Effect of triglyceride-glucose index in evaluating adipose tissue insulin resistance

doi:10.3969/j.issn.1006-7795.2023.03.006

Abstract

Abstract: Objective Triglyceride-glucose (TyG) index is a simple surrogate indicator for insulin resistance (IR). Ectopic fat deposition caused by adipose tissue IR (adipose-IR) can lead to glucose and lipid metabolism disorders. This study aimed to investigate the value of TyG index in evaluating adipose-IR. Methods A total of 419 patients with abdominal obesity were enrolled in the study from Beijing Friendship Hospital, Capital Medical University from April 2019 to March 2022. The general clinical data and metabolic related indicators, including fasting plasma glucose, insulin, serum lipid, glycosylated hemoglobin A1c (HbA1c), free fatty acid were evaluated. According to median value of TyG index, participants were divided into high-TyG group(n=209) and low-TyG group(n=210). The glycometabolic and lipid metabolism indexes and adipose-IR index between the two groups were compared, and Logistic regression analysis was performed with TyG index and adipose-IR index. Results The average age ［(34.28±0.66） years vs （30.86±0.58） years, P<0.001］ and proportion of males (36.36% vs 31.28%, P<0.001) were significantly higher in the high-TyG group than in low-TyG group. Compared with the low-TyG group, the adipose-IR index ［144.3(77.87, 241.9) vs 104.1(63.40, 174.1), P<0.001］ and homeostasis model assessment of insulin resistance (HOMA-IR) index ［9.72(6.28, 14.17) vs 6.00(3.64, 9.84), P<0.001］ were significantly increased in the high-TyG group. The homeostasis model assessment of β-cell function (HOMA-β) index in the high-TyG group was significantly lower than that in the low TyG group (P<0.001). The TyG index positively correlated with adipose-IR index (r=0.310, P<0.001), HOMA-IR index (r=0.432, P<0.001) and HbA1c (r=0.553, P<0.001), and negatively correlated with HOMA-β (r=－0.397, P<0.001). Bivariate Logistic regression analysis revealed that TyG index was an independent influencing factor for adipose-IR, with an odds ratio (OR) of 1.004(95%CI:1.001－1.009). Conclusion TyG index was positively correlated with adipose-IR index. High TyG index predicted more severe adipose-IR. TyG index might be used as a simple method to evaluate adipose-IR in obese patients.

Key words: obesity, adipose tissue, insulin resistance, triglyceride-glucose index

CLC Number:

R589

Li Xiaohui, Yin Jie, Liu Bing, Yu Hengchi, Zhu Yingna, Ma Chifa, Yuan Mingxia. Effect of triglyceride-glucose index in evaluating adipose tissue insulin resistance[J]. Journal of Capital Medical University, 2023, 44(3): 393-399.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2023.03.006

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2023/V44/I3/393

References

［1］Collaborators G B D O, Afshin A, Forouzanfar M H, et al. Health effects of overweight and obesity in 195 countries over 25 years ［J］. N Engl J Med,2017,377(1):13－27.
［2］Hershkop K, Besor O, Santoro N, et al. Adipose insulin resistance in obese adolescents across the spectrum of glucose tolerance［J］. J Clin Endocrinol Metab, 2016,101(6):2423－2431.
［3］Scherer P E. Adipose tissue: from lipid storage compartment to endocrine organ［J］. Diabetes, 2006,55(6):1537－1545.
［4］Shulman G I. Ectopic fat in insulin resistance, dyslipidemia, and cardiometabolic disease［J］. N Engl J Med, 2014,371(12):1131－1141.
［5］Kim J Y, Bacha F, Tfayli H, et al. Adipose tissue insulin resistance in youth on the spectrum from normal weight to obese and from normal glucose tolerance to impaired glucose tolerance to type 2 diabetes［J］. Diabetes Care, 2019,42(2):265－272.
［6］Li X, Liu J, Zhou B, et al. Sex differences in the effect of testosterone on adipose tissue insulin resistance from overweight to obese adults［J］. J Clin Endocrinol Metab, 2021,106(8):2252－2263.
［7］Sanchez-Garcia A, Rodriguez-Gutierrez R, Mancillas-Adame L, et al. Diagnostic accuracy of the triglyceride and glucose index for insulin resistance: a systematic review［J］. Int J Endocrinol, 2020,2020:4678526.
［8］Zhang Y, Ding X, Hua B, 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［J］. Cardiovasc Diabetol, 2021,20(1):43.
［9］中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版) ［J］. 中华糖尿病杂志, 2021,13(4): 315－409.
［10］Guerrero-Romero F, Simental-Mendia L E, Gonzalez-Ortiz M, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp［J］. J Clin Endocrinol Metab, 2010,95(7):3347－3351.
［11］Simental-Mendia L E, Rodriguez-Moran M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects［J］. Metab Syndr Relat Disord, 2008,6(4):299－304.
［12］Avgerinos K I, Spyrou N, Mantzoros C S, et al. Obesity and cancer risk: emerging biological mechanisms and perspectives［J］. Metabolism, 2019,92:121－135.
［13］Ouchi N, Parker J L, Lugus J J, et al. Adipokines in inflammation and metabolic disease［J］. Nat Rev Immunol, 2011,11(2):85－97.
［14］Romeo G R, Lee J, Shoelson S E. Metabolic syndrome, insulin resistance, and roles of inflammation--mechanisms and therapeutic targets［J］. Arterioscler Thromb Vasc Biol, 2012,32(8):1771－1776.
［15］乔晶,刘乙君,王彦. 甘油三酯－葡萄糖指数与胰岛素抵抗相关代谢性疾病的关系［J］. 国际内分泌代谢杂志,2022,42(3):223－226.
［16］Li R, Li Q, Cui M, et al. Clinical surrogate markers for predicting metabolic syndrome in middle-aged and elderly Chinese［J］. J Diabetes Investig, 2018,9(2):411－418.
［17］Saklayen M G. The global epidemic of the metabolic syndrome［J］. Curr Hypertens Rep, 2018,20(2):12.
［18］Hackett G. Metabolic effects of testosterone therapy in men with type 2 diabetes and metabolic syndrome［J］. Sex Med Rev, 2019,7(3):476－490.
［19］Prospective Studies C. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies［J］. Lancet, 2009,373(9669):1083－1096.
［20］Cerqueira M S, Santos C A D, Silva D A S, et al. Validity of the body adiposity index in predicting body fat in adults: a systematic review［J］. Adv Nutr, 2018,9(5):617－624.
［21］Bernhard A B, Scabim V M, Serafim M P, et al. Modified body adiposity index for body fat estimation in severe obesity［J］. Hum Nutr Diet, 2017,30(2):177－184.
［22］Fedewa M V, Nickerson B S, Esco M R. Associations of body adiposity index, waist circumference, and body mass index in young adults［J］. Clin Nutr, 2019,38(2):715－720.
［23］Cree-Green M W P, Stuppy J J, Thurston J, et al. Youth with type 2 diabetes have hepatic, peripheral, and adipose insulin resistance［J］. Am J Physiol Endocrinol Metab, 2019,316(2):E186-E195.
［24］Lomonaco R, Ortiz-Lopez C, Orsak B, et al. Effect of adipose tissue insulin resistance on metabolic parameters and liver histology in obese patients with nonalcoholic fatty liver disease［J］. Hepatology, 2012,55(5):1389－1397.
［25］Muzurovic E, Mikhailidis D P, Mantzoros C. Non-alcoholic fatty liver disease, insulin resistance, metabolic syndrome and their association with vascular risk［J］. Metabolism, 2021,119:154770.
［26］Rosso C, Kazankov K, Younes R,et al. Crosstalk between adipose tissue insulin resistance and liver macrophages in non-alcoholic fatty liver disease［J］. J Hepatol, 2019,71(5):1012－1021.
［27］Guo W, Lu J, Qin P, et al. The triglyceride-glucose index is associated with the severity of hepatic steatosis and the presence of liver fibrosis in non-alcoholic fatty liver disease: a cross-sectional study in Chinese adults［J］. Lipids Health Dis, 2020,19(1):218.
［28］Zou S, Yang C, Shen R, et al. Association between the triglyceride-glucose index and the incidence of diabetes in people with different phenotypes of obesity: a retrospective study［J］. Front Endocrinol (Lausanne), 2021,12:784616.