440 ◽  
Author(s):  
Dario Friso
Keyword(s):  
Relative Error ◽  
Piecewise Linear ◽  
Single Equation ◽  
Air Velocity ◽  
Tree Crops ◽  
Mean Relative Error ◽  
Air Jet ◽  
Significant Difference ◽  
Non Linear ◽  
Velocity Decay

The velocity of air that crosses the canopy of tree crops when using orchard sprayers is a variable that affects pesticide dispersion in the environment. Therefore, having an equation to describe air velocity decay through the canopy is of interest. It was necessary to start from a more general non-linear ordinary differential equation (ODE) obtained from the momentum theorem. After approximating the non-linearity with some piecewise linear terms, analytic solutions were found. Subsequently, to obtain a single equation for velocity decay, a combination of these solutions was proposed by using rectangle functions formed through the hyperbolic tangent function. This single equation was assessed in comparison to the experimental value obtained on a vineyard row by measuring the air velocity at exit of canopy. The results have shown good correspondence, with a mean relative error of 6.6%; moreover, there was no significant difference. To simplify, a combination of only two linearized solutions was also proposed. Again, there was no significant difference between the experimental value and the predicted one, but the mean relative error between the two equations was 3.6%.

scholarly journals Do cigarette and alcohol affect semen analysis?

2016 ◽  
Vol 88 (1) ◽  
pp. 56 ◽  
Author(s):  
Mehmet Zeynel Keskin ◽  
Salih Budak ◽  
Saim Gubari ◽  
Kalender Durmaz ◽  
Mehmet Yoldas ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Semen Analysis ◽  
Threshold Value ◽  
Semen Parameters ◽  
Control Group ◽  
Cigarette Use ◽  
Group 4 ◽  
Semen Volume ◽  
Significant Difference ◽  
The Relationship

Objectives: There are a number of studies about the effect of cigarette and alcohol on semen parameters in the literature. There is not a consensus on the relationship between use of cigarette and alchol and semen parameters in those studies. The number of studies in which cigarette and alcohol use are evaluated together is limited. This study was aimed to analyze the effect of cigarette and/or alcohol use on semen parameters. Methods: In this prospective study, 762 patients who applied to an hospital urology polyclinic between January 2015 and March 2015 due to infertility, were questioned for alcohol and cigarette use in anamnesis. The remaining 356 patients were included in our study. Then, semen analysis of the patients was performed. The patients were divided into five groups according to cigarette use, into five groups according to alcohol use and into four groups according to cigarette and/or alcohol use. Significant differences were analyzed between the groups in terms of semen volume, semen concentration, total motility, forward motility and morphological (normality, head anomaly, neck anomaly, tail anomaly) values. Results: According to cigarette use, only in group 4 (who use more than 20 package-years cigarette) semen volume was significantly lower than the control group (Mann-Whitney U, p = 0.009). There was no significant difference in any of the other parameters and groups compared with the control group (Mann-Whitney U, p &gt; 0,05) Conclusion:According to our study, using more than 20 package- years cigarette decreases semen volume. The reason of this result might be the fact that the threshold value, from which the effect of cigarette and alcohol use on the semen parameters has to be determined.

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