Salazar Juan, Bermúdez Valmore, Olivar Luis Carlos, Torres Wheeler, Palmar Jim, Añez Roberto, Ordoñez Maria Gratzia, Rivas José Ramón, Martínez María Sofía, Hernández Juan Diego, Graterol Modesto, Rojas Joselyn
Endocrine and Metabolic Research Center, University of Zulia, Maracaibo, Venezuela.
Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cucuta, Colombia.
F1000Res. 2018 Jan 11;7:44. doi: 10.12688/f1000research.13610.2. eCollection 2018.
Insulin resistance (IR) is a metabolic disorder related to atherosclerosis. Its measurement is of great importance not only as a marker of diabetes but also for cardiovascular disease. The aim of this research study was to evaluate the relationship between various IR indices and coronary risk in an adult population from Maracaibo city, Venezuela. The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub study, 1272 individuals of both genders were selected with the measurement of basal insulin and coronary risk according to the Framingham-Wilson formula calibrated for our population. The insulin resistance indices evaluated were HOMA2-IR, triglycerides and glucose index (TyG) and triglycerides/HDL ratio (TG/HDL). The predictive capacity and association between each index and the coronary risk event in 10 years were determined. Of the evaluated population, 55.2% were female, 34.8% had a coronary risk ≥5% in 10 years, with the TG/HDL and TyG indices showing the highest AUC 0.712 (0.681-0.743) and 0.707 (0.675-0.739), respectively; compared to HOMA2-IR. Both were also the indices most associated with increased coronary risk, especially TG/HDL ≥3 with a higher association [OR = 2.83 (1.74-4.61); p<0.01] after multivariable adjustment. TyG (≥4.5) and TG/HDL (≥3) indices showed a great predictive capacity of higher coronary risk, with being TG/HDL more associated even after adjusting for abdominal obesity and hs-CRP. Therefore, these represent useful tools for determining IR.
胰岛素抵抗（IR）是一种与动脉粥样硬化相关的代谢紊乱。其测量不仅对于作为糖尿病的标志物很重要，而且对于心血管疾病也很重要。本研究的目的是评估委内瑞拉马拉开波市成年人群中各种IR指标与冠心病风险之间的关系。马拉开波市代谢综合征患病率研究是一项采用随机多阶段抽样的描述性横断面研究。在这项子研究中，根据为我们的人群校准的弗雷明汉 - 威尔逊公式，选取了1272名男女个体，测量了基础胰岛素和冠心病风险。评估的胰岛素抵抗指标有HOMA2-IR、甘油三酯与葡萄糖指数（TyG）以及甘油三酯/高密度脂蛋白比值（TG/HDL）。确定了每个指标与10年冠心病风险事件之间的预测能力和关联。在评估人群中，55.2%为女性，34.8%在10年内冠心病风险≥5%，TG/HDL和TyG指标的曲线下面积（AUC）最高，分别为0.712（0.681 - 0.743）和0.707（0.675 - 0.739）；与HOMA2-IR相比。这两个指标也是与冠心病风险增加最相关的指标，尤其是多变量调整后TG/HDL≥3时关联更强[比值比（OR）= 2.83（1.74 - 4.61）；p<0.01]。TyG（≥4.5）和TG/HDL（≥3）指标显示出对较高冠心病风险有很大的预测能力，即使在调整腹部肥胖和高敏C反应蛋白（hs-CRP）后，TG/HDL的关联性更强。因此，这些是确定IR的有用工具。
