Concordance between Triglyceride Glucose Index and Admission Insulin Resistance Index in Non-diabetic Subjects of Acute Coronary Syndrome

Andi  Irham; Husaini  Umar; Fabiola Maureen Shinta  Adam; Idar  Mappangara; Syakib  Bakri; Risna  Halim; Alfian  Zainuddin

doi:10.3889/oamjms.2021.7075

Authors

Andi Irham Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Husaini Umar Department of Internal Medicine, Division of Endocrine Metabolic and Diabetes, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Fabiola Maureen Shinta Adam Department of Internal Medicine, Division of Endocrine Metabolic and Diabetes, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Idar Mappangara Department of Internal Medicine, Division of Cardiology and Vascular Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Syakib Bakri Department of Internal Medicine, Division of Nephrology and Hypertension, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Risna Halim Department of Internal Medicine, Division of Tropical Medicine and Infectious Disease, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Alfian Zainuddin Department of Biostatistics, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.7075

Keywords:

Insulin resistance, Triglyceride glucose index, Admission insulin resistance index, Non-diabetic of acute coronary syndrome

Abstract

BACKGROUND: Acute coronary syndrome (ACS) is the leading cause of death in the world and is closely related to insulin resistance (IR). The examination of the triglyceride glucose (TyG) Index and admission IR index (AIRI) can be an alternative examination to assess IR.

AIM: The aim of the study was to analyze the concordance between the TyG index and AIRI in assessing IR in nondiabetic subjects of ACS.

METHODS: This study was a cross-sectional study using secondary data from ACS patient medical records in Wahidin Sudirohusodo Hospital Makassar from September 2020 until April 2021. An examination of RBG, TyG, and fasting insulin was performed. The statistical test results were considered significant if the p < 0.05.

RESULTS: This study included 67 subjects, of which 54 were male and 13 were female, there were 24 people aged <50 years, 43 people aged 50 years old, with a mean of 55.15 ± 12.71 years, a diagnosis of ST-elevation myocardial infarction (STEMI) 25 people, non STEMI 34 people and unstable angina pectoris 8 people, p < 0.05. The receiver operating characteristic curve showed that the cut-off value of the TyG index in predicting AIRI was 3141, with a sensitivity of 88.98% and specificity of 59.09%. The OR value revealed that subjects with a TyG index of >9.06 indicated an 11-time greater risk for IR than subjects with a TyG index ≤9.06.

CONCLUSIONS: There was a significant concordance between the TyG index and the AIRI in non-diabetic acute coronary syndrome patient.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Jan S, Lee SW, Sawhney JP. Catastropic health expenditure on acute coronary events in Asia: A prospective study. Bull World Health Organ. 2016;94(3):193-200. https://doi.org/10.2471/blt.15.158303 PMid:26966330 DOI: https://doi.org/10.2471/BLT.15.158303

Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuñiga FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018;17(1):1-14. https://doi.org/10.1186/s12933-018-0762-4 DOI: https://doi.org/10.1186/s12933-018-0762-4

Juzar DA, Dany SS, Irmalita I, Tobing DPL, Firdaus F, Widyantor B. Pedoman Tatalaksana Sindrom Koroner Akut. Perhimpun Dokter Spesialis Kardiovaskuler Indonesia. Jakarta: Interna Publishing; 2015.

Lim J, Kim J, Kwon GC, Koo SH. Comparison of triglyceride glucose index, and related parameters to predict insulin resistance in Korean adults: An analysis of the 2007-2010 Korean National Health and Nutrition Examination Survey. PLoS One. 2019;14(3):e0212963. https://doi.org/10.1371/journal.pone.0212963 PMid:30845237 DOI: https://doi.org/10.1371/journal.pone.0212963

Abel ED, O’Shea KM, Ramasamy R. Insulin resistance: Metabolic mechanisms and consequences in the heart. Arterioscler Thromb Vasc Biol. 2012;32(9):2068-76. https://doi.org/10.1161/atvbaha.111.241984 PMid:22895668 DOI: https://doi.org/10.1161/ATVBAHA.111.241984

Chen L, Chen R, Wang H, Liang F. Mechanisms linking inflammation to insulin resistance. Int J Endocrinol. 2015;2015:508409. PMid:26136779 DOI: https://doi.org/10.1155/2015/508409

De Souza AL, Batista GA, Alegre SM. Assessment of insulin sensitivity by the hyperinsulinemic euglycemic clamp: Comparison with the spectral analysis of photoplethysmography. J Diabetes Complications. 2017;31(1):128-33. https://doi.org/10.1016/j.jdiacomp.2016.10.018 PMid:27839921 DOI: https://doi.org/10.1016/j.jdiacomp.2016.10.018

Conwell LS, Trost SG, Brown WJ, Batch JA. Indexes of insulin resistance and secretion in obese children and adolescents: A validation study. Diabetes Care. 2004;27(2):314-9. https://doi.org/10.2337/diacare.27.2.314 PMid:14747206 DOI: https://doi.org/10.2337/diacare.27.2.314

Rosalina R, Umar H, Tandean P, Kasim H, Aman AM, Rasyid H, et al. The comparison of AIRI values in obese and non obese acute coronary syndrome patients. Eurol J Mol Clin Med. 2020;7(8):190-7.

Luo E, Wang D, Yan G, Qiao Y, Liu B, Hou J, et al. High triglyceride-glucose index is associated with poor prognosis in patiens with acute ST-elevation myocardial infarction after percutaneous coronary intervention. J Cardiovasc Diabetol. 2019;18(1):2-12. https://doi.org/10.1186/s12933-019-0957-3 Mid:31722708 DOI: https://doi.org/10.1186/s12933-019-0957-3

Aman M, Resnawita D, Rasyid H, Kasim H, Bakri S, Umar H, et al. The concordance of triglyceride glucose index (TyG index) and homeostatic model assessment for insulin resistance (Homa-IR) in non-diabetic subjects of adult Indonesian males. Clin Epidemiol Glob Health. 2021;9:227-30. https://doi.org/10.1016/j.cegh.2020.09.003 DOI: https://doi.org/10.1016/j.cegh.2020.09.003

Mozaffarian D, Benjamin JE, Amett KD. Heart Disease an stroke statistics. Circ Aha J. 2015;131(3):1-323.

Bonura F, Vitale G. Insulin resistance and acute coronary syndrome. Atherosclerosis. 2010;211(2):672-5. PMid:20466373 DOI: https://doi.org/10.1016/j.atherosclerosis.2010.03.033

Kim MK, Ahn CW, Kang S, Nam JS, Kim KR, Park JS. Relationship between the triglyseride glucose index and coronary artery calcification in Korean adults. J Cardiovasc Diabetol. 2017;16(1):1-7. https://doi.org/10.1186/s12933-017-0589-4 PMid:28830471 DOI: https://doi.org/10.1186/s12933-017-0589-4

Mao Q, Zhou D, Li Y, Wang Y, Wang Y, Xu SC, Zhao XH. The triglyceride-glucose index predicts coronary artery disease severity and cardiovascular outcomes in patients with non-ST-segment elevation acute coronary syndrome. Dis Markers. 2019;2019:6891537. https://doi.org/10.1155/2019/6891537 PMid:31281548 DOI: https://doi.org/10.1155/2019/6891537

Lee EY, Yang HK, Lee J, Kang B, Yang Y, Lee SH, et al. Triglyceride glucose index, a marker of insulin resistance, is associated with coronary artery stenosis in asymptomatic subjects with Type 2 diabetes. Lipids Health Dis. 2016;15(1):155. https://doi.org/10.1186/s12944-016-0324-2 PMid:27633375 DOI: https://doi.org/10.1186/s12944-016-0324-2

Hong S, Han K, Park CY. The triglyceride glucose index is a simple and low-cost marker associated with atherosclerotic cardiovascular disease: A population-based study. BMC Med. 2020;18(1):1-8. https://doi.org/10.1186/s12916-020-01824-2 DOI: https://doi.org/10.1186/s12916-020-01824-2

Refaie W, Elewa A. Admission insulin resistance index in non diabetic patients with acute coronary syndrome; clinical and angiographic features. Egypt Hear J. 2013;65(4):301-5. https://doi.org/10.1016/j.ehj.2013.02.004 DOI: https://doi.org/10.1016/j.ehj.2013.02.004

Abdullah I, Hasan G, Altunkeser BB, Ozdemir K, Gürbilek M, Gederet YT, et al. Evaluation of “admission index of insulin resistance (AIRI)” as an early stage risk predictor in non-diabetic acute coronary syndromes. Anatol J Cardiol. 2002;2(3):194-201. PMid:12223324

Wang S, Shi J, Peng Y, Fang Q, Mu Q, Gu W, et al. Stronger association of triglyceride glucose index than the HOMA-IR with arterial stiffness in patients with Type 2 diabetes: A real-world single-centre study. Cardiovasc Diabetol. 2021;20(1):1-10. https://doi.org/10.1186/s12933-021-01274-x DOI: https://doi.org/10.1186/s12933-021-01274-x