Association between triglyceride glucose index and atherosclerotic plaques and Burden: findings from a community-based study
Tóm tắt
Insulin resistance is an important cause of cardiovascular events and cerebral infarction development. We aimed to investigate the association of the triglyceride glucose (TyG) index with atherosclerotic burden and plaques in coronary, intra- and extracranial arteries in participants with non-diabetes, and compared the results with that of the homeostasis model assessment of insulin resistance (HOMA-IR). Participants without diabetes in the PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study were included. We categorized participants by tertiles of the TyG index and the concordance/discordance of the TyG index and HOMA-IR. Discordance was defined as a TyG index equal to or greater than the median and HOMA-IR less than the median, or vice versa. The atherosclerosis plaques and burden in coronary, intra- and extracranial arteries were evaluated. The association of HOMA-IR and TyG index with the presence of atherosclerotic plaques and atherosclerotic burden was assessed by binary and ordinal logistic regression models, respectively. Among 2,719 included participants, the average age was 60.9 (± 6.6) years, and 53.0% were female. Both TyG index and HOMA-IR were associated with increased odds of coronary/intra- and extracranial atherosclerotic plaques and burden after adjustment for age, sex, currenting smoking and drinking (all P < 0.05). However, the association between HOMA-IR and intracranial atherosclerosis was not statistically significant after adjustment for all potential confounders. Discordantly high TyG index with HOMA-IR had a higher odd of extracranial plaque (odds ratio [OR]: 1.34, 95% confidence interval [CI]: 1.04–1.71), extracranial atherosclerotic burden (common odds ratio [cOR]: 1.35, 95% CI 1.06–1.71), coronary plaque (OR: 1.30, 95% CI 1.01–1.68) and segment stenosis score (cOR: 1.39, 95% CI 1.09–1.78) as compared with concordantly low TyG index with HOMA-IR. The TyG index had a better net reclassification improvement ability than HOMA-IR for atherosclerotic plaques when adding to baseline model. Elevated TyG index was associated with increased odds of atherosclerosis in coronary/intra- and extracranial arteries. Compared with HOMA-IR, the TyG index was more strongly associated with intracranial atherosclerosis. Moreover, discordantly high TyG index with HOMA-IR was also important for atherosclerosis identification.
Tài liệu tham khảo
Park K, Ahn CW, Lee SB, Kang S, Nam JS, Lee BK, et al. Elevated TyG index predicts progression of coronary artery calcification. Diabetes Care. 2019;42:1569–73.
Zhao Y, Sun H, Zhang W, Xi Y, Shi X, Yang Y, et al. Elevated triglyceride-glucose index predicts risk of incident ischaemic stroke: The Rural Chinese cohort study. Diabetes Metab. 2021;47:101246.
Liang CP, Han S, Senokuchi T, Tall AR. The macrophage at the crossroads of insulin resistance and atherosclerosis. Circ Res. 2007;100:1546–55.
Farhan S, Redfors B, Maehara A, McAndrew T, Ben-Yehuda O, De Bruyne B, et al. Relationship between insulin resistance, coronary plaque, and clinical outcomes in patients with acute coronary syndromes: an analysis from the PROSPECT study. Cardiovasc Diabetol. 2021;20:10.
Bonora E, Kiechl S, Willeit J, Oberhollenzer F, Egger G, Meigs JB, et al. Insulin resistance as estimated by homeostasis model assessment predicts incident symptomatic cardiovascular disease in caucasian subjects from the general population: the Bruneck study. Diabetes Care. 2007;30:318–24.
Wang S, Shi J, Peng Y, Fang Q, Mu Q, Gu W, et al. Stronger association of triglyceride glucose index than the HOMA-IR with arterial stiffness in patients with type 2 diabetes: a real-world single-centre study. Cardiovasc Diabetol. 2021;20:82.
Zhang Y, Ding X, Hua B, Liu Q, Gao H, Chen H, et al. Predictive effect of triglycerideglucose index on clinical events in patients with type 2 diabetes mellitus and acute myocardial infarction: results from an observational cohort study in China. Cardiovasc Diabetol. 2021;20:43.
Lee EY, Yang HK, Lee J, Kang B, Yang Y, Lee SH, et al. Triglyceride glucose index, a marker of insulin resistance, is associated with coronary artery stenosis in asymptomatic subjects with type 2 diabetes. Lipids Health Dis. 2016;15:155.
Kim MK, Ahn CW, Kang S, Nam JS, Kim KR, Park JS. Relationship between the triglyceride glucose index and coronary artery calcification in Korean adults. Cardiovasc Diabetol. 2017;16:108.
Lee SB, Ahn CW, Lee BK, Kang S, Nam JS, You JH, et al. Association between triglyceride glucose index and arterial stiffness in Korean adults. Cardiovasc Diabetol. 2018;17:41.
Pan Y, Jing J, Cai X, Wang Y, Wang S, Meng X, et al. PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE)-a population-based prospective cohort study: rationale, design and baseline participant characteristics. Stroke Vasc Neurol. 2021;6:145–51.
Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, et al Status of Hypertension in China: Results From the China Hypertension Survey, 2012–2015. Circulation. 2018 137: 2344–2356.
Joint Committee on the Revision of Guidelines for Prevention and Treatment of Adult Dyslipidemia in China. Guidelines for the prevention and treatment of adult dyslipidemia in China (revised in 2016) (in Chinese). Chin Circulation J. 2016;31:937–53.
Hu C, Zhang J, Liu J, Liu Y, Gao A, Zhu Y, et al. Discordance between the triglyceride glucose index and fasting plasma glucose or HbA1C in patients with acute coronary syndrome undergoing percutaneous coronary intervention predicts cardiovascular events: a cohort study from China. Cardiovasc Diabetol. 2020;19:116.
Rana JS, Dunning A, Achenbach S, Al-Mallah M, Budoff MJ, Cademartiri F, et al. Differences in prevalence, extent, severity, and prognosis of coronary artery disease among patients with and without diabetes undergoing coronary computed tomography angiography: results from 10,110 individuals from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes): an InteRnational Multicenter Registry. Diabetes Care. 2012;35:1787–94.
Min JK, Shaw LJ, Devereux RB, Okin PM, Weinsaft JW, Russo DJ, et al. Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality. J Am Coll Cardiol. 2007;50:1161–70.
Ye Qiao EG, Fareed K, Suri L, Liu Y, Zhang Z, Anwar S, Mirbagheri, YuanYuan Joyce Xie, Nariman Nezami, Jarunee Intrapiromkul, Shuqian Zhang, Alvaro Alonso, Haitao Chu, David Couper, Bruce A, Wasserman. MR imaging Measures of intracranial atherosclerosis in a Population-based study. Radiology. 2016.
Ye Qiao PSRZ, PhD Saeedeh Mirbagheri MD, Richard Leigh MD, Victor Urrutia MD, Robert Wityk MD, Bruce MD. A. Wasserman, MD. Intracranial Plaque enhancement in Patients with cerebrovascular events on highspatial-resolution Mr images. Radiology. 2014;271:2.
Owen B. Samuels GJJ, Lynn MJ, Smith HA, Marc I. Chimowitz. A standardized method for measuring intracranial arterial stenosis. American Society of Neuroradiology. 2000: 643–646.
Allan J. Fox M. FRCPC How to measure carotid stenosis. Radiology. 1993.
Kong Q, Ma X, Wang C, Du X, Ren Y, Wan Y. Total Atherosclerosis burden of baroreceptor-resident arteries independently predicts blood pressure dipping in patients with ischemic stroke. Hypertension. 2020;75:1505–12.
Won KB, Kim YS, Lee BK, Heo R, Han D, Lee JH, et al. The relationship of insulin resistance estimated by triglyceride glucose index and coronary plaque characteristics. Med (Baltim). 2018;97:e10726.
Thai PV, Tien HA, Van Minh H, Valensi P. Triglyceride glucose index for the detection of asymptomatic coronary artery stenosis in patients with type 2 diabetes. Cardiovasc Diabetol. 2020;19:137.
Cho YR, Ann SH, Won KB, Park GM, Kim YG, Yang DH, et al. Association between insulin resistance, hyperglycemia, and coronary artery disease according to the presence of diabetes. Sci Rep. 2019;9:6129.
Wang A, Tian X, Zuo Y, Chen S, Zhang X, Guo J, et al. Association of triglyceride-glucose index with intra- and extra-cranial arterial stenosis: a combined cross-sectional and longitudinal analysis. Endocrine. 2021;74:308–17.
Bang OY. Intracranial Atherosclerotic Stroke: Specific Focus on the Metabolic Syndrome and Inflammation. 2006 8: 330–336.
V Salomaa WR, Kark JD, Nardo C, Folsom AR. Non-insulin-dependent diabetes mellitus and fasting glucose and insulin concentrations are associated with arterial stiffness indexes. The ARIC Study. Atherosclerosis Risk in Communities Study. Circulation. 1995;91:1432–43.
Wang Q, Zhao Y, Wang X, Ji X, Sang S, Shao S, et al Association between asymptomatic intracranial arterial stenosis and insulin resistance or diabetes mellitus: a cross-sectional study in rural Shandong, China. BMJ Open Diabetes Res Care. 2020 8.
Lopez-Cancio E, Galan A, Dorado L, Jimenez M, Hernandez M, Millan M, et al. Biological signatures of asymptomatic extra- and intracranial atherosclerosis: the Barcelona-AsIA (Asymptomatic Intracranial Atherosclerosis) study. Stroke. 2012;43:2712–9.
Irace C, Carallo C, Scavelli FB, De Franceschi MS, Esposito T, Tripolino C, et al. Markers of insulin resistance and carotid atherosclerosis. A comparison of the homeostasis model assessment and triglyceride glucose index. Int J Clin Pract. 2013;67:665–72.
Sascau R, Clement A, Radu R, Prisacariu C, Statescu C. Triglyceride-Rich lipoproteins and their remnants as silent promoters of atherosclerotic cardiovascular disease and other metabolic disorders: A review. Nutrients. 2021;13:1774.
GARY F. LEWIS, AC, KHOSROW ADELI, AND ADRIA GIACCA. Disordered fat storage and mobilization in the pathogenesis of insulin resistance and type 2 diabetes. Endocr Rev. 2002;23(2):201–29.