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

Chen, Y ORCID: 0000-0002-2808-6286, Zhong, Z, Gue, Y, Banach, M ORCID: 0000-0001-6690-6874, McDowell, G ORCID: 0000-0002-2880-5236, Mikhailidis, DP, Toth, PP, Penson, PE ORCID: 0000-0001-6763-1489, Tomasik, T, Windak, A, Gierlotka, M, Osadnik, T, Kuras, A, Miga, M, Jozwiak, J and Lip, GYH ORCID: 0000-0002-7566-1626 (2024) Impact of surrogates for insulin resistance on mortality and life expectancy in primary care: a nationwide cross-sectional study with registry linkage (LIPIDOGRAM2015). The Lancet Regional Health - Europe, 49.

Preview

Text Impact of surrogates for insulin resistance on mortality and life.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview

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.

Item Type:	Article
Uncontrolled Keywords:	LIPIDOGRAM2015 Investigators; All-cause mortality; Insulin resistance; Premature mortality; Triglyceride-glucose index; TyG-adjusted body mass index; TyG-adjusted waist circumference; Years of life lost; Obesity; Nutrition; Aging; Clinical Research; 3 Good Health and Well Being
Subjects:	Q Science > QH Natural history > QH301 Biology R Medicine > R Medicine (General)
Divisions:	Pharmacy and Biomolecular Sciences
Publisher:	Elsevier
Date of acceptance:	2 December 2024
Date of first compliant Open Access:	14 January 2025
Date Deposited:	14 Jan 2025 11:52
Last Modified:	03 Jul 2025 16:30
DOI or ID number:	10.1016/j.lanepe.2024.101182
URI:	https://researchonline.ljmu.ac.uk/id/eprint/25265

View Item