diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13073diaendo-13073Research ArticleОригинальные исследованияOriginal StudiesИндекс триглицериды-глюкоза TyG ассоциирован с субклиническим атеросклерозом и субклинической дисфункцией миокарда у пациентов с впервые выявленным сахарным диабетом 2 типаTriglyceride glucose index is associated with subclinical atherosclerosis and subclinical myocardial dysfunction in patients with newly diagnosed type 2 diabetes mellitusUstabaşS. H.UstabasS. H.

Sena Hekimoglu Ustabas, Research Assistant

Стамбул

Sena Hekimoglu Ustabas, Research Assistant

Istanbul

senahekimoglu@gmail.comAltunogluЕ. G.AltunogluE. G.

Esma Guldal Altunoglu, Professor Dr.

Стамбул

Esma Guldal Altunoglu, Professor Dr.

Istanbul

esmaaltunoglu@gmail.comhttps://orcid.org/0000-0003-3731-8699KarabagT.KarabagT.

Turgut Karabag, Professor Dr.,

Istanbul Egitim Arastırma Hastanesi, Kardiyoloji Bölümü, Kat:6 Fatih

Turgut Karabag, Professor Dr.

Istanbul Egitim Arastırma Hastanesi, Kardiyoloji Bölümü, Kat:6 Fatih

turgutkarabag@yahoo.comSaglik Bilimleri UniversityТурцияSaglik Bilimleri University, Istanbul Education and Research Hospital, Department of Internal MedicineTurkeySaglik Bilimleri UniversityТурцияSaglik Bilimleri University, Istanbul Education and Research Hospital, Department of CardiologyTurkey202427062024273224232Copyright © Ustabaş S.H., Altunoglu Е.G., Karabag T., 20242024Ustabaş S.H., Altunoglu Е.G., Karabag T.Ustabas S.H., Altunoglu E.G., Karabag T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13073ОБОСНОВАНИЕ

ОБОСНОВАНИЕ. Предыдущие исследования показали, что индекс триглицериды-глюкоза (TyG) связан с развитием сердечно-сосудистых заболеваний.

ЦЕЛЬ

ЦЕЛЬ. Наше исследование было направлено на определение индекса TyG в дебюте сахарного диабета 2 типа (СД2), а также выявление взаимосвязи между индексом Tyg и комплекса интима-медиа (ТКИМ) сонных артерий, а также функциями миокарда и эпикардиальной жировой тканью.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ. В исследование были включены 105 человек (58 женщин, 47 мужчин; средний возраст 50,4±9,8 года) с впервые выявленным СД2 и, в качестве контрольной группы, 51 здоровый человек (30 женщин и 21 мужчина; средний возраст 49,8±8,9 лет) без хронических заболеваний. Помимо лабораторных показателей, у всех пациентов исследовали ТКИМ сонных артерий с помощью трансторакальной эхокардиографии с линейным сосудистым датчиком.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. Индекс TyG был значительно выше у пациентов с впервые диагностированным СД2 по сравнению с контрольной группой. Выявлена положительная корреляция между индексом TyG и ТКИМ сонных артерий, толщиной эпикардиального жира, уровнем гликированного гемоглобина, индексом инсулинорезистентности HOMA-IR, площадью поверхности тела, окружностью талии, окружностью бедер, индексом массы тела и уровнем С-реактивного белка. При оценке диастолической функции наблюдалась отрицательная корреляция с показателем E/A и положительная корреляция с показателем E/e’. Индекс TyG также отрицательно коррелировал с фракцией выброса. Регрессионный анализ показал, что возраст и индекс TyG были связаны с увеличением ТКИМ сонных артерий.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. Индекс TyG, измеренный у пациентов с впервые выявленным СД2, связан с субклиническим атеросклерозом, ухудшением систолической и диастолической функции левого желудочка.

BACKGROUND

BACKGROUND: Previous studies have shown that, the triglyceride glucose index (TyG index) is related with the development of cardiovascular disease.

AIM

AIM: Our novel study aimed to determine whether the TyG index measured at the time of diagnosis conducted on newly diagnosed type 2 diabetic individuals and the relationship between TyG index and carotid intima media thickness, as well as both myocardial functions and epicardial adipose tissue was investigated.

MATERIALS AND METHODS

MATERIALS AND METHODS: The study included 105 individuals (58 F, 47 M; mean age 50.4±9.8 years) newly diagnosed with T2DM and 51 healthy subjects (30 females, 21 males, mean age 49.8±8.9 years) without any chronic disease as the control group. In addition to laboratory parameters, transthoracic echocardiography carotid intima-media thickness with linear vascular probe were examined in all individuals.

RESULTS

RESULTS: TyG index was significantly higher in newly diagnosed type 2 diabetic individuals compared to the controls. There was a positive correlation between the TyG index and carotid intima-media thickness, epicardial fat thickness, HbA1c, Homa-IR, body surface area, waist circumference, hip circumference, body mass index and CRP. When diastolic functions were considered, there was a negative correlation with E/A and a positive correlation with E/e’ septal. TyG index was also negatively correlated with EF. Regression analysis revealed that age and TyG index were associated with an increase in carotid IMT thickness.

CONCLUSION

CONCLUSION: TyG index measured at the time of diagnosis in newly diagnosed type 2 diabetic patients is also associated with subclinical atherosclerosis, deterioration in left ventricular systolic and diastolic functions.

сахарный диабет 2 типаиндекс триглицериды-глюкозасубклинический атеросклерозфункция миокардаtype 2 diabetestriglyceride glucose indexsubclinical atherosclerosismyocardial functionsReferencesInternational Diabetes Federation. IDF diabetes atlas 2021. IDF Diabetes Atlas. (n.d.). Retrieved March 29, 2022, from https://diabetesatlas.org/atlas/tenth-edition/International Diabetes Federation. IDF diabetes atlas 2021. IDF Diabetes Atlas. (n.d.). Retrieved March 29, 2022, from https://diabetesatlas.org/atlas/tenth-edition/Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiological Reviews. 2013;93(1):137–188. doi: https://doi.org/10.1152/physrev.00045.2011Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiological Reviews. 2013;93(1):137–188. doi: https://doi.org/10.1152/physrev.00045.2011Haas AV, McDonnell ME. Pathogenesis of cardiovascular disease in diabetes. Endocrinol Metab Clin North Am. 2018;47(1):51–63. doi: https://doi.org/10.1016/j.ecl.2017.10.010Haas AV, McDonnell ME. Pathogenesis of cardiovascular disease in diabetes. Endocrinol Metab Clin North Am. 2018;47(1):51–63. doi: https://doi.org/10.1016/j.ecl.2017.10.010Peterson LR, McKenzie CR, Schaffer JE. Diabetic cardiovascular disease: Getting to the heart of the matter. J Cardiovasc Transl Res. 2012;5(4):436–45. doi: https://doi.org/10.1007/s12265-012-9374-7.Peterson LR, McKenzie CR, Schaffer JE. Diabetic cardiovascular disease: Getting to the heart of the matter. J Cardiovasc Transl Res. 2012;5(4):436–45. doi: https://doi.org/10.1007/s12265-012-9374-7.Poznyak A, Grechko AV, Poggio P, et al. The diabetes mellitus– atherosclerosis connection: The role of lipid and glucose metabolism and chronic inflammation. Int J Mol Sci. 2020;21(5):1835. doi: https://doi.org/10.3390/ijms21051835Poznyak A, Grechko AV, Poggio P, et al. The diabetes mellitus– atherosclerosis connection: The role of lipid and glucose metabolism and chronic inflammation. Int J Mol Sci. 2020;21(5):1835. doi: https://doi.org/10.3390/ijms21051835American Diabetes Association Professional Practice Committee. 10. cardiovascular disease and risk management: standards of medical care in diabetes — 2022. Diabetes Care. 2022; 45 (Suppl. 1):144-174. doi: https://doi.org/10.2337/dc22-s010American Diabetes Association Professional Practice Committee. 10. cardiovascular disease and risk management: standards of medical care in diabetes — 2022. Diabetes Care. 2022; 45 (Suppl. 1):144-174. doi: https://doi.org/10.2337/dc22-s010Cole JB, Florez J C. Genetics of diabetes mellitus and diabetes complications. Nat Rev Nephrol. 2020;16(7):377–90. doi: https://doi.org/10.1038/s41581-020-0278-5Cole JB, Florez J C. Genetics of diabetes mellitus and diabetes complications. Nat Rev Nephrol. 2020;16(7):377–90. doi: https://doi.org/10.1038/s41581-020-0278-5Papatheodorou K, Banach M, Bekiari E, et al. Complications of diabetes 2017. J Diabetes Res. 2018:3086167. doi: https://doi.org/10.1155/2018/3086167Papatheodorou K, Banach M, Bekiari E, et al. Complications of diabetes 2017. J Diabetes Res. 2018:3086167. doi: https://doi.org/10.1155/2018/3086167Wang L, Cong HL, Zhang JX, et al. Triglyceride-glucose index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome. Cardiovasc Diabetol. 2020;19(1):80. doi: https://doi.org/10.1155/2018/3086167Wang L, Cong HL, Zhang JX, et al. Triglyceride-glucose index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome. Cardiovasc Diabetol. 2020;19(1):80. doi: https://doi.org/10.1155/2018/3086167da Silva A, Caldas APS, Rocha DMUP, et al. Triglycerideglucose index predicts independently type 2 diabetes mellitus risk: A systematic review and meta-analysis of Cohort studies. Prim Care Diabetes. 2020;14(6),584–93. doi: https://doi.org/10.1016/j.pcd.2020.09.001da Silva A, Caldas APS, Rocha DMUP, et al. Triglycerideglucose index predicts independently type 2 diabetes mellitus risk: A systematic review and meta-analysis of Cohort studies. Prim Care Diabetes. 2020;14(6),584–93. doi: https://doi.org/10.1016/j.pcd.2020.09.001Hameed EK. TyG index a promising biomarker for glycemic control in type 2 diabetes mellitus. Diabetes Metab Syndr. 2019;13(1),560–563. doi: https://doi.org/10.1016/j.dsx.2018.11.030Hameed EK. TyG index a promising biomarker for glycemic control in type 2 diabetes mellitus. Diabetes Metab Syndr. 2019;13(1),560–563. doi: https://doi.org/10.1016/j.dsx.2018.11.030Selvi NMK, Nandhini S, Sakthivadivel V, et al. Association of Triglyceride–Glucose Index (TyG index) with HbA1c and Insulin Resistance in Type 2 Diabetes Mellitus. Maedica (Bucur). 2021;16(3):375-381. doi: https://doi.org/10.26574/maedica.2021.16.3.375Selvi NMK, Nandhini S, Sakthivadivel V, et al. Association of Triglyceride–Glucose Index (TyG index) with HbA1c and Insulin Resistance in Type 2 Diabetes Mellitus. Maedica (Bucur). 2021;16(3):375-381. doi: https://doi.org/10.26574/maedica.2021.16.3.375Ding X, Wang X, Wu J, et al. Triglyceride–glucose index and the incidence of atherosclerotic cardiovascular diseases: A metaanalysis of Cohort studies. Cardiovasc Diabetol. 2021;20(1):76. doi: https://doi.org/10.1186/s12933-021-01268-9Ding X, Wang X, Wu J, et al. Triglyceride–glucose index and the incidence of atherosclerotic cardiovascular diseases: A metaanalysis of Cohort studies. Cardiovasc Diabetol. 2021;20(1):76. doi: https://doi.org/10.1186/s12933-021-01268-9Hong 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):361. doi: https://doi.org/10.1186/s12916-020-01824-2Hong 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):361. doi: https://doi.org/10.1186/s12916-020-01824-2Sánchez-Íñigo L, Navarro-González D, Fernández-Montero A, et al. The TYG index may predict the development of cardiovascular events. Eur J Clin Invest. 2016;46(2),189–197. doi: https://doi.org/10.1111/eci.12583Sánchez-Íñigo L, Navarro-González D, Fernández-Montero A, et al. The TYG index may predict the development of cardiovascular events. Eur J Clin Invest. 2016;46(2),189–197. doi: https://doi.org/10.1111/eci.12583Won KB, Park EJ, Han D, et al. Triglyceride glucose index is an independent predictor for the progression of coronary artery calcification in the absence of heavy coronary artery calcification at baseline. Cardiovasc Diabetol. 2020;19(1): 34. doi: https://doi.org/10.1186/s12933-020-01008-5Won KB, Park EJ, Han D, et al. Triglyceride glucose index is an independent predictor for the progression of coronary artery calcification in the absence of heavy coronary artery calcification at baseline. Cardiovasc Diabetol. 2020;19(1): 34. doi: https://doi.org/10.1186/s12933-020-01008-5Li Z, He Y, Wang S, et al. Association between triglyceride glucose index and carotid artery plaque in different glucose metabolic states in patients with coronary heart disease: A RCSCD-TCM study in China. Cardiovascr Diabetol. 2022;21(1):38. doi: https://doi.org/10.1186/s12933-022-01470-3Li Z, He Y, Wang S, et al. Association between triglyceride glucose index and carotid artery plaque in different glucose metabolic states in patients with coronary heart disease: A RCSCD-TCM study in China. Cardiovascr Diabetol. 2022;21(1):38. doi: https://doi.org/10.1186/s12933-022-01470-3Wu Z, Wang J, Li Z, et al. Triglyceride glucose index and carotid atherosclerosis incidence in the Chinese population: A prospective cohort study. Nutr Metab Cardiovasc Dis. 2021;31(7), 2042–50. doi: https://doi.org/10.1016/j.numecd.2021.03.027Wu Z, Wang J, Li Z, et al. Triglyceride glucose index and carotid atherosclerosis incidence in the Chinese population: A prospective cohort study. Nutr Metab Cardiovasc Dis. 2021;31(7), 2042–50. doi: https://doi.org/10.1016/j.numecd.2021.03.027Zhao S, Yu S, Chi C, et al. Association between macroand microvascular damage and the triglyceride glucose index in community-dwelling elderly individuals: The Northern Shanghai Study. Cardiovasc Diabetol. 2019;18(1):95. doi: https://doi.org/10.1186/s12933-019-0898-xZhao S, Yu S, Chi C, et al. Association between macroand microvascular damage and the triglyceride glucose index in community-dwelling elderly individuals: The Northern Shanghai Study. Cardiovasc Diabetol. 2019;18(1):95. doi: https://doi.org/10.1186/s12933-019-0898-xIrace C, Carallo C, Scavelli FB, et al. Markers of insulin resistance and carotid atherosclerosis. A comparison of the homeostasis model assessment and Triglyceride Glucose Index. Int J Clin Pract. 2013;67(7),665–672. doi: https://doi.org/10.1111/ijcp.12124Irace C, Carallo C, Scavelli FB, et al. Markers of insulin resistance and carotid atherosclerosis. A comparison of the homeostasis model assessment and Triglyceride Glucose Index. Int J Clin Pract. 2013;67(7),665–672. doi: https://doi.org/10.1111/ijcp.12124Chiu TH, Tsai HJ, Chiou HYC, et al. A high triglycerideglucose index is associated with left ventricular dysfunction and atherosclerosis. Int J Med Sci. 2021;18(4),1051–1057. doi: https://doi.org/10.7150/ijms.53920Chiu TH, Tsai HJ, Chiou HYC, et al. A high triglycerideglucose index is associated with left ventricular dysfunction and atherosclerosis. Int J Med Sci. 2021;18(4),1051–1057. doi: https://doi.org/10.7150/ijms.53920Parsaee M, Bahmanziari P, Ardeshiri M, et al. Obvious or Subclinical Right Ventricular Dysfunction in Diabetes Mellitus (Type II): An Echocardiographic Tissue Deformation Study. J Tehran Heart Cent. 2012;7(4),177–181Parsaee M, Bahmanziari P, Ardeshiri M, et al. Obvious or Subclinical Right Ventricular Dysfunction in Diabetes Mellitus (Type II): An Echocardiographic Tissue Deformation Study. J Tehran Heart Cent. 2012;7(4),177–181Kosmala W, Colonna P, Przewlocka-Kosmala M, et al. Right ventricular dysfunction in asymptomatic diabetic patients. Diabetes Care. 2004;27(11),2736–2738. doi: https://doi.org/10.2337/diacare.27.11.2736Kosmala W, Colonna P, Przewlocka-Kosmala M, et al. Right ventricular dysfunction in asymptomatic diabetic patients. Diabetes Care. 2004;27(11),2736–2738. doi: https://doi.org/10.2337/diacare.27.11.2736Murtaza G, Virk HU, Khalid M, et al. Diabetic cardiomyopathy - a comprehensive updated review. Prog Cardiovasc Dis. 2019;62(4), 315–326. doi: https://doi.org/10.1016/j.pcad.2019.03.003Murtaza G, Virk HU, Khalid M, et al. Diabetic cardiomyopathy - a comprehensive updated review. Prog Cardiovasc Dis. 2019;62(4), 315–326. doi: https://doi.org/10.1016/j.pcad.2019.03.003Boyer J K, Thanigaraj S, Schechtman KB, et al. Prevalence of ventricular diastolic dysfunction in asymptomatic, normotensive patients with diabetes mellitus. The American Journal of Cardiology. 2004; 93(7), 870–875. doi: https://doi.org/10.1016/j.amjcard.2003.12.026Boyer J K, Thanigaraj S, Schechtman KB, et al. Prevalence of ventricular diastolic dysfunction in asymptomatic, normotensive patients with diabetes mellitus. The American Journal of Cardiology. 2004; 93(7), 870–875. doi: https://doi.org/10.1016/j.amjcard.2003.12.026Zoroufian A, Razmi T, Taghavi-Shavazi M, Lotfi-Tokaldany M, Jalali A. Evaluation of subclinical left ventricular dysfunction in diabetic patients: Longitudinal strain velocities and left ventricular dyssynchrony by twodimensional speckle tracking echocardiography study. Echocardiography. 2013;31(4),456–463. doi: https://doi.org/10.1111/echo.1238Zoroufian A, Razmi T, Taghavi-Shavazi M, Lotfi-Tokaldany M, Jalali A. Evaluation of subclinical left ventricular dysfunction in diabetic patients: Longitudinal strain velocities and left ventricular dyssynchrony by twodimensional speckle tracking echocardiography study. Echocardiography. 2013;31(4),456–463. doi: https://doi.org/10.1111/echo.1238

The authors declare that there are no conflicts of interest present.