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The product of fasting plasma glucose and triglycerides improves risk prediction of type 2 diabetes in middle-aged Koreans.
BMC Endocr Disord. 2018 May 30; 18(1):33.BE

Abstract

BACKGROUND

Screening for risk of type 2 diabetes mellitus (T2DM) is an important public health issue. Previous studies report that fasting plasma glucose (FPG) and triglyceride (TG)-related indices, such as lipid accumulation product (LAP) and the product of fasting glucose and triglyceride (TyG index), are associated with incident T2DM. We aimed to evaluate whether FPG or TG-related indices can improve the predictive ability of a diabetes risk model for middle-aged Koreans.

METHODS

7708 Koreans aged 40-69 years without diabetes at baseline were eligible from the Korean Genome and Epidemiology Study. The overall cumulative incidence of T2DM was 21.1% (766 cases) in men and 19.6% (797 cases) in women. Therefore, the overall cumulative incidence of T2DM was 20.3% (1563 cases). Multiple logistic regression analysis was conducted to compare the odds ratios (ORs) for incident T2DM for each index. The area under the receiver operating characteristic curve (AROC), continuous net reclassification improvement (cNRI), and integrated discrimination improvement (IDI) were calculated when each measure was added to the basic risk model for diabetes.

RESULTS

All the TG-related indices and FPG were more strongly associated with incident T2DM than WC in our study population. The adjusted ORs for the highest quartiles of WC, TG, FPG, LAP, and TyG index compared to the lowest, were 1.64 (95% CI, 1.13-2.38), 2.03 (1.59-2.61), 3.85 (2.99-4.97), 2.47 (1.82-3.34), and 2.79 (2.16-3.60) in men, and 1.17 (0.83-1.65), 2.42 (1.90-3.08), 2.15 (1.71-2.71), 2.44 (1.82-3.26), and 2.85 (2.22-3.66) in women, respectively. The addition of TG-related parameters or FPG, but not WC, to the basic risk model for T2DM (including age, body mass index, family history of diabetes, hypertension, current smoking, current drinking, and regular exercise) significantly increased cNRI, IDI, and AROC in both sexes.

CONCLUSIONS

Adding either TyG index or FPG into the basic risk model for T2DM increases its prediction and reclassification ability. Compared to FPG, TyG index was a more robust T2DM predictor in the stratified sex and fasting glucose level. Therefore, TyG index should be considered as a screening tool for identification of people at high risk for T2DM in practice.

Authors+Show Affiliations

Division of Cardiovascular Diseases, Center for Biomedical Sciences, Korea National Institute of Health, 187 Osongsaengmyeng 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, 361-951, South Korea. Department of Public Health Sciences, Graduate School, Korea University, Seoul, South Korea.Division of Cardiovascular Diseases, Center for Biomedical Sciences, Korea National Institute of Health, 187 Osongsaengmyeng 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, 361-951, South Korea.Division of Cardiovascular Diseases, Center for Biomedical Sciences, Korea National Institute of Health, 187 Osongsaengmyeng 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, 361-951, South Korea. mdhypark@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29843706

Citation

Lee, Joung-Won, et al. "The Product of Fasting Plasma Glucose and Triglycerides Improves Risk Prediction of Type 2 Diabetes in Middle-aged Koreans." BMC Endocrine Disorders, vol. 18, no. 1, 2018, p. 33.
Lee JW, Lim NK, Park HY. The product of fasting plasma glucose and triglycerides improves risk prediction of type 2 diabetes in middle-aged Koreans. BMC Endocr Disord. 2018;18(1):33.
Lee, J. W., Lim, N. K., & Park, H. Y. (2018). The product of fasting plasma glucose and triglycerides improves risk prediction of type 2 diabetes in middle-aged Koreans. BMC Endocrine Disorders, 18(1), 33. https://doi.org/10.1186/s12902-018-0259-x
Lee JW, Lim NK, Park HY. The Product of Fasting Plasma Glucose and Triglycerides Improves Risk Prediction of Type 2 Diabetes in Middle-aged Koreans. BMC Endocr Disord. 2018 May 30;18(1):33. PubMed PMID: 29843706.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The product of fasting plasma glucose and triglycerides improves risk prediction of type 2 diabetes in middle-aged Koreans. AU - Lee,Joung-Won, AU - Lim,Nam-Kyoo, AU - Park,Hyun-Young, Y1 - 2018/05/30/ PY - 2017/07/18/received PY - 2018/05/16/accepted PY - 2018/5/31/entrez PY - 2018/5/31/pubmed PY - 2018/10/3/medline KW - Risk model KW - TyG index KW - Type 2 diabetes mellitus SP - 33 EP - 33 JF - BMC endocrine disorders JO - BMC Endocr Disord VL - 18 IS - 1 N2 - BACKGROUND: Screening for risk of type 2 diabetes mellitus (T2DM) is an important public health issue. Previous studies report that fasting plasma glucose (FPG) and triglyceride (TG)-related indices, such as lipid accumulation product (LAP) and the product of fasting glucose and triglyceride (TyG index), are associated with incident T2DM. We aimed to evaluate whether FPG or TG-related indices can improve the predictive ability of a diabetes risk model for middle-aged Koreans. METHODS: 7708 Koreans aged 40-69 years without diabetes at baseline were eligible from the Korean Genome and Epidemiology Study. The overall cumulative incidence of T2DM was 21.1% (766 cases) in men and 19.6% (797 cases) in women. Therefore, the overall cumulative incidence of T2DM was 20.3% (1563 cases). Multiple logistic regression analysis was conducted to compare the odds ratios (ORs) for incident T2DM for each index. The area under the receiver operating characteristic curve (AROC), continuous net reclassification improvement (cNRI), and integrated discrimination improvement (IDI) were calculated when each measure was added to the basic risk model for diabetes. RESULTS: All the TG-related indices and FPG were more strongly associated with incident T2DM than WC in our study population. The adjusted ORs for the highest quartiles of WC, TG, FPG, LAP, and TyG index compared to the lowest, were 1.64 (95% CI, 1.13-2.38), 2.03 (1.59-2.61), 3.85 (2.99-4.97), 2.47 (1.82-3.34), and 2.79 (2.16-3.60) in men, and 1.17 (0.83-1.65), 2.42 (1.90-3.08), 2.15 (1.71-2.71), 2.44 (1.82-3.26), and 2.85 (2.22-3.66) in women, respectively. The addition of TG-related parameters or FPG, but not WC, to the basic risk model for T2DM (including age, body mass index, family history of diabetes, hypertension, current smoking, current drinking, and regular exercise) significantly increased cNRI, IDI, and AROC in both sexes. CONCLUSIONS: Adding either TyG index or FPG into the basic risk model for T2DM increases its prediction and reclassification ability. Compared to FPG, TyG index was a more robust T2DM predictor in the stratified sex and fasting glucose level. Therefore, TyG index should be considered as a screening tool for identification of people at high risk for T2DM in practice. SN - 1472-6823 UR - https://www.unboundmedicine.com/medline/citation/29843706/The_product_of_fasting_plasma_glucose_and_triglycerides_improves_risk_prediction_of_type_2_diabetes_in_middle_aged_Koreans_ L2 - https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-018-0259-x DB - PRIME DP - Unbound Medicine ER -