PROGNOSTIC VALUE OF THE TRIGLYCERIDE-GLUCOSE INDEX IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE, ASTHMA AND THEIR OVERLAP

Abstract

Considering that patients with concurrent COPD and asthma frequently have metabolic disorders, special attention should be given to their detection and subsequent correction, as their presence triggers mechanisms of mutual exacerbation, and their progression worsens the prognosis.The goal is to study the correlation between the triglyceride-glucose index, bioimpedance analysis parameters, and spirometry in patients with chronic obstructive pulmonary disease, asthma, asthma-COPD overlap, and comorbid type 2 diabetes.Materials and methods. 25 patients with COPD, 23 with asthma, 25 with asthma-COPD overlap (ACO), and 33 patients with ACO and diabetes mellitus type 2 were examined. The average age of patients was 57[52;67] in the COPD cohort, 52[50;65] for asthma, 51[43;52] for asthma-COPD overlap (ACO), and 60[53.5;65] for ACO with diabetes mellitus type 2. The parameters of external respiration were determined using the BTL 08 SpiroPRO spirometer (UK), bioimpedance analysis was carried out using the portable TANITA BC-601 device (Japan). The level of triglycerides (mmol/L) was determined by the colorimetric method, and fasting glucose was determined by the glucose oxidase method. The triglyceride-glucose index was calculated using the formula: TyG index = ln [fasting TG (mg/dL) x fasting glucose (mg/dL) / 2].Results. The following correlations were established: BMI and FEV1/FVC before bronchodilation (r = 0.23, p = 0.02) and SVC (r = -0.24, p = 0.01); % fat and FVC before bronchodilation (r = -0.23, p = 0.01), as well as SVC (r = -0.21, p = 0.03); visceral fat levels with FEV1 before and after bronchodilation (r = -0.36, p < 0.001 and r = -0.35, p < 0.001) and FVC before and after bronchodilation (r = -0.32, p < 0.001 and r = -0.30, p < 0.001) and SVC (r = -0.33, p < 0.001); TyG and FEV1 before and after the bronchodilation test (r = -0.25, p = 0.01 and r = -0.28, p = 0.005), as well as FVC only after the use of bronchodilator (r = -0.25, p = 0.02).Conclusions. The bioimpedance analysis and TyG index correlate with pulmonary function test parameters (FEV1, FVC, FEV1/FVC ratio, SVC, MVV) in examined patients with COPD, asthma, ACO, and the combination of ACO and type 2 diabetes. Further research prospects. Further studies are needed to clarify the possibility of using the TyG index in clinical practice not only as an alternative indicator of insulin resistance but also as a marker of deteriorating lung function in case of airflow obstruction.