Correlation between TyG (Fasting Triglyceride-glucose) Index, TyG BMI Index & Liver Transaminases in Women with Polycystic Ovary Disease Syndrome

Background: Polycystic Ovary Disease Syndrome (PCOS) and NAFLD are interlinked with the common culprit i.e. Insulin resistance (IR). The triglyceride and glucose index (TyG) has been recommended as a reliable and simple surrogate index for IR. So we evaluated TyG index, TyG–BMI index as a marker of IR and its correlation with liver transaminases (ALT, AST) to detect NAFLD in women with PCOS. Aim and Objectives: Correlation of TyG index and TyG-BMI index and liver transaminases (ALT, AST) in study groups. Materials and methods: A prospective study was done on 25 participants (14 controls and 11cases of PCOS according to Rotterdam’s criteria). The TG, FBG, ALT and AST were analyzed on autoanlyzers. TyG -BMI index was calculated by the formula and correlation was done. Result: The ROC Curve showed the optimal cut off value for TyG index as 4.55 and TyG –BMI index in PCOS as 104.76. The positive linear regression was 2.55 for TyG index indicating that test was associated with IR. TyG index has shown the better performance as compared to TyG BMI index. No significant correlation was found between TyG index, TyG BMI index and transaminases. Conclusion: TG and FBG are inexpensive and routinely performed investigations. TyG index which can be easily calculated makes it the first choice screening alternative to detect risk of IR in PCOS women. Keywords: PCOS, TyG -BMI index, Nonalcoholic fatty liver disease, liver transaminases

Association between neutrophil-lymphocyte ratio and gestational diabetes – a systematic review and meta-analysis

A growing body of evidence shows that the neutrophil-lymphocyte ratio (NLR) is a surrogate index of systemic inflammation in several chronic diseases. Conflicting associations between NLR and gestational diabetes (GDM) have been reported in individual studies. This meta-analysis sought to investigate the association between NLR and GDM. The PubMed, EMBASE and Google Scholar databases were searched to identify relevant articles. The pooled standardized mean difference with 95% confidence interval were calculated using a random effects model. Subgroup and meta-regression analysis were carried out to control for the effects of GDM diagnostic criteria, ethnicity, body mass index and age. Eleven eligible articles were included, containing 1271 participants with GDM and 1504 controls. Pooled outcomes indicated a higher NLR in GDM pregnancies than in normoglycemic controls (SMD = 0.584, 95% CI = 0.339 - 0.830, p < 0.001), although extensive heterogeneity between studies was noted. Subgroup analysis revealed that the higher pooled estimate in GDM was not affected by diagnostic criteria, ethnicity, or BMI, although matching for BMI reduced heterogeneity between studies. This meta-analysis supports the higher NLR in GDM described by some individual studies.

Is Disease Intensity a Good Surrogate for Yield Loss or Toxin Contamination? A Case Study with Fusarium Head Blight of Wheat

Sometimes plant pathologists assess disease intensity when they are primarily interested in other response variables, such as yield loss or toxin concentration in harvested products. In these situations, disease intensity potentially could be considered a surrogate of yield or toxin. A surrogate is a variable which can be used instead of the variable of interest in the evaluation of experimental treatments or in making predictions. Surrogates can be measured earlier, more conveniently, or more cheaply than the variable of primary interest, but the reliability or validity of the surrogate must be shown. We demonstrate ways of quantifying two facets of surrogacy by using a protocol originally developed by Buyse and colleagues for medical research. Coefficient-of-determination type statistics can be used to conveniently assess the strength of surrogacy on a unitless scale. As a case study, we evaluated whether field severity of Fusarium head blight (i.e., FHB index) can be used as a surrogate for yield loss and deoxynivalenol (DON) toxin concentration in harvested wheat grain. Bivariate mixed models and corresponding approximations were fitted to data from 82 uniform fungicide trials conducted from 2008 to 2013. Individual-level surrogacy—for predicting the variable of interest (yield or DON) from the surrogate (index) in plots with the same treatment—was very low. Trial-level surrogacy—for predicting the effect of treatment (e.g., mean difference) for the variable of interest based on the effect of the treatment on the surrogate (index)—was moderate for yield, and only low for DON. Challenges in using disease severity as a surrogate for yield and toxin are discussed.

Estimating bobcat (Lynx rufus) abundance in Wisconsin during 1981-2015

Quantifying and estimating trends in wildlife abundance is critical for their management and conservation. Harvest-based indices are often used as a surrogate index for wildlife population. Sex-Age-Kill (SAK) models generally use the age-at-harvest of males and females, combined with annual mortality and reproduction rates to calculate a preharvest population estimate. We used and SAK model to estimate abundance for bobcats from 1981-2015. Pre-hunt population size ranged from approximately 1630-2148 during 1981-1995 after which the population increased to a maximum of 4439 in 2005 before declining to 2598 in 2013. Pre-hunt population size was highly correlated an index of abundance from winter track counts (r = 0.93). We found that the model, as currently implemented by WNDR, appears to provide an accurate trend of statewide bobcat abundance. SAK models more logistically feasible for long-term evaluations of population trends overbroad spatial extents than more intensive methods. While SAK models may be the only technique available to wildlife managers for estimating the abundance of harvested species, we encourage additional research to evaluate the effects of potential biases on estimates of abundance.

Pharmacokinetics and Dose Proportionality of Betahistine in Healthy Individuals

Betahistine dihydrochloride is widely used to reduce the severity and frequency of vertigo attacks associated with Ménière’s disease. Betahistine is an analogue of histamine, and is a weak histamine H1 receptor agonist and potent histamine H3 receptor antagonist. The recommended therapeutic dose for adults ranges from 24 to 48 mg given in doses divided throughout the day. Betahistine undergoes extensive first-pass metabolism to the major inactive metabolite 2-pyridyl acetic acid (2PAA), which can be considered a surrogate index for quantitation of the parent drug due to extremely low plasma levels of betahistine. The aim of the present investigation was to assess the pharmacokinetics and dose proportionality of betahistine in Arabic healthy adult male subjects under fasting conditions. A single dose of betahistine in the form of a 8, 16, or 24 mg tablet was administered to 36 subjects in randomized, cross-over, three-period, three-sequence design separated by a one week washout period between dosing. The pharmacokinetic parameters Cmax, AUC0–t, AUC0–∞, Tmax, and Thalf were calculated for each subject from concentrations of 2-PAA in plasma, applying non-compartmental analysis. The current study demonstrated that betahistine showed linear pharmacokinetics (dose proportionality) in an Arabic population over the investigated therapeutic dose range of 8–24 mg.

Fasting triglycerides and glucose index: a useful screening test for assessing insulin resistance in patients diagnosed with rheumatoid arthritis and systemic lupus erythematosus

Background Insulin resistance (IR) is frequently observed in patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). In clinical practice, IR assessment is limited to a low proportion of patients due to cost and equipment and technical expertise requirements. The surrogate index of triglycerides and glucose (TyG index) has been validated in non-rheumatic populations, showing adequate sensitivity and specificity for IR, although this index has not yet been used in connective tissue disorders. The aim of this study was to evaluate the frequency of insulin resistance (IR) using the validated surrogate index of triglycerides and glucose (TyG index) and to explore factors associated with IR in Mexican women with RA or SLE. Methods Ninety-five female RA and 57 SLE patients were included in a cross-sectional study. Clinical and epidemiological variables were evaluated. IR was assessed using the TyG index with a cutoff value of > 4.68. Logistic regression analysis was performed to identify factors associated with IR excluding confounders. Results IR frequency in the entire sample was 50%, higher than the 10% observed in non-rheumatic controls (p < 0.001). The frequency of IR was similar in SLE (49.1%) and RA (50.5%, p = 0.8) patients. IR was associated with a longer duration of hypertension and higher total cholesterol and low density lipoprotein cholesterol levels. Based on multivariate analysis, the duration of hypertension (OR: 1.06; 95% CI 1.002–1.12, p = 0.04), waist circumference (OR: 1.04; 95% CI 1.01–1.08, p = 0.007), uric acid levels (OR: 1.46; 95% CI 1.08–1.97, p = 0.01), RA (OR: 4.87; 95% CI 1.31–18.78, p = 0.01) and SLE (OR: 4.22; 95% CI 1.06–16.74, p = 0.04) were the main risk factors for IR. Conclusions This study shows that the TyG index is a useful screening test for IR in RA and SLE patients. Future longitudinal studies should be performed with the aim of identifying the predictive value of TyG index results for identifying complications linked to IR.

Assessment of Nutritional Status in Sri Lankan Children: Validity of Current Anthropometry Cutoffs?

Despite socioeconomic improvement, undernutrition rates stagnate in Sri Lanka, while a slow rise in obesity and noncommunicable diseases (NCD) is seen. Inability to improve undernutrition and detection of NCD could be due to overdiagnosing stunting/wasting and underdiagnosing overweight/obesity. Obesity, being a risk factor for NCDs, needs correct tools for early diagnosis. Although body mass index (BMI) is a commonly used surrogate index, the validity of universal cutoffs is questioned. Evidence shows that body composition varies with ethnic origin and cutoff value reflecting fat mass (FM) varies in different ethnic groups. This study was conducted in 12 788, 5- to 15-year-old children from 8 schools in Negombo, Sri Lanka, to identify the validity of current anthropometric cutoffs. Obesity prevalence identified by body fat content was high. International BMI cutoffs had high specificity but varied sensitivity. Locally developed BMI cutoffs had high sensitivity and specificity. Validity of internationally developed anthropometric cutoffs in South Asian children is unsatisfactory; hence, locally/regionally developed anthropometric tools should be used for screening of obesity.