The Usefulness of TyG-index to determines insulin resistance in obese adolescents
TyG-index to determines insulin resistance
DOI:
https://doi.org/10.59747/smjidisurabaya.v1i2.25Keywords:
TyG-index, insulin resistance, obesity, HOMA-IRAbstract
Background: Obesity is associated with Insulin Resistance (IR). The Triglycerides Glucose (TyG) index have been used to assess IR, however it needs to establish cut-off points to use in the obese adolescence. Purpose: This study aims to analyse the TyG-index as marker of IR in obese adolescence. Methods: A cross sectional study was conducted on obese adolescents aged 13-18 years in secondary school. Anthropometric measurements were performed. Lipid profile, fasting blood glucose, and insulin level were measured. HOMA IR were calculated using the formula: [glucose (mg/dL) x Insulin (µu/L)] / 405, cut-off value to describes IR was > 3.43 for both sexes which performs for pediatric population. TyG-index was calculated by the formula: TyG = Ln [TG (mg/dl) × FBG (mg/dl)]/2. Receiving operation characteristic (ROC) were carried out to determines area under curve (AUC) and cut-off points of IR for TyG-index determines by the biggest value of Youden index. Results: A total of 256 adolescents with obesity were participated this study. 59.8% (153/256 or) were non-IR, while 40.2% (103/256) had IR; Male: female ratio was 144/112. TyG-index was higher significantly in subjects with IR than non-IR (4.63 + 0.25 vs 4.46 + 0.26; p<0.05). HOMA-IR correlated positively with TyG-index (r=0.397, p=0.000). AUC for TyG-index was 0.703, p=0.000 (95% CI [0.639-0.770]). The best cut-off points for TyG-index to determines IR >4.50, with sensitivity of 70.3% and specificity of 63.23%. Conclusion: TyG-index is useful to be an alternative marker for assessing IR in obese adolescence with the best cut-off point to distinguish IR is > 4.50.
References
Andrade, M.I.S. De, Oliveira, J.S., Leal, V.S., Lima, N.M.S. Da, Costa, E.C., Aquino, N.B. De, Lira, P.I.C. De, 2016. Identification of cutoff points for Homeostatic Model Assessment for Insulin Resistance index in adolescents: Systematic review. Rev. Paul. Pediatr. 34, 234–242.
Aslan Çin, N.N., Yardlmcl, H., Koç, N., Uçaktürk, S.A., Akçil Ok, M., 2020. Triglycerides/high-density lipoprotein cholesterol is a predictor similar to the triglyceride-glucose index for the diagnosis of metabolic syndrome using International Diabetes Federation criteria of insulin resistance in obese adolescents: A cross-sectio. J. Pediatr. Endocrinol. Metab. 33, 777–784.
Basila, A., Hernandez, J., Alarcon, M., 2011. Diagnostic methods of Insulin resistance in a pediatric population. Bol Med Hosp Infant Mex 68, 367–73.
Burrows, R., Correa-Burrows, P., Reyes, M., Blanco, E., Albala, C., Gahagan, S., 2015. Healthy chilean adolescents with HOMA-IR ≥ 2.6 have increased cardiometabolic risk: Association with genetic, biological, and environmental factors. J. Diabetes Res. 2015.
Chu, S.Y., Jung, J.H., Park, M.J., Kim, S.H., 2019. Risk assessment of metabolic syndrome in adolescents using the triglyceride/high-density lipoprotein cholesterol ratio and the total cholesterol/high-density lipoprotein cholesterol ratio. Ann. Pediatr. Endocrinol. Metab. 24, 41–48.
D’Annunzio, G., Vanelli, M., Pistorio, A., Minuto, N., Bergamino, L., Iafusco, D., Lorini, R., Arrigo, T., Banin, P., Cardella, F., Cerutti, F., Cherubini, V., Chiarelli, F., Cotellessa, M., Crinò, A., Meschi, F., Toni, S., Tonini, G., 2009. Insulin resistance and secretion indexes in healthy Italian children and adolescents: A multicentre study. Acta Biomed. l’Ateneo Parm. 80, 21–28.
De Abreu, V.G., Martins, C.J. de M., De Oliveira, P.A.C., Francischetti, E.A., 2017. High-molecular weight adiponectin/HOMA-IR ratio as a biomarker of metabolic syndrome in urban multiethnic Brazilian subjects. PLoS One 12, 1–12.
de Morais, P.R.S., Sousa, A.L.L., Jardim, T. de S.V., Nascente, F.M.N., Mendonça, K.L., Povoa, T.I.R., Carneiro, C. de S., Ferreira, V.R., de Souza, W.K.S.B., Jardim, P.C.B.V., 2016. Correlation of insulin resistance with anthropometric measures and blood pressure in adolescents. Arq. Bras. Cardiol. 106, 319–326.
DeFronzo, R.A., Tobin, J.D., Andres, R., 1979. Glucose clamp technique: A method for quantifying insulin secretion and resistance. Am. J. Physiol. Endocrinol. Metab. Gastrointest. Physiol. 6.
Expert panel on detection evaluation and treatment of high blood cholesterol in adults, 2001. Executive summary of the third report (NCEP) -adult treatment panel III. J. Am. Med. Assoc. 285, 2486–2497.
Guerrero-Romero, F., Simental-Mendía, L.E., González-Ortiz, M., Martínez-Abundis, E., Ramos-Zavala, M.G., Hernández-González, S.O., Jacques-Camarena, O., Rodríguez-Morán, M., 2010. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J. Clin. Endocrinol. Metab. 95, 3347–3351.
Karimi, H., Nezhadali, M., Hedayati, M., Mahdavi, M., Sheikholeslami, S., 2019. The Impact of Adiponectin Gene Polymorphisms on the Insulin Resistance Index in Patients with Diabetes and Newly Diagnosed Type 2 Diabetes. Int. J. Diabetes Metab. 25, 106–112.
Kimm, H., Lee, S.W., Lee, H.S., Shim, K.W., Cho, C.Y., Yun, J.E., Jee, S.H., 2010. Associations between lipid measures and metabolic syndrome, insulin resistance and adiponectin - Usefulness of lipid ratios in Korean men and women. Circ. J. 74, 931–937.
Kurtoglu, S., Hatipoglu, N., Mazcoglu, M., Kendirci, M., Keskin, M., Kondolot, M., 2010. Insulin resistance in obese children and adolescents: HOMA-IR cut-off levels in the prepubertal and pubertal periods. JCRPE J. Clin. Res. Pediatr. Endocrinol. 2, 100–106.
Liang, J., Fu, J., Jiang, Y., Dong, G., Wang, X., Wu, W., 2015. TriGlycerides and high-density lipoprotein cholesterol ratio compared with homeostasis model assessment insulin resistance indexes in screening for metabolic syndrome in the chinese obese children: A cross section study. BMC Pediatr. 15, 1–7.
Locateli, J.C., Lopes, W.A., Simões, C.F., De Oliveira, G.H., Oltramari, K., Bim, R.H., De Souza Mendes, V.H., Remor, J.M., Lopera, C.A., Nardo Junior, N., 2019. Triglyceride/glucose index is a reliable alternative marker for insulin resistance in South American overweight and obese children and adolescents. J. Pediatr. Endocrinol. Metab.
Mirzaalian, Y., Nourian, M., Gholamalizadeh, M., Doaei, S., Hatami, M., Hassanzadeh, A., Askari, G., Farahi, R., 2019. The association of quantitative insulin sensitivity indices (HOMA-IR and QUICKI) with anthropometric and cardiometabolic indicators in adolescents. Arch. Med. Sci. - Atheroscler. Dis. 4, 32–37.
Moran, A., Jacobs, D.R., Steinberger, J., Hong, C.P., Prineas, R., Luepker, R., Sinaiko, A.R., 1999. Insulin resistance during puberty: Results from clamp studies in 357 children. Diabetes 48, 2039–2044.
Özkaya, İ., Bavunoglu, I., Tunçkale, A., 2014. Body Mass Index and Waist Circumference Affect Lipid Parameters Negatively in Turkish Women. Am. J. Public Heal. Res. 2, 226–231.
Parhofer, K.G., 2015. Interaction between glucose and lipid metabolism: More than diabetic dyslipidemia. Diabetes Metab. J. 39, 353–362.
Romualdo, M.C.D.S., De Nóbrega, F.J., Escrivão, M.A.M.S., 2014. Insulin resistance in obese children and adolescents. J. Pediatr. (Rio. J). 90, 600–607.
Samuel, Varman T.; Shulman, G.I., 2012. Integrating mechanisms for insulin resistance. Cell 148, 852–871.
Simental-Mendía, L.E., Guerrero-Romero, F., 2020. The correct formula for the triglycerides and glucose index. Eur. J. Pediatr. 179, 1171.
Simental-Mendía, L.E., Rodríguez-Morán, M., Guerrero-Romero, F., 2008. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab. Syndr. Relat. Disord. 6, 299–304.
Singhal, S.K., Bansal, S., 2018. Original research article : Correlation between insulin resistance ( by HOMA-IR ) and lipid profile among obese adults. Int. J. Med. Heal. Res. 4, 23–25.
Tang, Q., Li, X., Song, P., Xu, L., 2015. Optimal cut-off values for the homeostasis model assessment of insulin resistance (HOMA-IR) and pre-diabetes screening: Developments in research and prospects for the future. Drug Discov. Ther. 9, 380–385.
Ye, J., 2013. Mechanisms of insulin resistance in obesity. Front Med 7, 14–24.
Yin, J., Li, M., Xu, L., Wang, Y., Cheng, H., Zhao, X., Mi, J., 2013. Insulin resistance determined by Homeostasis Model Assessment (HOMA) and associations with metabolic syndrome among Chinese children and teenagers. Diabetol. Metab. Syndr. 5, 1–9.
Zheng, S., Xu, H., Zhou, H., Ren, X., Han, T., Chen, Y., Qiu, H., Wu, P., Zheng, J., Wang, L., Liu, W., Hu, Y., 2017. Associations of lipid profiles with insulin resistance and β cell function in adults with normal glucose tolerance and different categories of impaired glucose regulation. PLoS One 12, 1–11.
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2023 Nur Aisiyah Widjaja, Roedi Irawan
This work is licensed under a Creative Commons Attribution 4.0 International License.
