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Comparison of two surrogate estimates of insulin resistance to predict cardiovascular disease in apparently healthy individuals.
Nutr Metab Cardiovasc Dis. 2017 Apr; 27(4):366-373.NM

Abstract

BACKGROUND AND AIMS

Insulin resistance is associated with a cluster of abnormalities that increase cardiovascular disease (CVD). Several indices have been proposed to identify individuals who are insulin resistant, and thereby at increased CVD risk. The aim of this study was to compare the abilities of 3 indices to accomplish that goal: 1) plasma triglyceride × glucose index (TG × G); 2) plasma triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C); and 3) Metabolic Syndrome (MetS).

METHODS AND RESULTS

In a population sample of 723 individuals (486 women and 237 men, 50 ± 16 and 51 ± 16 years old, respectively), baseline demographic and metabolic variables known to increase CVD risk and incident CVD were compared among individuals defined as high vs. low risk by: TG × G; TG/HDL-C; or MetS. CVD risk profiles appeared comparable in high risk subjects, irrespective of criteria. Crude incidence of CVD events was increased in high risk subjects: 12.2 vs. 5.3% subjects/10 years, p = 0.005 defined by TG/HDL-C; 13.4 vs. 5.3% subjects/10 years, p = 0.002 defined by TG × G; and 13.4% vs. 4.5% of subjects/10 years, p < 0.001 in subjects with the MetS. The area under the ROC curves to predict CVD were similar, 0.66 vs. 0.67 for TG/HDL-C and TG × G, respectively. However, when adjusted by age, sex and multiple covariates, hazard ratios for incident CVD were significantly increased in high risk patients classified by either TG/HDL-C ratio (2.18, p = 0.021) or MetS (1.93, p = 0.037), but not by TG × G index (1.72, p = 0.087).

CONCLUSION

Although the 3 indices identify CVD risk comparably, the TG × G index seems somewhat less effective at predicting CVD.

Authors+Show Affiliations

Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina; Facultad de Ciencias Médicas, UNLP, Argentina. Electronic address: salazarlandea@gmail.com.Facultad de Ciencias Médicas, UNLP, Argentina.Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina; Facultad de Ciencias Médicas, UNLP, Argentina.Hospital Municipal de Rauch, Buenos Aires, Argentina.Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina; Facultad de Ciencias Médicas, UNLP, Argentina.Stanford University School of Medicine, Stanford, CA, USA.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28254109

Citation

Salazar, M R., et al. "Comparison of Two Surrogate Estimates of Insulin Resistance to Predict Cardiovascular Disease in Apparently Healthy Individuals." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 27, no. 4, 2017, pp. 366-373.
Salazar MR, Carbajal HA, Espeche WG, et al. Comparison of two surrogate estimates of insulin resistance to predict cardiovascular disease in apparently healthy individuals. Nutr Metab Cardiovasc Dis. 2017;27(4):366-373.
Salazar, M. R., Carbajal, H. A., Espeche, W. G., Aizpurúa, M., Dulbecco, C. A., & Reaven, G. M. (2017). Comparison of two surrogate estimates of insulin resistance to predict cardiovascular disease in apparently healthy individuals. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 27(4), 366-373. https://doi.org/10.1016/j.numecd.2016.12.002
Salazar MR, et al. Comparison of Two Surrogate Estimates of Insulin Resistance to Predict Cardiovascular Disease in Apparently Healthy Individuals. Nutr Metab Cardiovasc Dis. 2017;27(4):366-373. PubMed PMID: 28254109.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of two surrogate estimates of insulin resistance to predict cardiovascular disease in apparently healthy individuals. AU - Salazar,M R, AU - Carbajal,H A, AU - Espeche,W G, AU - Aizpurúa,M, AU - Dulbecco,C A, AU - Reaven,G M, Y1 - 2016/12/24/ PY - 2016/07/17/received PY - 2016/12/05/revised PY - 2016/12/12/accepted PY - 2017/3/4/pubmed PY - 2017/8/30/medline PY - 2017/3/4/entrez KW - Cardiovascular disease KW - Insulin resistance KW - Metabolic syndrome KW - TG/HDL-C ratio KW - TG × G index SP - 366 EP - 373 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 27 IS - 4 N2 - BACKGROUND AND AIMS: Insulin resistance is associated with a cluster of abnormalities that increase cardiovascular disease (CVD). Several indices have been proposed to identify individuals who are insulin resistant, and thereby at increased CVD risk. The aim of this study was to compare the abilities of 3 indices to accomplish that goal: 1) plasma triglyceride × glucose index (TG × G); 2) plasma triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C); and 3) Metabolic Syndrome (MetS). METHODS AND RESULTS: In a population sample of 723 individuals (486 women and 237 men, 50 ± 16 and 51 ± 16 years old, respectively), baseline demographic and metabolic variables known to increase CVD risk and incident CVD were compared among individuals defined as high vs. low risk by: TG × G; TG/HDL-C; or MetS. CVD risk profiles appeared comparable in high risk subjects, irrespective of criteria. Crude incidence of CVD events was increased in high risk subjects: 12.2 vs. 5.3% subjects/10 years, p = 0.005 defined by TG/HDL-C; 13.4 vs. 5.3% subjects/10 years, p = 0.002 defined by TG × G; and 13.4% vs. 4.5% of subjects/10 years, p < 0.001 in subjects with the MetS. The area under the ROC curves to predict CVD were similar, 0.66 vs. 0.67 for TG/HDL-C and TG × G, respectively. However, when adjusted by age, sex and multiple covariates, hazard ratios for incident CVD were significantly increased in high risk patients classified by either TG/HDL-C ratio (2.18, p = 0.021) or MetS (1.93, p = 0.037), but not by TG × G index (1.72, p = 0.087). CONCLUSION: Although the 3 indices identify CVD risk comparably, the TG × G index seems somewhat less effective at predicting CVD. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/28254109/Comparison_of_two_surrogate_estimates_of_insulin_resistance_to_predict_cardiovascular_disease_in_apparently_healthy_individuals_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(16)30332-5 DB - PRIME DP - Unbound Medicine ER -