İzole Bozulmuş Glukoz Toleransı Olan Erişkinlerde Bir İnsülin Direnci Belirteci Olarak Trigliserit-Glukoz İndeksinin Değerlendirilmesi
Öz
Giriş: Amacımız uzun dönem laboratuvar verilerini analiz ederek, izole bozulmuş açlık glukoz (BAG)'lu yetişkin popülasyon da TyG ile İnsülin Direncinin Homeostatik Modeli Değerlendirmesi (HOMA-IR) arasındaki ilişkiyi değerlendirmek ve IR'yi ön görmek için popülasyonumuzdaki TyG kesim değerini belirlemektir.
Araçlar ve Yöntem: Bu çalışmada BAG ve sağlıklı toplam 440 erişkin birey retrospektif olarak değerlendirildi. Klinik veriler tıbbi kayıtlardan toplandı. Açlık glukozu, lipid paneli [total kolesterol, trigliserid (TG), düşük dansiteli lipoprotein (LDL), yüksek dansiteli lipoprotein (HDL)] ve insülin düzeyleri ticari reaktifler kullanılarak ölçüldü. (Roche Cobas C701, Roche Diagnostic, Germany). Hemoglobin A1c (HbA1c) ise yüksek performanslı likit kromotografi (HPLC) (Lifotronic H9, Lifotrophic Technology, China) ile ölçüldü. TyG, HOMA-IR ve TG/HDL-kolesterol hesaplandı. HOMA-IR ≥2.5 olanlar IR olarak tanımlandı.
Bulgular: Çalışmamıza 230'u kontrol, 210'u BAG olan hasta dahil edildi. Kontrol hastaları için ortalama yaş 42.5±12.0 yıl ve BAG’li hasta grubu için 44.7±10.7 yıl idi. Glukoz, total kolesterol, HbA1c, TG, LDL-kolesterol, insülin, TG/HDL-kolesterol, HOMA-IR ve TyG indeksi BAG hasta grubunda anlamlı olarak yüksek bulundu (p<0.001). HOMA-IR ile TyG indeksi arasında zayıf fakat anlamlı bir korelasyon vardı (r=0.210, p=0.009). ROC analizine göre HOMA-IR için AUC 0.867 (%95 Güven Aralığı (GA), 0.833-0.900, p<0.001) ve TyG indeksi için AUC 0.708 (%95 GA, 0.659-0.758, p<0.001) bulundu.
Sonuç: Çalışmamıza göre, TyG indeksi, BAG'li hastalarda IR’nin değerlendirmesi için nispeten doğru, basit, kolay erişilebilir ve düşük maliyetli bir belirteç olarak önerilmektedir. Ancak popülasyonumuz için daha yüksek hasta katılımı olan popülasyon temelli çalışmalara ihtiyaç vardır.
Anahtar Kelimeler
HOMA-IR İnsülin direnci TG/HDL-C TyG indeksi Bozulmuş açlık glukozu Bozulmuş glukoz toleransı
Kaynakça
- 1. Gelaye B, Revilla L, Lopez T, et al. Association between insulin resistance and C-reactive protein among Peruvian adults. Diabetol Metab Syndrome. 2010;2(1):30-36.
- 2. DeFronzo RA, Tobin JD, Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol Endocrinol Metab. 1979;237:E214.
- 3. Singh B, Saxena A. Surrogate markers of insulin resistance: A review. World J Diabetes. 2010;1(2):36-47.
- 4. Simental-Mendía LE, Gamboa-Gómez CI, Aradillas-García C, Rodríguez-Morán M, Guerrero-Romero F. The triglyceride and glucose index is a useful biomarker to recognize glucose disorders in apparently healthy children and adolescents. Eur J Pediatr. 2020;179:953-958.
- 5. Simental-Mendía LE, Guerrero-Romero F. The correct formula for the triglycerides and glucose index. Eur J Pediatr. 2020;179(7):1171.
- 6. Hong S, Han K, Park CY. The triglyceride glucose index is a simple and low-cost marker associated with atherosclerotic cardiovascular disease: a population-based study. BMC Med. 2020;18(1):361.
- 7. Khan RMM, Chua ZJY, Tan JC, Yang Y, Liao Z, Zhao Y. From Pre-Diabetes to Diabetes: Diagnosis, Treatments and Translational Research; Medicina. 2019;55(9):546-550.
- 8. Shi W, Xing L, Jing L, el al. Value of triglyceride-glucose index for the estimation of ischemic stroke risk: Insights from a general population. Nutr Metab Cardiovasc Dis. 2020;30(2):245-253.
- 9. Ding X, Wang X, Wu J, et al Triglyceride-glucose index and the incidence of atherosclerotic cardiovascular diseases: a meta-analysis of cohort studies. Cardiovasc Diabetol. 2021;20(1):1-13.
- 10. Da Silva A, Caldas APS, Hermsdorff HHM, et al. Triglyceride-glucose index is associated with symptomatic coronary artery disease in patients in secondary care. Cardiovasc Diabetol. 2019;18(1):1-8.
- 11. Bakan E, Polat H, Ozarda Y, et al. A reference interval study for common biochemical analytes in eastern turkey: a comparison of a reference population with laboratory data mining. Biochem Medica. 2016; 26(2):210-223.
- 12. American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020:43(Suppl 1):14-31.
- 13. Sulistyoningrum DC, Gasevic D, Lear SA, Mente A, Devlin AM. Total and high molecular weight adiponectin and ethnic-specific differences in adiposity and insulin resistance: a cross-sectional study. Cardiovasc Diabetol. 2013;12:170.
- 14. Zhang S, Du T, Zhang J, et al. The triglyceride and glucose index (TyG) is an effective biomarker to identify nonalcoholic fatty liver disease. Lipids Health Dis. 2017;16(1):15.
- 15. Mazidi M, Kengne AP, Katsiki N, Mikhailidis DP, Banach M. Lipid accumulation product and triglycerides/glucose index are useful predictors of insulin resistance. J Diabetes Complications. 2018;32(3):266-270.
- 16. Navarro-González D, Sánchez-Íñigo L, Pastrana-Delgado J, Fernández-Montero A, Martinez JA. Triglyceride-glucose index (TyG index) in comparison with fasting plasma glucose improved diabetes prediction in patients with normal fasting glucose: The Vascular-Metabolic CUN cohort. Prev Med. 2016; 86:99-105.
- 17. Lee JW, Lim NK, Park HY. The product of fasting plasma glucose and triglycerides improves risk prediction of type 2 diabetes in middle-aged Koreans. BMC Endocr Disord. 2018;18(1):33-43.
- 18. Wen J, Wang A, Liu G, et al. Elevated triglyceride-glucose (TyG) index predicts incidence of Prediabetes: a prospective cohort study in China. Lipids Health Dis. 2020;19(1):226-236.
- 19. Huang R, Cheng Z, Jin X, et al. Usefulness of four surrogate indexes of insulin resistance in middle-aged population in Hefei, China. Ann Med. 2022;54(1):622-632.
- 20. Mohd Nor NS, Lee S, Bacha F, Tfayli H, Arslanian S. Triglyceride glucose index as a surrogate measure of insulin sensitivity in obese adolescents with normoglycemia, prediabetes, and type 2 diabetes mellitus: comparison with the hyperinsulinemic-euglycemic clamp. Pediatr Diabetes. 2016;17(6):458-465.
- 21. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95(7):3347-3351.
- 22. Sánchez-García A, Rodríguez-Gutiérrez R, Mancillas-Adame L, et al. Diagnostic Accuracy of the Triglyceride and Glucose Index for Insulin Resistance: A Systematic Review. Int J Endocrinol. 2020;2020:4678526.
- 23. Locateli JC, Lopes WA, Simões CF, et al. Triglyceride/glucose index is a reliable alternative marker for insulin resistance in South American overweight and obese children and adolescents. J Pediatr Endocrinol Metab. 2019;32(10):1163-1170.
Evaluation of the Triglyceride Glucose Index as a Marker of Insulin Resistance in Adults with Isolated Impaired Glucose Tolerance
Öz
Purpose: By analyzing long-term laboratory data, we aim to evaluate the relationship between the TyG and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in the adult population with isolated impaired fasting glucose (IFG), and also to determine the cut off value of The triglyceride (TG) to glucose index (TyG) to estimate the IR in our population.
Materials and Methods: In this study, data were evaluated retrospectively from medical records. Fasting glucose, lipid panel [Total cholesterol, TG, High-density lipoprotein (HDL), Low-density lipoprotein (LDL)] and insulin levels were analyzed with commercially reagents. (Roche Cobas C701, Roche Diagnostic, Germany). High-Performance Liquid Chromatography (HPLC) method was used for hemoglobin A1c (HbA1c) (Lifotronic H9, Lifotrophic Technology, China). TyG, HOMA-IR, and TG/HDLcholesterol were calculated. IR was defined as HOMA-IR ≥2.5.
Results: A total of 440 subject, (controls: 230 and IFG:210), were included in our study. The average age of the subjects was 42.5±12.0 years and 44.7±10.7 years for IFG and control, respectively. Glucose, total cholesterol, TG, LDL-cholesterol, insulin, HbA1c, TG/HDL-cholesterol, HOMA-IR, and TyG were significantly higher in the IFG group (p<0.001). There was a weak but significant correlation between HOMA-IR and the TyG (r=0.210, p=0.009). In the ROC analysis, the AUC for HOMA-IR and the TyG, respectively was 0.867 (95% CI, 0.833-0.900, p<0.001) and 0.708 (95% CI, 0.659-0.758, p<0.001).
Conclusions: In our study, the TyG is proposed as a relatively accurate, simple, easily accessible, and low-cost marker for IR evaluation with IFG patients. However, population-based studies with higher patient participation are needed for future studies.
Anahtar Kelimeler
HOMA-IR Insulin resistance TG/HDL-C TyG index Impaired fasting glucose Impaired glucose tolerance
Kaynakça
- 1. Gelaye B, Revilla L, Lopez T, et al. Association between insulin resistance and C-reactive protein among Peruvian adults. Diabetol Metab Syndrome. 2010;2(1):30-36.
- 2. DeFronzo RA, Tobin JD, Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol Endocrinol Metab. 1979;237:E214.
- 3. Singh B, Saxena A. Surrogate markers of insulin resistance: A review. World J Diabetes. 2010;1(2):36-47.
- 4. Simental-Mendía LE, Gamboa-Gómez CI, Aradillas-García C, Rodríguez-Morán M, Guerrero-Romero F. The triglyceride and glucose index is a useful biomarker to recognize glucose disorders in apparently healthy children and adolescents. Eur J Pediatr. 2020;179:953-958.
- 5. Simental-Mendía LE, Guerrero-Romero F. The correct formula for the triglycerides and glucose index. Eur J Pediatr. 2020;179(7):1171.
- 6. Hong S, Han K, Park CY. The triglyceride glucose index is a simple and low-cost marker associated with atherosclerotic cardiovascular disease: a population-based study. BMC Med. 2020;18(1):361.
- 7. Khan RMM, Chua ZJY, Tan JC, Yang Y, Liao Z, Zhao Y. From Pre-Diabetes to Diabetes: Diagnosis, Treatments and Translational Research; Medicina. 2019;55(9):546-550.
- 8. Shi W, Xing L, Jing L, el al. Value of triglyceride-glucose index for the estimation of ischemic stroke risk: Insights from a general population. Nutr Metab Cardiovasc Dis. 2020;30(2):245-253.
- 9. Ding X, Wang X, Wu J, et al Triglyceride-glucose index and the incidence of atherosclerotic cardiovascular diseases: a meta-analysis of cohort studies. Cardiovasc Diabetol. 2021;20(1):1-13.
- 10. Da Silva A, Caldas APS, Hermsdorff HHM, et al. Triglyceride-glucose index is associated with symptomatic coronary artery disease in patients in secondary care. Cardiovasc Diabetol. 2019;18(1):1-8.
- 11. Bakan E, Polat H, Ozarda Y, et al. A reference interval study for common biochemical analytes in eastern turkey: a comparison of a reference population with laboratory data mining. Biochem Medica. 2016; 26(2):210-223.
- 12. American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020:43(Suppl 1):14-31.
- 13. Sulistyoningrum DC, Gasevic D, Lear SA, Mente A, Devlin AM. Total and high molecular weight adiponectin and ethnic-specific differences in adiposity and insulin resistance: a cross-sectional study. Cardiovasc Diabetol. 2013;12:170.
- 14. Zhang S, Du T, Zhang J, et al. The triglyceride and glucose index (TyG) is an effective biomarker to identify nonalcoholic fatty liver disease. Lipids Health Dis. 2017;16(1):15.
- 15. Mazidi M, Kengne AP, Katsiki N, Mikhailidis DP, Banach M. Lipid accumulation product and triglycerides/glucose index are useful predictors of insulin resistance. J Diabetes Complications. 2018;32(3):266-270.
- 16. Navarro-González D, Sánchez-Íñigo L, Pastrana-Delgado J, Fernández-Montero A, Martinez JA. Triglyceride-glucose index (TyG index) in comparison with fasting plasma glucose improved diabetes prediction in patients with normal fasting glucose: The Vascular-Metabolic CUN cohort. Prev Med. 2016; 86:99-105.
- 17. Lee JW, Lim NK, Park HY. The product of fasting plasma glucose and triglycerides improves risk prediction of type 2 diabetes in middle-aged Koreans. BMC Endocr Disord. 2018;18(1):33-43.
- 18. Wen J, Wang A, Liu G, et al. Elevated triglyceride-glucose (TyG) index predicts incidence of Prediabetes: a prospective cohort study in China. Lipids Health Dis. 2020;19(1):226-236.
- 19. Huang R, Cheng Z, Jin X, et al. Usefulness of four surrogate indexes of insulin resistance in middle-aged population in Hefei, China. Ann Med. 2022;54(1):622-632.
- 20. Mohd Nor NS, Lee S, Bacha F, Tfayli H, Arslanian S. Triglyceride glucose index as a surrogate measure of insulin sensitivity in obese adolescents with normoglycemia, prediabetes, and type 2 diabetes mellitus: comparison with the hyperinsulinemic-euglycemic clamp. Pediatr Diabetes. 2016;17(6):458-465.
- 21. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95(7):3347-3351.
- 22. Sánchez-García A, Rodríguez-Gutiérrez R, Mancillas-Adame L, et al. Diagnostic Accuracy of the Triglyceride and Glucose Index for Insulin Resistance: A Systematic Review. Int J Endocrinol. 2020;2020:4678526.
- 23. Locateli JC, Lopes WA, Simões CF, et al. Triglyceride/glucose index is a reliable alternative marker for insulin resistance in South American overweight and obese children and adolescents. J Pediatr Endocrinol Metab. 2019;32(10):1163-1170.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri, Klinik Tıp Bilimleri (Diğer) |
| Bölüm | Bilimsel Araştırma Makaleleri |
| Yazarlar | |
| Erken Görünüm Tarihi | 5 Temmuz 2023 |
| Yayımlanma Tarihi | 7 Ağustos 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 7 Sayı: 2 |
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