Assessment of eight insulin resistance surrogate indexes for predicting metabolic syndrome and hypertension in Thai law enforcement officers

Abstract

Police officers in Thailand have an increased risk of heart disease, stroke, and type 2 diabetes, possibly due to a high prevalence of hypertension and metabolic syndrome (MetS). In this study, the researchers aimed to understand the relationship between surrogate markers of insulin resistance (IR) and the prevalence of MetS and hypertension in Thai police officers. The study included 7,852 police officer participants, of which 91.8% were men with an average age of 48.56 years. The prevalence of hypertension and MetS were found to be 51.1% and 30.8%, respectively, and the participants with MetS and hypertension were older compared to the regular group. The study looked at eight IR indices, including markers such as atherogenic index of plasma (AIP), lipid accumulation product (LAP), metabolic score for insulin resistance (METS-IR), triglyceride glucose (TyG) index, TyG index with body mass index (TyG-BMI), TyG index with waist circumference (TyG-WC), the ratio of triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-c), and visceral obesity index (VAI). These indices were found to be positively correlated with waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), and triglycerides (TG), while being negatively correlated with high-density lipoprotein cholesterol (HDL-c). In addition, the multiple regression analysis showed that higher quartiles of all IR indices were significantly associated with increased risks of MetS and hypertension. Interestingly, the IR indices were more accurate in predicting MetS (ranges 0.848 to 0.892) than traditional obesity indices, with the AUC difference at p < 0.001. Among the IR indices, TyG-WC performed the best in predicting MetS (AUC value 0.892 and Youden index 0.620). At the same time, TyG-BMI had the highest accuracy in predicting hypertension (AUC value of 0.659 and Youden index of 0.236). In addition, this study found that when two markers were combined for diagnosing metabolic syndrome, a significantly improved predictive value for disease risk was observed, as evidenced by higher AUC and Yoden index. Moreover, the IR indices were found to have higher predictive power for MetS and hypertension in younger police personnel (age < 48 years) than older personnel. In conclusion, this study highlights the importance of reducing cardiovascular disease risks among law enforcement personnel as a strategic goal to improve their health and wellness. The findings suggest that IR indices may be valuable tools in predicting MetS and hypertension in law enforcement personnel and could potentially aid in the early identification and prevention of law enforcement personnel health conditions.

Comparison of atherogenic indices for predicting the risk of metabolic syndrome in Southwest Iran: results from the Hoveyzeh Cohort Study (HCS)

“…Therefore, the TyG index presents a more complete evaluation of IR. Consistent with the findings of Li et al [ 31 ] and Rattanatham et al [ 16 ], we also confirmed an increase in MetS risk across TyG index quartiles. Compared with quartile 1, quartile 4 of TyG index was related to an elevated risk of MetS with an OR of 20.74 (95% CI 14.83–29, P < 0.001) in men and 52.47 (95% CI 40.48–68.02, P < 0.001) in women.…”

“…Duan et al demonstrated that the TyG index had a good predictive value (AUC between 0.841 and 0.886) in Chinese adults [ 14 ]. Another study in Thailand found that the TyG index had excellent predictive ability for MetS in law enforcement officers (AUC = 0.88) [ 16 ]. Furthermore, the excellent predictive value of the TyG index to identify MetS was found in Polish [ 15 ], Korean [ 17 ], and Taiwanese populations [ 13 ].…”

Which surrogate insulin resistance indices best predict coronary artery disease? A machine learning approach

“…The tests were conducted utilizing a biochemical autoanalyzer (BT 3000, Italy). The key exposure variables of interest were calculated using the following equations [ 18 ]: …”

“…In light of the drawbacks of direct measurement of insulin, numerous surrogate markers, based on glucose and lipid profiles as well as some anthropometric features, have emerged. These surrogate markers do not necessitate the measurement of serum insulin levels, and they have an even better correlation with the hyperinsulinemic-euglycemic clamp method compared to HOMA-IR [ 16 – 18 ]. The ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDL-C), triglyceride-glucose index (TyG index), TyG-index with body mass index (TyG-BMI), TyG index with waist circumference (TyG-WC), and metabolic score for insulin resistance (METS-IR), are the most common of these less complicated and practical markers [ 19 , 20 ].…”

Negative correlation between metabolic score for insulin resistance index and testosterone in male adults

“…TyG and TG/HDL ratio) [ 15 ]. Although the relationship between METS-IR and various diseases, such as DM [ 15 ], non-alcoholic fatty liver disease (NAFLD) [ 16 ], hyperuricemia[ 17 ], hypertension [ 18 ] and metabolic syndrome [ 19 ], has been documented in previous research, with a lack of research investigating the potential links between METS-IR and testosterone at present.…”