Sex‐specific incidence rates and risk factors of insulin resistance and β–cell dysfunction: a decade follow‐up in a Middle Eastern population

Derakhshan, Arash; Tohidi, Maryam; Hajebrahimi, Mohammad Ali; Saadat, Navid; Azizi, Fereidoun; Hadaegh, Farzad

doi:10.1111/dme.13117

“…Moreover, consistent with our previous short-term follow-up [3], hypertriglyceridemia (in categorical analysis) and low HDL-C (in continuous analysis) remained independent risk factors, but only among women. A possible explanation for this might be related to the association of the TG/HDL-C ratio with incident IR in the study population [35].…”

Section: Discussionmentioning

confidence: 96%

Sex-Specific Incidence Rates and Risk Factors for Hypertension During 13 Years of Follow-up: The Tehran Lipid and Glucose Study

Asgari

¹

,

Moazzeni

²

,

Azizi

³

et al. 2020

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Background: Hypertension, with a prevalence of 25.6% is a serious public health concern in Iran. Objective: To investigate the population-based incidence of hypertension and its potential risk factors in Tehranian adults during a median follow-up of 13.1 years. Methods: A total of 6,533 non-hypertensive participants (women = 3,639), aged ≥20 years participated in the study. Crude and age-standardized incidence rates per 1000 person-years were calculated for each sex, separately. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for all potential risk factors. Results: The crude and age-standardized incidence rates (95% CI) of hypertension per 1000 person-years were 29.7 (27.8-31.6) and 34.9 (32.5-37.4) among men and 25.8 (24.3-27.3) and 38.7 (35.5-42.0) among women, respectively. The incidence rate of hypertension in younger age groups was higher among men. However, after the 4 th decade, the incidence rate was higher among women. Significant interactions of sex with age groups, body mass index categories, marital status, hypertriglyceridemia and glycemic categories were found in multivariable analyses (all p-values < 0.05). In the multivariable model, the risk in both sexes was found to be significantly associated with older age, obesity, and normal or high normal blood pressure (BP). Moreover, factors such as being overweight [HR: 1.20 (1.00-1.44)], former smoking [2.15 (1.52-3.04)], hypertriglyceridemia [1.23 (1.06-1.43)] and pre-diabetes status [1.19 (1.02-1.39)] were significant predictors of incident hypertension among women. Central obesity was found to be a significant predictor among men [1.26 (1.03-1.54)]. The optimism-corrected Harrell's C index (95% CI) in the categorical adjusted model was 0.75 (0.74-0.79) among men and 0.75 (0.74-0.76) among women. Conclusion: In the Tehranian population, nearly 2.7% of total participants (3% of men and 2.6% of women) develop hypertension each year. Obesity and high BP levels are the main modifiable risk factors in both sexes. Hypertriglyceridemia, prediabetes and former smoking are risk factors for hypertension among women.

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“…Although there are also data of thyroid hormone levels in the 2009–2012 database, the thyroid data in these years are subsamples of the NHANES sample, and NHANES strongly advises not to combine different subsamples from a single survey cycle in any analysis. We did not separately examine males and females, and study has shown there are differences between males and females with respect to factors associated with IR 29 , 30 .…”

Section: Discussionmentioning

confidence: 99%

Low total and free triiodothyronine levels are associated with insulin resistance in non-diabetic individuals

Wang

¹

,

Yu

²

,

Shih

³

et al. 2018

Sci Rep

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This study examined associations of thyroid hormone levels and insulin resistance (IR) in non-diabetic individuals. Using a cross-sectional design, 2007–2008 data from the National Health and Nutrition Examination Survey (NHANES) were analyzed. NHANES participants ≥20 years of age with complete data of interest were included. The homeostatic model assessment (HOMA) was used to quantify IR, and treated as a continuous variable. Self-reported diabetes or a fasting glucose ≥7 mmol/L were used as criteria to exclude diabetic subjects. Race, liver function, obesity, hypertension, dyslipidemia, smoking, physical activity, vigorous recreational activity, 2-hour glucose, hemoglobin A1C (HbA1C), high-density lipoprotein, triglyceride, vitamin D and C-reactive protein were covariates significantly associated with HOMA-IR. A total of 1,560 non-diabetic subjects were included in the analysis. When adjusted for all factors significant in the univariate analysis (race, liver function, obesity, hypertension, dyslipidemia, smoking, physical activity, vigorous recreational activity, 2-hour glucose, HbA1C, high-density lipoprotein, triglyceride, vitamin D, and CRP) low total triiodothyronine (TT3) and low free T3 (FT3) were significantly associated with decreased HOMA-IR (adjusted coefficient = −0.486, 95% confidence interval [CI]: −0.936, −0.036; adjusted coefficient = −1.151, 95% CI: −1.952, −0.350, respectively). Insulin resistance is associated with low thyroid hormone levels in non-diabetic individuals.

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“…Due to the high burden of IR and CVD among residents of the MENA region [18], we examined the association between TyG-index and incident CVD and coronary heart disease (CHD) for the first time, during a follow-up of more than a decade in the oldest cohort of the region namely the Tehran Lipid and Glucose Study (TLGS). Moreover, we also examined these associations in each gender, and among elderly vs younger adult populations.…”

Section: Introductionmentioning

confidence: 99%

The impact of triglyceride-glucose index on incident cardiovascular events during 16 years of follow-up: Tehran Lipid and Glucose Study

Barzegar

¹

,

Tohidi

²

,

Hasheminia

³

et al. 2020

Cardiovasc Diabetol

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Background To investigate whether the Triglyceride-Glucose index (TyG-index) is associated with increased risk of cardiovascular diseases (CVD)/coronary heart disease (CHD). Methods A total of 7521 Iranians aged ≥ 30 years (male = 3367) were included in the study. Multivariate Cox regression analyses (adjusted for age, gender, waist circumference, body mass index, educational level, smoking status, physical activity, family history of CVD, type 2 diabetes, hypertension, low and high density lipoprotein cholesterol, and lipid lowering drugs) were used to assess the risk of incident CVD/CHD across quintiles and for 1-standard deviation (SD) increase in the TyG-index. The cut off point for TyG-index was assessed by the minimum value of $$\sqrt {\left( {1 - sensitivity} \right)^{2} + \left( {1 - specificity} \right)^{2} }$$ 1 - s e n s i t i v i t y 2 + 1 - s p e c i f i c i t y 2 . We also examined the added value of the TyG-index in addition to the Framingham risk score when predicting CVD. Results During follow-up, 1084 cases of CVD (male = 634) were recorded. We found a significant trend of TyG-index for incident CVD/CHD in multivariate analysis (both Ps for tend ≤ 0.002). Moreover, a 1-SD increase in TyG-index was associated with significant risk of CVD/CHD in multivariate analysis [1.16 (1.07–1.25) and 1.19 (1.10–1.29), respectively]. The cut-off value of TyG-index for incident CVD was 9.03 (59.2% sensitivity and 63.2% specificity); the corresponding value of TyG-index for incident CHD was 9.03 (60.0% sensitivity and 62.8% specificity), respectively. Although no interaction was found between gender and TyG-index for CVD/CHD in multivariate analysis (both Ps for interaction > 0.085), the significant trend of TyG-index was observed only among females for incident CVD (P = 0.035). A significant interaction was found between age groups (i.e. ≥ 60 vs < 60 years) and TyG-index for CVD outcomes in the multivariate model (P-value for interaction = 0.046). Accordingly, a significant association between the TyG-index and outcomes was found only among the younger age group. Among the population aged < 60 the addition of TyG-index to the Framingham risk score (FRS) did not show improvement in the predictive ability of the FRS, using integrated discrimination improvement. Conclusion The TyG-index is significantly associated with increased risk of CVD/CHD incidence; this issue was more prominent among the younger population. However, adding TyG-index to FRS does not provide better risk prediction for CVD.

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Sex‐specific incidence rates and risk factors of insulin resistance and β–cell dysfunction: a decade follow‐up in a Middle Eastern population

Abstract: Modifiable risk factors are related to the incidence of insulin resistance and β-cell dysfunction, which can be prevented with proper strategies although the difference between men and women should be taken into account.

Cited by 18 publications

References 30 publications

Sex-Specific Incidence Rates and Risk Factors for Hypertension During 13 Years of Follow-up: The Tehran Lipid and Glucose Study

Sex-Specific Incidence Rates and Risk Factors for Hypertension During 13 Years of Follow-up: The Tehran Lipid and Glucose Study

Low total and free triiodothyronine levels are associated with insulin resistance in non-diabetic individuals

The impact of triglyceride-glucose index on incident cardiovascular events during 16 years of follow-up: Tehran Lipid and Glucose Study

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