Triglyceride glucose index as a surrogate measure of insulin sensitivity in obese adolescents with normoglycemia, prediabetes, and type 2 diabetes mellitus: comparison with the hyperinsulinemic-euglycemic clamp

Nor, Noor Shafina Mohd; Lee, So Jung; Bacha, Fida; Tfayli, Hala; Arslanian, Silva

doi:10.1111/pedi.12303

Cited by 117 publications

(62 citation statements)

References 38 publications

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“…The TG:HDL correlated with Matsuda calculated IR from an OGTT in adults with PCOS . In adolescents, Mohd Nor et al found that the TyG index as a surrogate measure of IR significantly associated with clamp measurements of IR in 225 obese children, although the correlation coefficient with clamp GIR was lower at r = −0.419 . We did not find that the TG:HDL ratio or TyG were as useful in youth with PCOS, perhaps due to the fact that HDL is nearly universally low in sedentary obese youth with PCOS, and fasting glucose concentrations also were in the normal range with little variability in our cohort.…”

Section: Discussionmentioning

confidence: 53%

Using simple clinical measures to predict insulin resistance or hyperglycemia in girls with polycystic ovarian syndrome

et al. 2018

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Background: Polycystic ovarian syndrome (PCOS) includes insulin resistance (IR) and impaired glucose tolerance (IGT) in youth, and a greatly elevated risk of type 2 diabetes in adulthood. Identifying IR is challenging and documenting IGT requires an oral glucose tolerance test (OGTT). Objective: Identify an easily applied surrogate measures for IR and IGT in girls with PCOS. Methods: We studied 28 girls with PCOS [BMI percentile 98 (83,99); 15.5 (14.5,16.6) years of age] and 20 with normal menses [BMI percentile (97 (88,99); 15.5 (13.3,16.1) years]. Hyperinsulinemic-euglycemic clamps (insulin dose of 80 μU/ml/min) to determine glucose infusion rate (GIR) and a 75 gram OGTT were performed. Surrogates for IR including fasting insulin, HOMA-IR, Matsuda index and eIS were compared to IGT status and GIR. Spearman correlations were performed between surrogates and GIR or IGT, and receiver operator curve (ROC) analysis to predict GIR below the median or IGT status. Results: GIR was lower in PCOS (12.9±4.6 vs. 17.1±5.1 mg/kg fat free mass·min; p=0.01). Within PCOS, HOMA-IR (r=−0.78, p<0.0001), e-IS (r=0.70, p<0.001), and Matsuda (r=0.533, p<0.001) correlated with GIR. e-IS provided a good sensitivity (100%) and specificity (71%) to identify IR (e-IS cutoff: <6.3, ROC-area under curve=0.898). Fasting insulin >22 IU/ml had the best sensitivity (88%), specificity (78%) and ROC (0.760) for IGT status. Conclusions: Girls with PCOS have significant IR, and IGT is common. Both eIS and fasting insulin are obtainable without an OGTT or clamp and could be used clinically to guide treatment in PCOS.

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Section: Discussionmentioning

confidence: 53%

Using simple clinical measures to predict insulin resistance or hyperglycemia in girls with polycystic ovarian syndrome

et al. 2018

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“…Insulin resistance was demonstrated not only by the increased HOMA-IR index but also by augmented TG/HDL-c ratio and the TyG index, which have previously been used as surrogate measures of impaired insulin sensitivity in obese adolescents with normoglycemia, in prediabetes, as well as in T2DM [31]. …”

Section: Discussionmentioning

confidence: 99%

Glucose and Lipid Dysmetabolism in a Rat Model of Prediabetes Induced by a High-Sucrose Diet

et al. 2017

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Glucotoxicity and lipotoxicity are key features of type 2 diabetes mellitus, but their molecular nature during the early stages of the disease remains to be elucidated. We aimed to characterize glucose and lipid metabolism in insulin-target organs (liver, skeletal muscle, and white adipose tissue) in a rat model treated with a high-sucrose (HSu) diet. Two groups of 16-week-old male Wistar rats underwent a 9-week protocol: HSu diet (n = 10)—received 35% of sucrose in drinking water; Control (n = 12)—received vehicle (water). Body weight, food, and beverage consumption were monitored and glucose, insulin, and lipid profiles were measured. Serum and liver triglyceride concentrations, as well as the expression of genes and proteins involved in lipid biosynthesis were assessed. The insulin-stimulated glucose uptake and isoproterenol-stimulated lipolysis were also measured in freshly isolated adipocytes. Even in the absence of obesity, this rat model already presented the main features of prediabetes, with fasting normoglycemia but reduced glucose tolerance, postprandial hyperglycemia, compensatory hyperinsulinemia, as well as decreased insulin sensitivity (resistance) and hypertriglyceridemia. In addition, impaired hepatic function, including altered gluconeogenic and lipogenic pathways, as well as increased expression of acetyl-coenzyme A carboxylase 1 and fatty acid synthase in the liver, were observed, suggesting that liver glucose and lipid dysmetabolism may play a major role at this stage of the disease.

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“…The effectiveness of the TyG index for detecting IR has been widely proved in studies of adults from different ethnic groups , but paediatric studies are scarce . The paediatric efficacy of the TyG index, in comparison with the euglyceamic‐hyperinsulinemic clamp, has only previously been evaluated by Mohd et al in obese adolescents .…”

Section: Discussionmentioning

confidence: 99%

“…The TyG index has proved to be effective and reliable for assessing IR in adults from different ethnic groups and obese adolescents , but not normal weight children. Thus, the objective of this study was to evaluate the TyG index for recognising IR in school children from the general population.…”

Section: Introductionmentioning

confidence: 99%

The triglyceride and glucose index is useful for recognising insulin resistance in children

2017

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Triglyceride glucose index as a surrogate measure of insulin sensitivity in obese adolescents with normoglycemia, prediabetes, and type 2 diabetes mellitus: comparison with the hyperinsulinemic-euglycemic clamp

Cited by 117 publications

References 38 publications

Using simple clinical measures to predict insulin resistance or hyperglycemia in girls with polycystic ovarian syndrome

Using simple clinical measures to predict insulin resistance or hyperglycemia in girls with polycystic ovarian syndrome

Glucose and Lipid Dysmetabolism in a Rat Model of Prediabetes Induced by a High-Sucrose Diet

The triglyceride and glucose index is useful for recognising insulin resistance in children

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