Purpose Diabetes is the leading cause of kidney disease. Up to 40% of the population with diabetes experience diabetic kidney disease (DKD). The correlation of DKD with insulin resistance (IR) indices has been shown in previous studies. In this study, the objective was to evaluate surrogate IR indices, including the Triglyceride-Glucose (TyG) index, Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) to find the most valuable index for the correlation between albuminuria and IR in the type 2 diabetes (T2D) population. Albuminuria is defined as urine albumin excretion of > 30 mg/day. Methods In this cross-sectional study, 2934 participants were enrolled and evaluated for urinary albumin excretion, and albuminuria was detected in 526 of the entries. The logistic regression models and Receiver Operating Characteristic (ROC) curve analysis were performed to assess the relationship of TyG index, VAI, LAP, and HOMA-IR's with albuminuria in patients with T2D. Results The TyG index had the highest association (OR 1.67) with the presence of albuminuria in patients with T2D, followed by HOMA-IR (OR 1.127), VAI (OR 1.028), and LAP (OR 1.004). These four indices remained independent after adjustment for multiple confounders. Based on the ROC curve, TyG revealed the best area under the curve (AUC) for revealing albuminuria with sufficient accuracy (AUC: 0.62) in comparison with other measured indices. The calculated TyG index cut-off point for the presence of albuminuria was 9.39. Conclusion Among the indices, TyG index had the most significant correlation with albuminuria in patients with T2D.
Background: Sarcopenia is defined as loss of muscle mass with attendant loss of muscle strength and physical function and is associated with advancing age. Inflammatory condition of chronic disease leads to more rapid progression of this syndrome, which may adversely affect quality of life. The aim of this study was to determine the relationship between chronic obstructive pulmonary disease (COPD) and sarcopenia. Methods: This study included 108 COPD patients who were treated in the pulmonary clinic at Masih Daneshvari Hospital. Patients were categorized into three groups based on Global Initiative for Obstructive Lung Disease criteria. Sarcopenic parameters including muscle mass, muscle strength, and physical performance were measured by Bioimpedance Analysis, hand grip dynamometer, and the Short Physical Performance Battery test, respectively. According to the European Working Group on Sarcopenia in Older People cutoff points and the definition of sarcopenic obesity, sarcopenic patients were diagnosed and categorized based on different COPD severity scores. Results: The relationship between sarcopenia and COPD grading, which was assessed using multiple regression models with adjustment of confounding factors, including age, chronic diseases, and smoking, was statistically insignificant. However, by using forced expiratory volume in 1 second (FEV1) or ratio of FEV1 to forced vital capacity in this model, the results were significant (P = 0.026). A positive linear correlation was observed between skeletal muscle index (SMI) and spirometric data, which was assessed by Spearman's correlation test. By exploring the association between sarcopenia and obesity with the one-way analysis of variance test, sarcopenic patients represented to have the minimal spirometric measures.
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