BACKGROUND Gastric cancer(GC)is the fifth most common malignancy and the third leading cause of death worldwide.Despite advancements in immunotherapies,patient prognosis remains poor,necessitating the identification o...BACKGROUND Gastric cancer(GC)is the fifth most common malignancy and the third leading cause of death worldwide.Despite advancements in immunotherapies,patient prognosis remains poor,necessitating the identification of key prognostic factors to optimize the treatment approaches.Insulin resistance,as indicated by the triglyceride glucose(TyG)index,is increasingly recognized for its impact on cancer progression and immune modulation,and its potential role in GC prognosis is of particular interest.AIM To investigate whether the TyG index,a surrogate marker of insulin resistance,can predict the prognosis of patients with advanced GC receiving immunotherapy combined with chemotherapy.METHODS This retrospective study included 300 patients with advanced GC who received sintilimab combined with chemotherapy.The patients were categorized into two groups according to high or low TyG index,and independent prognostic factors for overall survival(OS)were determined using Cox proportional hazards regression analysis,which led to the development of a nomogram model.RESULTS Of the included patients,136 had a high TyG index and 164 had a low TyG index.The median progression-free survival of the high TyG index group was significantly longer than that of the low TyG index group.Similarly,the median OS of the high TyG index group was significantly longer than that of the low TyG index group.The ob-jective response and disease control rates in the two groups were 18.38%vs 9.15%and 58.82%vs 46.95%,res-pectively.No significant difference was noted in the incidence of adverse reactions at any level between the two groups(P>0.05).In multivariate analysis,the Eastern Cooperative Oncology Group score,programmed cell death ligand 1 expression,and TyG index acted as independent prognostic factors for OS.Of these factors,the hazard ratio of the TyG index was 0.36(95%confidence interval:0.36-0.55,P<0.001),and the nomogram model re-emphasized its importance as the main predictor of patient prognosis,followed by programmed cell death ligand 1 expression and the Eastern Cooperative Oncology Group score.CONCLUSION The TyG index is a long-term predictor of the efficacy of immunotherapy combined with chemotherapy,and patients with a high index have a better prognosis.展开更多
BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of...BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep;however,the relationship between these two conditions remains unexplored.We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.AIM To assess the association between TyG-BMI and OSA in adults in the United States.METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018.TyGBMI was calculated as Ln[triglyceride(mg/dL)×fasting blood glucose(mg/dL)/2]×BMI.Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence.To identify potential nonlinear relationships,we combined Cox proportional hazard regression with smooth curve fitting.We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.RESULTS We included 16794 participants in the final analysis.Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence.After adjusting for all covariates,TyG-BMI was positively correlated with the prevalence of OSA(odds ratio:1.28;95%confidence interval:1.17,1.40;P<0.001);no significant nonlinear relationship was observed.Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes.The correlation between TyG-BMI and OSA was influenced by age,sex,smoking status,marital status,hypertensive stratification,and obesity;these subgroups played a moderating role between TyGBMI and OSA.Even after adjusting for all covariates,there was a positive association between TYG-BMI and OSA prevalence.CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA.As TyG-BMI is an indicator of IR,managing IR may help reduce the risk of OSA.展开更多
BACKGROUND Although recent studies have reported the reliability of triglyceride-glucose index(TyG)as a biomarker for evaluation of insulin resistance,the research exploring the association of TyG-body mass index(BMI)...BACKGROUND Although recent studies have reported the reliability of triglyceride-glucose index(TyG)as a biomarker for evaluation of insulin resistance,the research exploring the association of TyG-body mass index(BMI)with major cardiovascular outcomes and all-cause mortality among the type 2 diabetes mellitus(T2DM)population remains scarce.AIM To ascertain whether TyG-BMI correlates with cardiovascular outcomes and mortality risk in individuals diagnosed with T2DM.METHODS Data were drawn from the ACCORD trial and its subsequent follow-up(ACCORDION),which together included 10190 participants.To evaluate the associations of TyG-BMI with future cardiovascular outcomes and overall mortality risk among T2DM patients,Cox’s proportional-hazards model was employed.Non-linear associations and thresholds were investigated by performing restricted cubic spline regression,fitting smooth curves,and conducting piecewise regression.Additionally,we examined whether the above findings were robust through interaction and subgroup analyses.The robustness of results was further verified by a series of sensitivity assessments.Through the area under the receiver operating characteristic curve estimation,the incremental predictive power of TyG-BMI beyond conventional risk factors was also evaluated.RESULTS Applying multivariable Cox regression analysis,we identified a significant correlation of TyG-BMI with both cardiovascular outcomes and overall mortality.Specifically,after adjusting for multiple confounders,the cardiovascular mortality,congestive heart failure(CHF)and overall mortality risks in the highest TyG-BMI quartile were 1.74,2.65 and 1.42 times greater,respectively,when compared to the lowest quartile.The analysis revealed that TyG-BMI was linked nonlinearly to both types of mortality,while a two-stage linear regression discerned inflection points at 252.77 for cardiovascular mortality and 245.90 for overall mortality.TyG-BMI was found to correlate positively with future CHF.Additionally,introducing TyG-BMI into conventional prediction models resulted in a substantial improvement of their predictability for cardiovascular outcomes and overall mortality when compared to incorporating TyG or BMI alone.CONCLUSION Among T2DM individuals,a higher TyG-BMI is linked strongly to elevated risks of cardiovascular outcomes and overall mortality,highlighting its utility as a predictive marker for these risks.展开更多
Hypertriglyceridemia is the third leading cause of acute pancreatitis(AP),and its incidence is increasing.Due to its relatively insidious etiology,it is easy to be ignored in the early stages.In China,Chaiqin Chengqi ...Hypertriglyceridemia is the third leading cause of acute pancreatitis(AP),and its incidence is increasing.Due to its relatively insidious etiology,it is easy to be ignored in the early stages.In China,Chaiqin Chengqi Decoction(CQCQD)has long been employed for treating AP.AIM To evaluate the effectiveness of CQCQD in patients diagnosed with mild/moderately severe hypertriglyceridemic AP(HTG-AP).METHODS In this study,the clinical data of 39 patients with HTG-AP admitted from January 2019 to November 2022 were collected.The changes of blood lipids,gastrointestinal symptoms,and abdominal pain before and after treatment were analyzed and compared between the two groups.RESULTS Twenty patients were treated with the conventional HTG-AP regimen,and 19 patients were additionally treated with CQCQD.After receiving treatment,the triglycerides(TG)level of the CQCQD group was lower than that of the CQCQD group(3.14±0.25 mmol/L vs 4.96±0.47 mmol/L,P<0.01).After 3 d of treatment,the patients in the CQCQD group had more bowel movements than the control group(2.51±0.25 times vs 1.00±0.17 times,P=0.01).The gastrointestinal function of most patients returned to normal,and the acute gastrointestinal injury score was significantly lower than that of the control group(0.11±0.07 vs 0.42±0.11,P<0.01).CONCLUSION In patients with HTG-AP,CQCQD can significantly reduce the TG level,shorten the recovery time of defecation,significantly improve the gastrointestinal function.展开更多
BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and const...BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and constipation,and the triglyceride glucose(TyG)index,a marker of IR,has not yet been investigated.AIM To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation.METHODS This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010.TyG was used as an exposure variable,with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables.A demographic investigation based on TyG quartile subgroups was performed.The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG,chronic diarrhea,and constipation.Subgroup analyses were performed to examine the stability of any potential associations.RESULTS In the chosen sample,chronic diarrhea had a prevalence of 8.00%,while chronic constipation had a prevalence of 8.04%.In multiple logistic regression,a more prominent positive association was found between TyG and chronic diarrhea,particularly in model 1(OR=1.45;95%CI:1.17-1.79,P=0.0007)and model 2(OR=1.40;95%CI:1.12-1.76,P=0.0033).No definite association was observed between the TyG levels and chronic constipation.The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63(OR=1.89;95%CI:1.05-3.41,P=0.0344),and another positive association with chronic constipation when it was greater than 8.2(OR=1.74;95%CI:1.02-2.95,P=0.0415).The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations.CONCLUSION Higher TyG levels were positively associated with abnormal bowel health.展开更多
There is an increasing attention on oxidative derivatives of triglycerides,a group of potential thermal processing induced food toxicants,which are formed during the thermal processing of food lipids.This review aims ...There is an increasing attention on oxidative derivatives of triglycerides,a group of potential thermal processing induced food toxicants,which are formed during the thermal processing of food lipids.This review aims to summarize current knowledge about their formation mechanisms,detection approaches,and toxicology impacts.Oxidative derivatives of triglycerides are generated through the oxidation,cyclization,polymerization,and hydrolysis of triglycerides under high-temperature and abundant oxygen.The analytical techniques,including GC,HPSEC,MS,^(1)H-NMR were discussed in analyzing these components.In addition,their toxic effects on human health,including effects on the liver,intestines,cardiovascular system,immune system,and metabolism were elucidated.Information in this review could be used to improve the understanding of oxidative derivatives of triglycerides and ultimately improve academic and industrial strategies for eliminating these compounds in thermal processing food systems.展开更多
d-Allulose, a rare sugar, exerts anti-obesity effects by inhibiting hepatic lipogenesis and promoting energy expenditure. Medium-chain triglycerides (MCTs) consist of three medium-chain fatty acids connected by glycer...d-Allulose, a rare sugar, exerts anti-obesity effects by inhibiting hepatic lipogenesis and promoting energy expenditure. Medium-chain triglycerides (MCTs) consist of three medium-chain fatty acids connected by glycerol. MCTs have been extensively investigated for their ability to reduce body fat accumulation. We previously investigated the anti-obesity effects of a combination of dietary d-allulose and MCT (5% - 13%) in rats;however, we could not confirm the anti-obesity effects of MCT or observed synergetic effects between d-allulose and MCT on body fat loss. We speculated that our previous studies were influenced by the excessive amount of MCT in the diets. Therefore, in this study, we aimed to investigate the anti-obesity effects of the simultaneous intake of d-allulose and MCT in rats fed an obesity-inducing high-fat diet with a low amount of MCTs (2%). Thirty-two male Wistar rats (3-week-old) were randomly divided into four groups: control, d-allulose, MCT, and d-allulose + MCT groups. Rats in each group were fed ad libitum on a control (no d-Allulose or MCT), 5% d-allulose, 2% MCT, or 5% d-allulose + 2% MCT diets for 16 weeks. Abdominal adipose tissue weights were significantly lower in the d-allulose diet group than in the control group, whereas no differences were observed between results of the MCT-supplemented groups. The total body fat mass was significantly lower in the d-allulose and MCT diet groups than in the control group, but no differences were observed between the MCT-supplemented groups. These results suggested that anti-obesity effects of dietary d-allulose were observed, and the effects of dietary MCTs were weaker than those of d-allulose. Moreover, we confirmed the interaction between dietary d-allulose and MCT on indicators of obesity. Interestingly, their effects were not synergistic, as MCT supplementation offset the anti-obesity effects of dietary d-allulose. However, the specific mechanisms underlying those effects remain unknown, warranting further investigation.展开更多
Changes in lipid metabolism have been implicated in protection against infectious diseases. In the first experiment of this study, we measured clinical lipid parameters in a murine model where the unmethylated cytidin...Changes in lipid metabolism have been implicated in protection against infectious diseases. In the first experiment of this study, we measured clinical lipid parameters in a murine model where the unmethylated cytidine phosphate guanosine (CpG) oligodinucleotide (ODN1826), a Toll-like receptor 9 (TLR9) agonist was administered in combination with D-galactosamine (GalN) that caused relatively liver-specific inflammation and toxicity. In the control mice group injected with phosphate-buffered saline (PBS) (acute psychological stress model associated with blood sampling), the serum triglyceride (TG) levels showed a rapid decrease followed by a rebound at 24 h as we have recently reported. However, such a TG rebound was impaired in the CpG/GalN- and solely CpG-treated groups of mice despite an absence of liver injury based on serum alanine aminotransferase levels in the latter group. Thus, the stress-associated serum TG rebound was abrogated by the injection of a sub-hepatotoxic CpG dose. In the second experiment, we simply measured the hepatic CD36 and SACRB1 (the gene for scavenger receptor B1 (SR-B1)) transcripts after the i.p. administration of PBS, CpG or CpG/GalN. There was a remarkable elevation of hepatic CD36 transcript expression in both the CpG- and CpG/GalN-treated mice at 8 h post-CpG injection whereas the increase in the PBS-treated mice was slower than the former two groups, suggesting that hepatic CD36 transcript expression is more pronounced in the combined stress models than under psychological stress alone. The individual mice data showed that the increase in CD36 expression was accompanied by a reduction in SCARB1 mRNA, showing reciprocal regulation between these two genes. Together with our previously reported findings, these data suggest that, in a murine model combining psychological stress with TLR-triggered hepatic inflammation, the psychological stress facilitates liver uptake of plasma TG (and its components fatty acids), but the subsequent re-esterification and/or release of TG-rich lipoproteins from the liver is impaired due to the concomitant TLR-signaling. We hypothesize that lipid metabolism during acute stress shifts toward an elevated hepatic uptake of lipids due to concomitant TLR signaling, facilitating the clearance of bacterial lipids by the liver.展开更多
Background: In response to the escalating burden of cardiovascular diseases (CVDs) worldwide, exacerbated by lifestyle changes and socioeconomic shifts, acute coronary syndromes (ACS) stand out as a leading cause of m...Background: In response to the escalating burden of cardiovascular diseases (CVDs) worldwide, exacerbated by lifestyle changes and socioeconomic shifts, acute coronary syndromes (ACS) stand out as a leading cause of morbidity and mortality. The pivotal role of insulin resistance in the pathogenesis of atherosclerosis, independent of traditional risk factors, has garnered significant interest. Objective: This review aims to synthesize the recent advancements in the utilization of the triglyceride glucose index (TyG index) as a biomarker for assessing the severity and predicting the prognosis of ACS lesions. Methods: A systematic search was conducted across PubMed, Embase, and Scopus databases, incorporating keywords such as “triglyceride glucose index”, “TyG index”, “acute coronary syndrome”, “cardiovascular disease”, “insulin resistance”, “coronary artery calcification”, “SYNTAX score”, “Gensini score”, and “major adverse cardiac events”. Studies were included from the inception of each database up to July 2024. Selection criteria encompassed observational studies, case-control studies, and randomized controlled trials, with a particular emphasis on evaluating the diagnostic and prognostic value of the TyG index in patients with acute coronary syndromes. Ultimately, 46 publications met the inclusion criteria. Data extraction and quality assessment were performed in accordance with established guidelines. Results: Evidence suggests that the TyG index, reflecting insulin resistance, blood glucose, and lipid levels, is significantly associated with lesion severity in ACS, including coronary artery calcification, SYNTAX score, and Gensini score. Moreover, it demonstrates predictive power for major adverse cardiovascular events, underscoring its potential as a valuable tool in clinical decision-making. Conclusion: The review highlights the emerging role of the TyG index in the assessment and prognosis of ACS, advocating for its incorporation into clinical practice as a complement to existing diagnostic modalities. However, the establishment of standardized reference ranges and further validation across diverse populations are warranted to refine its applicability in personalized medicine. The interdisciplinary approach is essential to advance our understanding of the complex interplay between insulin resistance and cardiovascular disease, paving the way for the development of more effective prevention and treatment strategies.展开更多
Background Research has indicated that the triglyceride-glucose(Ty G)index is associated with the development and prognosis of cardiovascular diseases.However,there is still uncertainty regarding whether the Ty G inde...Background Research has indicated that the triglyceride-glucose(Ty G)index is associated with the development and prognosis of cardiovascular diseases.However,there is still uncertainty regarding whether the Ty G index can predict adverse cardiovascular events in patients with acute myocardial infarction(AMI).The present study aimed to explore the prognostic value of the Ty G index in patients with AMI.Methods AMI patients who underwent emergency percutaneous coronary intervention(PCI)in Guangdong General Hospital from February 2021 to June 2022 were enrolled.The study population was grouped based on the median Ty G index.The end point of the study was major adverse cardiovascular events(MACEs),defined as all-cause mortality,cardiogenic shock,recurrent myocardial infarction,acute attack of heart failure,repeat revascularization induced by cardiac ischemia,and urgent visit due to aggravation of chest pain.The Ty G index was calculated as follows:LN[fasting triglycerides(mg/d L)×fasting blood glucose(mg/d L)x1/2].Results A total of 196 patients were included.In the multivariate logistic regression analysis,Ty G index[odds ratio(OR):0.99,95%confidence interval(CI):0.45-2.16,P=0.98]was not significantly correlated with the occurrence of MACEs in AMI patients during hospitalization.Afterwards a total of 178 patients were followed up for an average of 12.66±5.35 months.In the multivariate Cox proportional hazards model,Ty G index[hazard ratio(HR):1.91,95%CI:1.02-3.6,P<0.05]were independent predictor of adverse events during follow-up,and the area under the receiver operating characteristic(ROC)curve(AUC)was0.63(0.53-0.73,P<0.05).Conclusions Ty G index can independently predict the prognosis of AMI patients during the follow-up period.[S Chin J Cardiol 2024;25(1):11-20]展开更多
BACKGROUND The incidence of hypertriglyceridemic acute pancreatitis(HTG-AP)has increased yearly,but updated population-based estimates on the incidence of HTG-AP are lacking.Reducing serum triglyceride(TG)levels quick...BACKGROUND The incidence of hypertriglyceridemic acute pancreatitis(HTG-AP)has increased yearly,but updated population-based estimates on the incidence of HTG-AP are lacking.Reducing serum triglyceride(TG)levels quickly is crucial in the early treatment of HTG-AP.Decreased serum TG levels are treated by non-invasive methods,which include anti-lipidemic agents,heparin,low-molecular weight heparin,and insulin,and invasive methods,such as blood purification including hemoperfusion(HP),plasmapheresis,and continuous renal replacement therapy.However,authoritative guidelines have not been established.Early selection of appropriate treatment is important and beneficial in controlling the development of HTG-AP.AIM To evaluate the effect between patients treated with intravenous insulin(INS)and HP to guide clinical treatment.METHODS We retrospectively reviewed 371 patients with HTG-AP enrolled in the Department of Fujian Provincial Hospital form April 2012 to March 2021.The inpatient medical and radiologic records were reviewed to determine clinical features,severity,complications,mortality,recurrence rate,and treatment.Multivariate logistic regression analyses were used to analyze risk factors for severe HTG-AP.Propensity score matching was used to compare the clinical outcomes of INS and HP.RESULTS A total of 371 patients met the HTG-AP criteria.The incidence of HTG-AP was increased by approximately 2.6 times during the 10 years(8.4%in April 2012-March 2013 and 22.3%in April 2020-March 2021).The highest incidence rate of acute pancreatitis was observed for men in the age group of 30-39 years.The amylase level was elevated in 80.1%of patients but was only three times the normal value in 46.9%of patients.The frequency of severe acute pancreatitis(26.9%),organ failure(31.5%),rate of recurrence(32.9%),and mortality(3.0%)of HTG-AP was high.Improved Marshall score,modified computed tomography severity index score,baseline TG,baseline amylase,C-reactive protein(CRP),albumin,aspartate aminotransferase,low-density lipoprotein cholesterol,urea nitrogen,creatinine,calcium,hemoglobin,free triiodothyronine,admission to intensive care unit,and mortality were significantly different between patients with different grades of severity(P<0.050).Multivariate logistic regression analysis confirmed that high CRP[P=0.005,odds ratio(OR)=1.011,95%CI:1.003-1.019],low calcium(P=0.003,OR=0.016,95%CI:0.001-0.239),and low albumin(P=0.023,OR=0.821,95%CI:0.693-0.973)were risk factors of severe HTG-AP.After propensity score matching adjusted by sex,age,severity of HTG-AP,and baseline TG,the serum TG significantly decreased in patients treated with INS(P<0.000)and HP(P<0.000)within 48 h.However,the clearance rate of TG(57.24±33.70%vs 56.38±33.61%,P=0.927)and length of stay(13.04±7.92 d vs 12.35±6.40 d,P=0.730)did not differ between the two groups.CONCLUSION The incidence of HTG-AP exhibited a significant increase,remarkable severity,and recurrent trend.Patients with mild and moderately severe acute pancreatitis can be treated effectively with INS safely and effectively without HP.展开更多
We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type Ⅴ hyperlip...We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type Ⅴ hyperlipidemia. Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase levels.The imaging examination of ultrasonography could not detect significant findings of acute pancreatitis and a computer tomography scan eventually confirmed the findings of acute pancreatitis.Both cases responded to a low fat diet and administration of a cholecystokinin receptor antagonist,exhibiting a relief of abdominal symptoms.As in the present cases with acute abdomen following the ingestion of fatty food,the identification of serum hypertriglyceridemia and an abdominal computer tomography scan might be useful in establishing the diagnosis of acute pancreatitis and in developing the therapeutic regimen,when hypertriglyceridemia interferes with the evaluation of pancreatic enzyme activities and ultrasound examination provides poor pancreatic visualization.展开更多
Crosslinked N, O-carboxymethyl chitosan resins which can selectively adsorb triglyceride, were prepared by the reaction of N, O- carboxymethyl chitosan with glutaraldehyde solution. Adsorption experiments were perform...Crosslinked N, O-carboxymethyl chitosan resins which can selectively adsorb triglyceride, were prepared by the reaction of N, O- carboxymethyl chitosan with glutaraldehyde solution. Adsorption experiments were performed by adding the resins to the serum. The results showed that this type of adsorbent could cut down the concentration of triglyceride in serum by 56. 4% (3. 35mg/gresin ) at most, while concentration of the total protein (TP ) decreased only by 10. 9% at least, so this novel adsorbent can be used to cure hypertriglyceridemia by hemoperfusion in the future.展开更多
Hypertriglyceridemia is defined as an abnormal concentration of triglyceride in the blood and has been associated with atherosclerosis,even in the absence of hypercholesterolemia.This case report is of 40-year-old man...Hypertriglyceridemia is defined as an abnormal concentration of triglyceride in the blood and has been associated with atherosclerosis,even in the absence of hypercholesterolemia.This case report is of 40-year-old man diagnosed to have hypertriglyceridemia who attended for routine screening in our diagnostic laboratory at Barasat.He was nonsmoker,non-alcoholic,had a reasonable diet with abundant fruits and vegetables,and was on regular exercise.He was not taking any lipid lowering medications.He hailed from Barasat,and was employed in Government sector in Barasat and policeman by profession.His father died at the age of 57 years in a heart attack;but his mother is healthy and now almost 62 years of age,and he has two brothers one elder and another younger to him,both are healthy.His blood pressure was normal,his body-mass index was 27,and his waist circumference was 96 cm and hip circumference was 103.His waist/hip ratio was 0.932.The Biochemical analyses were as follows- Fasting Glucose:186 mg/dL,Total Cholesterol:90 mg/dL,Triglycerides:372 mg/dL,High-density cholesterol:3.80 mg/dL,Low-density cholesterol:2.90 mg/dL,VLDL:83.20 mg/dL,Cholesterol/HDL-C ratio:23.6:1,LDL-C/HDL-C:0.07:1.This study revealed the increased prevalence of dyslipidemia to be more prevalent in 31-40 year males,suggesting that this group is at an increased risk of developing CAD leading to young infarcts.Combination lifestyle therapies i.e.,enhanced physical activity and dietary modification and therapeutic intervention would help us in the treatment and management of dyslipidemia.展开更多
Objective:To investigate hypertriglyceridemia and hepatomegaly caused by Schisandrae Sphenantherae Fructus(FSS)and Schisandra chinensis Fructus(FSC)oils in mice.Methods:Mice were orally administered a single dose of S...Objective:To investigate hypertriglyceridemia and hepatomegaly caused by Schisandrae Sphenantherae Fructus(FSS)and Schisandra chinensis Fructus(FSC)oils in mice.Methods:Mice were orally administered a single dose of SchisandraeFructusoils.Serumandhepatictriglyceride(TG),triglyceridetransferprotein(TTP),apolipoproteinB48(Apo B48),very-low-densitylipoprotein(VLDL),hepatocytegrowth factor(HGF),alanine aminotransfease(ALT)and liver index were measured at 6-120 h post-dosing.Results:FSS and FSC oil caused time and dose-dependent increases in serum and hepatic TG levels,with maximum increases in the liver(by 297%and 340%)at 12 h post-dosing and serum(244%and 439%)at 24-h post-dosing,respectively.Schisandrae Fructus oil treatments also elevated the levels of serum TTP by 51%and63%,Apo B48 by 152%and 425%,and VLDL by 67%and 38%in mice,respectively.FSS and FSC oil treatments also increased liver mass by 53%and 55%and HGF by 106%and 174%,but lowered serum ALT activity by 38%and 22%,respectively.Fenofibrate pre/co-treatment attenuated the FSS and FSC oil-induced elevation in serum TG levels by 41%and 49%at 48 h post-dosing,respectively,but increased hepatic TG contents(by 38%and 33%,respectively)at 12 h post-dosing.Conclusions:Our findings provide evidence to support the establishment of a novel mouse model of hypertriglyceridemia by oral administration of FSS oil(mainly increasing endogenous TG)and FSC oil(mainly elevating exogenous TG).展开更多
Non-alcoholic fatty liver disease (NAFLD) is a common liver disease worldwide. There is no specific biomarker for the diagnosis of NAFLD. Trigly-ceride and glucose index (TyG) may predict the subsequent occurrence of ...Non-alcoholic fatty liver disease (NAFLD) is a common liver disease worldwide. There is no specific biomarker for the diagnosis of NAFLD. Trigly-ceride and glucose index (TyG) may predict the subsequent occurrence of NAFLD in later life. This cross sectional study was aimed to evaluate the effectiveness of triglyceride and glucose index (TyG) as a possible biomarker of NAFLD. The study was conducted at the Department of Laboratory Medicine, Bangabandhu Sheikh Mujib Medical University (B中央人民政府), Dhaka, Bangladesh from March 2019 to February 2020. A total of 124 subjects were taken as study population following selection criteria. Among them 62 were diagnosed patients of NAFLD and 62 were healthy subjects as control group. Fasting plasma glucose was measured by glucose oxidase method and serum triglyceride was measured by enzymatic-colorimetric method, while TyG index was calculated accordingly. The mean age was 39.5 ± 11.27 years in NAFLD patients and 37.10 ± 12.28 years in control subjects with male female ratio 1:1.7 and 1:1.8 respectively. Major portion of NAFLD patients (62.9%) were overweight (BMI ≥ 25). The mean fasting plasma glucose level was 5.73 ± 1.47 mmol/L in NAFLD patients and 5.27 ± 0.69 mmol/L in control group (p < 0.027). The mean serum triglyceride level was 237.19 ± 96.47 mg/dl in NAFLD patients and 117.32 ± 53.07 mg/dl in control group (p < 0.001). The triglyceride and glucose index (TyG) was 9.36 ± 0.47 in NAFLD group and 8.53 ± 0.42 in control group. TyG index was significantly higher in NAFLD patients in comparison to control group (p < 0.001). In ROC analysis, cut off value of TyG index was 8.85 with sensitivity 93.5% and specificity 79%. As a fast and effective method, TyG index can be used as a diagnostic tool to predict NAFLD.展开更多
Background: Managing hypertriglyceridemia in HIV-infected patients often requires multiple pharmacologic strategies. Many protease inhibitors (PIs), one of 6 classes of drugs used to treat HIV, have been associated wi...Background: Managing hypertriglyceridemia in HIV-infected patients often requires multiple pharmacologic strategies. Many protease inhibitors (PIs), one of 6 classes of drugs used to treat HIV, have been associated with hypercholesterolemia and drug interactions. For this study, we examined a dual strategy to manage hypertriglyceridemia in HIV-infected patient taking PIs: 1) switching patients to fosamprenavir (FPV), a PI with fewer drug interactions, and 2) adding prescription fish oil (LOVAZA?), which has been shown to reduce triglycerides. Methods: This multicenter, 24-week study enrolled 36 patients virologically suppressed (HIV-1 RNA <50 copies/mL) on PI-containing therapy with screening triglyceride levels of 200 - 1200 mg/dL and LDL cholesterol levels ≤160 mg/dL. At baseline, patients were switched to ritonavir (RTV)-boosted fosamprenavir (FPV 1400 mg/RTV 100 mg QD) and any lipid-lowering agents were stopped. At Week 6, LOVAZA 4 g QD was added. Results: Five patients prematurely discontinued due to adverse events (2), non-compliance, lost-to-follow up, and protocol violation. Median triglyceride concentration was 303 mg/dL at screening, 262 mg/dL at baseline, 290 mg/dL at Week 6 (+8% from baseline), and 218 mg/dL at Week 24 (–30% from Week 6). At Week 24, 39% (12/31) of patients had triglycerides <200 mg/dL. Among patients reaching Week 24, 100% (31/31) and 90% (28/31) had HIV-1 RNA <400 and <50 copies/mL, respectively. Conclusions: In this study, a switch to FPV/RTV followed by LOVAZA decreased median triglyceride levels and modestly increased the percentage of patients with triglyceride levels <200 mg/dL while maintaining virologic suppression in HIV-infected subjects with hypertriglyceridemia. Our data suggest that baseline PI may affect the likelihood of achieving triglycerides <200 mg/dL after 18 weeks on study. A larger study would be needed to understand the relative contributions of choice of protease inhibitor and LOVAZA to triglyceride concentrations in HIV-infected patients.展开更多
Background Triglyceride glucose (TyG) index is a novel marker for metabolic disorders, and recently it has been reported to be associated with cardiovascular disease (CVD) risk in apparently healthy individuals.Howeve...Background Triglyceride glucose (TyG) index is a novel marker for metabolic disorders, and recently it has been reported to be associated with cardiovascular disease (CVD) risk in apparently healthy individuals.However the prognostic value of TyG index in patients with stable coronary artery disease (CAD) is not determined.展开更多
AIM： To determine the real association between serum lipid levels and colonic polyp formation. METHODS： We performed a large scale retrospective study to analyze the correlation between the incidence of colorectal a...AIM： To determine the real association between serum lipid levels and colonic polyp formation. METHODS： We performed a large scale retrospective study to analyze the correlation between the incidence of colorectal adenoma or carcinoma and the fasting serum levels of total cholesterol （TC） and triglycerides （TG） in patients who underwent total colonoscopy for screening for colon cancer. RESULTS： Both levels were significantly elevated in patients with adenomas as compared with patients without any neoplastic lesion （TC 207.6 ± 29.5 vs 199.5 ±34.3, n= 4883, p〈 0.001; TG 135.0 ± 82.2 vs 108.7± 71.5, n= 4874, p〈 0.001）. The difference was significant in patients with tubular adenoma but not in those with villous or serrated adenoma. Multiple logistic regression analysis including age and sex revealed that TG was an independent correlation factor in male （p〈0.01）, but not in female patients. The level of TG in patients with invasive carcinoma did not show a significant elevation from that in patients with adenoma. These findings suggest that hypertriglyceridemia is an independent risk factor for colonic adenoma in men. CONCLUSION： Although a high level of serum triglyceride does not appear to be mechanically involved in the development of carcinoma, reduction of serum TG and intensive surveillance with total colonoscopy may have benefit in men with hypertriglyceridemia.展开更多
Hepatic steatosis defined as lipid accumulation in hepatocytes is very frequently found in adults and obese adolescents in the Western World. Etiologically, obesity and associated insulin resistance or excess alcohol ...Hepatic steatosis defined as lipid accumulation in hepatocytes is very frequently found in adults and obese adolescents in the Western World. Etiologically, obesity and associated insulin resistance or excess alcohol intake are the most frequent causes of hepatic steatosis. However, steatosis also often occurs with chronic hepatitis C virus(HCV) infection and is also found in rare but potentially life-threatening liver diseases of pregnancy. Clinical significance and outcome of hepatic triglyceride accumulation are highly dependent on etiology and histological pattern of steatosis. This review summarizes current concepts of pathophysiology of common causes of hepatic steatosis, including non-alcoholic fatty liver disease(NAFLD), alcoholic fatty liver disease, chronic HCV infections, drug-induced forms of hepatic steatosis, and acute fatty liver of pregnancy. Regarding the pathophysiology of NAFLD, this work focuses on the close correlation between insulin resistance and hepatic triglyceride accumulation, highlighting the potential harmful effects of systemic insulin resistance on hepatic metabolism of fatty acids on the one side and the role of lipid intermediates on insulin signalling on the other side. Current studies on lipid droplet morphogenesis have identified novel candidate proteins and enzymes in NAFLD.展开更多
文摘BACKGROUND Gastric cancer(GC)is the fifth most common malignancy and the third leading cause of death worldwide.Despite advancements in immunotherapies,patient prognosis remains poor,necessitating the identification of key prognostic factors to optimize the treatment approaches.Insulin resistance,as indicated by the triglyceride glucose(TyG)index,is increasingly recognized for its impact on cancer progression and immune modulation,and its potential role in GC prognosis is of particular interest.AIM To investigate whether the TyG index,a surrogate marker of insulin resistance,can predict the prognosis of patients with advanced GC receiving immunotherapy combined with chemotherapy.METHODS This retrospective study included 300 patients with advanced GC who received sintilimab combined with chemotherapy.The patients were categorized into two groups according to high or low TyG index,and independent prognostic factors for overall survival(OS)were determined using Cox proportional hazards regression analysis,which led to the development of a nomogram model.RESULTS Of the included patients,136 had a high TyG index and 164 had a low TyG index.The median progression-free survival of the high TyG index group was significantly longer than that of the low TyG index group.Similarly,the median OS of the high TyG index group was significantly longer than that of the low TyG index group.The ob-jective response and disease control rates in the two groups were 18.38%vs 9.15%and 58.82%vs 46.95%,res-pectively.No significant difference was noted in the incidence of adverse reactions at any level between the two groups(P>0.05).In multivariate analysis,the Eastern Cooperative Oncology Group score,programmed cell death ligand 1 expression,and TyG index acted as independent prognostic factors for OS.Of these factors,the hazard ratio of the TyG index was 0.36(95%confidence interval:0.36-0.55,P<0.001),and the nomogram model re-emphasized its importance as the main predictor of patient prognosis,followed by programmed cell death ligand 1 expression and the Eastern Cooperative Oncology Group score.CONCLUSION The TyG index is a long-term predictor of the efficacy of immunotherapy combined with chemotherapy,and patients with a high index have a better prognosis.
基金Supported by Sanming Project of Medicine in Shenzhen,No.SZZYSM202202010。
文摘BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep;however,the relationship between these two conditions remains unexplored.We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.AIM To assess the association between TyG-BMI and OSA in adults in the United States.METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018.TyGBMI was calculated as Ln[triglyceride(mg/dL)×fasting blood glucose(mg/dL)/2]×BMI.Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence.To identify potential nonlinear relationships,we combined Cox proportional hazard regression with smooth curve fitting.We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.RESULTS We included 16794 participants in the final analysis.Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence.After adjusting for all covariates,TyG-BMI was positively correlated with the prevalence of OSA(odds ratio:1.28;95%confidence interval:1.17,1.40;P<0.001);no significant nonlinear relationship was observed.Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes.The correlation between TyG-BMI and OSA was influenced by age,sex,smoking status,marital status,hypertensive stratification,and obesity;these subgroups played a moderating role between TyGBMI and OSA.Even after adjusting for all covariates,there was a positive association between TYG-BMI and OSA prevalence.CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA.As TyG-BMI is an indicator of IR,managing IR may help reduce the risk of OSA.
文摘BACKGROUND Although recent studies have reported the reliability of triglyceride-glucose index(TyG)as a biomarker for evaluation of insulin resistance,the research exploring the association of TyG-body mass index(BMI)with major cardiovascular outcomes and all-cause mortality among the type 2 diabetes mellitus(T2DM)population remains scarce.AIM To ascertain whether TyG-BMI correlates with cardiovascular outcomes and mortality risk in individuals diagnosed with T2DM.METHODS Data were drawn from the ACCORD trial and its subsequent follow-up(ACCORDION),which together included 10190 participants.To evaluate the associations of TyG-BMI with future cardiovascular outcomes and overall mortality risk among T2DM patients,Cox’s proportional-hazards model was employed.Non-linear associations and thresholds were investigated by performing restricted cubic spline regression,fitting smooth curves,and conducting piecewise regression.Additionally,we examined whether the above findings were robust through interaction and subgroup analyses.The robustness of results was further verified by a series of sensitivity assessments.Through the area under the receiver operating characteristic curve estimation,the incremental predictive power of TyG-BMI beyond conventional risk factors was also evaluated.RESULTS Applying multivariable Cox regression analysis,we identified a significant correlation of TyG-BMI with both cardiovascular outcomes and overall mortality.Specifically,after adjusting for multiple confounders,the cardiovascular mortality,congestive heart failure(CHF)and overall mortality risks in the highest TyG-BMI quartile were 1.74,2.65 and 1.42 times greater,respectively,when compared to the lowest quartile.The analysis revealed that TyG-BMI was linked nonlinearly to both types of mortality,while a two-stage linear regression discerned inflection points at 252.77 for cardiovascular mortality and 245.90 for overall mortality.TyG-BMI was found to correlate positively with future CHF.Additionally,introducing TyG-BMI into conventional prediction models resulted in a substantial improvement of their predictability for cardiovascular outcomes and overall mortality when compared to incorporating TyG or BMI alone.CONCLUSION Among T2DM individuals,a higher TyG-BMI is linked strongly to elevated risks of cardiovascular outcomes and overall mortality,highlighting its utility as a predictive marker for these risks.
基金The Hangzhou Science and Technology Bureau,No.B20230285.
文摘Hypertriglyceridemia is the third leading cause of acute pancreatitis(AP),and its incidence is increasing.Due to its relatively insidious etiology,it is easy to be ignored in the early stages.In China,Chaiqin Chengqi Decoction(CQCQD)has long been employed for treating AP.AIM To evaluate the effectiveness of CQCQD in patients diagnosed with mild/moderately severe hypertriglyceridemic AP(HTG-AP).METHODS In this study,the clinical data of 39 patients with HTG-AP admitted from January 2019 to November 2022 were collected.The changes of blood lipids,gastrointestinal symptoms,and abdominal pain before and after treatment were analyzed and compared between the two groups.RESULTS Twenty patients were treated with the conventional HTG-AP regimen,and 19 patients were additionally treated with CQCQD.After receiving treatment,the triglycerides(TG)level of the CQCQD group was lower than that of the CQCQD group(3.14±0.25 mmol/L vs 4.96±0.47 mmol/L,P<0.01).After 3 d of treatment,the patients in the CQCQD group had more bowel movements than the control group(2.51±0.25 times vs 1.00±0.17 times,P=0.01).The gastrointestinal function of most patients returned to normal,and the acute gastrointestinal injury score was significantly lower than that of the control group(0.11±0.07 vs 0.42±0.11,P<0.01).CONCLUSION In patients with HTG-AP,CQCQD can significantly reduce the TG level,shorten the recovery time of defecation,significantly improve the gastrointestinal function.
文摘BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and constipation,and the triglyceride glucose(TyG)index,a marker of IR,has not yet been investigated.AIM To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation.METHODS This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010.TyG was used as an exposure variable,with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables.A demographic investigation based on TyG quartile subgroups was performed.The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG,chronic diarrhea,and constipation.Subgroup analyses were performed to examine the stability of any potential associations.RESULTS In the chosen sample,chronic diarrhea had a prevalence of 8.00%,while chronic constipation had a prevalence of 8.04%.In multiple logistic regression,a more prominent positive association was found between TyG and chronic diarrhea,particularly in model 1(OR=1.45;95%CI:1.17-1.79,P=0.0007)and model 2(OR=1.40;95%CI:1.12-1.76,P=0.0033).No definite association was observed between the TyG levels and chronic constipation.The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63(OR=1.89;95%CI:1.05-3.41,P=0.0344),and another positive association with chronic constipation when it was greater than 8.2(OR=1.74;95%CI:1.02-2.95,P=0.0415).The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations.CONCLUSION Higher TyG levels were positively associated with abnormal bowel health.
基金funded by the National Natural Science Foundation of China (Grant No.32272426).
文摘There is an increasing attention on oxidative derivatives of triglycerides,a group of potential thermal processing induced food toxicants,which are formed during the thermal processing of food lipids.This review aims to summarize current knowledge about their formation mechanisms,detection approaches,and toxicology impacts.Oxidative derivatives of triglycerides are generated through the oxidation,cyclization,polymerization,and hydrolysis of triglycerides under high-temperature and abundant oxygen.The analytical techniques,including GC,HPSEC,MS,^(1)H-NMR were discussed in analyzing these components.In addition,their toxic effects on human health,including effects on the liver,intestines,cardiovascular system,immune system,and metabolism were elucidated.Information in this review could be used to improve the understanding of oxidative derivatives of triglycerides and ultimately improve academic and industrial strategies for eliminating these compounds in thermal processing food systems.
文摘d-Allulose, a rare sugar, exerts anti-obesity effects by inhibiting hepatic lipogenesis and promoting energy expenditure. Medium-chain triglycerides (MCTs) consist of three medium-chain fatty acids connected by glycerol. MCTs have been extensively investigated for their ability to reduce body fat accumulation. We previously investigated the anti-obesity effects of a combination of dietary d-allulose and MCT (5% - 13%) in rats;however, we could not confirm the anti-obesity effects of MCT or observed synergetic effects between d-allulose and MCT on body fat loss. We speculated that our previous studies were influenced by the excessive amount of MCT in the diets. Therefore, in this study, we aimed to investigate the anti-obesity effects of the simultaneous intake of d-allulose and MCT in rats fed an obesity-inducing high-fat diet with a low amount of MCTs (2%). Thirty-two male Wistar rats (3-week-old) were randomly divided into four groups: control, d-allulose, MCT, and d-allulose + MCT groups. Rats in each group were fed ad libitum on a control (no d-Allulose or MCT), 5% d-allulose, 2% MCT, or 5% d-allulose + 2% MCT diets for 16 weeks. Abdominal adipose tissue weights were significantly lower in the d-allulose diet group than in the control group, whereas no differences were observed between results of the MCT-supplemented groups. The total body fat mass was significantly lower in the d-allulose and MCT diet groups than in the control group, but no differences were observed between the MCT-supplemented groups. These results suggested that anti-obesity effects of dietary d-allulose were observed, and the effects of dietary MCTs were weaker than those of d-allulose. Moreover, we confirmed the interaction between dietary d-allulose and MCT on indicators of obesity. Interestingly, their effects were not synergistic, as MCT supplementation offset the anti-obesity effects of dietary d-allulose. However, the specific mechanisms underlying those effects remain unknown, warranting further investigation.
文摘Changes in lipid metabolism have been implicated in protection against infectious diseases. In the first experiment of this study, we measured clinical lipid parameters in a murine model where the unmethylated cytidine phosphate guanosine (CpG) oligodinucleotide (ODN1826), a Toll-like receptor 9 (TLR9) agonist was administered in combination with D-galactosamine (GalN) that caused relatively liver-specific inflammation and toxicity. In the control mice group injected with phosphate-buffered saline (PBS) (acute psychological stress model associated with blood sampling), the serum triglyceride (TG) levels showed a rapid decrease followed by a rebound at 24 h as we have recently reported. However, such a TG rebound was impaired in the CpG/GalN- and solely CpG-treated groups of mice despite an absence of liver injury based on serum alanine aminotransferase levels in the latter group. Thus, the stress-associated serum TG rebound was abrogated by the injection of a sub-hepatotoxic CpG dose. In the second experiment, we simply measured the hepatic CD36 and SACRB1 (the gene for scavenger receptor B1 (SR-B1)) transcripts after the i.p. administration of PBS, CpG or CpG/GalN. There was a remarkable elevation of hepatic CD36 transcript expression in both the CpG- and CpG/GalN-treated mice at 8 h post-CpG injection whereas the increase in the PBS-treated mice was slower than the former two groups, suggesting that hepatic CD36 transcript expression is more pronounced in the combined stress models than under psychological stress alone. The individual mice data showed that the increase in CD36 expression was accompanied by a reduction in SCARB1 mRNA, showing reciprocal regulation between these two genes. Together with our previously reported findings, these data suggest that, in a murine model combining psychological stress with TLR-triggered hepatic inflammation, the psychological stress facilitates liver uptake of plasma TG (and its components fatty acids), but the subsequent re-esterification and/or release of TG-rich lipoproteins from the liver is impaired due to the concomitant TLR-signaling. We hypothesize that lipid metabolism during acute stress shifts toward an elevated hepatic uptake of lipids due to concomitant TLR signaling, facilitating the clearance of bacterial lipids by the liver.
文摘Background: In response to the escalating burden of cardiovascular diseases (CVDs) worldwide, exacerbated by lifestyle changes and socioeconomic shifts, acute coronary syndromes (ACS) stand out as a leading cause of morbidity and mortality. The pivotal role of insulin resistance in the pathogenesis of atherosclerosis, independent of traditional risk factors, has garnered significant interest. Objective: This review aims to synthesize the recent advancements in the utilization of the triglyceride glucose index (TyG index) as a biomarker for assessing the severity and predicting the prognosis of ACS lesions. Methods: A systematic search was conducted across PubMed, Embase, and Scopus databases, incorporating keywords such as “triglyceride glucose index”, “TyG index”, “acute coronary syndrome”, “cardiovascular disease”, “insulin resistance”, “coronary artery calcification”, “SYNTAX score”, “Gensini score”, and “major adverse cardiac events”. Studies were included from the inception of each database up to July 2024. Selection criteria encompassed observational studies, case-control studies, and randomized controlled trials, with a particular emphasis on evaluating the diagnostic and prognostic value of the TyG index in patients with acute coronary syndromes. Ultimately, 46 publications met the inclusion criteria. Data extraction and quality assessment were performed in accordance with established guidelines. Results: Evidence suggests that the TyG index, reflecting insulin resistance, blood glucose, and lipid levels, is significantly associated with lesion severity in ACS, including coronary artery calcification, SYNTAX score, and Gensini score. Moreover, it demonstrates predictive power for major adverse cardiovascular events, underscoring its potential as a valuable tool in clinical decision-making. Conclusion: The review highlights the emerging role of the TyG index in the assessment and prognosis of ACS, advocating for its incorporation into clinical practice as a complement to existing diagnostic modalities. However, the establishment of standardized reference ranges and further validation across diverse populations are warranted to refine its applicability in personalized medicine. The interdisciplinary approach is essential to advance our understanding of the complex interplay between insulin resistance and cardiovascular disease, paving the way for the development of more effective prevention and treatment strategies.
基金supported by Medical Scientific Research Foundation of Guangdong Province(No.A2021025)National Natural Science Foundation of China(No.82000057)Science and Technology Project of Guangdong Province(No.2023A1515010177)。
文摘Background Research has indicated that the triglyceride-glucose(Ty G)index is associated with the development and prognosis of cardiovascular diseases.However,there is still uncertainty regarding whether the Ty G index can predict adverse cardiovascular events in patients with acute myocardial infarction(AMI).The present study aimed to explore the prognostic value of the Ty G index in patients with AMI.Methods AMI patients who underwent emergency percutaneous coronary intervention(PCI)in Guangdong General Hospital from February 2021 to June 2022 were enrolled.The study population was grouped based on the median Ty G index.The end point of the study was major adverse cardiovascular events(MACEs),defined as all-cause mortality,cardiogenic shock,recurrent myocardial infarction,acute attack of heart failure,repeat revascularization induced by cardiac ischemia,and urgent visit due to aggravation of chest pain.The Ty G index was calculated as follows:LN[fasting triglycerides(mg/d L)×fasting blood glucose(mg/d L)x1/2].Results A total of 196 patients were included.In the multivariate logistic regression analysis,Ty G index[odds ratio(OR):0.99,95%confidence interval(CI):0.45-2.16,P=0.98]was not significantly correlated with the occurrence of MACEs in AMI patients during hospitalization.Afterwards a total of 178 patients were followed up for an average of 12.66±5.35 months.In the multivariate Cox proportional hazards model,Ty G index[hazard ratio(HR):1.91,95%CI:1.02-3.6,P<0.05]were independent predictor of adverse events during follow-up,and the area under the receiver operating characteristic(ROC)curve(AUC)was0.63(0.53-0.73,P<0.05).Conclusions Ty G index can independently predict the prognosis of AMI patients during the follow-up period.[S Chin J Cardiol 2024;25(1):11-20]
文摘BACKGROUND The incidence of hypertriglyceridemic acute pancreatitis(HTG-AP)has increased yearly,but updated population-based estimates on the incidence of HTG-AP are lacking.Reducing serum triglyceride(TG)levels quickly is crucial in the early treatment of HTG-AP.Decreased serum TG levels are treated by non-invasive methods,which include anti-lipidemic agents,heparin,low-molecular weight heparin,and insulin,and invasive methods,such as blood purification including hemoperfusion(HP),plasmapheresis,and continuous renal replacement therapy.However,authoritative guidelines have not been established.Early selection of appropriate treatment is important and beneficial in controlling the development of HTG-AP.AIM To evaluate the effect between patients treated with intravenous insulin(INS)and HP to guide clinical treatment.METHODS We retrospectively reviewed 371 patients with HTG-AP enrolled in the Department of Fujian Provincial Hospital form April 2012 to March 2021.The inpatient medical and radiologic records were reviewed to determine clinical features,severity,complications,mortality,recurrence rate,and treatment.Multivariate logistic regression analyses were used to analyze risk factors for severe HTG-AP.Propensity score matching was used to compare the clinical outcomes of INS and HP.RESULTS A total of 371 patients met the HTG-AP criteria.The incidence of HTG-AP was increased by approximately 2.6 times during the 10 years(8.4%in April 2012-March 2013 and 22.3%in April 2020-March 2021).The highest incidence rate of acute pancreatitis was observed for men in the age group of 30-39 years.The amylase level was elevated in 80.1%of patients but was only three times the normal value in 46.9%of patients.The frequency of severe acute pancreatitis(26.9%),organ failure(31.5%),rate of recurrence(32.9%),and mortality(3.0%)of HTG-AP was high.Improved Marshall score,modified computed tomography severity index score,baseline TG,baseline amylase,C-reactive protein(CRP),albumin,aspartate aminotransferase,low-density lipoprotein cholesterol,urea nitrogen,creatinine,calcium,hemoglobin,free triiodothyronine,admission to intensive care unit,and mortality were significantly different between patients with different grades of severity(P<0.050).Multivariate logistic regression analysis confirmed that high CRP[P=0.005,odds ratio(OR)=1.011,95%CI:1.003-1.019],low calcium(P=0.003,OR=0.016,95%CI:0.001-0.239),and low albumin(P=0.023,OR=0.821,95%CI:0.693-0.973)were risk factors of severe HTG-AP.After propensity score matching adjusted by sex,age,severity of HTG-AP,and baseline TG,the serum TG significantly decreased in patients treated with INS(P<0.000)and HP(P<0.000)within 48 h.However,the clearance rate of TG(57.24±33.70%vs 56.38±33.61%,P=0.927)and length of stay(13.04±7.92 d vs 12.35±6.40 d,P=0.730)did not differ between the two groups.CONCLUSION The incidence of HTG-AP exhibited a significant increase,remarkable severity,and recurrent trend.Patients with mild and moderately severe acute pancreatitis can be treated effectively with INS safely and effectively without HP.
文摘We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type Ⅴ hyperlipidemia. Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase levels.The imaging examination of ultrasonography could not detect significant findings of acute pancreatitis and a computer tomography scan eventually confirmed the findings of acute pancreatitis.Both cases responded to a low fat diet and administration of a cholecystokinin receptor antagonist,exhibiting a relief of abdominal symptoms.As in the present cases with acute abdomen following the ingestion of fatty food,the identification of serum hypertriglyceridemia and an abdominal computer tomography scan might be useful in establishing the diagnosis of acute pancreatitis and in developing the therapeutic regimen,when hypertriglyceridemia interferes with the evaluation of pancreatic enzyme activities and ultrasound examination provides poor pancreatic visualization.
文摘Crosslinked N, O-carboxymethyl chitosan resins which can selectively adsorb triglyceride, were prepared by the reaction of N, O- carboxymethyl chitosan with glutaraldehyde solution. Adsorption experiments were performed by adding the resins to the serum. The results showed that this type of adsorbent could cut down the concentration of triglyceride in serum by 56. 4% (3. 35mg/gresin ) at most, while concentration of the total protein (TP ) decreased only by 10. 9% at least, so this novel adsorbent can be used to cure hypertriglyceridemia by hemoperfusion in the future.
文摘Hypertriglyceridemia is defined as an abnormal concentration of triglyceride in the blood and has been associated with atherosclerosis,even in the absence of hypercholesterolemia.This case report is of 40-year-old man diagnosed to have hypertriglyceridemia who attended for routine screening in our diagnostic laboratory at Barasat.He was nonsmoker,non-alcoholic,had a reasonable diet with abundant fruits and vegetables,and was on regular exercise.He was not taking any lipid lowering medications.He hailed from Barasat,and was employed in Government sector in Barasat and policeman by profession.His father died at the age of 57 years in a heart attack;but his mother is healthy and now almost 62 years of age,and he has two brothers one elder and another younger to him,both are healthy.His blood pressure was normal,his body-mass index was 27,and his waist circumference was 96 cm and hip circumference was 103.His waist/hip ratio was 0.932.The Biochemical analyses were as follows- Fasting Glucose:186 mg/dL,Total Cholesterol:90 mg/dL,Triglycerides:372 mg/dL,High-density cholesterol:3.80 mg/dL,Low-density cholesterol:2.90 mg/dL,VLDL:83.20 mg/dL,Cholesterol/HDL-C ratio:23.6:1,LDL-C/HDL-C:0.07:1.This study revealed the increased prevalence of dyslipidemia to be more prevalent in 31-40 year males,suggesting that this group is at an increased risk of developing CAD leading to young infarcts.Combination lifestyle therapies i.e.,enhanced physical activity and dietary modification and therapeutic intervention would help us in the treatment and management of dyslipidemia.
基金supported by the National Natural Science Foundation of China(No.81803793 and 31071989)the Young Scientist Program by Beijing University of Chinese Medicine。
文摘Objective:To investigate hypertriglyceridemia and hepatomegaly caused by Schisandrae Sphenantherae Fructus(FSS)and Schisandra chinensis Fructus(FSC)oils in mice.Methods:Mice were orally administered a single dose of SchisandraeFructusoils.Serumandhepatictriglyceride(TG),triglyceridetransferprotein(TTP),apolipoproteinB48(Apo B48),very-low-densitylipoprotein(VLDL),hepatocytegrowth factor(HGF),alanine aminotransfease(ALT)and liver index were measured at 6-120 h post-dosing.Results:FSS and FSC oil caused time and dose-dependent increases in serum and hepatic TG levels,with maximum increases in the liver(by 297%and 340%)at 12 h post-dosing and serum(244%and 439%)at 24-h post-dosing,respectively.Schisandrae Fructus oil treatments also elevated the levels of serum TTP by 51%and63%,Apo B48 by 152%and 425%,and VLDL by 67%and 38%in mice,respectively.FSS and FSC oil treatments also increased liver mass by 53%and 55%and HGF by 106%and 174%,but lowered serum ALT activity by 38%and 22%,respectively.Fenofibrate pre/co-treatment attenuated the FSS and FSC oil-induced elevation in serum TG levels by 41%and 49%at 48 h post-dosing,respectively,but increased hepatic TG contents(by 38%and 33%,respectively)at 12 h post-dosing.Conclusions:Our findings provide evidence to support the establishment of a novel mouse model of hypertriglyceridemia by oral administration of FSS oil(mainly increasing endogenous TG)and FSC oil(mainly elevating exogenous TG).
文摘Non-alcoholic fatty liver disease (NAFLD) is a common liver disease worldwide. There is no specific biomarker for the diagnosis of NAFLD. Trigly-ceride and glucose index (TyG) may predict the subsequent occurrence of NAFLD in later life. This cross sectional study was aimed to evaluate the effectiveness of triglyceride and glucose index (TyG) as a possible biomarker of NAFLD. The study was conducted at the Department of Laboratory Medicine, Bangabandhu Sheikh Mujib Medical University (B中央人民政府), Dhaka, Bangladesh from March 2019 to February 2020. A total of 124 subjects were taken as study population following selection criteria. Among them 62 were diagnosed patients of NAFLD and 62 were healthy subjects as control group. Fasting plasma glucose was measured by glucose oxidase method and serum triglyceride was measured by enzymatic-colorimetric method, while TyG index was calculated accordingly. The mean age was 39.5 ± 11.27 years in NAFLD patients and 37.10 ± 12.28 years in control subjects with male female ratio 1:1.7 and 1:1.8 respectively. Major portion of NAFLD patients (62.9%) were overweight (BMI ≥ 25). The mean fasting plasma glucose level was 5.73 ± 1.47 mmol/L in NAFLD patients and 5.27 ± 0.69 mmol/L in control group (p < 0.027). The mean serum triglyceride level was 237.19 ± 96.47 mg/dl in NAFLD patients and 117.32 ± 53.07 mg/dl in control group (p < 0.001). The triglyceride and glucose index (TyG) was 9.36 ± 0.47 in NAFLD group and 8.53 ± 0.42 in control group. TyG index was significantly higher in NAFLD patients in comparison to control group (p < 0.001). In ROC analysis, cut off value of TyG index was 8.85 with sensitivity 93.5% and specificity 79%. As a fast and effective method, TyG index can be used as a diagnostic tool to predict NAFLD.
文摘Background: Managing hypertriglyceridemia in HIV-infected patients often requires multiple pharmacologic strategies. Many protease inhibitors (PIs), one of 6 classes of drugs used to treat HIV, have been associated with hypercholesterolemia and drug interactions. For this study, we examined a dual strategy to manage hypertriglyceridemia in HIV-infected patient taking PIs: 1) switching patients to fosamprenavir (FPV), a PI with fewer drug interactions, and 2) adding prescription fish oil (LOVAZA?), which has been shown to reduce triglycerides. Methods: This multicenter, 24-week study enrolled 36 patients virologically suppressed (HIV-1 RNA <50 copies/mL) on PI-containing therapy with screening triglyceride levels of 200 - 1200 mg/dL and LDL cholesterol levels ≤160 mg/dL. At baseline, patients were switched to ritonavir (RTV)-boosted fosamprenavir (FPV 1400 mg/RTV 100 mg QD) and any lipid-lowering agents were stopped. At Week 6, LOVAZA 4 g QD was added. Results: Five patients prematurely discontinued due to adverse events (2), non-compliance, lost-to-follow up, and protocol violation. Median triglyceride concentration was 303 mg/dL at screening, 262 mg/dL at baseline, 290 mg/dL at Week 6 (+8% from baseline), and 218 mg/dL at Week 24 (–30% from Week 6). At Week 24, 39% (12/31) of patients had triglycerides <200 mg/dL. Among patients reaching Week 24, 100% (31/31) and 90% (28/31) had HIV-1 RNA <400 and <50 copies/mL, respectively. Conclusions: In this study, a switch to FPV/RTV followed by LOVAZA decreased median triglyceride levels and modestly increased the percentage of patients with triglyceride levels <200 mg/dL while maintaining virologic suppression in HIV-infected subjects with hypertriglyceridemia. Our data suggest that baseline PI may affect the likelihood of achieving triglycerides <200 mg/dL after 18 weeks on study. A larger study would be needed to understand the relative contributions of choice of protease inhibitor and LOVAZA to triglyceride concentrations in HIV-infected patients.
文摘Background Triglyceride glucose (TyG) index is a novel marker for metabolic disorders, and recently it has been reported to be associated with cardiovascular disease (CVD) risk in apparently healthy individuals.However the prognostic value of TyG index in patients with stable coronary artery disease (CAD) is not determined.
基金Supported by a Grant-in-Aid for Scientific Research from the Ministry of Education,Science,Sports and Culture of Japan and by a Grant from the Ministry of Health and Welfare of Japan
文摘AIM： To determine the real association between serum lipid levels and colonic polyp formation. METHODS： We performed a large scale retrospective study to analyze the correlation between the incidence of colorectal adenoma or carcinoma and the fasting serum levels of total cholesterol （TC） and triglycerides （TG） in patients who underwent total colonoscopy for screening for colon cancer. RESULTS： Both levels were significantly elevated in patients with adenomas as compared with patients without any neoplastic lesion （TC 207.6 ± 29.5 vs 199.5 ±34.3, n= 4883, p〈 0.001; TG 135.0 ± 82.2 vs 108.7± 71.5, n= 4874, p〈 0.001）. The difference was significant in patients with tubular adenoma but not in those with villous or serrated adenoma. Multiple logistic regression analysis including age and sex revealed that TG was an independent correlation factor in male （p〈0.01）, but not in female patients. The level of TG in patients with invasive carcinoma did not show a significant elevation from that in patients with adenoma. These findings suggest that hypertriglyceridemia is an independent risk factor for colonic adenoma in men. CONCLUSION： Although a high level of serum triglyceride does not appear to be mechanically involved in the development of carcinoma, reduction of serum TG and intensive surveillance with total colonoscopy may have benefit in men with hypertriglyceridemia.
基金Supported by Austrian Federal Ministry of ScienceResearch and Economy and the National Foundation for ResearchTechnology and Development
文摘Hepatic steatosis defined as lipid accumulation in hepatocytes is very frequently found in adults and obese adolescents in the Western World. Etiologically, obesity and associated insulin resistance or excess alcohol intake are the most frequent causes of hepatic steatosis. However, steatosis also often occurs with chronic hepatitis C virus(HCV) infection and is also found in rare but potentially life-threatening liver diseases of pregnancy. Clinical significance and outcome of hepatic triglyceride accumulation are highly dependent on etiology and histological pattern of steatosis. This review summarizes current concepts of pathophysiology of common causes of hepatic steatosis, including non-alcoholic fatty liver disease(NAFLD), alcoholic fatty liver disease, chronic HCV infections, drug-induced forms of hepatic steatosis, and acute fatty liver of pregnancy. Regarding the pathophysiology of NAFLD, this work focuses on the close correlation between insulin resistance and hepatic triglyceride accumulation, highlighting the potential harmful effects of systemic insulin resistance on hepatic metabolism of fatty acids on the one side and the role of lipid intermediates on insulin signalling on the other side. Current studies on lipid droplet morphogenesis have identified novel candidate proteins and enzymes in NAFLD.
