Impact of surrogates for insulin resistance on mortality and life expectancy in primary care: a nationwide cross-sectional study with registry linkage (LIPIDOGRAM2015)

IF 13.6 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Europe Pub Date : 2025-02-01 DOI:10.1016/j.lanepe.2024.101182

Yang Chen , Ziyi Zhong , Ying Gue , Maciej Banach , Garry McDowell , Dimitri P. Mikhailidis , Peter P. Toth , Peter E. Penson , Tomasz Tomasik , Adam Windak , Marek Gierlotka , Tadeusz Osadnik , Agnieszka Kuras , Marcin Miga , Jacek Jozwiak , Gregory Y.H. Lip

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引用次数: 0

Abstract

Background

Insulin resistance (IR) is an important risk factor for multiple chronic diseases, increasing mortality and reducing life expectancy. The associations between emerging surrogates for IR, triglyceride-glucose index (TyG) and TyG-related indicators, with all-cause mortality and life expectancy in middle-aged and older patients in primary care are unclear.

Methods

This study originated from the Polish primary care cohort LIPIDOGRAM2015, including patients aged ≥45 years. Baseline fasting triglycerides and fasting glucose were used to derive TyG. Other TyG-related indicators included TyG-adjusted body mass index (TyG-BMI), TyG-adjusted waist circumference (TyG-WC), TyG-adjusted waist-to-hip, and TyG-adjusted waist-to-height. In this longitudinal analysis, we assessed associations between TyG-related indicators with total all-cause mortality, premature (age at death ≤75 years) all-cause mortality and years of life lost (YLL).

Findings

We included 10,688 patients (mean age 61.8 ± 9.3 years; 63.5% female). Cumulative total and premature all-cause mortality were 7.2% and 4.6%, respectively, during 5.7 years (IQR 5.6–5.7) of follow-up. Lowest (Q1) and highest quartile (Q4) of TyG-BMI and TyG-WC were associated with total all-cause mortality (second quartile [Q2]: reference; TyG-BMI: Q1: aHR 1.33, 95% CI 1.07–1.65, Q4: aHR 1.28, 95% CI 1.03–1.58; TyG-WC: Q1: aHR 1.44, 95% CI 1.14–1.82, Q4: aHR 1.29, 95% CI 1.04–1.59), similar results for premature all-cause mortality. Within age 45–80 years, compared with Q2 and third quartile, YLL were 4.49 and 5.46 years for TyG-BMI Q1 and Q4, respectively, 3.24 and 5.31 years for TyG-WC Q1 and Q4, respectively.

Interpretation

TyG-BMI and TyG-WC demonstrated a U-shaped association with total and premature all-cause mortality. Low and high levels of TyG-BMI and TyG-WC were associated with reduced life expectancy. Despite the relatively short follow-up period, significant associations were still observed, but longer follow-up studies are required to further explore these relationships.

Funding

Polish Lipid Association, College of Family Physician in Poland, Valeant in Poland.

查看原文本刊更多论文

胰岛素抵抗替代物对初级保健中死亡率和预期寿命的影响：一项具有登记联系的全国性横断面研究（LIPIDOGRAM2015）。

背景：胰岛素抵抗（Insulin resistance， IR）是多种慢性疾病的重要危险因素，可增加死亡率，降低预期寿命。新出现的IR替代品、甘油三酯-葡萄糖指数（TyG）和TyG相关指标与初级保健中老年患者的全因死亡率和预期寿命之间的关系尚不清楚。方法：本研究来源于波兰初级保健队列LIPIDOGRAM2015，纳入年龄≥45岁的患者。基线空腹甘油三酯和空腹血糖被用来推导TyG。其他与tyg相关的指标包括：tyg调整体重指数（TyG-BMI）、tyg调整腰围（TyG-WC）、tyg调整腰臀比、tyg调整腰高比。在这项纵向分析中，我们评估了tyg相关指标与总全因死亡率、过早（死亡年龄≤75岁）全因死亡率和生命损失年数（YLL）之间的相关性。结果：纳入10,688例患者(平均年龄61.8±9.3岁；63.5%的女性)。在5.7年（IQR 5.6-5.7）的随访期间，累积总死亡率和过早全因死亡率分别为7.2%和4.6%。TyG-BMI和TyG-WC最低（Q1）和最高四分位数（Q4）与总全因死亡率相关(第二个四分位数[Q2]：参考；TyG-BMI: Q1: aHR 1.33, 95% CI 1.07-1.65, Q4: aHR 1.28, 95% CI 1.03-1.58；TyG-WC: Q1: aHR 1.44, 95% CI 1.14-1.82, Q4: aHR 1.29, 95% CI 1.04-1.59)，过早全因死亡率的结果相似。在45-80岁年龄组中，TyG-BMI Q1和Q4的YLL分别为4.49和5.46岁，TyG-WC Q1和Q4的YLL分别为3.24和5.31岁。解释：TyG-BMI和TyG-WC与总死亡率和过早全因死亡率呈u型相关。TyG-BMI和TyG-WC水平的高低与预期寿命的缩短有关。尽管随访时间相对较短，但仍观察到显著的相关性，但需要更长的随访研究来进一步探索这些关系。资助：波兰脂质协会，波兰家庭医师学院，波兰Valeant。

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来源期刊

Lancet Regional Health-Europe Multiple-

CiteScore

19.90

自引率

1.40%

发文量

260

审稿时长

9 weeks

期刊介绍： The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.