Triglyceride-Glucose Index, HOMA Index and metabolic syndrome in a sample of adult men.

Minerva medica Pub Date : 2024-06-01 Epub Date: 2024-05-09 DOI:10.23736/S0026-4806.24.09155-9
Lanfranco D'Elia, Maria Masulli, Antonio Barbato, Domenico Rendina, Roberto Iacone, Ornella Russo, Pasquale Strazzullo, Ferruccio Galletti
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Abstract

Background: Metabolic syndrome (MetS) and its components are directly associated with cardiovascular risk. Insulin resistance (IR) is the most common pathophysiological feature of MetS. A novel index, the triglyceride-glucose index (TyG), is considered a surrogate marker of IR. Hence, we estimated the ability of TyG to predict the risk to develop MetS over a follow-up period of 8 years. In addition, we compared the predictive role of TyG and that of the HOmeostatis Model Assessment (HOMA) of IR index (a widely used tool to evaluate IR).

Methods: The analysis included 440 adult men (The Olivetti Heart Study) without MetS at baseline. The optimal cut-off point of the association of continuous TyG or HOMA-IR with MetS was identified by ROC analysis.

Results: During the follow-up period, 21.6% of participants developed MetS. Baseline TyG and HOMA-IR were both significantly greater in those who developed MetS than in those who did not. These results were confirmed upon adjustment for the main confounders. After stratification by the optimal cut-off point, TyG >4.78 was a significant predictor of MetS, also after adjustment for main confounders. Likewise, HOMA-IR >2.14 was associated with the risk of MetS development in multivariate models.

Conclusions: The results of this prospective study indicate a significant predictive role of TyG on the risk of MetS, independently of the main confounders. They suggest that TyG may serve as a low-cost and simple non-invasive marker for cardio-metabolic risk stratification, with respect to more complex and expensive assays of IR requiring the insulin measurement.

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成年男性样本中的甘油三酯-葡萄糖指数、HOMA 指数和代谢综合征。
背景:代谢综合征(MetS)及其组成部分与心血管风险直接相关。胰岛素抵抗(IR)是代谢综合征最常见的病理生理特征。甘油三酯-葡萄糖指数(TyG)被认为是胰岛素抵抗的替代指标。因此,我们估算了 TyG 在 8 年随访期内预测 MetS 发病风险的能力。此外,我们还比较了TyG和HOMA(一种广泛用于评估IR的工具)IR指数的预测作用:分析对象包括 440 名成年男性(奥利维心脏研究),他们在基线时没有 MetS。通过ROC分析确定了连续TyG或HOMA-IR与MetS相关性的最佳临界点:结果:在随访期间,21.6%的参与者出现了 MetS。发生 MetS 的参与者的基线 TyG 和 HOMA-IR 均明显高于未发生 MetS 的参与者。在对主要混杂因素进行调整后,这些结果得到了证实。根据最佳截断点进行分层后,TyG>4.78 是 MetS 的一个重要预测指标,这也是在调整了主要混杂因素后得出的结果。同样,在多变量模型中,HOMA-IR>2.14 也与 MetS 的发病风险有关:这项前瞻性研究的结果表明,TyG 对 MetS 风险具有显著的预测作用,不受主要混杂因素的影响。这些结果表明,与需要测量胰岛素的更复杂、更昂贵的IR检测相比,TyG可作为心血管代谢风险分层的低成本、简单的无创标记物。
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