Índice triglicéridos y glucosa: un indicador útil de insulinorresistencia / Triglycerides and glucose index: a useful indicator of insulin resistance

INTRODUCCIÓN: La evaluación de la insulinorresistencia requiere de metodología sofisticada de difícil aplicación. Por lo cual se han sugerido distintos estimadores de esta condición. El objetivo de este estudio fue evaluar el índice triglicéridos y glucosa (TyG) como marcador de insulinorresistencia y compararlo con la relación triglicéridos y colesterol-HDL (TG/C-HDL), en individuos con y sin síndrome metabólico (SM). MATERIAL Y MÉTODOS: Se realizó un estudio observacional, transversal, en 525 individuos adultos de una población de Bahía Blanca, Argentina, quienes fueron divididos en dos grupos: con SM (n = 89) y sin SM (n = 436). Se evaluaron las capacidades discriminativas para SM del índice TyG, calculado como Ln(TG[mg/dL] X glucosa[mg/dL]/2), y de la relación TG/C-HDL. Probabilidad pretest para SM = 30%. RESULTADOS: El valor medio del índice TyG fue mayor en el grupo con SM comparado con el grupo sin SM y fue buena su correlación con TG/C-HDL. Los puntos de corte para SM en la población total fueron: 8,8 para el índice TyG (sensibilidad = 79%, especificidad = 86%), y 2,4 para la relación TG/C-HDL (sensibilidad = 88%, especificidad = 72%). Las razones de probabilidad y probabilidades postest positivas para dichos parámetros fueron 5,8 vs. 3,1 y 72% vs. 58%, respectivamente. El punto de corte para el índice TyG en hombres fue 8,8 y en mujeres 8,7; los valores respectivos para TG/C-HDL fueron 3,1 en hombres y 2,2 en mujeres. CONCLUSIONES: El índice TyG fue un buen discriminante de SM. La simplicidad de su cálculo justifica profundizar su estudio como marcador alternativo de insulinorresistencia

INTRODUCTION: Insulin resistance assessment requires sophisticated methodology of difficult application. Therefore, different estimators for this condition have been suggested. The aim of this study was to evaluate the triglycerides and glucose (TyG) index as a marker of insulin resistance and to compare it to the triglycerides/HDL cholesterol ratio (TG/HDL-C), in subjects with and without metabolic syndrome (MS). MATERIAL AND METHODS: An observational, cross-sectional study was conducted on 525 adults of a population from Bahia Blanca, Argentina, who were divided into two groups: with MS (n = 89) and without MS (n = 436). The discriminating capacities for MS of the TyG index, calculated as Ln (TG [mg/dL] X glucose [mg/dL]/2), and the TG/HDL-C ratio were evaluated. Pre-test probability for MS was 30%. RESULTS: The mean value of the TyG index was higher in the group with MS as compared to the group without MS and its correlation with the TG/HDL-C ratio was good. The cut-off values for MS in the overall population were 8.8 for the TyG index (sensitivity = 79%, specificity = 86%), and 2.4 for the TG/HDL-C ratio (sensitivity = 88%, specificity = 72%). The positive likelihood ratios and post-test probabilities for these parameters were 5.8 vs 3.1 and 72% vs 58% respectively. The cut-off point for the TyG index was 8.8 in men and 8.7 in women; the respective values for TG/C-HDL were 3.1 in men and 2.2 in women. CONCLUSIONS: The TyG index was a good discriminant of MS. Its simple calculation warrants its further study as an alternative marker of insulin resistance

Triglycerides and glucose index: a useful indicator of insulin resistance.

INTRODUCTION: Insulin resistance assessment requires sophisticated methodology of difficult application. Therefore, different estimators for this condition have been suggested. The aim of this study was to evaluate the triglycerides and glucose (TyG) index as a marker of insulin resistance and to compare it to the triglycerides/HDL cholesterol ratio (TG/HDL-C), in subjects with and without metabolic syndrome (MS). MATERIAL AND METHODS: An observational, cross-sectional study was conducted on 525 adults of a population from Bahia Blanca, Argentina, who were divided into two groups: with MS (n=89) and without MS (n=436). The discriminating capacities for MS of the TyG index, calculated as Ln (TG [mg/dL] x glucose [mg/dL]/2), and the TG/HDL-C ratio were evaluated. Pre-test probability for MS was 30%. RESULTS: The mean value of the TyG index was higher in the group with MS as compared to the group without MS and its correlation with the TG/HDL-C ratio was good. The cut-off values for MS in the overall population were 8.8 for the TyG index (sensitivity=79%, specificity=86%), and 2.4 for the TG/HDL-C ratio (sensitivity=88%, specificity=72%). The positive likelihood ratios and post-test probabilities for these parameters were 5.8 vs 3.1 and 72% vs 58% respectively. The cut-off point for the TyG index was 8.8 in men and 8.7 in women; the respective values for TG/C-HDL were 3.1 in men and 2.2 in women. CONCLUSIONS: The TyG index was a good discriminant of MS. Its simple calculation warrants its further study as an alternative marker of insulin resistance.

Proteína C reactiva: un marcador bioquímico asociado con el síndrome metabólico y la obesidad abdominal / C-Reactive Protein: a Biomarker Associated with the Metabolic Syndrome and Abdominal Obesity / C-Reactive Protein: a Biomarker Associated with the Metabolic Syndrome and Abdominal Obesity

Con el objetivo de analizar la distribución de proteína C reactiva de alta sensibilidad en una población argentina y estudiar la asociación de este parámetro bioquímico con el síndrome metabólico y con los componentes que lo conforman, se realizó un estudio transversal que incluyó 467 pacientes adultos de ambos sexos en los que se evaluaron parámetros clínicos y bioquímicos, incluida la proteína C reactiva de alta sensibilidad. El valor de la mediana de proteína C reactiva de alta sensibilidad en la población fue de 1,3 mg/L y no se observaron diferencias entre sexos. Los sujetos con síndrome metabólico presentaron niveles superiores de proteína C reactiva de alta sensibilidad respecto de aquellos sin síndrome metabólico, 3,1 y 1,1 (p = 0,000), respectivamente. Las variables asociadas en forma independiente con una PCR > 3,0 mg/dL fueron la obesidad abdominal, el C-HDL bajo según el sexo y la presión arterial = 130/85 mm Hg (OR 3,0 p = 0,000, OR 2,5 p = 0,000 y OR 2,1 p = 0,005, respectivamente). La probabilidad relativa de que los individuos con síndrome metabólico presentaran proteína C reactiva de alta sensibilidad > 3,0 mg/L fue 4,8 veces mayor respecto de aquellos sin síndrome metabólico luego de ajustar por variables confundidoras. Los resultados obtenidos evidencian la fuerte relación existente entre tejido adiposo, enfermedad cardiovascular e inflamación.

Clinical and biochemical parameters including high sensitivity C-reactive protein of an Argentine population of 467 adult patients from both sexes were evaluated in a cross-sectional study in order to analyze the distribution of high sensitivity C-reactive protein and to study the association of this biomarker with the metabolic syndrome and its components. The median value of high sensitivity C-reactive protein in the population was of 1.3 mg/L and there were no significant differences between both sexes. Subjects with metabolic syndrome had higher levels of high sensitivity C-reactive protein compared to those without metabolic syndrome, 3.1 and 1.1 (p = 0.000), respectively. Abdominal obesity, low HDL-C levels according to sex and blood pressure = 130/85 mm Hg were independent variables associated with CRP > 3.0 mg/dL (OR 3.0 p = 0,000, OR 2.5 p = 0,000 and OR 2.1 p = 0.005, respectively). After adjusting for confounders, the relative likelihood of presenting high sensitivity C-reactive protein > 3.0 mg/L was 4.8 times greater in subjects with metabolic syndrome compared to those without metabolic syndrome. These results show a strong relation between adipose tissue, cardiovascular disease and inflammation.

Proteína C reactiva: un marcador bioquímico asociado con el síndrome metabólico y la obesidad abdominal / C-Reactive Protein: a Biomarker Associated with the Metabolic Syndrome and Abdominal Obesity / C-Reactive Protein: a Biomarker Associated with the Metabolic Syndrome and Abdominal Obesity

Con el objetivo de analizar la distribución de proteína C reactiva de alta sensibilidad en una población argentina y estudiar la asociación de este parámetro bioquímico con el síndrome metabólico y con los componentes que lo conforman, se realizó un estudio transversal que incluyó 467 pacientes adultos de ambos sexos en los que se evaluaron parámetros clínicos y bioquímicos, incluida la proteína C reactiva de alta sensibilidad. El valor de la mediana de proteína C reactiva de alta sensibilidad en la población fue de 1,3 mg/L y no se observaron diferencias entre sexos. Los sujetos con síndrome metabólico presentaron niveles superiores de proteína C reactiva de alta sensibilidad respecto de aquellos sin síndrome metabólico, 3,1 y 1,1 (p = 0,000), respectivamente. Las variables asociadas en forma independiente con una PCR > 3,0 mg/dL fueron la obesidad abdominal, el C-HDL bajo según el sexo y la presión arterial = 130/85 mm Hg (OR 3,0 p = 0,000, OR 2,5 p = 0,000 y OR 2,1 p = 0,005, respectivamente). La probabilidad relativa de que los individuos con síndrome metabólico presentaran proteína C reactiva de alta sensibilidad > 3,0 mg/L fue 4,8 veces mayor respecto de aquellos sin síndrome metabólico luego de ajustar por variables confundidoras. Los resultados obtenidos evidencian la fuerte relación existente entre tejido adiposo, enfermedad cardiovascular e inflamación.(AU)

Clinical and biochemical parameters including high sensitivity C-reactive protein of an Argentine population of 467 adult patients from both sexes were evaluated in a cross-sectional study in order to analyze the distribution of high sensitivity C-reactive protein and to study the association of this biomarker with the metabolic syndrome and its components. The median value of high sensitivity C-reactive protein in the population was of 1.3 mg/L and there were no significant differences between both sexes. Subjects with metabolic syndrome had higher levels of high sensitivity C-reactive protein compared to those without metabolic syndrome, 3.1 and 1.1 (p = 0.000), respectively. Abdominal obesity, low HDL-C levels according to sex and blood pressure = 130/85 mm Hg were independent variables associated with CRP > 3.0 mg/dL (OR 3.0 p = 0,000, OR 2.5 p = 0,000 and OR 2.1 p = 0.005, respectively). After adjusting for confounders, the relative likelihood of presenting high sensitivity C-reactive protein > 3.0 mg/L was 4.8 times greater in subjects with metabolic syndrome compared to those without metabolic syndrome. These results show a strong relation between adipose tissue, cardiovascular disease and inflammation.(AU)