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Background: Women with PCOS usually suffer from metabolic disturbances and IR, which might be associated with vitamin D metabolism. The objectives of this study are to determine the association of Vitamin-D with metabolic and endocrine parameters in PCOS women and to evaluate specific role of Vitamin-D in PCOS and to correlate the serum Vitamin-D level with various demographic, anthropometric, biochemical, metabolic and hormonal parameters in PCOS patient.Methods: This case control study was carried out between July 2014 and June 2016 in the Department of Obstetrics and Gynaecology, IMS, BHU got ethical clearance from the institute. The study involved 192 patients with polycystic ovarian syndrome based on Rotterdam criteria and 200 healthy age matched women as controls. The data analysis was performed with the help of SPSS 16.0 version for windows.Results: When study subjects are compared according to vitamin-D level (sufficiency, insufficiency and deficiency) there was significant difference for BMI (kg/m2), Waist Hip ratio and TRG (mg/dl). Vitamin-D had significant negative correlation with BMI (p=0.000); Waist:Hip ratio (p=0.012); Triglyceride (p=0.022).Conclusions: Our study found an association between the high prevalence of obesity and metabolic dysfunction in women with PCOS, and vitamin-D deficiency could be secondary to obesity in such patients. Thus, vitamin-D deficiency cannot be considered as an independent factor through the development of metabolic disorders in PCOS patients.
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Background: Cardiovascular diseases (CVDs) are common in India, yet there is a lack of comprehensive studies on the specific risk factors for the Indian population. Our research aimed to identify CVD risk factors in individuals under 50 and compare them with healthy controls, offering insights into preventing CVDs in this younger demographic. Methods: This study focused on newly diagnosed cases of CVDs in males under 50 and matched controls with same demographic parameters. Data on personal, medical, lifestyle and biochemical parameters was compared to identify and understand the key risk factors associated with CVDs in this specific population group. Results: Elevated body mass index (BMI) and waist-hip ratio were linked to CVD, with BMI showing a significant association. High triglyceride (TGL) levels (>150 mg/dl) and LDL cholesterol levels (>130 mg/dl) were significantly associated with CVD. The total cholesterol to HDL cholesterol ratio (>4.5) and low HDL cholesterol (<40 mg/dl) were also linked to CVD risk. Diabetes mellitus was strongly associated with CVD (OR-14.04). Stress, as assessed by a stress score >12, was associated with CVD, although the association was not very strong (OR 1.39). Physical exercise was associated with a protective effect against CVD (OR-0.28). These findings emphasize the critical role of lifestyle factors, such as diet, exercise and stress management in CVD prevention and highlight the importance of managing conditions like obesity and diabetes. Conclusions: This study not only deepens our comprehension of CVD prevention but also provides actionable guidance for fostering heart health, both within the studied population and in broader contexts.
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Objective:To evaluate whether index of microcirculatory resistance(IMR)is associated with left ventricular(LV)remodeling in acute anterior ST elevation myocardial infarction(STEMI)pa-tients undergoing primary percutaneous coronary intervention(PPCI).Methods:This was a single-center retrospective cohort study.The patients with first anterior STEMI who received PPCI from January 2014 to August 2017 in Peking University Third Hospital was enrolled.After PPCI,IMR was measured immediately by using pressure/temperature guidewire.The success rate of IMR measurement was 100％.Also we collected some related clinical data from the medical records and laboratory results.Infarct size[assessed as creatine kinase(CK)peak],echocardiography at baseline and 1 year follow-up were as-sessed.LV adverse remodeling(LVAR)was defined as ≥20％increase in LV end-diastolic volume(LVEDV).Results:A total of forty-three patients were enrolled,with an average age of(58.7±12.4)years.The patients were divided into two groups as IMR ≤25 and IMR＞25 by normal values recommen-ded by previous literature.Compared with IMR ≤25 group,IMR＞25 group had a higher percentage of initial thrombolysis in myocardial infraction(TIMI)grade 0(95.7％vs.65.0％,P=0.029),higher serum CK peak value[4 090(383,15 833)vs.1 580(396,5 583),P=0.004].The IMR＞25 group suffered higher rates of ventricular aneurysm(30.4％vs.5.0％,P=0.021).There was no difference in LVEDV[(111.0±18.8)mL vs.(115.0±23.6)mL,P=0.503]between the two groups 1 day after MI,but after 1 year,LVEDV in IMR＞25 group was significantly higher than in IMR≤25 group[(141.5± 33.7)mLvs.(115.9±27.9)mL,P=0.018].The incidence of LVAR was more significant in IMR＞25 group(47.4％vs.11.8％,P=0.024).Binary Logistics regression showed that IMR[B=0.079,exp(B)(95％CI)=1.082(1.018-1.149),P=0.011]and serum triglyceride level[B=1.610,exp(B)(95％CI)=5.005(1.380-18.152),P=0.014]were the predictors of LVAR 1 year after MI.IMR had a good predictive value for LVAR 1 year after MI[area under the curve(AUC)=0.749,P=0.019],IMR＞29 was a good cutoff value with sensitivity 81.8％and specificity 68.0％.Conclusion:Our study elaborates that immediate measurement of IMR after PPCI in patients with STEMI can reflect the microvas-cular function.And IMR could be used as a quantitative biomarker to predict LVAR after STEMI.
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Objective To investigate the predictive value of new simplified insulin resistance(IR)assessment indexes in identifying subclinical left ventricular systolic function impairment in patients with type 2 diabetes mellitus(T2DM).Methods A total of 150 T2DM patients with preserved left ventricular ejection fraction(LVEF≥50%)who were admitted to Department of Endocrinology of the First Affiliated Hospital of Air Force Medical University from June 2021 to December 2021 were retrospectively analyzed.All patients underwent two-dimensional speckle tracking echocardiography to measure left ventricular global longitudinal strain(GLS).According to GLS value,the subjects were divided into the normal group(GLS≥18%group,n=80)and the impaired group(GLS<18%group,n=70).Some new simplified IR assessment indicators were calculated and compared between the two groups,including body mass index(BMI),TG/HDL-C ratio,triglyceride-glucose(TyG)index,TyG-BMI index,TyG-WHR and metabolic score for IR(METS-IR).Correlation between the GLS and the new simplified IR assessment indexes was analyzed.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of different simplified IR assessment indexes,with the area under the curve(AUC)calculated.Furthermore,according to whether the subjects were complicated with hypertension,binary logistics regression analysis was performed to explore the independent correlation between the simplified IR assessment index and GLS<18%.Results Total 150 were included with aged(54.5±13.7)years with 96(64.0%)men and 54(36.0%)women.Compared with the GLS≥18%group,the TG/HDL-C ratio,TyG index,TyG-BMI,and METS-IR of subjects in the GLS<18%group were significantly increased(P<0.05).Pearson correlation analysis showed that TG/HDL-C ratio,TyG index,TyG-BMI,TyG-WHR,and METS-IR were negatively correlated with GLS(P<0.05).ROC analysis showed that TyG index had a certain predictive value for the evaluation of GLS<18%(AUC=0.678,95%CI 0.591-0.765,P<0.001).Stratification based on hypertension and further adjusting for confounding factors,TyG index remains significantly associated with GLS<18%(OR=3.249,95%CI 1.045-10.103,P=0.042).Conclusions The novel simplified insulin resistance evaluation indexes are closely associated with left ventricular subclinical systolic dysfunction in T2DM patients with preserved ejection fraction.TyG index is an effective index to identify left ventricular subclinical dysfunction in these populations.
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Objective The objective of this study is to investigate whether there is a correlation between a high TyG index(serum triglyceride glucose index)and higher mortality rates among patients undergoing peritoneal dialysis(PD).Methods This study utilized a single-center retrospective cohort as the basis for its methods..From January 1,2007 to December 31,2015,a total of 519 PD patients kept under observation until December 31,2018.There searchers employed the Kaplan-Meier method and Cox proportional hazards modelsto examine the cor-relation between TyG index levels and mortality.Results Over a period of 40.5 months,104(20.0%)individuals with Parkinson's disease passed away,with 55(52.9%)of these deaths attributed to cardiovascular disease(CVD).The serum median TyG index at baseline was 8.44(6.48,11.94).Through Cox regression analysis subject to the adjustments of such parameters as gender,age,body mass index(BMI),presence of cardiovascular disease,hypertension,diabetes mellitus,hemoglobin,serum albumin,serum Ferritin,total cholesterol,renal residual function(RRF),An increased risk of all-cause mortality(HR = 2.22,95%CI:1.43～3.44,P＜0.001)and CVD mortality(HR = 2.50,95%CI:1.34～4.65,P = 0.004)was observed with a higher baseline TyG index(8.44).A comparable impact was observed in the correlation between the average TyG index over time(TA-TyG index)and both all-cause mortality and CVD mortality.(HR = 1.90,95%CI:1.25～2.90,P = 0.003;HR = 2.05,95%CI:1.14～3.70,P = 0.017,respectively).Conclusion PD patients with a higher serum TyG index have a greater risk of all-cause mortality and mortality related to cardiovascular disease.
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Objective:To investigate the correlation between triglyceride-glucose (TyG) index on admission and unfavorable outcomes of patients with moderate-to-severe traumatic brain injury (msTBI) at 6 months postinjury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 277 patients with msTBI admitted to Affiliated Jiangyin Hospital of Nantong University from January 2019 to December 2022, including 208 males and 69 females, aged 18-88 years [(57.0±15.1)years]. Glasgow Coma Scale (GCS) scores on admission were 3-8 points in 168 patients and 9-12 points in 109. According to the Glasgow Outcome Scale-Extended (GOSE) assessment at 6 months after injury, there were 121 patients with unfavorable outcomes (GOSE≤4 points) and 156 with favorable outcomes (GOSE≥5 points). The following indicators of the patients were recorded, including gender, age, history of diabetes, cause of injury, admission GCS, GCS motor score (GCSM), pupillary light reflex, worst Marshall CT classification within the first 24 hours after admission, admission TyG index, Mean Amplitude of Glycemic Excursions (MAGE) within 24 hours after admission, GCSM decline≥2 points within 72 hours after admission, craniotomy or not after admission, and prognosis, etc. TyG index served as the exposure variable focused in this study, which was calculated with fasting triglycerides and fasting blood glucose within 24 hours after admission. The 6-month prognosis of the patients was designated as the outcome variable of the study. After the patients were divided into different groups according to the three quantiles of the TyG index and unfavorable or favorable outcomes, the univariate analysis was conducted on watch variables, and variables with statistically significant differences were included in directed acyclic graphs (DAGs) for further identification of confounding variables. Factors which were found with no statistical significance in the univariate analysis but might affect insulin resistance after injury according to the authors′ previous researches were also included in the DAGs analysis. Three Logistic regression models were designed (Model 1 without correction, Model 2 with core variables of International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) corrected, and Model 3 with confounding variables screened by DAGs corrected) to analyze whether the TyG index was an independent risk factor for the prognosis of msTBI patients. The optimal Logistic regression model was selected and then restricted cubic spline (RCS) was employed to investigate the relationship between the TyG index and the unfavorable outcomes.Results:The univariate analysis suggested that there were significant differences in gender, history of diabetes, MAGE, GCSM decline, and prognosis among the three quantiles of the TyG index ( P<0.05 or 0.01). Significant differences in age, history of diabetes, GCSM, pupillary light reflex, Marshall CT classification, TyG index, MAGE and GCSM decline were observed between unfavorable and favorable outcome groups ( P<0.05 or 0.01). The results of Logistic regression analysis that identified the confounding variables that influenced the correlation between the TyG index and unfavorable prognosis with DAGs suggested that a high TyG index level was significantly correlated with unfavorable outcomes in msTBI patients. Moreover, Model 3 that was corrected with confounding variables screened by DAGs had an optimal goodness-of-fit and adaptability. Model 3-based further RCS analysis indicated that the risk of unfavorable outcomes following msTBI may increase approximately linearly with the increase in TyG index within a certain range (TyG index<9.79). Conclusions:A high TyG index level on admission is the identified as an independent risk factor for unfavorable outcomes of patients with msTBI at 6 months postinjury. As the TyG index level increases, the risk of unfavorable outcomes also rises and may show a linear increasing trend within a certain range (TyG index<9.79).
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Objective:To investigate the diagnostic value of non-high-density lipoprotein cholesterol (non-HDL-C),ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C), and triglyceride glucose index (TyG) on metabolic syndrome (MS) in adult women.Methods:This was a cross-sectional study. A total of 24 410 adult women who received health examination in health management center of the Affiliated Hospital of Southwest Medical University were selected from January 2019 to December 2021 as subjects. The subjects′ basic information, physical examination results, and laboratory examination data were collected retrospectively. The relationship between non-HDL-C, TG/HDL-C, TyG, and MS in adult women were examined using multivariate logistic regression analysis. The receiver operating characteristic (ROC) curves were constructed and the area under the curve (AUC) were calculated to evaluate the diagnostic value of each indicator for MS in adult women.Results:Among 24 410 adult females, 800 (3.3%) were found to have MS. After adjusting for age, body mass index, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, blood uric acid, history of hypertension, history of diabetes, fatty liver, non HDL-C ( OR=1.608), TG/HDL-C ( OR=1.311), TyG ( OR=13.288) were all risk factors for MS in adult women. non-HDL-C, TG/HDL-C, and TyG, as well as their combined AUC of ROC, were 0.795 (95% CI: 0.742-0.776), 0.909 (95% CI: 0.902-0.917), 0.942 (95% CI: 0.937-0.948), and 0.944 (95% CI: 0.937-0.950), respectively. TyG had the highest diagnostic value for MS in adult women among the three indicators, the optimal cutoff value for TyG was 8.237, with a sensitivity of 93.5% and a specificity of 85.5%. Conclusion:non-HDL-C, TG/HDL-C, TyG, as well as their combination, all demonstrate good diagnostic value for MS in adult women.
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Objective To investigate the correlation of ceramides(Cer),triglyceride-glucose(TyG)index,residual cholesterol(RC)and intracranial atherosclerotic stenosis(ICAS)in elderly with ischemic stroke(IS).Methods A total of 209 elderly IS patients admitted in the Affiliated Hospi-tal of Xuzhou Medical University from January to December 2022 were recruited,and according to intracranial artery stenosis,they were divided into stenosis group(n=122)and non-stenosis group(n=87).TyG index and RC levels were calculated after testing different types of Cer.Spearman correlation analysis and logistic regression analysis were used.Results Compared with the non-stenosis group,the stenosis group had significantly larger proportions of higher levels of LP(a),HbA1c,TyG index,RC and Cer16∶0,Cer18∶0,Cer24∶1,Cer16∶0/Cer24∶0,Cer24∶1/24∶0 and Cer18∶0/24∶0,and lower Cer24∶ 0 level(P＜0.05,P＜0.01).The levels of Cer16∶0,Cer18∶0,Cer24∶1,Cer16∶0/24∶0,Cer18∶0/24∶0,Cer24∶1/24∶0,LP(a),HbA1c,TyG index and RC were positively correlated with(r=0.290,0.343,0.383,0.436,0.434,0.481,0.166,0.248,0.140,0.204,P＜0.05,P＜0.01),and Cer24∶0 was negatively with ICAS(r=-0.247,P＜0.01).Cer18∶0,Cer24∶1,Cer16∶0/Cer24∶0,Cer18∶0/Cer24∶0 and RC were important influencing factors for ICAS(P＜0.05,P＜0.01).Conclusion The levels of Cer,TyG index and RC are higher in elderly IS patients,and these indicators might be the risk factors for ICAS.
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Objective:To investigate the correlation between metabolic syndrome (MS)and recurrent acute pancreatitis (RAP).Methods:From June 1, 2012 to June 1, 2023, 463 patients with RAP (recurrent group) who visited the First Affiliated Hospital of Chongqing Medical University were retrospectively collected. The clinical data of 463 patients without RAP (non-recurrent group) during the same period were randomly selected. The patients in the recurrence group were treated at the First Affiliated Hospital of Chongqing Medical University for both initial acute pancreatitis and RAP. The differences in the proportion of patients combined with MS and its components (obesity (body mass index ≥25 kg/m 2), fasting blood triglyceride (TG) ≥1.7 mmol/L, hypertension, hyperglycemia, fasting blood high-density lipoprotein cholesterol (HDL-C) <1.04 mmol/L) between the two groups were analyzed by Chi-square test. Binary logistic regression analysis was used to identify the risk factors of acute pancreatitis recurrence. Results:Among the 463 patients in the recurrent group, there were 221 patients (47.7%) with MS, 276 patients (59.6%) with obesity, 223 patients (48.2%) with hypertension, 185 patients (40.0%) with hyperglycemia, and 365 patients (78.8%) with fasting blood TG ≥1.7 mmol/L. Among the 463 patients in the non-recurrence group, there were 95 patients (20.5%) with MS, 245 patients (52.9%) with obesity, 115 patients (24.8%) with hypertension, 92 patients (19.9%) with hyperglycemia, and 301 patients (65.0%) with fasting blood TG ≥ 1.7 mmol/L. The percentages of MS, obesity, hypertension, hyperglycemia, and fasting blood TG ≥1.7 mmol/L of the recurrent group were all higher than those of the non-recurrent group, and the differences were statistically significant ( χ2=76.27, 4.22, 54.35, 44.55, 21.90; P<0.001, =0.040, <0.001, <0.001, <0.001). There was no statistically significant difference in the percentage of patients with fasting blood HDL-C <1.04 mmol/L between the recurrent group and the non-recurrent group (68.5%, 317/463 vs. 65.4%, 303/463, P>0.05). The results of binary logistic regression analysis showed that combined with MS ( OR=3.538, 95% confidence interval (95% CI) 2.647 to 4.728), hypertension ( OR=2.700, 95% CI 2.025 to 3.602), hyperglycemia ( OR=2.228, 95% CI 1.633 to 3.039), and fasting blood TG ≥1.7 mmol/L ( OR=1.757, 95% CI 1.276 to 2.421) all significantly increased the risk of acute pancreatitis recurrence ( P<0.001, <0.001, <0.001, =0.001). Obesity was not an independent risk factor for RAP ( OR=0.967, 95% CI 0.727 to 1.286, P=0.816). Conclusion:The combination of MS, hypertension, hyperglycemia, and fasting blood TG ≥1.7 mmol/L are independent risk factors for RAP.
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Objective The high incidence, disability, and mortality rates of stroke result in a heavy economic and social burden. The aim of this study was to investigate the relationship between triglyceride-glucose (TyG) index and new-onset stroke to assist in the identification of high-risk groups for stroke and to provide ideas for effective prevention. Methods The study was based on data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 and included 7630 eligible middle-aged and elderly participants. The association between TyG index and new-onset stroke was assessed by logistic regression modelling and restricted triple spline analysis. Results A total of 431 participants had a new stroke. The TyG index was found to be a risk factor for stroke occurrence when it was >8.523, and there was a positive linear association moderated by gender. Conclusion Elevated TyG index is a risk factor for new stroke. This study provides new ideas for the identification of high-risk groups for stroke and for intervention measures and timing.
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Objective To investigate the relationship between combined plasma ferritin and triglyceride (TG) concentrations in early pregnancy and the risk of gestational diabetes mellitus (GDM). Methods A total of 1 000 pregnant women who had antenatal care at the Sixth Hospital of Wuhan from January 2021 to January 2023 were selected as the research subjects. The cut-offs of ferritin and TG were analyzed by using unrestricted cube splines. All participants were divided into 4 groups according to the cut‐off values of ferritin and TG. Associations between combined ferritin and TG concentrations and GDM risk were estimated using multivariable logistic regression models. Results A total of 158 (15.8%) participants were diagnosed with GDM. The ferritin and TG levels in early pregnancy of pregnant women in the GDM group were significantly higher than those in the non-GDM group (P<0.05). After adjusting for potential confounders, the OR for the risk of developing GDM after combining ferritin with TG was 2.35 (1.65, 3.35). Couclusion The increase in plasma ferritin and TG concentrations in early pregnancy is positively correlated with the increased risk of GDM. Pregnant women with high plasma ferritin (˃65.7 ng/mL) and high TG (˃1.9mmoL/L) have the greatest risk of GDM.
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OBJECTIVES@#To explore the relationship of triglyceride-glucose index (TyG), triglyceride-glucose-body mass index (TyG-BMI), and triglyceride-glucose-waist circumference index (TyG-WC) with blood pressure abnormalities in adolescents, providing theoretical basis for the prevention and control of hypertension in adolescents.@*METHODS@#A stratified cluster sampling method was used to select 1 572 adolescents aged 12 to 18 years in Yinchuan City for questionnaire surveys, physical measurements, and laboratory tests. Logistic regression analysis and restricted cubic spline analysis were employed to examine the relationship of TyG, TyG-BMI, and TyG-WC with blood pressure abnormalities in adolescents.@*RESULTS@#Multivariable logistic regression analysis revealed that after adjusting for confounding factors, the groups with the highest quartile of TyG, TyG-BMI, and TyG-WC had 1.48 times (95%CI: 1.07-2.04), 3.71 times (95%CI: 2.67-5.15), and 4.07 times (95%CI: 2.89-5.73) higher risks of blood pressure abnormalities compared to the groups with the lowest quartile, respectively. Moreover, as the levels of TyG, TyG-BMI, and TyG-WC increased, the risk of blood pressure abnormalities gradually increased (P<0.05). A non-linear dose-response relationship was observed between TyG-BMI and the risk of blood pressure abnormalities (P overall trend<0.001, P non-linearity=0.002). Linear dose-response relationships were found between TyG and the risk of blood pressure abnormalities (P overall trend<0.001, P non-linearit =0.232), and between TyG-WC and the risk of blood pressure abnormalities (P overall trend<0.001, P non-linearity=0.224).@*CONCLUSIONS@#Higher levels of TyG and its derivatives are associated with an increased risk of blood pressure abnormalities in adolescents, with linear or non-linear dose-response relationships.
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Adolescent , Humans , Blood Pressure , Body Mass Index , Hypertension/etiology , Glucose , TriglyceridesABSTRACT
Objective To investigate the influence and predictive value of systemic immune inflammation(SII),fibrinogen(Fib)and triglyceride glucose index(TyG)on the risk of diabetic kidney disease(DKD).Methods A total of 1073 patients with type 2 diabetes mellitus(T2DM)admitted to The Endocrinology Department of Hebei Yiling Hospital Affiliated to Hebei Medical University were enrolled in this study from January 2020 to December 2022.All the patients were divided into two groups according to the urinary protein creatinine ratio:DKD group(UACR≥30 mg/g,DKD,n=412)and simple T2DM group(UACR<30 mg/g,T2DM,n=661).Pearson correlation analysis was used to evaluat the correlation between SII,TyG,Fib and other indicators.Multiple logistic regression analysis was used to find the influencing factors for DKD.The clinical value of Fib,SII,TyG,and combined indicators in diagnosing DKD was tested by receiver operating characteristic(ROC)curve analysis.Results Compared with T2DM group,age,duration of DM,FPG,TG,TyG,cystatin C(CysC),glutamyl transpeptidase,SUA,homocysteine,SII,neutrophil count,Fib and D-D were increased(P＜0.05 or P＜0.01),while albumin(ALB)and HDL-C were decreased(P＜0.05 or P＜0.01)in DKD group.Pearson correlation analysis showed that SII was positively correlated with CysC,Scr,SUA,Fib,FDP,and D-D(P＜0.05 or P＜0.01),and negatively correlated with eGFR,ALB(P＜0.01);TyG is positively correlated with SUA(P＜0.01);Fib is positively correlated with CysC,Scr(P＜0.01),and negatively correlated with eGFR(P＜0.01).Multiple logistic regression analysis showed that TyG and Fib were the influencing factors for DKD.The ROC curve analysis showed that the area under the ROC curve for the combined index was 0.679,with a specificity of 74.2%,a sensitivity of 53.5%,and an optimal cutoff value of 0.276.Conclusion SII and Fib can directly cause renal function damage in DKD,while IR promotes DKD progression through metabolic disorders.The combined predictive value of Fib,SII,and TyG for DKD risk is superior to a single indicator.
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Objective To explore the predictive role of the triglyceride-glucose(TyG)index in patients with acute ischemic stroke(AIS)treated with alteplase thrombolysis and create a comprehensive predictive model integrating multiple factors for assessing patient out-comes.Methods The clinical data of 302 patients with AIS undergoing alteplase intravenous thrombolysis at the Neurology Department of Fushun Central Hospital from January 2019 to October 2022 were retrospectively analyzed.The patients were categorized into a good prognosis group(n= 193)and a poor prognosis group(n= 109)based on their mRS scores at 90 days post-thrombolysis.Univariate and multivariate logistic regression analyses were employed to identify risk factors influencing adverse outcomes and to establish a predictive model.The predictive performance of the model was assessed using receiver operating characteristic(ROC)curve analysis.Results The results of the multivariate logistic regression analysis revealed that pre-thrombolysis high NIHSS score and TyG index≥9.37 were inde-pendent risk factors for unfavorable prognosis in AIS patients.A predictive model for AIS patient prognosis was successfully established:Logit(Y)=-17.167 + 1.681×TyG index+0.147×pre-thrombolysis NIHSS score.The optimal cutoff value for the TyG index was 9.37.The ROC areas under the curve for predicting unfavorable prognosis in AIS patients at 90 days post-thrombolysis were 0.713 for TyG index,0.705 for pre-thrombolysis NIHSS score,and 0.787 for the combined variable(Y),with the combined variable(Y)exhibiting the largest ROC curve area.Conclusion TyG index≥9.37 and pre-thrombolysis high NIHSS score are independent risk factors for poor prognosis.The combined variable the combined variable(Y)has higher predictive efficiency than the separate variables.
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Objective To analyze the co-expressed genes in blood lipid metabolism, hyperlipidemia and tacrolimus metabolism and their correlation with blood lipid levels in kidney transplant recipients. Methods Co-expressed genes were screened from Comparative Toxicogenomic Database (CTD). Baseline data of 25 kidney transplant recipients were collected. The expression levels of ATP binding cassette subfamily A member 1(ABCA1), peroxisome proliferator activated receptor γ (PPAR-γ) and glycosylphosphatidylinositol anchored high density lipoprotein binding protein 1 (GPIHBP1) were measured. All recipients were followed up. The concentrations of fasting blood glucose, glycosylated hemoglobin, triglyceride, total protein, albumin, globulin, cholesterol, high-density lipoprotein, low-density lipoprotein and tacrolimus blood concentration were collected at postoperative 1, 3, 6 and 12 months, and the incidence of hyperlipidemia in the recipients was analyzed. The correlation between ABCA1, GPIHBP1, PPAR-γ and clinical indexes was assessed. The diagnostic efficiency of related indexes for hyperlipidemia after kidney transplantation was evaluated. Results Three co-expressed genes including ABCA1, PPAR-γ and GPIHBP1 were screened. ABCA1 was positively correlated with cholesterol level at postoperative 6 months and tacrolimus blood concentration at postoperative 3 months, whereas negatively correlated with fasting blood glucose level at postoperative 3 months (all P<0.05). GPIHBP1 was negatively correlated with preoperative cholesterol and triglyceride levels, whereas positively correlated with tacrolimus blood concentration at postoperative 3 months (all P<0.05). PPAR-γ was negatively correlated with preoperative globulin and low-density lipoprotein levels (both P<0.05). ABCA1, GPIHBP1 and PPAR-γ combined with preoperative globulin and blood glucose level at postoperative 1 and 6 months after operation yielded high diagnostic efficiency for hypertriglyceridemia after kidney transplantation (AUC=0.900). ABCA1, GPIHBP1 and PPAR-γ combined with tacrolimus blood concentrations at postoperative 1 and 6 months and blood glucose level at postoperative 6 months had high diagnostic efficiency for hypercholesterolemia after kidney transplantation (AUC=0.931). Conclusions ABCA1, GPIHBP1 and PPAR-γ are correlated with blood lipid level and tacrolimus blood concentration after kidney transplantation to different degrees. No definite evidence has been supported for predicting hyperlipidemia after kidney transplantation. Immunity improvement and rational blood glucose management may be beneficial factors for hyperlipidemia control.
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SUMMARY BACKGROUND: Subfatin, a newly discovered adipokine, plays a pivotal role in the regulation of glucose metabolism. The relationship between gestational diabetes mellitus and maternal dyslipidemia is well-documented. AIMS: This study aims to assess serum subfatin levels and the triglyceride/high-density lipoprotein cholesterol ratio in women with one abnormal glucose tolerance test value and those with gestational diabetes mellitus. METHODS: In this case-control study, 105 pregnant women were categorized into three groups: women with normal 3-h oral glucose tolerance test results (n=35), women with one abnormal 3-h oral glucose tolerance test result (n=35), and women diagnosed with gestational diabetes mellitus (n=35). Serum subfatin levels were measured using human enzyme-linked immunosorbent assay kits. RESULTS: Serum subfatin levels were significantly lower in the gestational diabetes mellitus group (0.94±0.15 ng/mL) compared to the normal oral glucose tolerance test group (1.48±0.55 ng/mL) and the group with one abnormal oral glucose tolerance test result (1.50±0.59 ng/mL). The triglyceride/high-density lipoprotein cholesterol ratio was also lower in the healthy control group than in the gestational diabetes mellitus and one abnormal oral glucose tolerance test result groups. CONCLUSION: Serum subfatin levels in women with one abnormal abnormal glucose tolerance test value are compared to those in the control group, while the triglyceride/high-density lipoprotein cholesterol ratio is significantly altered in women with one abnormal abnormal glucose tolerance test value when compared to the control group.
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ABSTRACT Background: Insulin resistance (IR) contributes to the development of hypertension and mediated organ damage (HMOD) through various mechanisms. Objectives: The objective of the study was to assess the diagnostic performance of the triglyceride-glucose (TyG) index, a surrogate marker of IR, in predicting the presence and severity of HMOD in newly diagnosed untreated hypertensive patients from an academic training and research hospital. Methods: The study included 438 patients with newly diagnosed, untreated hypertension. The control group comprised normotensive individuals matched on a 1:1 ratio based on age, gender, body mass index, and smoking using the nearest neighbor method. The presence of HMOD was defined by renal damage (microalbuminuria > 30 mg/day or proteinuria > 150 mg/day), vascular damage (carotid intima-media thickness > 0.9 mm or presence of plaque), or cardiac damage (left ventricular mass index > 95 g/m2 in women and > 115 g/m2 in men). The severity of HMOD was considered as single-, two-, or triple-organ damage. Results: TyG index values were higher in the hypertensive group than the normotensive group. An increased TyG index was independently associated with HMOD (OR: 1.33, p < 0.001). The TyG index exhibited gradually increasing threshold values for distinguishing patients with single-organ HMOD (> 8.8 with 77.8% sensitivity and 74.3% specificity), two-organ HMOD (> 9.1 with 77.6% sensitivity and 71.4% specificity), and triple-organ HMOD (> 9.4 with 71.5% sensitivity and 87.7% specificity). Conclusions: In newly diagnosed hypertensive patients, the TyG index exhibits significant diagnostic performance in predicting multiple-organ damage beyond the presence of HMOD. Since the detection of multiple-organ HMOD requires a multidisciplinary approach, the TyG index can serve as a simple and inexpensive screening tool.
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ABSTRACT Background: Nonalcoholic fatty pancreatic disease (NAFPD) is an increase of fat in the pancreas, and has an important association with insulin resistance (IR) and type 2 diabetes mellitus. Research has confirmed that the triglyceridemia/glycemia (TyG) index determines IR as much as does the hyperinsulinemic-euglycemic clamp assessment as the homeostasis model testing of IR (HOMA-IR). Objective: To evaluate the association between degree of NAFPD and TyG index. Methods: In 72 patients undergoing ultrasound of abdomen with a diagnosis of NAFPD, insulin, glucose, and triglycerides levels were evaluated. The HOMA-IR and TyG indexes were used as a reference for IR. The degrees of NAFPD and the TyG index were presented through the receiver operating characteristics (ROC) curves in order to evaluate the association between different degrees of NAFPD, and the correlation of NAFPD with HOMA-IR was also evaluated. Results: There was a statistically significant correlation between the degree of NAFPD and the TyG index. The AUROC curve for the TyG index for predicting the degree of NADPD was 0.855 (0.840-0.865). The intensity-adjusted probabilities of the degree of NAFPD were more strongly associated with TyG values when compared with HOMA-IR. Conclusion: In this study the TyG index correlated positively with the degree of NAFPD, performing better than HOMA-IR.
RESUMO Contexto: A doença pancreática gordurosa não alcoólica (DPGNA) é um aumento de gordura pancreática, e tem uma importante associação com a resistência à insulina (RI) e com diabetes mellitus tipo 2. Pesquisas confirmaram que o índice triglicérides/glicemia (TyG) determina a RI tanto quanto a avaliação da clamp hiperinsulinêmico-euglicêmico como o teste do modelo de homeostasia da RI (HOMA-IR). Objetivo: Avaliar a associação entre o grau de DPGNA e o índice TyG. Métodos: Em 72 pacientes submetidos a ultrassonografia do abdome com diagnóstico de DPGNA, foram avaliados os níveis de insulina, glicose e triglicérides. Os índices HOMA-IR e TyG foram usados como referência para RI. Os graus de DGPNA e o índice TyG foram apresentados através da curva ROC com o objetivo de avaliar a associação entre diferentes graus de DPGNA, e a correlação do DGPNA com o HOMA-IR também foi avaliada. Resultados: Houve uma correlação estatisticamente significativa entre o grau de DPGNA e o índice TyG. A curva AUROC para o índice TyG para prever o grau do NADPD foi 0,855 (0,840-0,865). As probabilidades ajustadas de intensidade do grau de NAFPD foram mais fortemente associadas aos valores de TyG quando comparadas com o HOMA-IR. Conclusão: Neste estudo, o índice TyG correlacionou-se positivamente com o grau de DPGNA, tendo um desempenho melhor que o índice HOMA-IR.
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Background: Dyslipidemia in PCOS has multifactorial causation and insulin resistance plays a pivotal role by stimulation of lipolysis and altered lipases which are characterized by higher triglyceride and lower high-density lipoprotein cholesterol.1Methods: This observational cross-sectional study was conducted in the obstetrics and gynaecology department of SPS hospital Ludhiana Punjab and included 60 women with PCOS and 30 non PCOS women of age group 18-40 who meet the inclusion criteria.Results: PCOS women with BMI <18.5 (underweight) their mean cholesterol, HDL, LDL, VLDL and triglycerides were 158.00, 48.00, 74.00, 35.60, 178.00 respectively. PCOS women with BMI ranging from >18.5-24.99 (normal) the mean±SD for cholesterol, HDL, LDL, VLDL and triglycerides were 169.50 ± 21.83, 44.86±2.66, 85.80±20.33, 38.84±3.57, 194.18±17.86 respectively. PCOS Subjects with BMI25-29.99 (overweight) Mean±SD for total cholesterol was 197.04±18.16, HDL=40.48±3.19, LDL=112.37±18.10, VLDL=44.20±2.89 and for triglycerides was 221.00±14.45.Conclusions: An early treatment for obesity should be a priority to prevent cardiometabolic complications in future in women with Polycystic ovaries syndrome.
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The mammalian carboxylesterase 1 (Ces1/CES1) family comprises several enzymes that hydrolyze many xenobiotic chemicals and endogenous lipids. To investigate the pharmacological and physiological roles of Ces1/CES1, we generated Ces1 cluster knockout (Ces1 -/- ) mice, and a hepatic human CES1 transgenic model in the Ces1 -/- background (TgCES1). Ces1 -/- mice displayed profoundly decreased conversion of the anticancer prodrug irinotecan to SN-38 in plasma and tissues. TgCES1 mice exhibited enhanced metabolism of irinotecan to SN-38 in liver and kidney. Ces1 and hCES1 activity increased irinotecan toxicity, likely by enhancing the formation of pharmacodynamically active SN-38. Ces1 -/- mice also showed markedly increased capecitabine plasma exposure, which was moderately decreased in TgCES1 mice. Ces1 -/- mice were overweight with increased adipose tissue, white adipose tissue inflammation (in males), a higher lipid load in brown adipose tissue, and impaired blood glucose tolerance (in males). These phenotypes were mostly reversed in TgCES1 mice. TgCES1 mice displayed increased triglyceride secretion from liver to plasma, together with higher triglyceride levels in the male liver. These results indicate that the carboxylesterase 1 family plays essential roles in drug and lipid metabolism and detoxification. Ces1 -/- and TgCES1 mice will provide excellent tools for further study of the in vivo functions of Ces1/CES1 enzymes.