BACKGROUND Primary liver cancer,particularly hepatocellular carcinoma(HCC),ranks as the sixth most prevalent cancer globally and the third major cause of cancerassociated mortality.Despite the available immunotherapie...BACKGROUND Primary liver cancer,particularly hepatocellular carcinoma(HCC),ranks as the sixth most prevalent cancer globally and the third major cause of cancerassociated mortality.Despite the available immunotherapies and combined immunotherapy and targeted therapy,the prognosis for many patients remains dismal.Accurately identifying the appropriate patient cohorts is crucial for improving treatment outcomes.AIM To investigate the prognostic value of the triglyceride-glucose(TyG)index-a novel,accessible marker of insulin resistance-in predicting therapeutic outcomes among patients with hepatitis B virus(HBV)-related HCC treated with camrelizumab and lenvatinib.METHODS In this study,we conducted a retrospective review of 278 patients diagnosed with stage B/C HBV-related HCC who underwent combination therapy.Based on their TyG index,patients were categorized into high and low TyG index groups.A nomogram prediction model was developed based on independent prognostic factors for overall survival(OS)and validated using the C-index and calibration curves.RESULTS Of the 278 patients enrolled in the study,144 were assigned to the high TyG index group,while the remaining 134 were classified into the low index group.Importantly,patients with a low TyG index demonstrated a significantly prolonged median progression-free survival and OS relative to those with a high index.Additionally,the objective response rate and disease control rate were 22.39%and 64.18%in the low TyG index group,whereas they were 12.50%and 51.39%in the high TyG index group,respectively.Moreover,the incidence of hypertension was higher in the high TyG index group than in the low TyG index group.The incidence of other adverse effects did not differ significantly between the groups.Multivariate regression analysis identified independent prognostic factors for OS,including the Barcelona Clinic Liver Cancer stage,alpha-fetoprotein level,Eastern Cooperative Oncology Group score,distant metastasis,and the TyG index.The risk ratio of the TyG index was 0.48(95%confidence interval:0.31-0.72,P<0.001).CONCLUSION The TyG index is a reliable long-term predictor of response to combined immunotherapy and targeted therapy in patients with HBV-related HCC.Patients with a low TyG index tend to experience better clinical outcomes.展开更多
Background Insulin resistance(IR)is linked to coronary artery disease(CAD)and cardiovascular events.The triglyceride-glucose(TyG)index is a simple marker for IR,but its role in predicting CAD severity and long-term cl...Background Insulin resistance(IR)is linked to coronary artery disease(CAD)and cardiovascular events.The triglyceride-glucose(TyG)index is a simple marker for IR,but its role in predicting CAD severity and long-term clinical outcomes in people without previous heart disease is unclear.Methods This retrospective study included 619 patients who underwent elective coronary angiography for CAD evaluation.The TyG index was calculated us-ing the formula Ln[fasting triglycerides(mg/dL)×fasting blood glucose(mg/dL)/2].Clinical characteristics,labo-ratory results,and medication use were collected,and the severity of CAD was assessed by coronary angiography.During a median follow-up period of 30 months,the incidence of long-term major adverse cardiovascular events(MACE),including acute myocardial infarction(AMI),revascularization,stroke,and all-cause death,was record-ed.The association between the TyG index and the incidence of MACE was analyzed using Cox regression models.Results The TyG index was notably higher in the CAD group[10.1(9.8-10.5)vs.8.9(8.5-9.1),P<0.001].The TyG index was significantly associated with CAD severity,with higher TyG levels corresponding to greater steno-sis in the coronary arteries.Higher TyG index levels were also linked to an increased incidence of MACE,particu-larly AMI.In multivariate analysis,the TyG index was identified as an independent predictor of MACE(HR:2.117,95%CI:1.308-3.425,P=0.002).Kaplan-Meier curves showed that individuals in the high TyG index tertile had sig-nificantly higher MACEs rate compared to those in the low and medium TyG groups(P<0.0001).Conclusions The TyG index is a significant predictor of CAD severity and MACE in individuals without prior heart disease.This study highlighted the prognostic value of the TyG index in cardiovascular risk assessment,suggesting that it might be a valuable tool for identifying individuals at higher risk of severe CAD and adverse cardiovascular outcomes.展开更多
This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma pa...This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma patients undergoing combined camrelizumab and lenvatinib therapy.While we acknowledge the study’s clinical relevance in proposing an easily accessible metabolic biomarker,we delve into the mechanistic plausibility linking insulin resistance to immunotherapy response and angiogenic inhibition.We further critically examine the methodological limitations,including the retrospective design,the populationspecific TyG cut-off value,and unaddressed metabolic confounders.We highlight the imperative for future research to validate its utility across diverse etiologies and treatment settings,and to unravel the underlying immunometabolic pathways.展开更多
The associations of co-exposure to per-and polyfluoroalkyl substances(PFAS),polycyclic aromatic hydrocarbons(PAHs),and metals with children’s glycometabolism and the underlying mechanism of immune inflammation are la...The associations of co-exposure to per-and polyfluoroalkyl substances(PFAS),polycyclic aromatic hydrocarbons(PAHs),and metals with children’s glycometabolism and the underlying mechanism of immune inflammation are largely unclear.We conducted a longitudinal panel study to explore the effects of individual and mixture of 27 contaminants on an emerging surrogate indicator of insulin resistance,triglyceride-glucose index(TyG),and the mediation of immunoglobulins and cytokines in children aged 4–6 years and 11–13 years.The results showed robust associations of perfluorooctanoic acid(PFOA),perfluorononanoic acid(PFNA),perfluoroundecanoic acid(PFUnDA),and arsenic(As)with elevated TyG.The interaction of PFNA with PFOA was significant,showing a synergistic effect on TyG.And combined association of each pair of PFOA,PFNA,and As with TyG were enhanced.Meanwhile,the effect of contaminants mixture on TyG was significant for polyfluoroalkyl substances(PFAS)mixture,of which 6:2 Chlorinated polyfluorinated ether sulfonates(Cl-PFESA),PFNA,and PFUnDA weighted more than others.Notably,contaminants were related to immune globulins and cytokines,of which chemokine ligand(CCL)4,interleukin(IL)-1β,IL-9,and tumor necrosis factor(TNF)-α significantly mediated associations of PFOA,PFNA,and PFUnDA with TyG.Accordingly,PFAS and metals were individually and jointly associated with TyG elevation,with 6:2 Cl-PFESA,PFNA,and PFUnDA contributing the most,and CCL4,IL-1β,IL-9,and TNF-α might be the underlying mediators in children.展开更多
AIM:To investigate the levels of the triglyceride-glucose(TyG)index and sex hormone-binding globulin(SHBG)in patients with type 2 diabetes mellitus(T2DM)with diabetic retinopathy(DR),and to explore their correlations ...AIM:To investigate the levels of the triglyceride-glucose(TyG)index and sex hormone-binding globulin(SHBG)in patients with type 2 diabetes mellitus(T2DM)with diabetic retinopathy(DR),and to explore their correlations with biochemical parameters and the homeostasis model assessment of insulin resistance(HOMA-IR)in DR patients.METHODS:Patients with T2DM and healthy individuals were enrolled.Age and body mass index(BMI)of the participants were collected,TyG of the subjects was calculated using the formula,SHBG level of the subjects was detected,and blood biochemical indexes were measured at the same time.The changes of each index among the groups were statistically analyzed,and the relationship between TyG,SHBG,DR and each index was analyzed.RESULTS:A total of 150 patients with T2DM and 64 healthy individuals as normal controls(NC,28 males and 36 females,mean age 54.49±10.10y)were enrolled following ophthalmic evaluation.Patients were categorized into non-DR group(42 males and 36 females,mean age 56.68±8.02y)and DR group(35 males and 37 females,mean age,53.83±11.10y).TyG levels were significantly elevated in both non-DR(7.25±0.62)and DR groups(8.02±0.82)compared to controls(6.85±0.48),with the DR group demonstrating higher TyG values than the non-DR group(P<0.05).The level of SHBG(nmol/L)in DR group(25.05±14.06)was lower than that in control group(41.90±22.6)and non-DR group(36.27±20.00;P<0.05).TyG exhibited significant inverse correlations with SHBG(r=-0.455)and high density lipoprotein(HDL;r=-0.430)levels(P<0.05).It was positively correlated with BMI,fasting blood glucose(FBG),2h postprandial blood glucose(PBG),fasting C-peptide(FCP),glycated hemoglobin A1c(HbA1c),HOMA-IR,total cholesterol(TC)and triglycerides(TG)(r=0.406,0.768,0.386,0.393,0.475,0.250,0.242,0.888,respectively,P<0.05).SHBG was negatively correlated with BMI,FBG,FCP,HbA1c and TyG(r=-0.440,-0.304,-0.407,-0.209,-0.455,respectively,P<0.05),and positively correlated with age,TG and HDL(r=0.238,0.034,0.227,respectively,P<0.05).Further multiple regression analysis showed that SHBG was negatively correlated with TyG(P=0.006).CONCLUSION:Elevated TyG index,reduces SHBG levels,and their negative correlation in the DR group suggest potential roles of TyG and SHBG in the pathogenesis and progression of DR.Combined assessment of SHBG and TyG may provide valuable insights for DR prediction and diagnosis.展开更多
Background The triglyceride-glucose(TyG)index has been widely studied in metabolic and cardiovascular diseases.ST-segment elevation myocardial infarction(STEMI)patients undergoing percutaneous coronary inter-vention(P...Background The triglyceride-glucose(TyG)index has been widely studied in metabolic and cardiovascular diseases.ST-segment elevation myocardial infarction(STEMI)patients undergoing percutaneous coronary inter-vention(PCI)are at increased risk of pulmonary infection due to their stressful conditions.While previous studies have confirmed the predictive role of TyG index in the prognosis of STEMI patients,its potential association with pulmonary infection remains unclear.This study was to explored the relationship between the TyG index and pul-monary infection in STEMI patients PCI.Methods STEMI patients who underwent PCI were enrolled and strati-fied into three tertiles based on the TyG index measured after receiving PCI.Primary outcome was pulmonary infec-tion during hospitalization.Secondary outcomes were in-hospital bleeding,all-cause mortality and major adverse cardiac events(MACE)as well as MACE during follow-up.Logistic regression and Cox proportional hazard re-gression were mainly used to estimate outcomes.Results 3652 patients were enrolled in this study.In multivari-ate logistic regression,the TyG index was associated with in-hospital pulmonary infection[adjusted odds ratio(aOR):1.29,95%CI:1.05-1.58,P=0.014],mortality(aOR:2.27,95%CI:1.64-3.15,P<0.001),MACE(aOR:1.81,95%CI:1.39-2.37,P<0.001),and any bleeding(aOR:1.22,95%CI:1.04-1.43,P=0.013).The median follow-up was 1.70 years.After adjusting for potential confounders,the TyG index was positively related to long-term MACE(aHR:1.26,95%CI:1.06-1.49,P=0.009).Conclusions A high TyG index was associated with in-hospital pulmo-nary infection,bleeding,mortality and MACE in patients with STEMI undergoing PCI.Additionally,it is also asso-ciated with long-term MACE.展开更多
Gastric cancer(GC),the fifth most common malignancy worldwide,poses a substantial challenge in clinical oncology,particularly in its advanced stages.Despite advancements in immunotherapy,patient prognosis remains poor...Gastric cancer(GC),the fifth most common malignancy worldwide,poses a substantial challenge in clinical oncology,particularly in its advanced stages.Despite advancements in immunotherapy,patient prognosis remains poor,underscoring the need for reliable prognostic tools to refine treatment strategies.A study by Yao et al explores the role of the triglyceride-glucose(TyG)index as a prognostic marker for advanced GC patients receiving immunotherapy combined with chemotherapy.The results of the study demonstrate that the TyG index correlates with improved survival outcomes,including better progression-free survival and overall survival.This editorial critically evaluates the significance of these findings,discusses their implications for future research,and highlights innovative directions that could drive further breakthroughs in the application of the TyG index to cancer therapy.This editorial also highlights the potential of TyG in advancing precision oncology and advocates for global validation and mechanistic investigations to further solidify its clinical utility.Future research should focus on validating the TyG index across various malignancies,exploring its potential to influence immunotherapy through metabolic interventions,and developing multi-biomarker models that integrate TyG with immune and genomic profiles.展开更多
Gastric cancer(GC)remains one of the leading causes of cancer-related mortality worldwide.Accurate prognostic assessment,which is essential for enhancing overall survival(OS),currently depends on pathologic and clinic...Gastric cancer(GC)remains one of the leading causes of cancer-related mortality worldwide.Accurate prognostic assessment,which is essential for enhancing overall survival(OS),currently depends on pathologic and clinical staging.This underscores the urgent need for reliable and real-time prognostic biomarkers.The triglyceride-glucose(TyG)index,a readily available marker of insulin resistance,has recently emerged as a potential prognostic tool in GC.Numerous studies have consistently shown a significant association between elevated TyG levels and inferior OS as well as progression-free survival.Despite these promising findings,several challenges must be addressed before the TyG index can be widely adopted in clinical practice.Firstly,the TyG index lacks cancer-specificity,reflecting broader metabolic disturbances commonly observed in conditions such as obesity,diabetes,and cardiovascular disease.This lack of specificity complicates its interpretation in oncological settings.Additionally,the cutoff values for TyG index vary across studies,hindering the establishment of a standardized threshold for clinical application.While the TyG index provides valuable insights into a patient's metabolic health,its limited cancer specificity necessitates cautious use when evaluating the prognosis of GC treatment.展开更多
Gastric cancer(GC)remains a leading cause of cancer-related mortality worldwide,necessitating the identification of reliable prognostic indicators to enhance treatment outcomes.Recent research has highlighted the trig...Gastric cancer(GC)remains a leading cause of cancer-related mortality worldwide,necessitating the identification of reliable prognostic indicators to enhance treatment outcomes.Recent research has highlighted the triglyceride-glucose(TyG)index as a potential surrogate marker for insulin resistance,which may significantly influence the prognosis of patients undergoing immunotherapy combined with chemotherapy.In this context,the study by Yao et al demonstrates that a high TyG index correlates with improved overall survival and progressionfree survival in advanced GC patients receiving sintilimab and chemotherapy.Specifically,patients in the high TyG group had a significantly longer median progression-free survival of 9.8 months[95%confidence interval(CI):9.2-10.9]compared to 8.0 months(95%CI:7.5-8.5)in the low TyG group(hazard ratio=0.58,95%CI:0.43-0.79,P<0.001).Similarly,the median overall survival was significantly longer in the high TyG group at 23.1 months(95%CI:21.2-NA)vs 16.5 months(95%CI:13.9-18.3)in the low TyG group(hazard ratio=0.30,95%CI:0.21-0.42,P<0.001).These findings underscore the strong prognostic potential of the TyG index in guiding treatment strategies for advanced GC.These findings underscore the need for further investigation into the TyG index’s role as a prognostic tool and its underlying mechanisms in influencing treatment efficacy.We advocate for additional multicenter studies to validate these results and explore the TyG index’s applicability across diverse patient populations,ultimately aiming to refine treatment strategies and improve patient outcomes in advanced GC.展开更多
Objectives:To explore the predictive value of the atherogenic index of plasma(AIP),triglyceride-glucose(TyG)index,and cerebral small vascular disease(CSVD)imaging load score regarding the early prognosis of patients w...Objectives:To explore the predictive value of the atherogenic index of plasma(AIP),triglyceride-glucose(TyG)index,and cerebral small vascular disease(CSVD)imaging load score regarding the early prognosis of patients with acute ischemic stroke(AIS)after intravenous thrombolysis.Methods:A total of 379 inpatients(diagnosed with AIS at the Shengli Oilfield Central Hospital and treated with intravenous thrombolysis from January 2022 to December 2023)were retrospectively analyzed.Relevant data were collected,and the CSVD imaging load score was evaluated.The patients were classified into the good prognosis group(≥18%)and the poor prognosis group(<18%)based on the early neurological improvement rate 14 d after thrombolysis.An investigation into the independent risk factors influencing the early prognostic outcomes in patients suffering from AIS was conducted utilizing binary Logistic regression analysis.The efficacy of early prognosis prediction in patients undergoing intravenous thrombolysis was assessed through receiver operating characteristic(ROC)curve analysis.Results:Systolic blood pressure,AIP,TyG index,neutrophil to lymphocyte ratio(NLR),cerebral microbleeds(CMB),enlarged perivascular spaces(EPVS)and a CSVD imaging load score of 2 points or higher served as independentrisk factors influencing the early prognosis in AIS patients undergoing thrombolysis.The ROC curve analysis revealed that the area under the curve(AUC)for the CSVD imaging load score was 0.821,with a sensitivity of 80.4%and a specificity of 74%.The AUC of the AIP was 0.951,with a sensitivity of 89.2%and a specificity of 91.7%.The AUC of the TyG index was 0.918,with a sensitivity of 93.1%and a specificity of 82.7%.Conclusions:The AIP,TyG index,and CSVD imaging load score serve as efficacious indicators in assessing the premature prognostication of AIS patients who underwent subsequently to intravenous thrombolytic therapy.展开更多
BACKGROUND Recent studies have indicated that triglyceride glucose(TyG)-waist height ratio(WHtR)and TyG-waist circumference(TyG-WC)are effective indicators for evaluating insulin resistance.However,research on the ass...BACKGROUND Recent studies have indicated that triglyceride glucose(TyG)-waist height ratio(WHtR)and TyG-waist circumference(TyG-WC)are effective indicators for evaluating insulin resistance.However,research on the association in TyG-WHtR,TyG-WC,and the risk and prognosis of major adverse cardiovascular events(MACEs)in type 2 diabetes mellitus(T2DM)cases are limited.AIM To clarify the relation in TyG-WHtR,TyG-WC,and the risk of MACEs and overall mortality in T2DM patients.METHODS Information for this investigation was obtained from Action to Control Cardiovascular Risk in Diabetes(ACCORD)/ACCORD Follow-On(ACCORDION)study database.The Cox regression model was applied to assess the relation among TyG-WHtR,TyG-WC and future MACEs risk and overall mortality in T2DM cases.The RCS analysis was utilized to explore the nonlinear correlation.Subgroup and interaction analyses were conducted to prove the robustness.The receiver operating characteristic curves were applied to analysis the additional predicting value of TyG-WHtR and TyG-WC.RESULTS After full adjustment for confounding variables,the highest baseline TyG-WHtR cohort respectively exhibited a 1.353-fold and 1.420-fold higher risk for MACEs and overall mortality,than the lowest quartile group.Similarly,the highest baseline TyG-WC cohort showed a 1.314-fold and 1.480-fold higher risk for MACEs and overall mortality,respectively.Each 1 SD increase in TyG-WHtR was significantly related to an 11.7%increase in MACEs and a 14.9%enhance in overall mortality.Each 1 SD increase in TyG-WC corresponded to an 11.5%in MACEs and a 16.6%increase in overall mortality.Including these two indexes in conventional models significantly improved the predictive power for MACEs and overall mortality.CONCLUSION TyG-WHtR and TyG-WC were promising predictors of MACEs and overall mortality risk in T2DM cases.展开更多
文摘BACKGROUND Primary liver cancer,particularly hepatocellular carcinoma(HCC),ranks as the sixth most prevalent cancer globally and the third major cause of cancerassociated mortality.Despite the available immunotherapies and combined immunotherapy and targeted therapy,the prognosis for many patients remains dismal.Accurately identifying the appropriate patient cohorts is crucial for improving treatment outcomes.AIM To investigate the prognostic value of the triglyceride-glucose(TyG)index-a novel,accessible marker of insulin resistance-in predicting therapeutic outcomes among patients with hepatitis B virus(HBV)-related HCC treated with camrelizumab and lenvatinib.METHODS In this study,we conducted a retrospective review of 278 patients diagnosed with stage B/C HBV-related HCC who underwent combination therapy.Based on their TyG index,patients were categorized into high and low TyG index groups.A nomogram prediction model was developed based on independent prognostic factors for overall survival(OS)and validated using the C-index and calibration curves.RESULTS Of the 278 patients enrolled in the study,144 were assigned to the high TyG index group,while the remaining 134 were classified into the low index group.Importantly,patients with a low TyG index demonstrated a significantly prolonged median progression-free survival and OS relative to those with a high index.Additionally,the objective response rate and disease control rate were 22.39%and 64.18%in the low TyG index group,whereas they were 12.50%and 51.39%in the high TyG index group,respectively.Moreover,the incidence of hypertension was higher in the high TyG index group than in the low TyG index group.The incidence of other adverse effects did not differ significantly between the groups.Multivariate regression analysis identified independent prognostic factors for OS,including the Barcelona Clinic Liver Cancer stage,alpha-fetoprotein level,Eastern Cooperative Oncology Group score,distant metastasis,and the TyG index.The risk ratio of the TyG index was 0.48(95%confidence interval:0.31-0.72,P<0.001).CONCLUSION The TyG index is a reliable long-term predictor of response to combined immunotherapy and targeted therapy in patients with HBV-related HCC.Patients with a low TyG index tend to experience better clinical outcomes.
文摘Background Insulin resistance(IR)is linked to coronary artery disease(CAD)and cardiovascular events.The triglyceride-glucose(TyG)index is a simple marker for IR,but its role in predicting CAD severity and long-term clinical outcomes in people without previous heart disease is unclear.Methods This retrospective study included 619 patients who underwent elective coronary angiography for CAD evaluation.The TyG index was calculated us-ing the formula Ln[fasting triglycerides(mg/dL)×fasting blood glucose(mg/dL)/2].Clinical characteristics,labo-ratory results,and medication use were collected,and the severity of CAD was assessed by coronary angiography.During a median follow-up period of 30 months,the incidence of long-term major adverse cardiovascular events(MACE),including acute myocardial infarction(AMI),revascularization,stroke,and all-cause death,was record-ed.The association between the TyG index and the incidence of MACE was analyzed using Cox regression models.Results The TyG index was notably higher in the CAD group[10.1(9.8-10.5)vs.8.9(8.5-9.1),P<0.001].The TyG index was significantly associated with CAD severity,with higher TyG levels corresponding to greater steno-sis in the coronary arteries.Higher TyG index levels were also linked to an increased incidence of MACE,particu-larly AMI.In multivariate analysis,the TyG index was identified as an independent predictor of MACE(HR:2.117,95%CI:1.308-3.425,P=0.002).Kaplan-Meier curves showed that individuals in the high TyG index tertile had sig-nificantly higher MACEs rate compared to those in the low and medium TyG groups(P<0.0001).Conclusions The TyG index is a significant predictor of CAD severity and MACE in individuals without prior heart disease.This study highlighted the prognostic value of the TyG index in cardiovascular risk assessment,suggesting that it might be a valuable tool for identifying individuals at higher risk of severe CAD and adverse cardiovascular outcomes.
文摘This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma patients undergoing combined camrelizumab and lenvatinib therapy.While we acknowledge the study’s clinical relevance in proposing an easily accessible metabolic biomarker,we delve into the mechanistic plausibility linking insulin resistance to immunotherapy response and angiogenic inhibition.We further critically examine the methodological limitations,including the retrospective design,the populationspecific TyG cut-off value,and unaddressed metabolic confounders.We highlight the imperative for future research to validate its utility across diverse etiologies and treatment settings,and to unravel the underlying immunometabolic pathways.
基金supported by the National Key Research and Development Program of China(No.2022YFC3702702)the National Natural Science Foundation of China(No.82404295)the Fundamental Research Funds for the Central Universities,HUST(No.2020kfyXJJS058).
文摘The associations of co-exposure to per-and polyfluoroalkyl substances(PFAS),polycyclic aromatic hydrocarbons(PAHs),and metals with children’s glycometabolism and the underlying mechanism of immune inflammation are largely unclear.We conducted a longitudinal panel study to explore the effects of individual and mixture of 27 contaminants on an emerging surrogate indicator of insulin resistance,triglyceride-glucose index(TyG),and the mediation of immunoglobulins and cytokines in children aged 4–6 years and 11–13 years.The results showed robust associations of perfluorooctanoic acid(PFOA),perfluorononanoic acid(PFNA),perfluoroundecanoic acid(PFUnDA),and arsenic(As)with elevated TyG.The interaction of PFNA with PFOA was significant,showing a synergistic effect on TyG.And combined association of each pair of PFOA,PFNA,and As with TyG were enhanced.Meanwhile,the effect of contaminants mixture on TyG was significant for polyfluoroalkyl substances(PFAS)mixture,of which 6:2 Chlorinated polyfluorinated ether sulfonates(Cl-PFESA),PFNA,and PFUnDA weighted more than others.Notably,contaminants were related to immune globulins and cytokines,of which chemokine ligand(CCL)4,interleukin(IL)-1β,IL-9,and tumor necrosis factor(TNF)-α significantly mediated associations of PFOA,PFNA,and PFUnDA with TyG.Accordingly,PFAS and metals were individually and jointly associated with TyG elevation,with 6:2 Cl-PFESA,PFNA,and PFUnDA contributing the most,and CCL4,IL-1β,IL-9,and TNF-α might be the underlying mediators in children.
基金Supported by the Science and Technology Plan Project of Xi’an Science and Technology Bureau(No.23YXYJ0103)Chinese Society of Research Hospitals Ophthalmic New Technology Incubation Project(No.Y2025FH-YKYSJSJ07-18).
文摘AIM:To investigate the levels of the triglyceride-glucose(TyG)index and sex hormone-binding globulin(SHBG)in patients with type 2 diabetes mellitus(T2DM)with diabetic retinopathy(DR),and to explore their correlations with biochemical parameters and the homeostasis model assessment of insulin resistance(HOMA-IR)in DR patients.METHODS:Patients with T2DM and healthy individuals were enrolled.Age and body mass index(BMI)of the participants were collected,TyG of the subjects was calculated using the formula,SHBG level of the subjects was detected,and blood biochemical indexes were measured at the same time.The changes of each index among the groups were statistically analyzed,and the relationship between TyG,SHBG,DR and each index was analyzed.RESULTS:A total of 150 patients with T2DM and 64 healthy individuals as normal controls(NC,28 males and 36 females,mean age 54.49±10.10y)were enrolled following ophthalmic evaluation.Patients were categorized into non-DR group(42 males and 36 females,mean age 56.68±8.02y)and DR group(35 males and 37 females,mean age,53.83±11.10y).TyG levels were significantly elevated in both non-DR(7.25±0.62)and DR groups(8.02±0.82)compared to controls(6.85±0.48),with the DR group demonstrating higher TyG values than the non-DR group(P<0.05).The level of SHBG(nmol/L)in DR group(25.05±14.06)was lower than that in control group(41.90±22.6)and non-DR group(36.27±20.00;P<0.05).TyG exhibited significant inverse correlations with SHBG(r=-0.455)and high density lipoprotein(HDL;r=-0.430)levels(P<0.05).It was positively correlated with BMI,fasting blood glucose(FBG),2h postprandial blood glucose(PBG),fasting C-peptide(FCP),glycated hemoglobin A1c(HbA1c),HOMA-IR,total cholesterol(TC)and triglycerides(TG)(r=0.406,0.768,0.386,0.393,0.475,0.250,0.242,0.888,respectively,P<0.05).SHBG was negatively correlated with BMI,FBG,FCP,HbA1c and TyG(r=-0.440,-0.304,-0.407,-0.209,-0.455,respectively,P<0.05),and positively correlated with age,TG and HDL(r=0.238,0.034,0.227,respectively,P<0.05).Further multiple regression analysis showed that SHBG was negatively correlated with TyG(P=0.006).CONCLUSION:Elevated TyG index,reduces SHBG levels,and their negative correlation in the DR group suggest potential roles of TyG and SHBG in the pathogenesis and progression of DR.Combined assessment of SHBG and TyG may provide valuable insights for DR prediction and diagnosis.
基金supported by the Shuangqing Talent Program Project of Guangdong Provincial People′s Hospital(No.KJ012019084)and(No.KJ012019095)High-level Hospital Construction Project(No.DFJH2020021)Basic and Applied Basic Research Fund of Guangdong Province(No.2023A1515220174)。
文摘Background The triglyceride-glucose(TyG)index has been widely studied in metabolic and cardiovascular diseases.ST-segment elevation myocardial infarction(STEMI)patients undergoing percutaneous coronary inter-vention(PCI)are at increased risk of pulmonary infection due to their stressful conditions.While previous studies have confirmed the predictive role of TyG index in the prognosis of STEMI patients,its potential association with pulmonary infection remains unclear.This study was to explored the relationship between the TyG index and pul-monary infection in STEMI patients PCI.Methods STEMI patients who underwent PCI were enrolled and strati-fied into three tertiles based on the TyG index measured after receiving PCI.Primary outcome was pulmonary infec-tion during hospitalization.Secondary outcomes were in-hospital bleeding,all-cause mortality and major adverse cardiac events(MACE)as well as MACE during follow-up.Logistic regression and Cox proportional hazard re-gression were mainly used to estimate outcomes.Results 3652 patients were enrolled in this study.In multivari-ate logistic regression,the TyG index was associated with in-hospital pulmonary infection[adjusted odds ratio(aOR):1.29,95%CI:1.05-1.58,P=0.014],mortality(aOR:2.27,95%CI:1.64-3.15,P<0.001),MACE(aOR:1.81,95%CI:1.39-2.37,P<0.001),and any bleeding(aOR:1.22,95%CI:1.04-1.43,P=0.013).The median follow-up was 1.70 years.After adjusting for potential confounders,the TyG index was positively related to long-term MACE(aHR:1.26,95%CI:1.06-1.49,P=0.009).Conclusions A high TyG index was associated with in-hospital pulmo-nary infection,bleeding,mortality and MACE in patients with STEMI undergoing PCI.Additionally,it is also asso-ciated with long-term MACE.
基金Supported by the Natural Science Foundation of Fujian Province,No.2023J01160Scientific Research Project of Putian University,No.2022059Special Project for Outstanding Young Talents of Putian University,No.2024072.
文摘Gastric cancer(GC),the fifth most common malignancy worldwide,poses a substantial challenge in clinical oncology,particularly in its advanced stages.Despite advancements in immunotherapy,patient prognosis remains poor,underscoring the need for reliable prognostic tools to refine treatment strategies.A study by Yao et al explores the role of the triglyceride-glucose(TyG)index as a prognostic marker for advanced GC patients receiving immunotherapy combined with chemotherapy.The results of the study demonstrate that the TyG index correlates with improved survival outcomes,including better progression-free survival and overall survival.This editorial critically evaluates the significance of these findings,discusses their implications for future research,and highlights innovative directions that could drive further breakthroughs in the application of the TyG index to cancer therapy.This editorial also highlights the potential of TyG in advancing precision oncology and advocates for global validation and mechanistic investigations to further solidify its clinical utility.Future research should focus on validating the TyG index across various malignancies,exploring its potential to influence immunotherapy through metabolic interventions,and developing multi-biomarker models that integrate TyG with immune and genomic profiles.
基金Supported by National Natural Science Foundation of China,No.82301700(to Wang B)and No.82471464(to Li S)Liaoning Province Natural Science Foundation Project,No.2023-MS-266(to Teng Y)and No.2024-MS-157(to Wang B)+2 种基金Youth Talent Cultivation Fund Key Project of Dalian Medical University(to Wang B)Scientific Research Projects from Wuhan Municipal Health Commission,No.WX23Z26(to Xia M)Research Project Plan of the Qingpu Branch of Zhongshan Hospital,No.QYT2023-02(to Chen DF).
文摘Gastric cancer(GC)remains one of the leading causes of cancer-related mortality worldwide.Accurate prognostic assessment,which is essential for enhancing overall survival(OS),currently depends on pathologic and clinical staging.This underscores the urgent need for reliable and real-time prognostic biomarkers.The triglyceride-glucose(TyG)index,a readily available marker of insulin resistance,has recently emerged as a potential prognostic tool in GC.Numerous studies have consistently shown a significant association between elevated TyG levels and inferior OS as well as progression-free survival.Despite these promising findings,several challenges must be addressed before the TyG index can be widely adopted in clinical practice.Firstly,the TyG index lacks cancer-specificity,reflecting broader metabolic disturbances commonly observed in conditions such as obesity,diabetes,and cardiovascular disease.This lack of specificity complicates its interpretation in oncological settings.Additionally,the cutoff values for TyG index vary across studies,hindering the establishment of a standardized threshold for clinical application.While the TyG index provides valuable insights into a patient's metabolic health,its limited cancer specificity necessitates cautious use when evaluating the prognosis of GC treatment.
文摘Gastric cancer(GC)remains a leading cause of cancer-related mortality worldwide,necessitating the identification of reliable prognostic indicators to enhance treatment outcomes.Recent research has highlighted the triglyceride-glucose(TyG)index as a potential surrogate marker for insulin resistance,which may significantly influence the prognosis of patients undergoing immunotherapy combined with chemotherapy.In this context,the study by Yao et al demonstrates that a high TyG index correlates with improved overall survival and progressionfree survival in advanced GC patients receiving sintilimab and chemotherapy.Specifically,patients in the high TyG group had a significantly longer median progression-free survival of 9.8 months[95%confidence interval(CI):9.2-10.9]compared to 8.0 months(95%CI:7.5-8.5)in the low TyG group(hazard ratio=0.58,95%CI:0.43-0.79,P<0.001).Similarly,the median overall survival was significantly longer in the high TyG group at 23.1 months(95%CI:21.2-NA)vs 16.5 months(95%CI:13.9-18.3)in the low TyG group(hazard ratio=0.30,95%CI:0.21-0.42,P<0.001).These findings underscore the strong prognostic potential of the TyG index in guiding treatment strategies for advanced GC.These findings underscore the need for further investigation into the TyG index’s role as a prognostic tool and its underlying mechanisms in influencing treatment efficacy.We advocate for additional multicenter studies to validate these results and explore the TyG index’s applicability across diverse patient populations,ultimately aiming to refine treatment strategies and improve patient outcomes in advanced GC.
基金supported by Shandong Medical Health Science and Technology Surface Project(No.202303071517).
文摘Objectives:To explore the predictive value of the atherogenic index of plasma(AIP),triglyceride-glucose(TyG)index,and cerebral small vascular disease(CSVD)imaging load score regarding the early prognosis of patients with acute ischemic stroke(AIS)after intravenous thrombolysis.Methods:A total of 379 inpatients(diagnosed with AIS at the Shengli Oilfield Central Hospital and treated with intravenous thrombolysis from January 2022 to December 2023)were retrospectively analyzed.Relevant data were collected,and the CSVD imaging load score was evaluated.The patients were classified into the good prognosis group(≥18%)and the poor prognosis group(<18%)based on the early neurological improvement rate 14 d after thrombolysis.An investigation into the independent risk factors influencing the early prognostic outcomes in patients suffering from AIS was conducted utilizing binary Logistic regression analysis.The efficacy of early prognosis prediction in patients undergoing intravenous thrombolysis was assessed through receiver operating characteristic(ROC)curve analysis.Results:Systolic blood pressure,AIP,TyG index,neutrophil to lymphocyte ratio(NLR),cerebral microbleeds(CMB),enlarged perivascular spaces(EPVS)and a CSVD imaging load score of 2 points or higher served as independentrisk factors influencing the early prognosis in AIS patients undergoing thrombolysis.The ROC curve analysis revealed that the area under the curve(AUC)for the CSVD imaging load score was 0.821,with a sensitivity of 80.4%and a specificity of 74%.The AUC of the AIP was 0.951,with a sensitivity of 89.2%and a specificity of 91.7%.The AUC of the TyG index was 0.918,with a sensitivity of 93.1%and a specificity of 82.7%.Conclusions:The AIP,TyG index,and CSVD imaging load score serve as efficacious indicators in assessing the premature prognostication of AIS patients who underwent subsequently to intravenous thrombolytic therapy.
文摘BACKGROUND Recent studies have indicated that triglyceride glucose(TyG)-waist height ratio(WHtR)and TyG-waist circumference(TyG-WC)are effective indicators for evaluating insulin resistance.However,research on the association in TyG-WHtR,TyG-WC,and the risk and prognosis of major adverse cardiovascular events(MACEs)in type 2 diabetes mellitus(T2DM)cases are limited.AIM To clarify the relation in TyG-WHtR,TyG-WC,and the risk of MACEs and overall mortality in T2DM patients.METHODS Information for this investigation was obtained from Action to Control Cardiovascular Risk in Diabetes(ACCORD)/ACCORD Follow-On(ACCORDION)study database.The Cox regression model was applied to assess the relation among TyG-WHtR,TyG-WC and future MACEs risk and overall mortality in T2DM cases.The RCS analysis was utilized to explore the nonlinear correlation.Subgroup and interaction analyses were conducted to prove the robustness.The receiver operating characteristic curves were applied to analysis the additional predicting value of TyG-WHtR and TyG-WC.RESULTS After full adjustment for confounding variables,the highest baseline TyG-WHtR cohort respectively exhibited a 1.353-fold and 1.420-fold higher risk for MACEs and overall mortality,than the lowest quartile group.Similarly,the highest baseline TyG-WC cohort showed a 1.314-fold and 1.480-fold higher risk for MACEs and overall mortality,respectively.Each 1 SD increase in TyG-WHtR was significantly related to an 11.7%increase in MACEs and a 14.9%enhance in overall mortality.Each 1 SD increase in TyG-WC corresponded to an 11.5%in MACEs and a 16.6%increase in overall mortality.Including these two indexes in conventional models significantly improved the predictive power for MACEs and overall mortality.CONCLUSION TyG-WHtR and TyG-WC were promising predictors of MACEs and overall mortality risk in T2DM cases.
