Bullón-Vela Vanessa, Abete Itziar, Tur Josep A, Konieczna Jadwiga, Romaguera Dora, Pintó Xavier, Corbella Emili, Martínez-González Miguel A, Sayón-Orea Carmen, Toledo Estefanía, Corella Dolores, Macías-Gonzalez Manuel, Tinahones Francisco J, Fitó Montserrat, Estruch Ramon, Ros Emilio, Salas-Salvadó Jordi, Daimiel Lidia, Mascaró Catalina M, Zulet Maria Angeles, Martínez José Alfredo
Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain.
Department of Nutrition, Food Science and Physiology, Centre for Nutrition Research, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain.
Ther Adv Endocrinol Metab. 2020 Oct 23;11:2042018820958298. doi: 10.1177/2042018820958298. eCollection 2020.
Visceral adipose tissue (VAT) has a hazardous influence on systemic inflammation, insulin resistance and an adverse metabolic profile, which increases the risk of developing non-alcoholic fatty liver disease (NAFLD) and chronic complications of diabetes. In our study we aimed to evaluate the association of VAT and the triglyceride glucose (TyG) as a proxy of insulin resistance surrogated with metabolic and liver risk factors among subjects diagnosed with metabolic syndrome (MetS).
A cross-sectional study was performed including 326 participants with MetS (55-75 years) from the PREDIMED-Plus study. Liver-status markers, VAT and TyG were assessed. Participants were stratified by tertiles according to VAT ( = 254) and TyG ( = 326). A receiver operating characteristic curve was used to analyse the efficiency of TyG for VAT.
Subjects with greater visceral fat depots showed worse lipid profile, higher homeostatic model assessment for insulin resistance (HOMA-IR), TyG, alanine transaminase (ALT), fibroblast growth factor-21 (FGF-21), fatty liver index (FLI) and hepatic steatosis index (HSI) compared with participants in the first tertile. The multi-adjusted linear-regression analyses indicated that individuals in the third tertile of TyG (>9.1-10.7) had a positive association with HOMA-IR [ = 3.07 (95% confidence interval (CI) 2.28-3.86; trend < 0.001)], ALT [ = 7.43 (95% CI 2.23-12.63; trend = 0.005)], gamma glutamyl transferase (GGT) [ = 14.12 (95% CI 3.64-24.61; trend = 0.008)], FGF-21 [ = 190.69 (95% CI 93.13-288.25; trend < 0.001)], FLI [ = 18.65 (95% CI 14.97-22.23; trend < 0.001)] and HSI [ = 3.46 (95% CI, 2.23-4.68; trend < 0.001)] participants from the first tertile. Interestingly, the TyG showed the largest area under the receiver operating curve (AUC) for women (AUC = 0.713; 95% CI 0.62-0.79) compared with men (AUC = 0.570; 95% CI 0.48-0.66).
A disrupted VAT enlargement and impairment of TyG are strongly associated with liver status and cardiometabolic risk factors linked with NAFLD in individuals diagnosed with MetS. Moreover, the TyG could be used as a suitable and reliable marker estimator of VAT.
内脏脂肪组织（VAT）对全身炎症、胰岛素抵抗及不良代谢状况具有有害影响，会增加非酒精性脂肪性肝病（NAFLD）和糖尿病慢性并发症的发生风险。在我们的研究中，旨在评估内脏脂肪组织（VAT）与甘油三酯葡萄糖（TyG）的关联，TyG作为胰岛素抵抗的替代指标，在诊断为代谢综合征（MetS）的受试者中与代谢及肝脏风险因素相关。
进行了一项横断面研究，纳入了来自PREDIMED-Plus研究的326名患有代谢综合征（55 - 75岁）的参与者。评估了肝脏状态标志物、内脏脂肪组织（VAT）和TyG。参与者根据内脏脂肪组织（VAT）（n = 254）和TyG（n = 326）的三分位数进行分层。采用受试者工作特征曲线分析TyG对内脏脂肪组织（VAT）的预测效能。
与第一三分位数的参与者相比，内脏脂肪堆积较多的受试者脂质谱更差，胰岛素抵抗稳态模型评估（HOMA-IR）、TyG、丙氨酸转氨酶（ALT）、成纤维细胞生长因子21（FGF-21）、脂肪肝指数（FLI）和肝脂肪变性指数（HSI）更高。多因素调整线性回归分析表明，TyG第三三分位数（>9.1 - 10.7）的个体与第一三分位数的参与者相比，HOMA-IR [β = 3.07（95%置信区间（CI）2.28 - 3.86；P趋势<0.001）]、ALT [β = 7.43（95% CI 2.23 - 12.63；P趋势 = 0.005）]、γ-谷氨酰转移酶（GGT）[β = 14.12（95% CI 3.64 - 24.61；P趋势 = 0.008）]、FGF-21 [β = 190.69（95% CI 93.13 - 288.25；P趋势<0.001）]、FLI [β = 18.65（95% CI 14.97 - 22.23；P趋势<0.001）]和HSI [β = 3.46（95% CI，2.23 - 4.68；P趋势<0.001）]呈正相关。有趣的是，与男性（AUC = 0.570；�5% CI 0.48 - 0.66）相比，TyG在女性受试者工作特征曲线下面积最大（AUC = 0.713；95% CI 0.62 - 0.79）。
内脏脂肪组织（VAT）的异常增大和TyG的受损与诊断为代谢综合征的个体中与NAFLD相关的肝脏状态及心脏代谢风险因素密切相关。此外，TyG可作为内脏脂肪组织（VAT）合适且可靠的标志物评估指标。
