Relationship of triglyceride–glucose index with chronic limb-threatening ischemia in lower extremity peripheral artery disease

Vascular ◽  
2021 ◽  
pp. 170853812110183
Author(s):  
Arda Aybars Pala ◽  
Yusuf Salim Urcun
Keyword(s):  
Lower Extremity ◽  
High Density Lipoprotein ◽  
Peripheral Artery Disease ◽  
Density Lipoprotein ◽  
Peripheral Artery ◽  
Tyg Index ◽  
Triglyceride Glucose Index ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Objectives Triglyceride-glucose index (TyG index), which is defined as the simple and novel marker of insulin resistance, is becoming increasingly important as a promising predictive marker for atherosclerotic diseases. Chronic limb-threatening ischemia is defined as the most advanced stage of the lower extremity peripheral artery disease, whose main cause is atherosclerosis and is associated in this respect with amputation, impaired quality of life, and mortality. The main purpose of the present study was to investigate the relation between the calculated TyG index values and chronic limb-threatening ischemia development. Methods A total of 296 patients who were diagnosed with lower extremity peripheral artery disease in our outpatient clinic between October 2018 and October 2020 were included in this study retrospectively. Two groups were formed by clinically staging the patients according to Rutherford Classification. Patients who did not develop chronic limb-threatening ischemia were classified as “Group 1” ( n = 224) and those who developed were classified as “Group 2” ( n = 72). Results The mean TyG index values that were calculated in Group 2 were significantly higher than in Group 1 (9.27 ± 0.31 vs. 9.00 ± 0.34, p < 0.001). In the multivariate logistic regression analysis conducted to determine the predictors of chronic limb-threatening ischemia development, C-reactive protein (OR [Odds Ratio]: 1.220, 95% CI [confidence interval]: 1.092–1.363, p < 0.001), high-density lipoprotein cholesterol (OR: 0.775, 95% CI: 0.715–0.839, p < 0.001) and TyG index (OR: 5.796, 95% CI: 2.050–16.382, p = 0.001) were identified as independent predictors. Receiver operating characteristic analysis revealed that the cut-off value of TyG index was 9.13 (area under the curve: 0.721, p < 0.001) with 70.8% sensitivity and 65.2% specificity. The TyG index was significantly correlated with Rutherford category, high-density lipoprotein cholesterol and mean platelet volume. Conclusions Chronic limb-threatening ischemia development may be predicted with the TyG index value, which is calculated easily from routine biochemical parameters, in patients diagnosed with lower extremity peripheral artery disease.

Is it possible to predict the complexity of peripheral artery disease with atherogenic index?

Vascular ◽  
2020 ◽  
Vol 28 (5) ◽  
pp. 513-519
Author(s):  
Engin Mesut ◽  
Aydın Cihan ◽  
Guvenc Orhan
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Artery Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
Atherogenic Index ◽  
Peripheral Artery ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Objectives Lower extremity peripheral artery disease develops mainly due to atherosclerosis and occurs as a result of the systemic atherosclerotic process. Increased triglyceride (TG) and decreased high density lipoprotein cholesterol (HDL-C) values increase atherosclerosis risk. With regard to this information, TG/HDL-C ratio is used as the atherogenic index. The aim of the present study was to evaluate the role of TG/HDL-C ratio to predict the complexity of disease in patients with peripheral artery disease. Methods Patients who were diagnosed with peripheral artery disease and admitted to our clinic between August 2013 and August 2019 were included in this study retrospectively. Patients were divided into two groups based on angiographic evaluations with TransAtlantic Inter-Society Consensus-II classification. Those with TASC A-B lesions were included in Group 1 and those with TASC C-D lesions constituted Group 2. Results The mean ages of Group 1 ( n = 314) and Group 2 ( n = 98) patients were 56.1 ± 9.3 and 58.4.1 ± 8.1 years, respectively. The frequency of male gender and coronary artery disease was significantly higher in Group 2 ( p = 0.043, p = 0.001, respectively). In Group 2, triglyceride and TG/HDL-C ratios were significantly high, while HDL-C was significantly low ( p = 0.022, p < 0.001, p = 0.010, respectively). The multivariate logistic regression analysis performed to evaluate the parameters in predicting the angiographic complexity of peripheral artery disease showed that coronary artery disease (OR: 1.009 CI 95%: 1.003–1.021 p = 0.016) and TG/HDL-C ratio (OR: 5.385 CI 95%: 2.553–9.357 p = 0.001) were independent predictors for complexity. ROC analysis revealed that the cut-off value of TG/HDL-C was 2.9 (AUC = 0.670, p < 0.001) with 75.5% sensitivity and 56.7% specificity. Conclusions It is possible to predict the angiographic complexity of peripheral artery disease with TG/HDL-C ratio, also known as atherogenic index, which is easily obtained by routine biochemical parameters.

THE RELATIONSHIP BETWEEN INFLAMMATION MARKERS AND MAGNESIUM/PHOSPHATE RATIO WITH ENDOTEL FUNCTION IN PERIPHERAL ARTERY DISEASE

2021 ◽  
Vol 6 (15) ◽  
pp. 80-86
Author(s):  
Serhat Çalışkan ◽  
Mehmet ATAY ◽  
Ferit BÖYÜK
Keyword(s):  
High Density Lipoprotein ◽  
Peripheral Artery Disease ◽  
Density Lipoprotein ◽  
High Density ◽  
Magnesium Phosphate ◽  
Peripheral Artery ◽  
The Mean ◽  
Endothelial Functions ◽  
Artery Disease ◽  
The Relationship

Objective: In our study, it was aimed to evaluate the relationship between neutrophil/lymphocyte, monocyte/high-density lipoprotein and magnesium/phosphate ratios with endothelial functions in patients with peripheral artery disease. Methods: Sixty patients followed up with peripheral arterial disease were included in this study. Endothelial functions of the patients were evaluated by flow-mediated vasodilation test. Pearson correlation analysis was used to evaluate the relationship between magnesium/phosphate, neutrophil/lymphocyte, monocyte/high-density lipoprotein ratios with percent change in flow-mediated vasodilation. Results: 48.3% of the participants are male and 51.7% are female. The mean age of the patients were 66.85±11.08 years. The mean radial artery basal diameter was 0.24±0.02 cm in the flow-mediated vasodilatation test and after the test the mean radial artery diameter was 0.27±0.02 cm(p<0.001). In the flow-mediated dilatation test predicting endothelial functions, the percentage change in arterial diameter was positively correlated with the Magnesium/phosphate ratio (r=-0.326, p=0.011), and negatively correlated with the Neutrophil/lymphocyte ratio and monocyte/high-density lipoprotein ratio (respectively r= -0.411, p=0.001; r=-0.530, p=0.001). Conclusion: Magnesium/phosphate ratio, neutrophil/lymphocyte ratio and monocyte/high-density lipoprotein ratio can be used to predict endothelial dysfunction in patients with peripheral artery disease.

scholarly journals Approaches to reduce the risk of progression of peripheral artery disease from the standpoint of a cardiologist

2021 ◽  
Vol 10 (1) ◽  
pp. 55-64
Author(s):  
A. N. Sumin ◽  
Yu. D. Medvedeva ◽  
A. V. Shcheglova ◽  
L. S. Barbarash
Keyword(s):  
Peripheral Artery Disease ◽  
Myocardial Revascularization ◽  
Walking Distance ◽  
Adherence To Treatment ◽  
Peripheral Artery ◽  
Optimal Drug ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Aim. To determine the factors contributing to the progression of peripheral artery diseases in patients receiving outpatient care within the 3-year follow-up.Methods. 585 patients with peripheral artery disease undergoing outpatient treatment in the period from 2010 to 2016 were recruited in a study. The follow-up period was three years. Patients were divided into two groups: Group 1 patients (n = 225) with a favorable course of peripheral atherosclerosis, and Group 2 patients (n = 303) with an unfavorable course of peripheral atherosclerosis. Patients were assigned to the groups based on their medical history (a decrease in pain-free walking distance within three years, amputation) and/or data of duplex scanning of the lower extremity arteries (significant progression of stenosis >20% over three years).Results. 87.1% of patients from Group 1 and 70.63% of patients from Group 2 visited cardiologists regularly within 3 years (p<0.0001). A total of 69.33% of patients from Group 1 and 61.39% of patients from Group 2 (p = 0.058) visited vascular surgeons within the follow-up period. Within three years, 47 (8.9%) patients achieved hard endpoints. Of them, 18 deaths, 14 myocardial infarctions, and 15 ischemic strokes. 25 patients underwent myocardial revascularization. Adherence to treatment within 3-years follow-up was significantly higher in patients with a favorable course (57.33% vs. 45.21%, p = 0.006). Multivariate logistic regression reported that adherence to treatment years (р=0.0009) and regular visits to cardiologists (p<0.001) significantly improved the 3-year prognosis in patients with peripheral artery disease.Conclusion. 57% of patients had an adverse course of peripheral atherosclerosis within 3-years follow-up. These results show that regular outpatient examinations of patients with peripheral atherosclerosis by cardiologists allow prescribing optimal drug therapy and reducing the risk of atherosclerosis progression.

Disturbances of the transfer of cholesterol to high-density lipoprotein (HDL) in patients with peripheral artery disease with or without type 2 diabetes mellitus

2021 ◽  
pp. 1358863X2110211
Author(s):  
Flávio Roberto Cavalleiro de Macedo Ribeiro ◽  
Carolina Heitmann Mares Azevedo Ribeiro ◽  
Thauany Martins Tavoni ◽  
Erica dos Santos Sarges ◽  
Fatima Rodrigues Freitas ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
High Density Lipoprotein ◽  
Peripheral Artery Disease ◽  
Density Lipoprotein ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Hdl Metabolism

Introduction: Low high-density lipoprotein (HDL)-cholesterol is frequent in patients with peripheral artery disease (PAD) and also in type 2 diabetes mellitus (T2DM), the major risk factor for PAD. The transfer of cholesterol from the other lipoproteins to HDL is an important aspect of HDL metabolism and function, and may contribute to atherogenic mechanisms that lead to PAD development. Objective: The aim of this study was to investigate the status of cholesterol transfers in patients with PAD without or with T2DM. Methods: Patients with PAD ( n = 19), with PAD and T2DM (PAD + DM, n = 19), and healthy controls ( n = 20), all paired for age, gender, and BMI were studied. Transfer of both forms of cholesterol, unesterified (UC) and esterified (EC), was performed by incubating plasma with a donor nanoemulsion containing radioactive UC and EC, followed by chemical precipitation and HDL radioactive counting. Results: Low-density lipoprotein (LDL)-cholesterol and triglycerides were similar in the three groups. Compared to controls, HDL-C was lower in PAD + DM ( p < 0.05), but not in PAD. Transfer of UC was lower in PAD + DM than in PAD and controls (4.18 ± 1.17%, 5.13 ± 1.44%, 6.59 ± 1.25%, respectively, p < 0.001). EC transfer tended to be lower in PAD + DM than in controls (2.96 ± 0.60 vs 4.12 ± 0.89%, p = 0.05). Concentrations of cholesteryl ester transfer protein (CETP) and lecithin-cholesterol acyltransferase (LCAT), both involved in HDL metabolism, were not different among the three groups. Conclusion: Deficient cholesterol transfer to HDL may play a role in PAD pathogenesis. Since UC transfer to HDL was lower in PAD + DM compared to PAD alone, it is possible that defective HDL metabolism may contribute to the higher PAD incidence in patients with T2DM.Keywords

scholarly journals Association between Triglyceride Glucose Index and the Risk of Peripheral Artery Disease

2021 ◽  
Author(s):  
Yihai Liu ◽  
Mingyue Wu ◽  
Biao Xu ◽  
Lina Kang
Keyword(s):  
Peripheral Artery Disease ◽  
Surrogate Marker ◽  
Vascular Diseases ◽  
Peripheral Artery ◽  
Tyg Index ◽  
Health And Nutrition ◽  
Triglyceride Glucose Index ◽  
Artery Disease ◽  
The Relationship ◽  
Cardiometabolic Factors

Abstract Background The triglyceride glucose (TyG) index has been used as a simple surrogate marker of insulin resistance, an independent predictor of atherosclerotic vascular diseases. However, few studies have investigated the relationship between the TyG index and peripheral artery disease (PAD).Methods A total of 3375 participants with comleted TyG and ankle brachial pressure index (ABPI) records were enrolled from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. The TyG index was calculated as ln[triglycerides (mg/dL)×glucose (mg/dL)/2], and the presence of PAD was defined as ABPI ≤ 0.9. Results The participants were 60.1±12.8 year old and 51.3% (1730) were male. The prevelance of PAD was 7.1% (238). Compared with the reference lowest quartile of TyG index, the highest quartile was associated with 1.66-fold (odds ratio [OR], 95% confidence interval [CI] 1.15-2.43; p=0.008) risk of PAD. After adjusted for sociodemographic, lifestyles, and cardiometabolic factors, the multivariate-adjusted OR and 95% CI were 1.55 (1.03-2.37; p=0.039) or participants within the highest quartile. TyG index was also independently and linearly associated with higher presence of PAD (OR 1.27 [1.02-1.56]; p=0.027). Subgroup analysis showed that the association between TyG index and the risk of PAD was still consistant across groups except for obesity.Conclusions Higher TyG index was significantly associated with the higher risk of PAD, which could be a marker of PAD.

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