To systematically evaluate the association between insulin resistance indices and the risk of kidney stones and their recurrence in U.S. non-diabetic individuals, while identifying predictive indicators.

This cross-sectional study analyzed data from the 2007-2018 NHANES. Five IR indices were calculated. Weighted logistic regression, restricted cubic spline, and mediation analyses were used to assess the independent associations between these indices and the risk of kidney stones and recurrence in non-diabetic individuals.

This study of 9,605 non-diabetic participants showed an overall kidney stones incidence of 8.63% and a recurrence rate of 2.70%. Weighted logistic regression and RCS analyses revealed significant positive associations between METs-IR, HOMA-IR, TyG-BMI, and the risk of kidney stones and their recurrence. Every unit increase in METs-IR was linked to a 2% rise in the incidence of kidney stones (95% CI: 1.014-1.027, p < 0.001) and a 3.3% rise in recurrence (95% CI: 1.018-1.048, p < 0.001); each unit increase in HOMA-IR raised incidence by 5% (95% CI: 1.025-1.078, p < 0.001) and recurrence by 7.9% (95% CI: 1.041-1.118, p < 0.001). Adjusting for confounders shifted these relationships from nonlinear to linear (p > 0.05). METs-IR demonstrated the strongest diagnostic accuracy for predicting recurrence, with uric acid and vitamin D mediating associations between IR indices and the risk of kidney stones and their recurrence in non-diabetic individuals.

This study found that elevated IR indices (METs-IR, HOMA-IR, TyG-BMI) significantly increased kidney stone risk in a non-diabetic population. Serum uric acid and vitamin D mediated this association, with METs-IR best predicting kidney stones incidence and recurrence.

The triglyceride-glucose (TyG) related indices, indicators for insulin resistance, and depression are both established predictors of cardiovascular diseases. However, the single and combined effect of TyG related indices and depression on cardio-renal-metabolic multimorbidity (CRMM) risk remain uncertain.

This study included 7848 respondents aged 45 years and older, derived from the China Health and Retirement Longitudinal Study (CHARLS) 2011, 2020. Cox regression was used to determine independent and joint effect of TyG indices and depression on CRMM incidence. Restricted cubic spline (RCS) was further performed to identify associations of TyG indices with CRMM.

Results demonstrated that both TyG indices (including TyG-WC, TyG-WHtR, and TyG-BMI) and depression were independently linked to increased risk of CRMM. The RCS model further confirmed the significant dose-response relationships. Participants experiencing both elevated TyG indices and depression exhibited the highest CRMM risk, in contrast to those with neither condition (HR = 1.630, 95%CI: 1.467-1.811; HR = 1.631, 95%CI: 1.465-1.817; HR = 1.582, 95%CI: 1.419-1.764; HR = 1.532, 95%CI: 1.372-1.711, respectively).

Firstly, disease diagnoses in the CHARLS were self-reported, which might cause recall bias. Then, data was specific to the population over 45 years old, so the results may not apply broadly to all populations.

This study revealed both the single and joint effect of TyG, TyG-WC, TyG-WHtR, as well as TyG-BMI and depression on CRMM risk. Combined evaluations of the TyG index with depression screening is crucial for identifying related risk factors and enhancing prevention strategies against CRMM.

This study investigates how Dietary Inflammatory Index (DII) and Composite Dietary Antioxidant Index (CDAI) patterns relate to cardiovascular disease, with particular focus on their metabolic connections, providing novel insights for prophylaxis and remedy.

Data from NHANES (2009-2014) were utilized in this retrospective cross-sectional research. Binary logistic regression and the generalized linear model (GLM) were applied to assess the correlations among DII, CDAI, metabolic factors, and CVD. Moreover, causal mediation analysis was carried out to further probe into the mediating role of the TyG-index.

Significant positive correlations between DII (odds ratio [OR] 1.08, 95 % confidence interval [CI] 1.01-1.16, p = 0.036) and CVD were observed, while CDAI exhibits a nonlinear association with the risk of CVD. The combined effect analysis indicated that the group with a low DII and high CDAI combination had the least risk (OR 0.52, 95 % CI 0.35-0.78, p = 0.002). TyG-index was found to mediate 4.95 % of the connection between DII and CVD and 8.02 % of the linkage between CDAI and CVD, respectively.

This study manifests that DII and CDAI are respectively correlated with the risk of CVD incidence. The diet low in inflammation and rich in antioxidants can safeguard against disease occurrence. Serving as a metabolic marker, the TyG-index serves to establish the connection among DII, CDAI, and the progression of CVD.

Vascular insulin resistance has emerged as a pivotal factor in the genesis of cardiovascular disease (CVD) in people with diabetes. It forms a complex pathogenic partnership with metabolic insulin resistance to significantly amplify the CVD risk of diabetes and other affected populations. Metabolic insulin resistance (characterized by quantitatively diminished insulin action on glucose metabolism in skeletal muscle, liver, and adipose tissue) is a hallmark of diabetes, obesity, and related conditions. In contrast, vascular insulin resistance is a less appreciated and not well-quantified complication of these conditions. Importantly, an impaired vascular response to insulin contributes directly to vascular dysfunction and over 40 years of research has convincingly shown that vascular and metabolic insulin resistance synergize to create an environment that predisposes individuals to CVD. In this review, we examine the multifaceted vascular actions of insulin, including its roles in regulating blood pressure, blood flow, endothelial health, and arterial stiffness. We also examine how these processes become disrupted in the setting of vascular insulin resistance, which subsequently undermines endothelial function, compromises tissue microvascular perfusion, and promotes vascular rigidity and atherosclerosis. We then highlight potential therapeutic strategies with demonstrated efficacy to improve vascular insulin sensitivity in people with diabetes and suggest that targeting disordered vascular insulin signaling holds promise not only for refining the functional understanding of vascular insulin resistance but also for developing innovative treatments with potential to reduce CVD risk and improve cardiovascular outcomes in people with diabetes.

Despite increasing evidence linking triglyceride-glucose (TyG) related indices with metabolic and cardiovascular outcomes, the associations with severe infection in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) remain unclear.

We analyzed data from a large population-based cohort, which included participants who were diagnosed with MASLD and enrolled in 2016 and 2017, with follow-up until December 2022. Severe infections were defined as those requiring hospital admission or resulting in mortality. Multivariate Cox and restricted cubic spline (RCS) regression models were used to evaluate the associations between TyG-related indices and severe infection among participants with MASLD. Additionally, we examined these associations within subgroups defined by age, sex, hypertension, diabetes, obesity, and hyperlipidemia.

Among the 11,782 eligible participants with MASLD (mean age 57.02 years; 34.36 % male), a total of 898 (7.62 %) severe infections occurred during the median follow-up of 5.71 years. The multivariate Cox regression analyses revealed that high levels of TyG (HR = 1.175, 95%CI = 1.049-1.315), TyG-BMI (HR = 1.004, 95%CI = 1.001-1.006), and TyG-WC (HR = 1.002, 95%CI = 1.001-1.003) indices were significantly associated with the severe infection in patients with MASLD. The RCS curves showed positive linear correlations between three TyG-related indices with severe infection in MASLD. Subgroup analyses showed these associations were more pronounced among MASLD patients without obesity. Additionally, incorporating TyG-related indices into the basic model considerably improved the predictive ability for severe infection.

Our study indicated that a high TyG-related indices are associated with an increased risk of severe infection in MASLD patients. TyG-related indices would be the surrogate biomarkers for the follow-up of the MASLD population.

Incomplete endothelialization (IDE) of left atrial appendage closure (LAAC) devices increases the risk of device-related thrombosis (DRT) and stroke. Insulin resistance (IR) may contribute to IDE by impairing endothelial function, but its role remains unclear. This study aimed to investigate the association between IR markers and IDE and develop a predictive model for identifying high-risk patients.

This retrospective observational study included 168 patients with nonvalvular atrial fibrillation (AF) who underwent successful LAAC at Shanghai Ninth People's Hospital between January 2022 and December 2023. IDE was assessed using transesophageal echocardiography (TEE) and cardiac computed tomography angiography (CCTA) at 6 months post-procedure. IR was evaluated using the triglyceride-glucose (TyG) index, triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-c) ratio, and metabolic score for insulin resistance (METs-IR). Logistic regression analysis was performed to identify independent predictors of IDE, and a predictive model was constructed.

Among the 168 patients included in the analysis, 43 (25.5%) exhibited IDE, as determined by TEE or CCTA at 6 months post-procedure. Patients with IDE had a significantly higher body mass index, triglyceride (TG) levels, total TG/high-density lipoprotein ratio, TyG index, METs-IR index, and D-dimer levels, as well as a larger maximum LAA orifice diameter (p < 0.05). Multivariate logistic regression identified D-dimer, METs-IR, and maximum LAA orifice diameter as independent predictors of IDE. The predictive probability model incorporating these factors demonstrated high discriminatory ability (area under the curve 0.800, 95% confidence interval 0.71-0.89, p < 0.0001). The optimal predicted probability cut-off value was 0.284, achieving a sensitivity of 76.2% and a specificity of 85.2%.

IR markers, D-dimer levels, and LAA orifice size are significant predictors of IDE following LAAC. The logistic regression model proposed here provides an effective risk stratification tool for identifying patients at higher risk for IDE, enabling personalized anticoagulation strategies and optimizing post-procedural management. Future research should explore whether metabolic interventions can enhance endothelialization and improve long-term outcomes in patients undergoing LAAC.

Bioactive compounds derived from medicinal plants have become a significant source of drugs for inflammatory diseases treatment, particularly those caused by immune system abnormalities. Quercetin, a flavonol found in a wide variety of herbs, fruits, and vegetables, has garnered attention for its diverse biological properties, including anti-inflammatory, anticancer, and antiviral activities. Numerous in vivo and ex vivo studies have validated quercetin's role in treating inflammatory diseases through multiple pathways, mainly involving anti-oxidative stress, modulation of metabolism, intestinal flora, apoptosis, endoplasmic reticulum stress, and macrophage polarization, indicating it a promising pharmaceutical candidate for managing inflammatory and autoimmune conditions. We aimed to systematically review quercetin's anti-inflammatory activity and the mechanisms of action across various inflammatory diseases in the digestive, respiratory, endocrine, neurological, and osteoarticular systems. By summarizing the therapeutic potential of quercetin in these multifaceted conditions, this review seeks to provide a solid foundation for future clinical research and application strategies involving quercetin.

To investigate the association between estimated glucose disposal rate (eGDR) and mortality risk among patients with atherosclerotic cardiovascular disease (ASCVD).

NHANES (1999-2018) data were analyzed using weighted Cox regression and restricted cubic splines (RCS) to assess the association between eGDR and mortality. Improvement in predictive performance was evaluated. Subgroup, mediation, and sensitivity analyses were conducted.

Among 4,425 ASCVD patients (67.40 % ≥60 years, 44.66 % female), 1,815 deaths (35.62 %) and 751 CVD deaths (18.48 %) occurred over 7.7 years. Compared to the highest quartile, the lowest eGDR quartile had HRs of 2.13 and 2.06 for CVD and all-cause mortality, respectively. RCS demonstrated linearity (P-nonlinear > 0.05). Addition of eGDR improved the predictive performance for both CVD and all-cause mortality (P < 0.001), whereas other insulin resistance indicators did not yield comparable improvements. Diabetes status modified its association with CVD mortality (P-interaction = 0.029). Neutrophil-to-lymphocyte ratio and estimated pulse wave velocity were key mediators.

Lower eGDR was associated with increased mortality risk in ASCVD, particularly among patients without diabetes. eGDR enhances mortality prediction, supporting its role as a prognostic marker in ASCVD.

The study investigated the association between the triglyceride-glucose (TyG) index (a surrogate measure for insulin resistance) and all-cause and cardiovascular disease (CVD) mortality among individuals with cardiovascular-kidney-metabolic syndrome.

Population-based cohort study.

US National Health and Nutrition Examination Survey, 1999-2018.

A total of 13 585 participants who had valid data were included in this analysis.

Data from the participants were linked to death certificates to obtain follow-up mortality information from the National Death Index. Cox proportional hazards models were used to assess the associations between the TyG index and all-cause and CVD mortality. Non-linear associations and threshold effects were investigated using restricted cubic spline regression and a two-piecewise Cox proportional hazards model.

During a median follow-up of 99 months, a total of 2876 (16.24%) deaths occurred, of which 961 were attributed to CVD. Each one-unit increase in the TyG index was associated with an 8.9% relative increase in the hazard of all-cause mortality (HR 1.089, 95% CI 1.013 to 1.171) and a 19.5% relative increase in the hazard of CVD mortality (HR 1.195, 95% CI 1.027 to 1.390). Non-linear relationships were identified between the TyG index and all-cause and CVD mortality, with threshold values of 8.97 and 8.81 for all-cause and CVD mortality, respectively. A significant interaction effect was found between age and the TyG index.

There was a U-shaped relationship between the TyG index and both all-cause and CVD mortality. The thresholds of the TyG index may serve as potential tools for managing populations with cardiovascular-kidney-metabolic syndrome to reduce mortality risk.

Venous thrombosis is a serious complication that adversely impacts the prognosis of patients with intracerebral hemorrhage (ICH) and even threatens their lives. Triglyceride glucose product (TyG) index is closely related to the pathophysiological process of cerebral hemorrhage and venous thrombosis. A total of 308 ICH patients were divided into training (n = 215) and validation groups (n = 93). Single factor logistic regression analysis and multiple factor logistic regression analysis were performed. Seven factors associated with lower extremity venous thrombosis were identified: emergency cranial surgery, pneumonia, stroke history, age, TyG index, capryini score ≥ 10, and glomerular filtration rate. The area under the curve was found to be 0.79 (95% CI: 0.72-0.86) in the training group and 0.70 (95% CI: 0.58-0.83) in the validation group. Calibration plots demonstrated strong concordance between predicted probabilities from our model and observed outcomes; Decision curve analysis further confirmed that our nomogram provides substantial clinical net benefit. By integrating the TyG index with recognized clinical risk factors for ICH patients, we have developed a predictive nomogram that aids in early identification of individuals at high risk for lower extremity venous thrombosis as well as supports personalized management strategies for these patients.

The triglyceride-glucose body mass index (TyG-BMI) is acknowledged as a dependable surrogate biomarker for the evaluation of insulin resistance (IR). Current research indicates a significant correlation between TyG-BMI and the risk of subsequent cardiovascular events in individuals diagnosed with cardiovascular-kidney-metabolic syndrome (CKM) at stages 0-3. Nevertheless, the prognostic significance of TyG-BMI in patients with CKM stage 4 has not been extensively investigated, and there is a paucity of evidence available on this topic. The study utilized patient data from the Medical Information Mart for Intensive Care (MIMIC-IV) database, categorizing the data into quartiles based on the TyG-BMI index. The primary outcomes of interest were all-cause mortality at 180 days and at one year. To assess the relationship between the TyG-BMI index and these outcomes in patients diagnosed with stage 4 CKM, a Cox proportional hazards model was employed. Additionally, a restricted cubic splines(RCS) model was applied to further investigate the associations between the TyG-BMI index and the specified outcomes. A total of 1,885 patients participated in the study, with 62.49% of the cohort being male. The all-cause mortality rates were recorded at 30.50% at 180 days and 35.12% at one year. Analysis using a multivariate Cox proportional hazards model revealed that an increase in the TyG-BMI index was significantly correlated with a reduction in the risk of all-cause mortality at both the 180-day and one-year marks. Specifically, for each standard deviation increase in the TyG-BMI index, the risk of all-cause mortality decreased by 17% within 180 days (HR = 0.83, 95% CI: 0.76-0.91) and by 21% within one year (HR = 0.79, 95% CI: 0.71-0.87). Furthermore, regression analysis utilizing RCS indicated a linear decrease in all-cause mortality rates associated with increasing TyG-BMI index values over both the 180-day and one-year periods (P for nonlinearity = 0.171 and P for nonlinearity = 0.141, respectively). In patients diagnosed with stage 4 CKM syndrome, a reduced TyG-BMI index was found to be significantly correlated with a heightened risk of all-cause mortality within both 180 days and one year. Consequently, the TyG-BMI index may be utilized as an effective instrument for risk stratification and prognostic assessment in this patient population.

The aim of this study was to evaluate and compare the usefulness of the C-reactive protein (CRP)-triglyceride glucose (TyG) index (CTI) and other insulin resistance (IR) or inflammatory indexes for predicting recurrent cardiovascular events in percutaneous coronary intervention (PCI)-treated patients. In addition, the mediating effects of systemic inflammation, represented by high-sensitive CRP (hs-CRP), on TyG index-associated adverse cardiovascular events across different subgroups were also evaluated.

The formula for calculating the CTI was 0.412 × ln [high-sensitivity CRP (mg/L)] + ln [triglyceride (mg/dl) × fasting glucose (mg/dl)/2]. The primary endpoint was defined as the incidence of major adverse cerebrovascular and cardiovascular events (MACCEs), including cardiovascular death, nonfatal acute myocardial infarction (AMI), nonfatal ischemic stroke and repeat coronary revascularization.

Among the 2383 PCI-treated patients, 413 experienced MACCEs during a median of 34 months follow-up. Correlation analysis showed CTI was significantly associated with cardiometabolic factors. The CTI was the strongest predictor for MACCEs (adjusted HR 1.85, 95% CI 1.44-2.38) among the inflammatory and IR indicators. CTI had an incremental effect on the predictive ability of the prognostic model for MACCEs (NRI: 0.220, p < 0.001; IDI: 0.009, p < 0.001). Subgroup analysis revealed that the prognostic value of the CTI remained significant across all subgroups (all p < 0.05) whereas the predictive abilities of other IR or inflammatory indicators were more or less influenced by the metabolic abnormalities. Finally, mediation analysis revealed that the effects of systemic inflammation on TyG index-associated MACCEs were more prominent in patients with metabolic disorders.

CTI was a practical indicator for evaluating cardiometabolic diseases. Among the IR and inflammatory indicators, CTI was the most promising index for predicting recurrent cardiovascular risks in PCI-treated patients. TyG index-associated cardiovascular risks were partially mediated by systemic inflammation in patients with metabolic abnormalities.

The optical flow ratio (OFR), derived from optical coherence tomography (OCT) images, serves as a physiological index, while the Triglyceride-Glucose Index (TyG) is an alternative measure of insulin resistance. Both indices are positively correlated with poor prognosis in patients with acute coronary syndrome (ACS), but the relationship between the TyG index, OFR, and their prognostic value remains unclear. We included ACS patients who underwent OCT between January 1, 2021, and March 31, 2023. The TyG index was calculated as Ln[fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Patients were grouped into three categories (T1, T2, and T3) based on TyG tertiles. The primary endpoint was major adverse cardiovascular events (MACE). In our analysis, the T3 group showed a significantly higher incidence of MACE (P < 0.05), with a progressive decrease in vessel-level OFR observed as the TyG index increased, demonstrating a linear correlation (r = - 0.0146, P < 0.001). The restricted cubic splines (RCS) model revealed a nonlinear relationship between the TyG index and the likelihood of MACE (P for nonlinear < 0.021). Additionally, the cumulative incidence of MACE was significantly higher in patients with a higher TyG index (all Log-rank P < 0.001).These findings suggest a nonlinear relationship between the TyG index and MACE, and a linear association between the TyG index and vessel-level OFR. The combination of the TyG index and OFR significantly improved discriminatory ability (c-index: 0.720 vs. 0.757; P < 0.001) and reclassification ability (net reclassification index [NRI]: 0.373; integrated discrimination improvement [IDI]: 0.031; P < 0.0001) for predicting MACE compared to vessel-level OFR alone. This combination effectively identifies high-risk ACS patients.

The estimated glucose disposal rate (eGDR) serves as a straightforward and noninvasive indicator of insulin resistance (IR). This study aims to explore the association between eGDR and the risk of abdominal aortic calcification (AAC).

We utilized data from adult participants (≥40 years old, n=3006) from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) database. AAC was measured by dual-energy X-ray absorptiometry and quantified using the Kauppila score. Severe AAC (SAAC) was defined as an AAC score > 6. Logistic regression, restricted cubic spline (RCS), and subgroup analysis were used to analyze the relationship between eGDR and SAAC risk.

In fully adjusted models, eGDR was found to be negatively associated with SAAC (OR=0.86, 95%CI:0.79-0.94, P<0.001). Compared to participants in the lowest eGDR quantile, those in the highest quantile exhibited a lower risk of SAAC (OR=0.47, 95%CI:0.25-0.91, P=0.026). The RCS analysis indicates a nonlinear relationship between eGDR and SAAC risk, with a turning point at 7.05 mg/kg/min. Subgroup analysis showed that the association between eGDR and SAAC risk was more significant in women.

The degree of IR assessed by eGDR is associated with SAAC risk. The eGDR shows promise as an epidemiological tool for evaluating the influence of IR on AAC.

The triglyceride-glucose (TyG) index is regarded as a surrogate marker of systemic insulin resistance (IR). Studies have substantiated the impact of IR on cardiovascular diseases. Nonetheless, the prognostic value of the TyG index in critical patients with heart failure (HF) with intensive care unit (ICU) admission remains unclear. This study aims to assess the association between the TyG index and all-cause mortality in critically ill patients with HF. Patients with HF requiring ICU admission were identified from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and subsequently stratified into quartiles based on their TyG index. The primary outcome was 30-day all-cause mortality, and the secondary outcome was 1-year all-cause mortality. The relationship between the TyG index and all-cause mortality in HF patients was analyzed using multivariable Cox proportional hazards models and restricted cubic splines. A total of 1220 patients (62.4% men) were enrolled, with a mean age of 70.6 years. The 30-day and one-year all-cause mortality rate were 15.7% and 34.6%, respectively. Multivariable Cox regression revealed that TyG index was significantly associated with an elevated risk of 30-day all-cause mortality (adjusted HR, 1.360; 95% CI, 1.093-1.694; P = 0.006), but not with one-year mortality (adjusted HR 1.046; 95% CI 0.895-1.222, P = 0.574). Restricted cubic splines showed a progressively increasing risk of 30-day mortality was linearly related to an elevated TyG index. Subgroup analyses indicated a more prominent association between TyG index and 30-day mortality in patients with age ≤ 65, female or BMI > 30 kg/m2. In critically ill patients with HF, the TyG index is significantly associated with short-term all-cause mortality. Our results highlight that the TyG index can be useful in identifying HF patients at high risk of all-cause mortality and require close follow-up after discharge.

Insulin resistance and central obesity are major risk factors for cardiometabolic diseases. The triglyceride-glucose index (TyG) and lipid accumulation product (LAP) are markers that independently predict cardiometabolic risk. However, their combined long-term trajectories and impact on cardiometabolic multimorbidity (CMM) development remain unclear.

This cohort study utilized data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, which tracked 3467 participants at baseline. Dual-trajectory of TyG and LAP were identified using a group-based dual-trajectory model. Cox proportional hazards models were employed to assess the relationships between dual-trajectory groups and primary cardiometabolic outcomes, including first cardiometabolic disease (FCMD), CMM (two or more conditions such as type 2 diabetes, coronary heart disease, or stroke), and all-cause mortality. Multi-state models were performed to assess the associations of dual-trajectory with CMM development.

The study included 3467 participants with a mean age of 25.08 years (SD = 3.59). Of these, 43.4% (n = 1505) were male, and 53.2% (n = 1561) were White. Three distinct dual-trajectory groups were identified: low-increasing (61.5%), high-amplitude fluctuation (7.6%), and high-increasing (30.9%). After multivariate adjustment, compared with the low-increasing group, the high-amplitude fluctuation group exhibited significantly higher risks for FCMD (hazard ratio [HR] 1.38, 95% confidence interval [CI]: 1.08-1.77), CMM (HR 2.63, 95% CI 1.21-5.71), and all-cause mortality (HR 2.16, 95% CI 1.30-3.56), as well as elevated risks for transitions from baseline to FCMD (HR 1.41, 95% CI 1.17-1.63), FCMD to CMM (HR 2.07, 95% CI 1.53-3.96), CMM to death (HR 2.87, 95% CI 1.19-7.62). The high-increasing group showed similar results.

Elevated and fluctuating trajectories of TyG and LAP from early adulthood are associated with increased risks of CMM development in midlife.

Chronic kidney disease (CKD) is characterized as a progressive dysfunction of the kidney. The estimated glucose disposal rate (eGDR) is widely recognized as a dependable marker of insulin resistance (IR). Nonetheless, the potential link between eGDR and CKD incidence remains insufficiently clarified. This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS). The outcome of this study was CKD events. We performed adjusted Cox proportional hazards regression, restricted cubic splines (RCS), and mediation analyses. Among the 6,737 participants followed for a median of 108 months, 1,356 (20.13%) developed CKD. Relative to the lowest quartile (Q1) of eGDR, the adjusted HR for the highest quartile (Q4) was 0.85 (95% CI: 0.72-0.99). Each standard deviation increase in eGDR was linked to a 7% reduction in CKD risk (HR: 0.93, 95% CI: 0.88-0.99). The RCS curve indicated a linear relationship between eGDR and CKD risk (threshold = 8.21). The cardiovascular disease (CVD) significantly mediated 27.0% of the association between eGDR and CKD risk. This study demonstrates a significant inverse correlation between eGDR levels and CKD risk in middle-aged and elderly individuals within the Chinese population. Moreover, CVD emerges as a key intermediary linking eGDR and the heightened risk of CKD.

The triglyceride-glucose (TyG) index has been confirmed to be a predictor of cardiovascular diseases. The present study aimed to assess the predictive value of TyG index for left ventricular aneurysm (LVA) formation and prognosis in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).

This prospective study included 991 patients with acute STEMI who underwent primary PCI. Multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were used to assess the predictive value of TyG index for LVA formation. Prognosis analysis was performed with cox proportional hazard regression.

The prevalence of LVA was 14.4%. A higher TyG index was associated with a greater incidence of LVA (23.1% vs. 11.8%, P< 0.001). The TyG index was also higher in the LVA group than in the non-LVA group (9.4 ± 0.9 vs. 9.0 ± 0.8, P<0.001). Multivariable logistic regression analysis revealed that the TyG index was independently associated with the risk of LVA [odds ratio (OR)= 2.4, 95% confidence interval (CI)= 1.51-3.82, P< 0.001]. The predictive value of the TyG index remained significant even after cross-validation by dividing the study population into a training set (OR= 2.32, 95% CI= 1.24-4.35, P= 0.009) and validation set (OR= 3.19, 95% CI= 1.42-7.19, P= 0.005). Higher TyG index was correlated with increased risk of cardiac death (HR= 2.17, P= 0.04). The maximal length and width of LVA were significantly increased in patients with TyG index ≥ 9.68 compared with < 9.68 (P< 0.001). The discriminant power of TyG index for LVA was 0.742, which was superior to both triglyceride (C statistic= 0.666) and fasting blood glucose (C statistic= 0.613). The combination of TyG index, left ventricular ejection fraction, gensini score, and left anterior descending artery as the culprit vessel could significantly improve the predictive ability (C statistic= 0.908).

A higher TyG index was an independent predictor for LVA formation and increased risk of cardiac death in patients with STEMI who underwent primary PCI.

This study aimed to explore the effects of hypoglycemic agents with weight loss effect plus a high protein diet and moderate exercise on weight loss and diabetes remission in adults with obesity and newly diagnosed prediabetes/type 2 diabetes (T2D).

Participants with obesity and newly diagnosed prediabetes or T2D (n = 61) were randomly allocated to standard treatment group (conventional medication and lifestyle guidance for 12 months) and intensive treatment group (in addition to conventional medication, a high protein diet and moderate exercise were given for 12 months).

By month 12, 60 (98.4%) participants completed the 12-month follow-up visit. In the intensive treatment group, 73.33% patients in the prediabetes subgroup returned to normoglycemia and the diabetes remission rate was 86.67% in the diabetes subgroup, which were much higher than the remission rate of prediabetes subgroup (7.69%) and diabetes subgroup (16.67%) in the standard treatment group (P < 0.001). The mean weight change was - 19.29 kg (95% CI, - 22.95 to - 15.63) in the intensive treatment group and - 1.52 kg (95% CI, - 5.12 to 2.07) in the standard treatment group from baseline after intervention. The weight change between the two groups was significantly different (net difference, - 17.77 kg; 95% CI, - 22.90 to - 12.64; P < 0.001). Percent of body fat, visceral fat area, and hepatic controlled attenuation parameter value reduced significantly in the intensive treatment group compared to the standard treatment group (P < 0.001).

Hypoglycemic agents with weight loss effect plus a high protein diet and moderate exercise could lead to a considerable proportion of patients with diabetes achieving diabetes remission.

chictr.org.cn ChiCTR2100044305.

The triglyceride glucose-weight adjusted waist index (TyG-WWI) has emerged as a straightforward and reliable alternative for assessing insulin resistance (IR). However, the relationship between the TyG-WWI index and the incidence of stroke, especially in individuals with different glucose metabolism status, is still unclear. The data for this study was obtained from the China Health and Retirement Longitudinal Study (CHARLS). The primary endpoint was the occurrence of stroke events. We utilized multivariate Cox proportional hazard models and restricted cubic spline (RCS) analysis to examine the relationship between the TyG-WWI index and the risk of stroke in individuals with different glycemic metabolic states. A total of 8895 participants were included in this study, 831 (9.3%) stroke events were recorded during the follow-up period. After fully adjusting for covariates, per SD increase in the TyG-WWI index was associated with a 11% increase in stroke risk (HR: 1.11, 95% CI 1.02, 1.20) in all participants. The TyG-WWI index was further categorized into quartiles, the adjusted HRs (95% CIs) for Q2, Q3, and Q4 compared to Q1 being 1.37 (95% CI 1.09, 1.72), 1.42 (95% CI 1.13, 1.78), and 1.50 (95% CI 1.17, 1.93), respectively. Furthermore, high levels of the TyG-WWI index were found to be linked to an increased risk of stroke in prediabetes mellitus (Pre-DM) participants across Cox models. However, this association was not observed in participants with normal glucose regulation (NGR) and diabetes mellitus (DM) (all P > 0.05). RCS analysis also demonstrated that higher baseline TyG-WWI index levels were associated with higher HRs for stroke in all participants and those with Pre-DM. The TyG-WWI index significantly associates with stroke risk in middle-aged and elderly Chinese populations. Moreover, this relationship exhibits distinct characteristics influenced by the individual's glucose metabolism status.

The estimated glucose disposal rate (eGDR) is recognized as a reliable marker of insulin resistance. However, the association between eGDR and the risk of stroke remains unclear.

A total of 13 706 middle-aged and older participants were enrolled from CHARLS (China Health and Retirement Longitudinal Study). The primary end point was the occurrence of stroke events. The Kaplan-Meier curves, Cox proportional hazard models, and restricted cubic spline analysis were applied to explore the association between eGDR and the risk of stroke according to sex, age, and glycemic status. A total of 1101 stroke events were recorded. Our findings revealed a significant nonlinear relationship between eGDR and the occurrence of stroke. The association was similar between men (hazard ratio [HR], 0.83 [95% CI, 0.80-0.87]) and women (HR, 0.86 [95% CI, 0.80-0.87]), as well as among participants with normal glucose tolerance (HR, 0.83 [95% CI, 0.79-0.87]), prediabetes (HR, 0.85 [95% CI, 0.82-0.89]), and diabetes (HR, 0.87 [95% CI, 0.82-0.92]). However, the association was stronger in middle-aged participants (HR, 0.82 [95% CI, 0.78-0.86]) compared with older individuals (HR, 0.87 [95% CI, 0.83-0.90]; P for interaction=0.019).

This study demonstrates that lower eGDR levels are significantly linked to increased stroke risk. The relationship between eGDR and stroke risk was similar across different sexes and glycemic statuses and was stronger in middle-aged participants compared with older participants.

The triglyceride-glucose (TyG) index, recognized as a surrogate marker for insulin resistance, is an established cardiovascular risk factor. We aimed to prospectively investigate the association between the TyG index and aortic valve calcific (AVC) progression, as well as its relationship with incident calcific aortic valve stenosis (CAVS).

A post hoc analysis was conducted on 5589 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) database. The TyG index was calculated using ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2). Multivariate Cox regression assessed the association between baseline TyG index and AVC progression. Two-sample Mendelian randomization (MR) analysis was employed to evaluate the potential causality between the TyG index and CAVS.

Over a median 2.4 years follow up, 567 cases of AVC progression were idenrified. After adjusting for traditional cardiovascular risk factors, each 1-SD increase in the TyG index was associated with a 20.8% increased risk of AVC progression. Robustness was confirmed in sensitivity analyses and nearly all subgroups. Two sample MR analysis supported a causal relationship between a higher TyG index and increased risk of CAVS.

A higher TyG index independently predicts AVC progression and causally influences CAVS incidence in the general population.

Insulin resistance is a well-establsihed risk factor for stroke. However, the relationship between triglyceride-glucose (TyG) index; its modified indices‒TyG-waist circumference (TyG-WC); TyG-waist-to-height ratio (TyG-WHtR); and TyG-BMI and the risk of stroke in populations without diabetes remains underexplored.

Data from the CHARLS on 4,029 participants without diabetes aged 45+ years at baseline (2011‒2012) were analyzed, with follow-ups through 2020. Statistical analysis and modeling were performed in 2024. Incident strokes occurring between 2015 and 2020 were examined. TyG and its modified indices were categorized into tertiles and analyzed based on baseline levels, changes over time, and cumulative measures. Changes in TyG and its modified indices were identified using K-means clustering, while cumulative indices were calculated using a formula: (TyG2012+TyG2015)/2 × time (2015-2012).

Between 2015 and 2020, 225 participants (5.6%) experienced a stroke. After full adjustment, for cofounders only TyG-WC remained significantly associated at each level across its baseline levels, changes, and cumulative measures (p<0.05), outperforming TyG, TyG-WHtR and TyG-BMI. Compared to Tertile 1, AORs (95% CIs) for stroke associated with TyG-WC were 1.64 (1.10, 2.47) in Tertile 2 and 1.79 (1.15, 2.82) in Tertile 3. For changes in TyG-WC, ORs (95% CIs) were 1.70 (1.14, 2.60) in Class 2 and 1.80 (1.11, 2.97) in Class 3. Regarding cumulative TyG-WC, the ORs (95% CIs) were 1.61 (1.08, 2.41) for Tertile 2 and 1.70 (1.10, 2.66) for Tertile 3. Additionally, TyG-WC demonstrated superior predictive performance for stroke compared to other indices.

TyG-WC is strongly associated with stroke risk in populations without diabetes, offering superior risk stratification compared to other TyG indices.

This study examines the relationship between the TyG index and the risk of sudden cardiac death (SCD) in the patients with diabetic foot ulcer (DFU).

688 type 2 diabetes mellitus (T2DM) inpatients with DFU between January 2010 and December 2023 was included in this retrospective study. The 1:1 propensity score matching (PSM) method was applied. The relationship between TyG index and SCD risk was analyzed using the Kaplan-Meier (K-M) survival curve analysis, multivariate Cox proportional hazard regression model, Restricted cubic spline (RCS) model analysis and subgroup analyses.

Over a median follow-up period of 61 months, 38 cases of SCD were recorded. After PSM, 71 pairs of score-matched patients according to TyG index were generated. K-M survival curves revealed higher SCD rates in patients with TyG index ≥9.65. The Cox proportional hazard model, independently associated with the risk of SCD (HR: 75.98; 95 % CI: 9.16 ∼ 630.40; P < 0.001). RCS model showed that SCD risk was non-linearly correlated with gradual increases in TyG index levels. Stratified analyses indicated a consistent relationship between increasing TyG index and SCD risk across all subgroups.

Elevated TyG index independently confers an increased risk for SCD in individuals with DFU.

Limited researches have investigated the association between the Triglyceride-glucose index (TyG) and frailty vulnerability in middle-aged and older Chinese populations. This study aims to strengthen the scientific foundation for frailty prevention and management by analyzing the correlation between TyG and frailty, ultimately providing more targeted intervention strategies.

This study included middle-aged and older individuals who participated in the China Health and Retirement Longitudinal Study (CHARLS) from 2015. A multiple logistic regression model was constructed to assess the correlation between the TyG index and frailty. Additionally, restricted cubic spline (RCS) analysis was employed to evaluate the dose-response correlation between the two variables.

Among the 3,978 participants included in the study, 667 individuals (16.8%) were identified with frailty. After adjusting for multiple factors in a logistic regression model, it was determined that individuals in the highest quartile group of the TyG index had a 1.43 times higher risk of frailty compared to those in the lowest quartile group (OR = 1.43, 95% CI: 1.10 ~ 1.85, p = 0.007). The RCS analysis further revealed a positive dose-response relationship, indicating that a higher TyG index was associated with an increased risk of frailty in middle-aged and older adults.

Research has shown a significant positive linear relationship between an increased TyG index and a higher prevalence of frailty in middle-aged and older individuals. Elevated TyG index levels could signal an increased vulnerability to frailty among individuals.

It is increasingly recognized that the brain continuously interacts with other body systems such as the immune system, the gut-brain axis, and the endocrine system. Dysfunctions in these systems can impact mental health by altering neurotransmitter levels and the neurochemical environment. This shift in understanding underscores the need for therapeutic strategies that address systemic health and mitochondrial function, alongside psychosocial aspects of the disease, offering a more personalized and adaptive approach to treatment.

This study utilizes a translational research approach structured through the Work Breakdown Structure methodology, dividing the process into six interconnected Work Packages (WPs). These include systematic literature reviews on endocrine dysfunctions and hormonal therapies in mental disorders, application of Design Thinking for neuroendocrine innovation, and hypothesis exploration of hCG as a systemic adjunctive treatment for psychiatric disorders, culminating in result dissemination and evaluation.

Work The study identified multiple mechanistic impacts of human chorionic gonadotropin (hCG) relevant to psychiatric treatment. Key findings from hCG Hormetic Therapy (HHT) include stimulation of sex hormone production, reduction of insulin resistance and systemic inflammation, enhancement of hypothalamic activity to regulate appetite, sleep, and emotions, and LH-like effects on cognition. HHT also increases IGF-1 availability, promoting neuroprotection, cognitive improvements, and reduced mitochondrial dysfunction, restoring cellular function critical for brain health.

The findings underscore the significance of enhancing endocrine and metabolic functions as a viable strategy for improving psychiatric care, aligning with trends that advocate holistic treatment strategies. The suggested dose for future research protocols is 500 IU IM per week for at least 10 weeks.

Supporting diverse and varied research is crucial for advancing medical knowledge. Continuous exploration of neuroendocrine dysfunctions in mental disorders using advanced tools from neuroscience, endocrinology, and psychiatry can provide new pathways for more effective and personalized treatments. The study of HHT effects offers insights into complex neuroendocrine interactions, underscoring the potential for innovative therapeutic strategies in psychiatry.

The triglyceride-glucose (TyG) index, derived from the calculation of two biomarkers, fasting plasma glucose and triglyceride levels, is a reliable indicator of insulin resistance and has been demonstrated to be associated with the adverse clinical outcomes of patients in the intensive care unit (ICU). This study aims to investigate the relationship between the TyG index and the 28-day all-cause mortality of these patients during their ICU stay.

This study employed a multicenter retrospective cohort design, analyzing data from 18,883 ICU patients in the eICU database. We calculated the TyG index for each patient and assessed its association with 28-day all-cause mortality. The Cox proportional hazards model was utilized for analysis, adjusting for various clinical and laboratory variables to control for confounding factors. We performed sensitivity analyses, subgroup analyses, and interaction analyses to evaluate the robustness of the results.

The study identified a significant positive correlation between the TyG index and 28-day all-cause mortality. Specifically, each one-unit increase in the TyG index corresponded to a 58% increase in mortality risk (HR=1.58, 95% CI: 1.25-2.00, P=0.0001). Additionally, the analysis revealed a non-linear threshold effect of the TyG index on mortality, with a cutoff point at 8.82; mortality was lower below this value and significantly increased above it. Sensitivity and subgroup analyses indicated robust findings, while E-value analysis suggested resilience against unmeasured confounding.

This study establishes the TyG index as an independent predictor of 28-day all-cause mortality in critically ill patients, highlighting its potential value in clinical management and risk assessment. By recognizing the non-linear effect of the TyG index, clinicians can more effectively adjust treatment strategies to reduce mortality among high-risk patients.

Metabolic aberrations are fundamental to the complex pathophysiology and challenges associated with diabetic wound healing. These alterations, induced by the diabetic environment, trigger a cascade of events that disrupt the normal wound-healing process. Key factors in this metabolic alternation include chronic hyperglycemia, insulin resistance, and dysregulated lipid and amino acid metabolism. In this review, we summarize the underlying mechanisms driving these metabolic changes in diabetic wounds, while emphasizing the broad implications of these disturbances. Additionally, we discuss therapeutic approaches that target these metabolic anomalies and how their integration with existing wound-healing treatments may yield synergistic effects, offering promising avenues for innovative therapies.

The triglyceride-glucose (TyG) index serves as a reliable indicator of insulin resistance and metabolic risk factors. Most research has focused on obese individuals, with limited exploration in those with a normal body mass index (BMI).

This study analyzed 4,440 adults with normal BMI from NHANES 2003-2018. Logistic regression, linear regression, subgroup analysis, and survival analysis examined the relationship between TyG-related indices (TyG, TyG-BMI, TyG-WC, TyG-WHtR) and outcomes like liver fibrosis, stroke, cardiovascular disease (CVD), and mortality.

In 4,440 individuals, 279 developed CVD, 134 had stroke, 1,382 developed liver fibrosis, and 548 died, with a median observation period of 100 months (IQR, 59-145 months). The TyG index was divided into four quartiles (Q1, Q2, Q3, Q4) and significant trends in various clinical indicators across the quartiles were observed (demographic characteristics, metabolic and biochemical indicators). Further analysis revealed linear correlations between TyG, TyG-WC, TyG-BMI, TyG-WHtR and liver function metrics (ALT, AST, GGT, FIB-4, APRI), kidney function metrics (creatinine, eGFR, uric acid), and blood lipids (triglycerides, cholesterol) (P < 0.01). Univariate logistic regression showed that compared to Q1, Q4 showed a significantly higher risk of liver fibrosis, CVD, stroke, and death for all TyG-related parameters (P < 0.001). After adjusting for cofounders, TyG Q4 still had a significantly higher risk of liver fibrosis (P < 0.05) and mortality (P < 0.001); TyG-BMI Q4 showed a higher risk of mortality (P < 0.001); TyG-WC Q4 showed a significantly higher risk of liver fibrosis (P < 0.001), stroke (P < 0.01), CVD (P < 0.001), and mortality (P < 0.001); TyG-WHtR Q4 showed a significantly higher risk of liver fibrosis (P < 0.001), stroke (P < 0.01), CVD (P < 0.001), and mortality (P < 0.001). Subgroup analysis yielded similar conclusions. Additionally. Survival analysis revealed significant differences in survival across the different quartiles of TyG, TyG-WC, TyG-BMI, and TyG-WHtR (P < 0.001).

The study identified a link between TyG-related markers and negative outcomes in individuals with a normal BMI, indicating that insulin resistance exists even in non-obese populations.

BackgroundThe triglyceride-glucose (TyG) index is considered a robust surrogate for insulin resistance (IR). The relationship between the trajectory patterns of the TyG index and subsequent brain structure changes is still unclear.ObjectiveThis study investigates the relationship between 10-year trajectories of TyG-related indices and brain structural integrity in a 10-year follow-up.MethodsThis prospective study included 898 participants (mean age 55.6 years, 34.4% males) from the community-based Shunyi Study. IR was assessed using the TyG index, TyG-body mass index (BMI) index, TyG-waist circumference index, and TyG-waist-to-height ratio (WHtR) index. The group-based trajectory model was employed to identify the 10-year trajectories. Structural brain measurements included structural changes of the whiter matter (white matter hyperintensities (WMHs), fractional anisotropy, and mean diffusivity) and gray matter (brain parenchymal fraction (BPF), cortical thickness, and hippocampal volume). General linear models were utilized to examine the association between the trajectory patterns of TyG-related indices and brain structure.ResultsThree distinct trajectories of TyG-related indices were identified from 2013 to 2023. The high-level trajectory groups of TyG-related indices exhibited a greater volume of WMHs and were more susceptible to disruptions in white matter microstructural integrity. This association was most significant for the TyG-BMI and TyG-WHtR trajectory groups. No significant correlations were found for BPF and cortical thickness among the different TyG-related indices trajectories.ConclusionsThe findings suggest that long-term IR primarily damages brain white matter rather than causing structural changes in gray matter.

The ST segment elevation myocardial infarction (STEMI) patients tend to experience cardiovascular events following percutaneous coronary intervention (PCI), and the prognosis remains suboptimal. The objective of this investigation was to examine the correlation between the ratio of glycosylated hemoglobin A1c/Apolipoprotein A1 (HbA1c/ApoA-1) and the short-term prognosis in STEMI patients following PCI. This study conducted a retrospective analysis of the clinical data of 182 patients diagnosed with STEMI following PCI and admitted to our hospital between January 2022 and June 2023. The patients were categorized into two groups based on the occurrence of major adverse cardiovascular events (MACEs), and a comparative analysis of baseline characteristics was performed. The significant correlation between HbA1c/ApoA-1 with short-term MACEs in STEMI patients post-PCI were determined through univariate and multivariate logistic regression analysis. Different models and Subgroup analysis demonstrated that HbA1c/ApoA-1 was independent risk factor for MACEs in STEMI patients post-PCI and exhibited high stability. Receiver operating characteristic (ROC) curve and area under curve (AUC) value were utilized to validate the predictive value of HbA1c/ApoA-1 in forecasting outcomes among STEMI patients post-PCI, with an AUC of 0.752 (95% CI: 0.68-0.86), sensitivity of 85.7%, and specificity of 56.8%. Restricted cubic spline (RCS) was employed to evaluate the potential non-linear relationship between HbA1c/ApoA-1 levels and MACEs in STEMI patients post-PCI. Our results demonstrated high and significant correlation between HbA1c/ApoA-1 and short-term prognosis, and indicated that HbA1c/ApoA-1 was independent risk factor for MACEs in STEMI patients following PCI and possessed significant predictive value, facilitating the early identification of high-risk cohorts and the anticipation of MACEs.

This research investigates the relationships between the composite dietary antioxidant index (CDAI) and the likelihood of cardiovascular disease (CVD) and mortality in older adults with hypertension. Utilized data from the National Health and Nutrition Examination Survey (NHANES) to investigate the potential mediating role of the triglyceride-glucose (TyG) index in these relationships.

A cohort of 5,276 participants, aged 65 years or older and diagnosed with hypertension, was extracted from the NHANES database. The main outcomes examined were the odds of CVD and mortality, utilizing data from the National Center for Health Statistics (NCHS). Multivariate logistic regression models were utilized to evaluate the relationship between CDAI and CVD. Cox proportional hazards regression models and Kaplan-Meier survival curves were utilized to analyze the relationship between CDAI and mortality. Mediation analysis was conducted to assess the potential intermediary role of TyG-related indicators-specifically TyG, TyG-BMI, TyG-WC, and TyG-WHtR- in the connection between CDAI and mortality.

The mean CDAI for the study participants was 1.88 ± 3.90, and the average age was 74.15 ± 5.96 years. During an average follow-up duration of 109.51 months, 4,712 cases of CVD and 725 recorded deaths were observed. In the fully adjusted models, CDAI showed a negative association with both CVD (Odds Ratio [OR] = 0.94, 95% Confidence Interval [CI] = 0.92-0.97) and mortality (Hazard Ratio [HR] = 0.95, 95% CI = 0.93-0.97). Mediation analysis indicated that the TyG-BMI, TyG-WC, and TyG-WHtR indices accounted for 33.1%, 34.3%, and 19.1% of the relationship between CDAI and mortality, respectively.

A higher CDAI demonstrated an inverse association with both CVD and mortality in elderly hypertensive individuals. The relationship was partially mediated by TyG-related indices, indicating that increased antioxidant intake may lead to improved health outcomes and a decreased risk of poor prognosis in this population.

Atherosclerosis is a common cardiovascular disease, the mechanism of which is complex and related to many factors. Changes in the molecular chemical structure of fetoglobulin may play a key role in the development of atherosclerosis. The aim of this study was to reveal how the chemical structure of fetoglobulin affects atherosclerosis and to analyze its association with TyG index and insulin resistance in different sexes. Subjects were patients with confirmed atherosclerosis and were grouped according to carotid color ultrasound and clinical criteria. The chemical structure of fetoglobulin, TyG index, and the role of insulin resistance in atherosclerosis were evaluated by collecting baseline data and conducting corresponding statistical analyses, including multivariate logistic regression analysis. The results showed that the molecular chemical structure of fetoglobulin was significantly different in patients with atherosclerosis. Multivariate logistic regression analysis showed that fetoglobulin level was significantly correlated with the occurrence of carotid atherosclerosis. TyG index and the association between insulin resistance and the incidence of carotid atherosclerosis were also significantly different in different genders.

Although several studies have demonstrated the relationship between the triglyceride glucose (TyG) index and the prevalence of atrial fibrillation (AF), more attention needs to be paid to patients with AF in intensive care units because the prevalence of AF is as high as one-third of the population. This study investigated the relationship between the TyG index and short-term prognosis in patients with critical care AF. We selected critically ill patients with AF from the MIMIC-IV database and categorized them into quartiles based on their TyG index levels. The primary outcome assessed was 30-day all-cause mortality, with secondary outcomes of 7-day and 15-day all-cause mortality. We utilized Kaplan-Meier survival curves, restricted cubic spline, and Cox proportional hazards regression models to illustrate the relationship between the TyG index and clinical outcomes in critically ill patients with AF. 1,146 critically ill patients with AF were included in this study, with a mean age of 75.90. The female population accounted for 48.43% of the total. Kaplan-Meier survival curves demonstrated a significant association between the TyG index and all-cause mortality at 7, 15, and 30 days. Cox proportional hazards analysis, after adjusting for multiple confounders, revealed a substantial increase in all-cause mortality in the fourth quartile of the TyG index compared to the first quartile (HR = 1.71, 95% CI: 1.17-2.49). Restricted cubic spline further illustrated that higher TyG index were associated with an elevated risk of all-cause mortality in critically ill patients with AF. The stratified analysis provided additional support for the robustness of this association. The TyG index demonstrated a significant association with 7-day, 15-day, and 30-day all-cause mortality in critically ill patients with AF. These findings suggest that the TyG index may serve as a useful tool in identifying AF patients at a higher risk of all-cause mortality, enabling early and effective intervention strategies.

Postoperative recurrence remains a major challenge in patients with locally advanced gastric cancer (LAGC). Identifying reliable biomarkers for predicting recurrence can guide clinical decision-making and improve patient outcomes. This study aimed to investigate the association between four peripheral blood metabolic markers and postoperative recurrence in LAGC patients, and to develop a predictive model based on these markers.

This retrospective cohort study analyzed data from 1,040 patients with LAGC who underwent radical surgical resection between January 2010 and December 2019. Peripheral blood metabolic indicators, including low-density lipoprotein/high-density lipoprotein (LHR), cholesterol/high-density lipoprotein (TCHR), triglycerides/high-density lipoprotein (TGHR), and triglycerides × fasting blood glucose (TyG), were used to assess metabolic status. Multivariable regression and survival analysis were performed to assess the prognostic value of these markers. A nomogram combining metabolic markers and clinical factors was developed and validated for predicting postoperative recurrence.

High levels of LHR, TCHR, TGHR, and TyG were significantly associated with increased risk of postoperative recurrence in LAGC patients (P < 0.001). Multivariable analysis identified TNM stage, pathological type, systemic immune inflammation index (SII), and metabolic score as independent predictors of recurrence. A predictive model incorporating these factors demonstrated superior performance compared to clinical features alone, with an area under the curve (AUC) of 0.867 (95% CI: 0.836-0.897) in the training set, 0.887 (95% CI: 0.844-0.929) in internal validation set, 0.859 (95% CI: 0.817-0.899) in the external validation set. Patients with high metabolic scores had significantly worse overall survival (OS) and disease-free survival (DFS), further supporting the model's prognostic value.

Peripheral blood metabolic markers, particularly LHR, TCHR, TGHR, and TyG, are valuable predictors of postoperative recurrence in LAGC patients. The combined predictive model, integrating metabolic markers and clinical features, provides an effective tool for personalized risk stratification and may assist in optimizing postoperative management in LAGC.

Background: Alcohol consumption is a major public health concern, influencing metabolic health and insulin resistance (IR). While moderate alcohol intake has been associated with potential metabolic benefits, excessive consumption is linked to IR and related disorders. This study examines the association between sociodemographic variables, health habits, and IR risk using validated metabolic indices. Methods: A dual-phase study was conducted, including a cross-sectional analysis of 139,634 Spanish workers and a retrospective longitudinal follow-up of 40,431 participants (2009-2019). Data on sociodemographic factors (age, sex and socioeconomic status) and health habits (smoking, alcohol consumption, diet and physical activity) were collected through standardized occupational health assessments. IR risk was assessed using the Triglyceride-Glucose Index (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single-Point Insulin Sensitivity Estimator (SPISE-IR). Binary logistic regression was used for statistical analysis. Results: Age, male sex, lower socioeconomic status, smoking, alcohol consumption, physical inactivity and low adherence to the Mediterranean diet were significantly associated with higher IR risk across all indices (p < 0.001). Alcohol consumption exhibited a dose-dependent relationship with IR, with excessive intake significantly increasing the risk of IR. Longitudinal data revealed a worsening IR profile over time, particularly among older, low-income and physically inactive individuals. Conclusions: Sociodemographic factors and lifestyle habits strongly influence IR. Preventive strategies focused on reducing alcohol consumption, smoking cessation and promoting physical activity and dietary improvements are essential to mitigate the risk of IR, especially in vulnerable populations. Further longitudinal studies are needed to establish causal relationships and refine intervention strategies.

The triglyceride‒glucose index (TyG index) has been verified to be a useful predictor of insulin resistance (IR), and is associated with the occurrence of acute coronary syndrome (ACS). However, the effect of the TyG index on vulnerable plaques (VP), which were identified when at least two high-risk features are present within the same lesion, in type 2 diabetes mellitus (T2DM) patients is not fully understood. This study aimed to explore the association between the TyG index and the presence of VP.

We retrospectively enrolled 2056 T2DM patients who underwent coronary computed tomography angiography (CCTA) examinations at West China Hospital from February 2017 to February 2022. These patients were divided into four groups on the basis of the quartiles of the TyG index. The high-risk coronary plaque features, vulnerable plaques, plaque type, coronary artery stenosis, segment involvement score (SIS), segment stenosis score (SSS) and multivessel disease (MVD) based on CCTA data were evaluated and compared among the four groups.

Patients with a higher TyG index had more noncalcified and mixed plaques, high-risk plaque features, vulnerable plaques and fewer calcified plaques (P < 0.05 for all). The proportion of patients with high-risk plaque features, including low-attenuation noncalcified plaques, positive remodeling and "napkin ring" sign was associated with the TyG index (P for trend < 0.05 for all). Multivariate analysis revealed that the TyG index was significantly associated with vulnerable plaques in T2DM patients [OR = 1.23 (95% CI 1.00-1.51), P = 0.046]. Subgroup analysis revealed that the association between the TyG index and vulnerable plaques varied with age and the prevalence of cardiovascular (CVD) symptoms, even after controlling for confounding factors (P for interaction < 0.05 for both).

The TyG index was independently associated with vulnerable plaques of the coronary artery among patients with T2DM. The TyG index could be regarded as a marker to reduce the incidence of cardiovascular events in the targeted population of T2DM patients.