Utility of three novel insulin resistance‐related lipid indices for predicting type 2 diabetes mellitus among people with normal fasting glucose in rural China

Wang, Bingyuan; Zhang, Ming; Liu, Yu; Sun, Xizhuo; Lu, Zhen; Wang, Chongjian; Li, Linlin; Ren, Yongcheng; Han, Chulhee; Zhao, Yang; Zhou, Jun‐Mei; Pang, Chao; Li, Yin; Feng, Ting; Zhao, Jiupeng; Hu, Dongsheng

doi:10.1111/1753-0407.12642

Cited by 49 publications

(42 citation statements)

References 43 publications

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“…compared the TyG index with the euglycemic‐hyperinsulinemic clamp test, and suggested that TyG could be useful for the identification of individuals with decreased insulin sensitivity in 2010 . A series of cohort and cross‐sectional studies confirmed a strong correlation between the TyG index and IR, type 2 diabetes mellitus, MetS, hypertension, cardiovascular events and fatty liver both in China and elsewhere. Published studies have shown that the TyG index is helpful for the prediction and early identification of individuals at high risk of cardiometabolic diseases.…”

Section: Discussionmentioning

confidence: 99%

Fasting triglycerides and glucose index is more suitable for the identification of metabolically unhealthy individuals in the Chinese adult population: A nationwide study

Wang

Zhang

et al. 2018

J of Diabetes Invest

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Aims/Introduction Metabolic unhealth can be defined by the components of metabolic syndrome, which is closely connected to insulin resistance. We aimed to determine a simple index to identify metabolic unhealth in the Chinese adult population. Materials and Methods A total of 30,291 individuals were screened from the China National Diabetes and Metabolic Disorders Study carried out from June 2007 to May 2008. Metabolic unhealth was defined using components of metabolic syndrome, except waist circumference. We compared the three surrogate indices of insulin resistance : the product of fasting triglycerides and glucose (TyG), triglycerides divided by high‐density lipoprotein cholesterol and the metabolic score for insulin resistance for the evaluation of metabolic status. Results All indices had high sensitivity and specificity for the identification of metabolic unhealth, especially the TyG index with an area under the curve of 0.863 for men and 0.867 for women. Participants were divided into subgroups for further analysis. The TyG index also showed high diagnostic values, especially for younger individuals and men with normal waist circumference . Sex‐specific cut‐offs for three indices were also used to define metabolic unhealth. The TyG index showed the highest agreement with κ values of 0.603 and 0.605 for men and women between the components of metabolic syndrome and three indices. Conclusions We propose that the TyG index, just read in one blood laboratory test report, is simpler and more suitable for the identification of metabolically unhealthy individuals as well as who have high risk of cardiometabolic diseases of the Chinese adult population.

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Section: Discussionmentioning

confidence: 99%

Fasting triglycerides and glucose index is more suitable for the identification of metabolically unhealthy individuals in the Chinese adult population: A nationwide study

Wang

Zhang

et al. 2018

J of Diabetes Invest

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“…Since 2008, TyG has been compared to HOMA‐IR and HEC, and studies have suggested that TyG could be a surrogate for identifying IR Subsequently, a series of clinical studies confirmed a strong association between TyG and T2D, metabolic syndrome, hypertension, and cardiometabolic diseases . Zheng et al conducted a longitudinal study with 4686 subjects followed up for 9 years and demonstrated that TyG could predict incident hypertension among the Chinese population .…”

Section: Discussionmentioning

confidence: 99%

“…Since 2008, TyG has been compared to HOMA-IR and HEC, and studies have suggested that TyG could be a surrogate for identifying IR 12,31 Subsequently, a series of clinical studies confirmed a strong association between TyG and T2D, metabolic syndrome, hypertension, and cardiometabolic diseases. 32,33 Zheng et al conducted a…”

Section: Ir-compensatory Hyperinsulinemia Induces Carotid Body Overacmentioning

confidence: 99%

METS‐IR, a novel simple insulin resistance indexes, is associated with hypertension in normal‐weight Chinese adults

Liu¹,

Fan

Pan³

2019

J of Clinical Hypertension

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Insulin resistance (IR) plays a crucial role in the development of hypertension, so early recognition of IR is of substantial clinical importance for the management of hypertension. But traditional IR indexes are invasive, complex, and impractical. We aimed to evaluate the associations between three simple IR indexes and hypertension in different body mass index (BMI) categories. A total of 142 005 adults who did not take antihypertensive medication were included in this analysis. The ratio of triglycerides to high‐density lipoprotein cholesterol (TG/HDLc), the product of fasting triglycerides and glucose (TyG), and metabolic score for IR (METS‐IR) were calculated according to the corresponding formulas. The associations between them and hypertension were analyzed by logistic regression. Among the three indicators, only METS‐IR had positive correlations with blood pressure levels (all P < 0.001). After full adjustment, METS‐IR was significantly associated with hypertension in the normal BMI group but not in the elevated BMI group. The OR for hypertension in the normal BMI group in the highest quartile of METS‐IR was 2.884 (95% CI: 2.468‐3.369) in the total sample, 1.915 (95% CI: 1.614‐2.271) in females and 2.083 (95% CI: 1.717‐2.527) in males. Our findings indicate that METS‐IR, a simple and cost‐effective IR index, was strongly associated with hypertension in normal‐weight Chinese subjects. It could help monitor and manage hypertension in normal‐weight individuals.

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“…For anthropometric indices associated with metabolic risk, sex-specific cutoff values of BMI, WC, and WHtR are 24.12 kg/m 2 , 83.5 cm and 0.51 for males and 23.53 kg/m 2 , 77.5 cm and 0.49 for females, respectively, as derived from the Chinese elderly population [21]. Furthermore, sex-specific cut-off values of VAI and LAP associated with impaired glucose metabolism are 2.25 and 36.96 for Chinese males and 2.5 and 37.84 for Chinese females, respectively [29]. Hypertension is defined as SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg.…”

Section: Methodsmentioning

confidence: 99%

Factors associated with glycemic control in community-dwelling elderly individuals with type 2 diabetes mellitus in Zhejiang, China: a cross-sectional study

Zhu

et al. 2019

BMC Endocr Disord

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Background Although exercise seems to be beneficial for type 2 diabetes mellitus (T2DM) patients, there is limited research elucidating the optimal accessible indices of adiposity and insulin resistance for identifying elderly T2DM patients with poor glycemic control, which could be improved by performing regular exercise. Methods A community-based, cross-sectional study was conducted with 918 Chinese elderly individuals with T2DM in Zhejiang. Relevant risk factors for poor glycemic control, as determined using glycated haemoglobin A1c (HbA1c) > 7%, were explored using logistic regression analyses and included body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), fasting blood glucose (FBG), triglycerides (TGs), total cholesterol (TC), the product of fasting triglycerides and glucose (TyG), visceral adiposity index (VAI), lipid accumulation product (LAP), TyG-BMI, and TyG-WC. Comparisons of the risk factors’ ability to discriminate poor glycemic control as well as their optimal cutoff values were determined using receiver operating characteristic (ROC) analyses, and then the extent of poor glycemic control risk reduction through regular exercise was examined using multivariate logistic regression analyses. Results The overall poor glycemic control rate was 49.3%. The factors associated with poor glycemic control included FBG > 3.869, TyG > 8.73, TyG-BMI > 222.45, and TyG-WC > 713.48 in logistic regression analyses. The optimal cutoff points of FBG, TyG, TyG-WC, and TyG-BMI in discriminating poor glycemic control were 7.38, 9.22, 813.33, and 227.77, and their corresponding areas under the ROC curves were 0.864(0.840–0.886), 0.684(0.653–0.714), 0.604(0.571–0.635), and 0.574(0.541–0.606), respectively. Occasional and regular exercise reduced the odds ratios (95% confidence interval) of poor glycemic control to 0.187 (0.063–0.557) and 0.183 (0.059–0.571) for subjects with TyG-WC > 813.33 ( p = 0.008), to 0.349 (0.156–0.782) and 0.284 (0.123–0.652) for subjects with TyG > 9.22 ( p = 0.011), and to 0.390 (0.175–0.869) and 0.300(0.130–0.688) for subjects with TyG-BMI > 227.77 ( p = 0.017), respectively, after adjusting for multiple confounding factors. Conclusion Among elderly individuals with T2DM, poor glycemic control risk might be identified using indices calculated from FBG, TG, BMI, and WC measurements, which are indicative of adiposity and insulin resistance. TyG-WC seems to be an accessible and useful indicator to identify which elderly T2DM patients would benefit from performing regular exercise to achieve good glycemic control. Electronic supplementary material The online version of this article (10.1186/s12902-019-0384-1) contains supplementary material, which is available to authorized users.

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Utility of three novel insulin resistance‐related lipid indices for predicting type 2 diabetes mellitus among people with normal fasting glucose in rural China

Abstract: Prediction of T2DM was not improved by TyG, VAI, and LAP versus FPG or WC alone. Therefore, TyG, VAI, and LAP may not be inexpensive tools for predicting T2DM in rural Chinese people.

Cited by 49 publications

References 43 publications

Fasting triglycerides and glucose index is more suitable for the identification of metabolically unhealthy individuals in the Chinese adult population: A nationwide study

Fasting triglycerides and glucose index is more suitable for the identification of metabolically unhealthy individuals in the Chinese adult population: A nationwide study

METS‐IR, a novel simple insulin resistance indexes, is associated with hypertension in normal‐weight Chinese adults

Factors associated with glycemic control in community-dwelling elderly individuals with type 2 diabetes mellitus in Zhejiang, China: a cross-sectional study

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