Fasting Plasma Triglyceride Research Articles

Positive Changes in Body Composition and Profiles of Individuals with Diabetes 3 Years Following Laparoscopic Sleeve Gastrectomy in Japanese Patients with Obesity.

We analyzed the changes in obesity, glucose metabolism, and body composition over a 3-year period in Japanese patients with obesity following laparoscopic sleeve gastrectomy (LSG). Body weight, parameters related to diabetes such as glycated hemoglobin (HbA1c), and electrical impedance analysis were used to assess body composition in forty-eight Japanese patients with obesity before surgery and 6 months, 1 year, 2 years, and 3 years after LSG. At 6 months, 1, 2, and 3 years post-LSG, there were significant reductions in body weight, body mass index, blood pressure, fasting plasma glucose, triglyceride, and HbA1c levels. Six months after LSG, fat mass (FM), muscle mass (MM), and %FM all showed a decrease compared to pre-treatment values (all p < 0.05). FM and %FM remained in a decreased state until 3 years had passed. In contrast, %MM increased at 6 months post-LSG and was maintained up to 3 years post-LSG (all p < 0.05). Furthermore, changes in FM and %FM were associated with changes in body weight and A1C. In contrast, change in %MM exhibited a negative correlation with body weight and A1C following LSG. Finally, multivariate regression analyses demonstrated that alterations in FM were independent factors affecting body weight in patients with obesity 3 years after LSG. We observed improvements in FM, fasting plasma glucose, and HbA1c levels over a 3-year period in Japanese patients after LSG. The reduction in FM and maintenance of %MM after LSG were suggested as possible links between the effects of LSG on obesity and diabetes over 3 years.

Association of prior tuberculosis with cardiovascular status in perinatally HIV-1-infected adolescents

BackgroundWhether, and how, co-occurring HIV-1 infection (HIV) and tuberculosis (TB) impact cardiovascular status, especially in adolescents with perinatally acquired HIV (APHIV), have not been examined. We hypothesised that APHIV with...

Case detection of familial hypercholesterolemia using various criteria during an annual health examination in the workplace

BackgroundEarly diagnosis and appropriate treatment of subjects with familial hypercholesterolemia (FH) could prevent cardiovascular disease (CAD). ObjectiveWe aimed to identify potential cases of FH during a workplace screening and to explore their clinical data. MethodPersonnel who attended an annual health examination were invited to answer a questionnaire and to provide consent to review their laboratory results. FH was clinically diagnosed using any one of the three standard criteria: Dutch Lipid Clinic Network (DLCN), Simon Broome (SB), and Make Early Diagnosis to Prevent Early Deaths (MEDPED). Clinical characteristics were compared between FH and unlikely FH subjects. ResultsAmong 6607 participants, potential cases of FH were identified in 2.5 % by DLCN, 4.0 % by SB, and 0.8 % by MEDPED alone. Premature CAD, hypertension, and current smoking were significantly more common in potential FH subjects than in unlikely FH subjects. Potential FH subjects also had significantly higher body mass index, waist circumference, blood pressure, fasting plasma glucose and triglyceride levels than unlikely FH subjects. Among potential FH subjects, lipid-lowering medication was used in 28.4 %. The achievement of the LDL-C goal (<100 mg/dL) in potential FH subjects was significantly lower than that in unlikely FH subjects (15 % vs. 28 %, respectively, P = 0.005) despite a higher rate of high-intensity statin use (25 % vs. 10 %, respectively, P = 0.002). ConclusionThe workplace screening of FH detected a significant number of potential FH subjects with higher cardiovascular risk. This strategy identified individuals for whom intensification of both lifestyle modifications and pharmacological treatment should be a priority.

Metabolic Syndrome Severity Score in Subjects with and without Poly Cystic Ovarian Syndrome

Objective: To compare polycystic ovarian syndrome and their defining criteria with metabolic syndrome severity score among females with and without polycystic ovarian syndrome. Study Design: Comparative cross-sectional study. Place and Duration of Study: Naval Hospital Islamabad, from Jan 2018 to Dec 2021. Methodology: We evaluated 293 female subjects for Poly Cystic Ovarian Syndrome after several exclusions who presented with an initial complaint of disturbances in menstrual cycles. These subjects underwent clinical examination including blood pressure and anthropometric indices and measurements of modified Ferriman Gallway score. Biochemical measurements included fasting plasma glucose, HDL cholesterol, triglycerides and insulin measurement. These parameters were measured for various components included in defining the Poly Cystic Ovarian Syndrome as per Rotterdam criteria and Metabolic Syndrome Severity Score equation to compare metabolic syndrome severity and insulin resistance among subjects with Poly Cystic Ovarian Syndrome and without Poly Cystic Ovarian Syndrome. Results: Mean age among participants were 29.46±6.74 years. Disturbances in menstrual cycle reporting oligo/anovulation was reported by (181/293) 61.8% in comparison to (112/293) 38.2%. Hirsutism (modified Ferriman Gallway score&gt;8) was present in (142/293) 48.5%. Radiological findings pointing towards Poly Cystic Ovarian Syndrome diagnosis were found in (72/293) 24.6%. Metabolic Syndrome Severity Score showed higher correlation with age, and insulin resistance in contrast to hirsutism and free androgen indices. Hirsutism was higher among oligo/anovulation females than participants without menstrual complaints (14.17+8.99 vs. 11.16+7.88, p=0.004). Similarly, bioc Conclusion: Metabolic Syndrome Severity Score equation does not associate with Poly Cystic Ovarian Syndrome criteria as defined by Rotterdam. Insulin resi

What characterizes normotensive individuals with obesity and normal systolic heart function? A descriptive study from the SCAPIS cohort

Abstract Background Heart failure and cardiovascular disease are strongly related to obesity, and the incidence of these conditions shows a linear relationship with increasing body mass index (BMI). Despite these known facts, some individuals with obesity show no clinical signs of heart disease or arterial hypertension (AH). Purpose We aimed to investigate the characteristics of individuals with obesity without impaired left ventricular function and left ventricular hypertrophy (termed systolic heart function, SHF) and AH, compared to individuals with obesity with signs of impaired SHF or AH, and individuals without obesity with and without signs of impaired SHF or AH. Method A cross-sectional analysis was performed of the 4,692 individuals who had undergone a transthoracic echocardiography within the Swedish CArdioPulmonary bioImage Study (SCAPIS). Participants were divided into four groups: 1) individuals with obesity (BMI³30 kg/m2) without impaired SHF (normal left ventricular systolic function and left ventricular mass) and no AH (based upon the absence of antihypertensive treatment) (ObSHF/AH-, n=623; 13%), 2) individuals with obesity with impaired SHF or AH (ObSHF/AH+, n=252; 5%), 3) individuals without obesity and without impaired SHF and no AH (NObSHF/AH-, n=3179; 68%) and 4) individuals without obesity with impaired left ventricular systolic function, left ventricular hypertrophy or AH (NObSHF/AH+, n=638; 14%). Individuals in group 1 (ObSHF/AH-;) were compared to those in groups 2-4 through descriptive analyses. Results Compared to ObSHF/AH+ individuals, ObSHF/AH- subjects showed significantly lower HbA1c (p&amp;lt;0.001), fasting plasma glucose (p&amp;lt;0.001), triglyceride (p&amp;lt;0.001), NT-proBNP (p=0.035) and troponin I (p&amp;lt;0.001) levels. Furthermore, no significant differences between the two obese groups could be seen regarding BMI (p=0.074), whereas waist-to-hip ratio was lower in ObSHF/AH- subjects (p&amp;lt;0.001). ObSHF/AH- individuals had higher glucose and lipid levels as well as higher blood pressure than individuals without obesity. Interestingly, no differences were seen between ObSHF/AH- and NObSHF/AF- subjects regarding NT-proBNP (p=0.864) and troponin I levels (p=0.110). Furthermore, left ventricular mass index (LVMI) was significantly higher in ObSHF/AH- subjects compared to NObSHF/AH- individuals (73.8 vs. 72.1 g/m2, p=0.015) and the ejection fraction was significantly lower (57.4 vs. 59.6 %, p&amp;lt;0.001). Conclusion When ObSHF/AH- and NObSHF/AH- subjects were compared, markers of cardiac damage/remodeling did not differ significantly, indicating that heart function might be preserved despite a worsened metabolic profile and an obese phenotype, through putative protective mechanisms yet to be explored. However, parameters of SHF were unfavorable for ObSHF/AH- when compared to NObSHF/AH-, further implicating preclinical cardiac impairment in individuals with obesity.

Exploring the epidemiology and awareness of metabolic dysfunction-associated steatotic liver disease (MASLD) among health sciences students in an academic health care institute in India

BackgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) affects over 25 % of the global population, presenting a significant health challenge. It is often asymptomatic but linked to severe conditions like cirrhosis and liver cancer. Previous research indicates that people often underestimate MASLD risks. This study examines MASLD prevalence and awareness among medical students in an academic health care institute in India. Material and methodsThis cross-sectional study at SRM Medical College Hospital, Chennai, involved 80 medical and paramedical students aged 18–25. Exclusion criteria included history of alcohol use, neurological disorders, thyroid issues, diabetes, and hypertension. After obtaining informed consent, anthropometric data and blood samples were collected. Biochemical parameters including fasting plasma glucose, triglycerides, HDL-C, and GGT were measured. The Fatty Liver Index (FLI) was used to assess liver steatosis, with an FLI ≥60 indicating NAFLD. Data were analysed using SPSS Version 22.0, with statistical significance set at p < 0.05. ResultsAmong 80 participants, the mean age and BMI were 20.2 ± 1.03 years and 23.16 ± 4.55 kg/m2. The mean Fatty Liver Index (FLI) score was 15.11 ± 19.68. MASLD prevalence was 7.5 % (n = 6). Significant positive correlations were found between FLI and BMI, waist circumference, fasting plasma glucose, triglycerides, and GGT, while HDL-C showed a non-significant negative correlation. Most participants were aware of MASLD and its risk factors but showed varied adherence to preventive measures. ConclusionHealth Sciences undergraduates had a 7.5 % MASLD prevalence, highlighting a gap in understanding and testing. Addressing this requires better guidelines, awareness, and healthcare system enhancements.

Dissociation between liver fat content and fasting metabolic markers of selective hepatic insulin resistance in humans.

Fasting hyperglycemia and hypertriglyceridemia are characteristic of insulin resistance (IR) and rodent work has suggested this may be due to selective hepatic IR, defined by increased hepatic gluconeogenesis and de novo lipogenesis (DNL), but this has not been shown in humans. Cross-sectional study in men and women across a range of adiposity. Medication-free participants (n = 177) were classified as normoinsulinemic (NI) or hyperinsulinemic (HI) and as having low (LF) or high (HF) liver fat content measured by magnetic resonance spectroscopy. Fractional gluconeogenesis (frGNG) and hepatic DNL were measured using stable isotope tracer methodology following an overnight fast. Although HI and HF groups had higher fasting plasma glucose and triglyceride concentrations when compared to NI and LF groups respectively, there was no difference in frGNG. However, HF participants tended to have lower frGNG than LF participants. HI participants had higher DNL compared to NI participants but there was no difference observed between liver fat groups. Taken together, we found no metabolic signature of selective hepatic IR in fasting humans. DNL may contribute to hypertriglyceridemia in individuals with HI but not those with HF. Glycogenolysis and systemic glucose clearance may have a larger contribution to fasting hyperglycemia than gluconeogenesis, especially in those with HF, and these pathways should be considered for therapeutic targeting.

Triglyceride-Glucose Index Levels Positively Associated with Higher Risk of Low Muscle Mass in Patients with Type 2 Diabetes.

Although the interplay of insulin resistance (IR) and low muscle mass is increasingly recognized, it remains unknown whether the triglyceride-glucose (TyG) index, as an indicator of IR, is associated with low muscle mass in patients with type 2 diabetes (T2D). Our study aimed to investigate the association between TyG index and low muscle mass in hospitalized T2D patients. This cross-sectional study involved 2687 hospitalized participants with T2D. The TyG index was calculated by fasting plasma glucose (FPG) and triglyceride levels. The outcome variables were defined as appendicular skeletal muscle mass index (ASMI) and low muscle mass. To explore the relationship between TyG index and low muscle mass, we conducted the multivariate linear regression, multivariate logistic regression, and subgroup analysis. In the fully adjusted multivariate linear regression, there was a negative correlation between TyG index (β=-0.10, 95% CI: -0.14, -0.06) and ASMI. TyG index (OR = 1.34, 95% CI: 1.08, 1.65) had a more significant association with low muscle mass compared to FPG (OR = 1.05, 95% CI: 1.01, 1.09) and glycated hemoglobin A1c (OR = 1.07, 95% CI: 0.99, 1.15). The statistical significance of the trend persisted among the TyG index quartile groups. Subgroup analysis revealed stronger positive associations between TyG index and low muscle mass in females, individuals aged 60 years or older, those with a body mass index of 28kg/m2 or higher, and HbA1c levels of 6.5% or higher, as well as those with hypertension and dyslipidemia. A higher TyG index level is positively associated with a higher risk of low muscle mass, suggesting that TyG index could be a potential biomarker of low muscle mass in hospitalized T2D patients.

Greater oxidation of dietary linoleate compared to palmitate in humans following an acute high-carbohydrate diet

We have previously demonstrated that dietary saturated fatty acids (SFA), when compared to polyunsaturated fatty acids (PUFA), are preferentially partitioned into oxidation pathways. However, it remains unclear if this preferential handling is maintained when hepatocellular metabolism is shifted toward fatty acid (FA) esterification and away from oxidation, such as when hepatic de novo lipogenesis (DNL) is upregulated. To investigate whether an acute upregulation of hepatic DNL influences dietary FA partitioning into oxidation pathways. 20 healthy volunteers (11 females) underwent a fasting baseline visit followed by two study days, 2-weeks apart. Prior to each study day, participants consumed an isocaloric high-carbohydrate diet (to upregulate hepatic DNL) for 3-days. On the two study days, participants consumed an identical standardised test meal that contained either [U13C]palmitate or [U13C]linoleate, in random order, to trace the fate of dietary FA. Blood and breath samples were collected over a 6h postprandial period and 13C enrichment in breath CO2 and plasma lipid fractions were measured using gas-chromatography-combustion-isotope ratio mass spectrometry. Compared to the baseline visit, fasting plasma triglyceride concentrations and markers of hepatic DNL, the lipogenic and stearyl-CoA desaturase indices, were significantly (p<0.05) increased after consumption of the high-carbohydrate diet. Appearance of 13C in expired CO2 and tracer recovery were significantly (p<0.05) higher after consumption of the meal containing [U13C]linoleate compared to [U13C]palmitate (5.1±0.5% vs. 3.7±0.4%), respectively. Incorporation of 13C into the plasma triglyceride and non-esterified fatty acid pool was significantly (p<0.001) greater for [U13C]palmitate compared to [U13C]linoleate. Dietary PUFA compared to SFA appear to be preferentially partitioned into oxidation pathways during an acute upregulation of hepatic DNL, thus consumption of a PUFA-enriched diet may help mitigate intrahepatic triglyceride accumulation in individuals at risk of cardiometabolic disease.

Correlation analysis between serum free triiodothyronine and C-peptide-based insulin resistance index in euthyroid adults

Objective: To explore the correlation between serum free triiodothyronine (FT3) and C-peptide-based insulin resistance index (HOMA2 IR-CP) in euthyroid adults. Methods: A cross-sectional study. The clinical data of euthyroid adult participants who underwent physical examination in the Second Medical Center of Chinese PLA General Hospital from January to December in 2019 were retrospectively analyzed. According to the HOMA2 IR-CP level, the participants were divided into HOMA2 IR-CP>2.18 group (n=3 463) and HOMA2 IR-CP≤2.18 group (n=8 204). Univariate Pearson correlation analysis and multivariate logistic regression analysis were used to analyze the correlation between FT3 and HOMA2 IR-CP. The interaction model was used to analyze the interaction between FT3 and related factors, and the dose-response relationship between continuity variable FT3 and HOMA2 IR-CP was explored by using restricted cubic spline plots. Results: A total of 11 667 euthyroid adult participants aged (50.7±10.0)years were recruited according to the inclusion and exclusion criteria, with 7 756 males and 3 911 females. The proportion of males, body mass index, systolic blood pressure, glycated hemoglobin A1c, fasting plasma glucose, triglyceride, hemoglobin, alanine aminotransferase and FT3 levels in HOMA2 IR-CP>2.18 group were significantly higher than those in HOMA2 IR-CP≤2.18 group (all P<0.05). The levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and free thyroxine in HOMA2 IR-CP>2.18 group were lower than those in HOMA2 IR-CP≤2.18 group (all P<0.001). Univariate Pearson correlation analysis showed that FT3 was associated with HOMA2 IR-CP (r=0.21, P<0.001). Multivariate logistic regression analysis suggested an association between FT3 and HOMA2 IR-CP after adjusting for confounding factors(Pfor trend<0.001). Subgroup analysis showed an association between FT3 and HOMA2 IR-CP in different subgroups of gender, age and glucose metabolism status (Pfor trend<0.05). Multiplication interaction analysis suggested that there was an interaction between FT3 and age (Pinteraction<0.001). Restricted cubic spline model analysis demonstrated that the correlation between FT3 and HOMA2 IR-CP was linear (Poverall<0.001, Pnonlinear=0.479). Conclusions: There is a correlation between serum FT3 and HOMA2 IR-CP in euthyroid adults. With the increase of FT3 level, insulin resistance increases gradually.

Triglyceride glucose index as a predictor for non-alcoholic fatty liver disease: insights from a longitudinal analysis in non-obese individuals.

A substantial portion of non-obese population is afflicted with Non-alcoholic Fatty Liver Disease (NAFLD). The Triglyceride Glucose (TyG) index, a quantifier of insulin resistance magnitude, is determined by the product of fasting plasma glucose and triglyceride concentrations. The relationship between the TyG index and NAFLD within this cohort remains ambiguous. We conducted a retrospective analysis utilizing datasets acquired from the Dryad digital repository. Non-obese participants (BMI < 25 kg/m2) were enrolled at the Wenzhou Medical Center of Wenzhou People's Hospital between January 2010 and December 2014. Demographic information and biochemical parameters were systematically compiled, and the diagnosis of NAFLD was established through ultrasonographic evidence. This study cohort included 16,172 non-obese participants with a 5-year follow-up, among whom 2,322 (14.36%) developed NAFLD. The disparity between TyG index quartiles in the accumulative incidence of new-onset NAFLD was distinct, with an increasing risk of new-onset NAFLD as the TyG index increased. Participants in highest quartile exhibited the maximum risk of NAFLD. In the fully adjusted model 3, the hazard ratios for NAFLD in Q2, Q3, and Q4 were 2.15 (1.62, 2.87), 2.89 (2.20, 3.80) and 4.58 (3.48, 6.02), respectively. Meanwhile, the TyG index and NAFLD risk showed a highly significant overall correlation (p < 0.0001) and nonlinearity (p < 0.0001) according to the limited cubic splines. In subgroup analysis, a significant interaction was noted between new-onset NAFLD and SBP (<140 mmHg vs. ≥140 mmHg; P for interaction = 0.0114). The SBP < 140 mmHg subgroup demonstrated an enhanced TyG index influence on NAFLD risk (HR = 2.83, 95% CI: 2.48-3.23, p < 0.0001). The TyG index serves as a straightforward instrument for assessing NAFLD risk in non-obese individuals, enabling prompt identification and management in this population segment.

The relationship between the dietary index based Meiji nutritional profiling system for adults and lifestyle-related diseases: a predictive validity study from the National Institute for Longevity Sciences-Longitudinal Study of Aging.

Nutritional profiling system (NPS) holds promise as a public health tool for companies to measure product healthiness and for individuals in making healthier food choices. The Meiji NPS for adults specifically targets lifestyle-related diseases prevalent among Japan's adult population, including overweight/obesity, hypertension, diabetes, and dyslipidemia. This study examined the cross-sectional association between the Meiji NPS for adults Dietary Index (MNfA-DI) and indicators of lifestyle-related diseases in a population. The study comprised 1,272 middle-aged individuals (40-64 years, 50.1% male) who participated in the seventh wave (2010-2012) of the National Institute for Longevity Sciences-Longitudinal Study of Aging project, with no missing data on three-day dietary records. The MNfA-DI was computed at the individual diet level (accounting for the whole diet) using arithmetic energy-weighted means. A higher MNfA-DI indicated a greater nutritional quality of an individual's overall diet. Lifestyle-related disease indicators included body mass index (BMI, kg/m2), body fat (%), systolic and diastolic blood pressure (mmHg), fasting plasma glucose (mg/dL), HbA1c (%), triglyceride levels (mg/dL), LDL, and HDL cholesterol levels (mg/dL). A multiple regression model was used to assess the association between the MNfA-DI and lifestyle-related disease indicators, adjusting for demographics, socioeconomic status, lifestyle factors, disease history, and energy intake as covariates, depending on the outcome. The median (interquartile range) age and MNfA-DI were 53.0 (46.0, 59.0) years and 10.1 (6.0, 14.0) points, respectively. MNfA-DI was negatively associated with body fat [partial regression coefficient (95% confidence interval) -0.04 (-0.07, -0.01)], diastolic blood pressure [-0.08 (-0.17, -0.002)], fasting plasma glucose [-0.18 (-0.33, -0.01)], and triglyceride [-1.36 (-2.16, -0.55)]. Additionally, MNfA-DI was also associated with almost indicators (except for LDL and HDL cholesterol) among participants with a BMI between 18.5 and 24.9 kg/m2. These findings suggest that the Meiji NPS for adults could be associated with a lower risk of lifestyle-related diseases. In addition, from a public health nutrition perspective, the Meiji NPS for adults may be useful to assess the food healthiness of the adult population.

Efficacy and safety of glucagon-like peptide-1 receptor agonists on prediabetes: a systematic review and meta-analysis of randomized controlled trials

BackgroundPrediabetes is a condition preceding the development of diabetes and is associated with an increased risk of a number of complications. The primary mode of management is thought to be lifestyle modification. Pharmacological therapy, such as glucagon-like peptide-1 receptor agonists (GLP-1RAs), were not well addressed in the literature and were only evaluated in trials as secondary and exploratory outcomes with a limited sample size. Here, GLP-1RAs are evaluated as a comprehensive therapy approach for patients with prediabetes.MethodsA comprehensive search of Web of Science, SCOPUS, PubMed, and Cochrane was performed on May 5, 2023, to retrieve randomized controlled trials (RCTs) comparing the effect of GLP-1RAs to placebo and/or lifestyle modification on prediabetes reversion to normoglycemia, prevention of overt diabetes, glycemic control, anthropometric parameters, and lipid profiles. Review Manager (RevMan) version 5.4 was used. The quality of RCTs was assessed using the revised version of the Cochrane Risk of Bias Tool. GRADE was performed to evaluate the certainty of evidence.ResultsTwelve trials involving 2903 patients in the GLP-1RAs group and 1413 in the control group were included in the meta-analysis. Low quality of evidence revealed that GLP-1RAs significantly increased the incidence of prediabetes reversion to the normoglycemic state [RR = 1.76, 95% CI (1.45, 2.13), P < 0.00001] and moderate quality of evidence showed that GLP-1RAs significantly prevented new-onset diabetes [RR = 0.28, 95% CI (0.19, 0.43), P < 0.00001]. Significant reductions in HbA1c, fasting plasma glucose, body weight, waist circumference, triglycerides, and LDL were observed in the GLP-1RAs arm (P < 0.05). However, higher incidences of gastrointestinal disorders were reported in the GLP-1RAs group (P < 0.05).ConclusionsGLP-1RAs combined with lifestyle modification proved to be a more effective therapy for managing prediabetic patients than lifestyle modification alone, with a tolerable safety profile. Future guidelines should consider GLP-1RAs as an adjunct to lifestyle modification in the management of prediabetic patients to provide better management and improve treatment adherence.

Association of hypertriglyceridemic waist phenotype with metabolic syndrome traits and its diagnostic potential to predict metabolic syndrome in adults with excess body weight: A community-based cross-sectional study.

The hypertriglyceridemic waist (HTGW) phenotype is a simple measure to identify individuals at increased risk of metabolic syndrome (MetS) traits. The present study aimed to describe the HTGW prevalence, and its associations with MetS traits, and also determine the diagnostic potential of the mirror indices of HTGW phenotype to predict MetS and its components in community-dwelling adults with overweight or obesity in Southern, Sri Lanka. In a cross-sectional study, 300 adults with excess body weight (body mass index >23 kg/m2) were enrolled and examined for the HTGW phenotype (fasting plasma triglyceride concentration ≥1.695 mmol/L and waist circumference >90 and >85 cm in males and females, respectively). One in five adults with excess body weight had the HTGW phenotype. Phenotype-positive adults had significantly higher fasting plasma glucose (FPG) (p = 0.010), low-density lipoprotein cholesterol (HDL-C) (p < 0.001), total cholesterol (p < 0.001), atherogenic index (p < 0.001), coronary risk index (p = 0.001), triglyceride glucose index (p = 0.040), bioimpedance visceral fat (p = 0.041) and significantly lower HDL-C (p = 0.001) and cardioprotective index (p = 0.009) than those without the HTGW phenotype. Adults with excess body weight and the HTGW phenotype had an increased risk of FPG (odds ratio [OR] = 1.294; 95% confidence interval [CI] 1.051-1.594), atherogenic index (OR = 3.138; 95% CI = 1.559-6.317) and triglyceride glucose index (OR = 3.027; 95% CI = 1.111-8.249). The HTGW phenotype was strongly associated with MetS traits (OR = 16.584; 95% CI = 6.230-44.147). The cut-off values for the product of waist circumference × triglyceride, to identify the risk of having MetS and dyslipidemia among adults with excess body weight were 158.66 and 160.15 cm × mmol/L, respectively. The readily available and inexpensive measures of the HTGW phenotype could serve as a clinically useful marker to identify MetS traits in adults with excess body weight.

Effects of a Nonlinear Program on Different Health Parameters in the Elderly.

The aim of this research was to evaluate the impact of a nonlinear training program on visceral adipose tissue (VAT) and systolic (SBP) and diastolic (DBP) blood pressure, as well as the response of biochemical parameters such as fasting plasma glucose (FPG), total cholesterol (TC), high-density cholesterol (HDL-C), low-density cholesterol (LDL-C), and triglycerides (TG). The nonlinear periodized program would produce greater improvements in outcomes than the linear periodized training program. Randomized cross-sectional design. Level 3. Older adults with no previous training experience (10 male and 8 female [age, 64 ± 2.1 years; height, 165.12 ± 7.5 cm; body mass, 72.5 ± 11.4 kg; body max index, 26.5 ± 3.2 kg/m2]) were randomized to linear (n = 9, TT) or undulating (n = 9, UT) periodization. After a 3-week familiarization period, all participants performed 3 sessions of resistance training per week; 8 weeks of training were conducted for each group. Dual x-ray absorptiometry was used to measure VAT, and SBP and DBP were measured using an OMRON M3 digital automatic blood pressure monitor. Blood samples were collected between 8:00 a.m. and 9:30 a.m. after 12-hour overnight fasting. Both interventions significantly (P < 0.05) decreased FPG, TC, LDL-C, and TG. A significant decrease in SBP and DBP was observed only in the UT group (P < 0.05). No significant between-group differences in outcomes were observed (P > 0.5). However, the effect size was marginally more pronounced for all outcomes in the UT group. An undulating periodization program was effective in improving VAT, TC, LDL-C, FPG, HDL-C, TG, and blood glucose levels in older adults. Resistance training can be programmed in an undulating or traditional way in older adults based on improvements in health parameters, considering adherence and individual preferences.

Triglyceride-Glucose Index is a novel predictor of colorectal cancer

Aim: Colorectal cancer is the leading cause of cancer-related mortality. Metabolic syndrome is associated with obesity, pre-diabetes, and dyslipidemia. The purpose of the study was to investigate the effects of TyG Index as a novel biomarker on CRC risk. Material and Method: The study was conducted with 256 people in total, including the CRC (n=124) and Control Groups (n=132). TyG Index was calculated by using fasting triglycerides and glucose with the formula Ln [fasting TGs (mg/dL) x fasting glucose (mg/dL)/2]. The performance of the TyG Index to predict the presence of CRC was also evaluated. Results: Metabolic parameters associated with insulin resistance were found to be at statistically significant levels in the CRC Group. Fasting plasma glucose, triglyceride, insulin, hemoglobin A1c, and GGT were also statistically significant. It was also determined that the cut-off value of the TyG Index for the presence of CRC was 4.49 (AUC = 0.782, sensitivity 77%, specificity = 78.4%, and p=0.002). Conclusion: In the present study, it was found that the TyG Index is associated with the risk of CRC and can be used as a novel biomarker in high-risk CRC cases.

Triglyceride Glucose Index: A Potential Indicator in the Evaluation of Graves Ophthalmopathy.

To determine the relationship between Graves ophthalmopathy (GO) and triglyceride glucose index (TGI) and to evaluate the predictive importance of this index in terms of GO activity. This retrospective study included 20 inactive GO patients, 20 active GO patients, and 20 healthy controls. TGI was calculated using fasting plasma triglyceride and fasting plasma glucose levels and values were compared between the groups. The receiver operating characteristics curve was used to calculate the optimal TGI cutoff value and the sensitivity and specificity of this value between active and inactive GO groups. No significant difference was detected between the groups in terms of age and gender ( p = 0.561 and p = 0.762, respectively). TGI value was 8.49 (8.41, 8.67) in the control group, 8.76 (8.74, 8.87) in the inactive GO group, and 9.06 (8.87, 9.08) in the active GO group ( p < 0.001 for control group vs. inactive GO group; p < 0.001 for control group vs. active GO group; p = 0.001 for inactive GO group vs. active GO group). The optimal receiver operating characteristics cutoff value of TGI between active and inactive GO groups was 8.86 with 85% sensitivity and 75% specificity (area under curve: 0.837, p < 0.001, 95% confidence interval: 0.711-0.964). TGI was higher in both inactive and active GO patients compared with controls. It also appears that TGI may be used as a predictive marker indicating GO activity. This cheap and easily accessible parameter may be beneficial in detecting the disease and monitoring its activity in clinical practice.

Weight loss, glycolipid profile changes in type 2 diabetes patients after esophagectomy: a propensity score matching analysis

BackgroundType 2 diabetes mellitus (T2DM) is a common co-morbidity in patients who receive esophagectomy and has unfavorable effects on glucose and lipid metabolism in patients. This study examines how weight and glycolipid metabolism change in patients with T2DM following esophagectomy.MethodsThis retrospective, one-center, observational analysis with a propensity score matching analysis (PSM) included 114 patients who underwent esophageal surgery in the Department of Cardiothoracic Surgery, the 900th Hospital of Joint Logistic Support Force from 2017 to 2020, which were separated into T2DM group and Non-T2DM group. Weight, body mass index (BMI), fasting plasma glucose (FPG), triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were measured and analyzed before and after the operation.ResultsTwo groups showed similar reductions in weight and BMI after surgery. In the T2DM group, weight decreased from 63.10(10.31) before surgery to 55.10(11.60) kg at 6 months (P < 0.001) with BMI decreasing from 22.67 (2.90) to 19.77 (3.48); While in the Non-T2DM group, weight decreased from 61.42 (8.46) to 53.19 (9.26) kg at 6 months after surgery with BMI decline from 22.49 (2.77) before operation to 19.45 (3.08) at 6 months after surgery. Fasting plasma glucose levels showed a significant decrease (P = 0.035) in the T2DM group at a six-month point of 7.00 (2.21) mmol/L compared to preoperative levels of 7.67 (2.32) mmol/L. HDL levels increased significantly in the Non-T2DM group at six months postoperatively at 1.52 (0.05) with P < 0.001 compared to preoperative levels of 1.22(0.04) mmol/L. TG, LDL, and TC levels decreased significantly in both groups from the preoperative to the 6-month point.ConclusionsEsophagectomy induces weight loss in T2DM and Non-T2DM groups, improves long-term glucose metabolism in the T2DM group, and enhances lipid metabolism in both groups. Further research is needed to understand their mechanisms.

Triglyceride-glucose index: A surrogate marker of homeostasis model assessment of insulin resistance to predict diabetic nephropathy.

To determine the association of triglyceride-glucose index with homeostasis model assessment of insulin resistance in type 2 diabetes mellitus patients, and to determine the association of triglyceride-glucose index with urinary albumin-to-creatinine ratio for predicting diabetic nephropathy. The observational, cross-sectional study was conducted from September 2021 to September 2022 at the Department of Chemical Pathology, Pakistan Railway Hospital, Rawalpindi, Pakistan and comprised recently-diagnosed type 2 diabetes mellitus patients. Recorded data included age, gender, vitals, diabetes duration, body mass index and other pertinent demographic and clinical information. Measurements included spot urine albumin-to-creatinine ratio, triglycerideglucose index, homeostasis model assesment of insulin resistance as well as fasting serum insulin, fasting plasma glucose, glycosylated haemoglobin, triglycerides, total cholesterol and serum creatinine. On the basis of triglyceride-glucose index scores, the participants were divided into 4 quartiles; Q1=4.5-5, Q2=5.1-5.5, Q3=5.6-6, and Q4=>6. Data was analysed using SPSS 26. Of the 218 patients, 141(64.7%) were females and 77(35.3%) were males. The overall mean age was 49.22±11.46 years. There were 102(46.8%) overweight patients, 33(15.1%) obese and 82(37.2%) had normal weight. There were 58(26.6%) patients in Q1, 86(39.4%) in Q2, 46(21.1%) in Q3 and 28(12.8%) in Q4. Those in Q4 showed elevated fasting plasma glucose, glycated haemoglobin, triglycerides, total cholesterol, low-density lipoprotein cholesterol, homeostasis model assessment of insulin resistance and urine albumin-to-creatinine ratio (p<0.05), as well as low values for high-density lipoprotein cholesterol and estimated glomerular filtration rate(p<0.05). Fasting serum insulin was negatively linked to glycated haemoglobin (r=-0.12, p=0.07). Triglyceride-glucose index (r=0.76, p<0.001), homeostasis model assessment of insulin resistance (r=0.48, p<0.001), and urine albumin-to-creatinine ratio (r=0.10,p=0.05) positively correlated with glycated haemoglobin. Fasting serum insulin (r=-0.13, p=0.05), negatively correlated with triglyceride-glucose index, while homeostasis model assessment of insulin resistance (r= 0.32, p<0.001) and urine albumin-to-creatinine ratio (r=0.28, p=0.05) had a positive correlation. The estimated glomerular filtration rate was significantly positively linked with fasting serum insulin (r=0.05, p=0.05), and correlated significantly negatively with triglyceride-glucose index (r=-0.35, p=0.01), homeostasis model assessment of insulin resistance (r=-0.01, p=0.86) and urine albumin-to-creatinine ratio (r=-0.02, p=0.8). The triglyceride-glucose index showed a strong association with homeostasis model assessment of insulin resistance, and surpassed it in terms of predicting diabetic nephropathy in type 2 diabetes mellitus patients.

Cardiometabolic and immune response to exercise training in patients with metabolic syndrome: retrospective analysis of two randomized clinical trials.

Metabolic syndrome (MetS) is defined by the presence of central obesity plus ≥two metabolic/cardiovascular risk factors (RF), with inflammation being a major disease-driving mechanism. Structured endurance exercise training (ET) may positively affect these traits, as well as cardiorespiratory fitness (V̇O2peak). We explore individual ET-mediated improvements of MetS-associated RF in relation to improvements in V̇O2peak and inflammatory profile. MetS patients from two randomized controlled trials, ExMET (n = 24) and OptimEx (n = 34), had performed 4- or 3-months supervised ET programs according to the respective trial protocol. V̇O2peak, MetS-defining RFs (both RCTs), broad blood leukocyte profile, cytokines and plasma proteins (ExMET only) were assessed at baseline and follow-up. Intra-individual changes in RFs were analysed for both trials separately using non-parametric approaches. Associations between changes in each RF over the exercise period (n-fold of baseline values) were correlated using a non-parametrical approach (Spearman). RF clustering was explored by uniform manifold approximation and projection (UMAP) and changes in RF depending on other RF or exercise parameters were explored by recursive partitioning. Four months of ET reduced circulating leukocyte counts (63.5% of baseline, P = 8.0e-6), especially effector subtypes. ET response of MetS-associated RFs differed depending on patients' individual RF constellation, but was not associated with individual change in V̇O2peak. Blood pressure lowering depended on cumulative exercise duration (ExMET: ≥102 min per week; OptimEx-MetS: ≥38 min per session) and baseline triglyceride levels (ExMET: <150 mg/dl; OptimEx-MetS: <174.8 mg/dl). Neuropilin-1 plasma levels were inversely associated with fasting plasma triglycerides (R: -0.4, P = 0.004) and changes of both parameters during the ET phase were inversely correlated (R: -0.7, P = 0.0001). ET significantly lowered effector leukocyte blood counts. The improvement of MetS-associated cardiovascular RFs depended on individual basal RF profile and exercise duration but was not associated with exercise-mediated increase in V̇O2peak. Neuropilin-1 may be linked to exercise-mediated triglyceride lowering.