Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study [version 1; referees: 1 approved with reservations]

Background: Insulin resistance (IR) is a metabolic disorder related to atherosclerosis. Its measurement is of great importance not only as a marker of diabetes but also for cardiovascular disease. The aim of this research study was to evaluate the relationship between various IR indices and coronary...

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Autores:: Salazar, Juan
Bermúdez, Valmore
Olivar, Luis Carlos
Torres, Wheeler
Palmar, Jim
Añez, Roberto
Ordoñez, Maria Gratzia
Rivas, José Ramón
Martínez, María Sofía
Hernández, Juan Diego
Graterol, Modesto
Rojas, Joselyn

Tipo de recurso:

Fecha de publicación:: 2018

Institución:: Universidad Simón Bolívar

Repositorio:: Repositorio Digital USB

Idioma:: eng

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dc.title.eng.fl_str_mv	Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study [version 1; referees: 1 approved with reservations]
title	Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study [version 1; referees: 1 approved with reservations]
spellingShingle	Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study [version 1; referees: 1 approved with reservations] Insulin resistance Coronary risk Triglycerides HOMA2-IR HDL-C
title_short	Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study [version 1; referees: 1 approved with reservations]
title_full	Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study [version 1; referees: 1 approved with reservations]
title_fullStr	Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study [version 1; referees: 1 approved with reservations]
title_full_unstemmed	Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study [version 1; referees: 1 approved with reservations]
title_sort	Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study [version 1; referees: 1 approved with reservations]
dc.creator.fl_str_mv	Salazar, Juan Bermúdez, Valmore Olivar, Luis Carlos Torres, Wheeler Palmar, Jim Añez, Roberto Ordoñez, Maria Gratzia Rivas, José Ramón Martínez, María Sofía Hernández, Juan Diego Graterol, Modesto Rojas, Joselyn
dc.contributor.author.none.fl_str_mv	Salazar, Juan Bermúdez, Valmore Olivar, Luis Carlos Torres, Wheeler Palmar, Jim Añez, Roberto Ordoñez, Maria Gratzia Rivas, José Ramón Martínez, María Sofía Hernández, Juan Diego Graterol, Modesto Rojas, Joselyn
dc.subject.eng.fl_str_mv	Insulin resistance Coronary risk Triglycerides HOMA2-IR HDL-C
topic	Insulin resistance Coronary risk Triglycerides HOMA2-IR HDL-C
description	Background: Insulin resistance (IR) is a metabolic disorder related to atherosclerosis. Its measurement is of great importance not only as a marker of diabetes but also for cardiovascular disease. The aim of this research study was to evaluate the relationship between various IR indices and coronary risk in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub study, 1272 individuals of both genders were selected with the measurement of basal insulin and coronary risk according to the Framingham-Wilson formula calibrated for our population. The insulin resistance indices evaluated were HOMA2-IR, triglycerides and glucose index (TyG) and triglycerides/HDL ratio (TG/HDL). The predictive capacity and association between each index and the coronary risk event in 10 years were determined. Results: Of the evaluated population, 55.2% were female, 34.8% had a coronary risk ≥5% in 10 years, with the TG/HDL and TyG indices showing the highest AUC 0.712 (0.681-0.743) and 0.707 (0.675-0.739), respectively; compared to HOMA2-IR. Both were also the indices most associated with increased coronary risk, especially TG/HDL ≥3 with a higher association [OR = 2.83 (1.74-4.61); p<0.01] after multivariable adjustment. Conclusions: TyG (≥4.5) and TG/HDL (≥3) indices showed a great predictive capacity of higher coronary risk, with being TG/HDL more associated even after adjusting for abdominal obesity and hs-CRP. Therefore, these represent useful tools for determining IR.
publishDate	2018
dc.date.accessioned.none.fl_str_mv	2018-07-12T16:26:52Z
dc.date.available.none.fl_str_mv	2018-07-12T16:26:52Z
dc.date.issued.none.fl_str_mv	2018-03
dc.type.eng.fl_str_mv	article
dc.type.coar.fl_str_mv	http://purl.org/coar/resource_type/c_6501
dc.identifier.issn.none.fl_str_mv	20461402
dc.identifier.uri.none.fl_str_mv	http://hdl.handle.net/20.500.12442/2175
identifier_str_mv	20461402
url	http://hdl.handle.net/20.500.12442/2175
dc.language.iso.eng.fl_str_mv	eng
language	eng
dc.rights.coar.fl_str_mv	http://purl.org/coar/access_right/c_abf2
dc.rights.license.spa.fl_str_mv	Licencia de Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional
rights_invalid_str_mv	Licencia de Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional http://purl.org/coar/access_right/c_abf2
dc.publisher.eng.fl_str_mv	is published by F1000 Research Ltd
dc.source.eng.fl_str_mv	F1000Research
dc.source.spa.fl_str_mv	Vol. 7, No.44 (2018)
institution	Universidad Simón Bolívar
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spelling	Licencia de Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacionalhttp://purl.org/coar/access_right/c_abf2Salazar, Juanfbd053e7-5aea-424c-812f-92153ecb9181-1Bermúdez, Valmore29f9aa18-16a4-4fd3-8ce5-ed94a0b8663a-1Olivar, Luis Carlos212e67d1-e669-4a31-9299-d653994d03a6-1Torres, Wheelera82c8c05-2160-44dc-b397-ffc2ac51beca-1Palmar, Jim28ef000c-350b-4805-8bca-b85e40db0d66-1Añez, Roberto0a8ecfdc-a89a-4435-9859-b66bba8947fa-1Ordoñez, Maria Gratzia641b7517-a3d6-4c14-98b6-c2bdd3c96451-1Rivas, José Ramón23def8ec-3ddd-4f73-9cb1-ae826f043717-1Martínez, María Sofía24132de7-a45a-499c-aa91-9dc68c5cbf09-1Hernández, Juan Diegod2e3538d-158e-424a-a3d4-37f5b19a238c-1Graterol, Modesto59713475-4607-4bff-90c1-a66ad9f0a173-1Rojas, Joselyn2aa91570-0516-424d-8f76-25cd7b39be6e-12018-07-12T16:26:52Z2018-07-12T16:26:52Z2018-0320461402http://hdl.handle.net/20.500.12442/2175Background: Insulin resistance (IR) is a metabolic disorder related to atherosclerosis. Its measurement is of great importance not only as a marker of diabetes but also for cardiovascular disease. The aim of this research study was to evaluate the relationship between various IR indices and coronary risk in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub study, 1272 individuals of both genders were selected with the measurement of basal insulin and coronary risk according to the Framingham-Wilson formula calibrated for our population. The insulin resistance indices evaluated were HOMA2-IR, triglycerides and glucose index (TyG) and triglycerides/HDL ratio (TG/HDL). The predictive capacity and association between each index and the coronary risk event in 10 years were determined. Results: Of the evaluated population, 55.2% were female, 34.8% had a coronary risk ≥5% in 10 years, with the TG/HDL and TyG indices showing the highest AUC 0.712 (0.681-0.743) and 0.707 (0.675-0.739), respectively; compared to HOMA2-IR. Both were also the indices most associated with increased coronary risk, especially TG/HDL ≥3 with a higher association [OR = 2.83 (1.74-4.61); p<0.01] after multivariable adjustment. Conclusions: TyG (≥4.5) and TG/HDL (≥3) indices showed a great predictive capacity of higher coronary risk, with being TG/HDL more associated even after adjusting for abdominal obesity and hs-CRP. Therefore, these represent useful tools for determining IR.engis published by F1000 Research LtdF1000ResearchVol. 7, No.44 (2018)Insulin resistanceCoronary riskTriglyceridesHOMA2-IRHDL-CInsulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study [version 1; referees: 1 approved with reservations]articlehttp://purl.org/coar/resource_type/c_6501Rojas J, Bermúdez V, Leal E, et al.: Insulinorresistencia e hiperinsulinemia como factores de riesgo para enfermedad cardiovascular. Archivos Venezolanos de Farmacología y Terapéutica. 2008; 27(1Suppl): 29–39.Gastaldelli A: Role of beta-cell dysfunction, ectopic fat accumulation and insulin resistance in the pathogenesis of type 2 diabetes mellitus. Diabetes Res Clin Pract. 2011; 93(Suppl 1): S60–S65.Aminot-Gilchrist DV, Anderson HD: Insulin resistance-associated cardiovascular disease: potential benefits of conjugated linoleic acid. Am J Clin Nutr. 2004; 79(6 Suppl): 1159S–1163S.De Felice FG, Lourenco MV, Ferreira ST: How does brain insulin resistance develop in Alzheimer’s disease? Alzheimers Dement. 2014; 10(1 Suppl): S26–32.Fonseca VA: Early identification and treatment of insulin resistance: impact on subsequent prediabetes and type 2 diabetes. Clin Cornerstone. 2007; 8 Suppl 7: S7–18.DeFronzo RA, Tobin JD, Andres R: Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol. 1979; 237(3): E214–223.Matthews DR, Hosker JP, Rudenski AS, et al.: Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7): 412–419.Salazar J, Bermúdez V, Calvo M, et al.: Optimal cutoff for the evaluation of insulin resistance through triglyceride-glucose index: A cross-sectional study in a Venezuelan population [version 2; referees: 2 approved]. F1000Research. 2017; 6: 1337.Abel ED, O'Shea KM, Ramasamy R: Insulin resistance: metabolic mechanisms and consequences in the heart. Arterioscler Thromb Vasc Biol. 2012; 32(9): 2068–76.Bermúdez V, Marcano RP, Cano C, et al.: The Maracaibo city metabolic syndrome prevalence study: design and scope. Am J Ther. 2010; 17(3): 288–294.Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F: The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008; 6(4): 299–304.McLaughlin T, Abbasi F, Cheal K, et al.: Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med. 2003; 139(10): 802–9.Bermúdez V, Rojas J, Martínez MS, et al.: Epidemiologic Behavior and Estimation of an Optimal Cut-Off Point for Homeostasis Model Assessment- 2 Insulin Resistance: A Report from a Venezuelan Population. Int Sch Res Notices. 2014; 2014: 616271.Bermúdez V, Salazar J, Bello L, et al.: Coronary Risk Estimation According to a Recalibrated Framingham-Wilson Score in the Maracaibo City Metabolic Syndrome Prevalence Study. The Journal for Cardiology Photon. 2014; 107: 160–170.American Diabetes Association: Standards of Medical Care in Diabetes-2017: Summary of Revisions. Diabetes Care. 2017; 40(Suppl 1): S4–S5.Bermúdez V, Rojas J, Salazar J, et al.: Sensitivity and Specificity Improvement in Abdominal Obesity Diagnosis Using Cluster Analysis during Waist Circumference Cut-Off Point Selection. J Diabetes Res. 2015; 2015: 750265.Bermudez V, Cabrera M, Mendoza L, et al.: Epidemiological behavior of high–sensitivity C-Reactive Protein (hs-CRP) in adult individuals in the Maracaibo city, Venezuela. Revista Latinoamericana de Hipertensión. 2013; 8: 16–24.Akobeng AK: Understanding diagnostic tests 3: Receiver operating characteristic curves. Acta Pediatre. 2007; 96(5): 644–7.Demler OV, Pencina MJ, D'Agostino RB Sr: Misuse of DeLong test to compare AUCs for nested models. Stat Med. 2012; 31(23): 2577–87.Muniyappa R, Iantorno M, Quon MJ: An integrated view of insulin resistance and endothelial dysfunction. Endocrinol Metab Clin North Am. 2008; 37(3): 685–711.Bornfeldt KE, Tabas I: Insulin resistance, hyperglycemia, and atherosclerosis. Cell Metab. 2011; 14(5): 575–585.Martínez-Larrad MT, Lorenzo C, González-Villalpando C, et al.: Associations between surrogate measures of insulin resistance and waist circumference, cardiovascular risk and the metabolic syndrome across Hispanic and non- Hispanic white populations. Diabet Med. 2012; 29(11): 1390–4.Kim MK, Ahn CW, Kang S, et al.: Relationship between the triglyceride glucose index and coronary artery calcification in Korean adults. Cardiovasc Diabetol. 2017; 16(1): 108.Kim JH, Lee DY, Park SE, et al.: Triglyceride glucose index predicts coronary artery calcification better than other indices of insulin resistance in Korean adults: the Kangbuk Samsung Health Study. Precision and Future Medicine. 2017; 1(1): 43–51Sánchez-Íñigo L, Navarro-González D, Fernández-Montero A, et al.: The TyG index may predict the development of cardiovascular events. Eur J Clin Invest. 2016; 46(2): 189–97.Irace C, Carallo C, Scavelli FB, et al.: Markers of insulin resistance and carotid atherosclerosis. A comparison of the homeostasis model assessment and triglyceride glucose index. Int J Clin Pract. 2013; 67(7): 665–672.Quijada Z, Paoli M, Zerpa Y, et al.: The triglyceride/HDL-cholesterol ratio as a marker of cardiovascular risk in obese children; association with traditional and emergent risk factors. Pediatr Diabetes. 2008; 9(5): 464–71.Salazar MR, Carbajal HA, Espeche WG, et al.: Identifying cardiovascular disease risk and outcome: use of the plasma triglyceride/high-density lipoprotein cholesterol concentration ratio versus metabolic syndrome criteria. J Intern Med. 2013; 273(6): 595–601.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.Du T, Yuan G, Zhang M, et al.: Clinical usefulness of lipid ratios, visceral adiposity indicators, and the triglycerides and glucose index as risk markers of insulin resistance. Cardiovasc Diabetol. 2014; 13: 146.Wallace TM, Levy JC, Matthews DR: Use and abuse of HOMA modeling. Diabetes Care. 2004; 27(6): 1487–95.Watt MJ: Storing up trouble: does accumulation of intramyocellular triglyceride protect skeletal muscle from insulin resistance? Clin Exp Pharmacol Physiol. 2009; 36(1): 5–11.Kim SH, Reaven G: Sex differences in insulin resistance and cardiovascular disease risk. J Clin Endocrinol Metab. 2013; 98(11): E1716–21.Salazar J, Bermúdez V, Olivar LC, et al.: Dataset 1 in: Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study. 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Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study [version 1; referees: 1 approved with reservations]

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