Comparison of Triglyceride-Glucose Index between Patients with Gallstone and Healthy Individuals
Abstract
Background: Triglyceride-glucose index is a product of triglycerides and fasting plasma glucose (FPG) and is a new index of insulin resistance found to correlate with direct measurements. This study aimed to evaluate the relationship between gallstones and triglyceride-glucose index (TGI).
Methods: A total of 210 patients were included in this retrospective study. Overall, 105 patients with gallstones were included in the patient group. Patients with diabetes mellitus, chronic diseases, malignant diseases, and patients using cholesterol-lowering drugs were excluded from the study. Healthy individuals (105 cases) were selected for the control group. TGI was calculated separately for each individual using the following formula: (TGI) = ln (fasting TG (mg/dL) x fasting glucose (mg/dL)/2)
Results: Plasma triglyceride levels were significantly higher in patients with gallstones compared to the control group (P=0.001). Plasma HDL, LDL, and total cholesterol did not differ between the groups (P>0.05). Fasting blood glucose was significantly higher in patients with gallstones compared to the control group (P=0.001). The triglyceride glucose index was significantly higher in patients with gallstones compared to the control group (P<0.001). When the relationship between body mass index and TGI was analyzed, TGI was lower in patients with normal BMI compared to overweight or obese patients (P<0.001).
Conclusion: Increased triglyceride/glucose index in patients with gallstones is an indicator of insulin resistance. It is instrumental in demonstrating the presence of insulin resistance in patients with gallstones and may be a useful guide in earlier detection, prevention, and treatment of insulin resistance.
1. Liu T, Wang W, Ji Y, et al (2018). Association between different combination of measures for obesity and new-onset gallstone disease. PLoS One, 13 (5):e0196457.
2. Kim HS, Cho SK, Kim CS, Park JS (2019). Big data and analysis of risk factors for gallbladder disease in the young generation of Korea. PLoS One, 14 (2):e0211480.
3. Stokes CS, Krawczyk M, Lammert F (2011). Gallstones: environment, lifestyle and genes. Dig Dis, 29 (2):191-201.
4. Kuipers F, Bloks VW, Groen AK (2014). Beyond intestinal soap--bile acids in metabolic control. Nat Rev Endocrinol, 10 (8):488-98.
5. Lammert F, Gurusamy K, Ko CW, et al (2016). Gallstones. Nat Rev Dis Primers, 2:16024.
6. Aune D, Norat T, Vatten LJ (2015). Body mass index, abdominal fatness and the risk of gallbladder disease. Eur J Epidemiol, 30 (9):1009-19.
7. Stender S, Nordestgaard BG, Tybjaerg-Hansen A (2013). Elevated body mass index as a causal risk factor for symptomatic gallstone disease: a Mendelian randomization study. Hepatology, 58 (6):2133-41.
8. Scragg RK, Calvert GD, Oliver JR (1984). Plasma lipids and insulin in gall stone disease: a case-control study. Br Med J (Clin Res Ed), 289 (6444):521-5.
9. Nepokroeff CM, Lakshmanan MR, Ness GC, et al (1974). Regulation of the diurnal rhythm of rat liver beta-hydroxy-beta-methylglutaryl coenzmye A reductase activity by insulin, glucagon, cyclic AMP and hydrocortisone. Arch Biochem Biophys, 160 (2):387-96.
10. Ruhl CE, Everhart JE (2000). Association of diabetes, serum insulin, and C-peptide with gallbladder disease. Hepatology, 31 (2):299-303.
11. Du T, Yuan G, Zhang M, et al (2014). Clinical usefulness of lipid ratios, visceral adiposity indicators, and the triglycerides and glucose index as risk markers of insulin resistance. Cardiovasc Diabetol, 13:146.
12. Abbasi F, Reaven GM (2011). Comparison of two methods using plasma triglyceride concentration as a surrogate estimate of insulin action in nondiabetic subjects: triglycerides × glucose versus triglyceride/high-density lipoprotein cholesterol. Metabolism, 60 (12):1673-6.
13. Khan SH, Sobia F, Niazi NK, et al (2018). Metabolic clustering of risk factors: evaluation of Triglyceride-glucose index (TyG index) for evaluation of insulin resistance. Diabetol Metab Syndr, 10:74.
14. Committee ADAPP (2022). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2022. Diabetes Care, 45 (Suppl 1):S17-S38.
15. Ayoub NM, Yaghan RJ, Abdo NM, et al (2019). Impact of Obesity on Clinicopathologic Characteristics and Disease Prognosis in Pre- and Postmenopausal Breast Cancer Patients: A Retrospective Institutional Study. J Obes, 2019:3820759.
16. Babic N, Valjevac A, Zaciragic A, et al (2019). The Triglyceride/HDL Ratio and Triglyceride Glucose Index as Predictors of Glycemic Control in Patients with Diabetes Mellitus Type 2. Med Arch, 73 (3):163-168.
17. Cleland C, Ferguson S, Ellis G, Hunter RF (2018). Validity of the International Physical Activity Questionnaire (IPAQ) for assessing moderate-to-vigorous physical activity and sedentary behaviour of older adults in the United Kingdom. BMC Med Res Methodol, 18 (1):176.
18. Méndez-Sánchez N, Chavez-Tapia NC, Motola-Kuba D, et al (2005). Metabolic syndrome as a risk factor for gallstone disease. World J Gastroenterol, 11 (11):1653-7.
19. Biddinger SB, Haas JT, Yu BB, et al (2008). Hepatic insulin resistance directly promotes formation of cholesterol gallstones. Nat Med, 14 (7):778-82.
20. Almobarak AO, Jervase A, Fadl AA, et al (2020). The prevalence of diabetes and metabolic syndrome and associated risk factors in Sudanese individuals with gallstones: a cross sectional survey. Transl Gastroenterol Hepatol, 5:14.
21. Sasazuki S, Kono S, Todoroki I, et al (1999). Impaired glucose tolerance, diabetes mellitus, and gallstone disease: an extended study of male self-defense officials in Japan. Eur J Epidemiol, 15 (3):245-51.
22. Misciagna G, Guerra V, Di Leo A, et al (2000). Insulin and gall stones: a population case control study in southern Italy. Gut, 47 (1):144-7.
23. Kim SS, Lee JG, Kim DW, et al (2011). Insulin resistance as a risk factor for gallbladder stone formation in Korean postmenopausal women. Korean J Intern Med, 26 (3):285-93.
24. Chen CH, Huang MH, Yang JC, et al (2006). Prevalence and risk factors of gallstone disease in an adult population of Taiwan: an epidemiological survey. J Gastroenterol Hepatol, 21 (11):1737-43.
25. Angelico F, Del Ben M, Barbato A, et al (1997). Ten-year incidence and natural history of gallstone disease in a rural population of women in central Italy. The Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO). Ital J Gastroenterol Hepatol, 29 (3):249-54.
26. Chen JY, Hsu CT, Liu JH, Tung TH (2014). Clinical predictors of incident gallstone disease in a Chinese population in Taipei, Taiwan. BMC Gastroenterol, 14:83.
27. Halldestam I, Kullman E, Borch K (2009). Incidence of and potential risk factors for gallstone disease in a general population sample. Br J Surg, 96 (11):1315-22.
28. Festi D, Dormi A, Capodicasa S, et al (2008). Incidence of gallstone disease in Italy: results from a multicenter, population-based Italian study (the MICOL project). World J Gastroenterol, 14 (34):5282-9.
29. Ruhl CE, Everhart JE (2001). Relationship of serum leptin concentration and other measures of adiposity with gallbladder disease. Hepatology, 34 (5):877-83.
30. Wang H, So H, Ko SW, et al (2022). Gallstone Is Associated with Metabolic Factors and Exercise in Korea. Healthcare (Basel), 10 (8):1372.
31. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, et al (2010). The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab, 95 (7):3347-51.
32. Wang J, Shen S, Wang B, et al (2020). Serum lipid levels are the risk factors of gallbladder stones: a population-based study in China. Lipids Health Dis, 19 (1):50.
33. Chen LY, Qiao QH, Zhang SC, et al (2012). Metabolic syndrome and gallstone disease. World J Gastroenterol, 18 (31):4215-20.
34. Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F (2008). The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord, 6 (4):299-304.
35. Lee SH, Han K, Yang HK, et al (2015). A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose. Nutr Diabetes, 5 (4):e149.
36. Selvi NMK, Nandhini S, Sakthivadivel V, et al (2021). Association of Triglyceride-Glucose Index (TyG index) with HbA1c and Insulin Resistance in Type 2 Diabetes Mellitus. Maedica (Bucur), 16 (3):375-381.
2. Kim HS, Cho SK, Kim CS, Park JS (2019). Big data and analysis of risk factors for gallbladder disease in the young generation of Korea. PLoS One, 14 (2):e0211480.
3. Stokes CS, Krawczyk M, Lammert F (2011). Gallstones: environment, lifestyle and genes. Dig Dis, 29 (2):191-201.
4. Kuipers F, Bloks VW, Groen AK (2014). Beyond intestinal soap--bile acids in metabolic control. Nat Rev Endocrinol, 10 (8):488-98.
5. Lammert F, Gurusamy K, Ko CW, et al (2016). Gallstones. Nat Rev Dis Primers, 2:16024.
6. Aune D, Norat T, Vatten LJ (2015). Body mass index, abdominal fatness and the risk of gallbladder disease. Eur J Epidemiol, 30 (9):1009-19.
7. Stender S, Nordestgaard BG, Tybjaerg-Hansen A (2013). Elevated body mass index as a causal risk factor for symptomatic gallstone disease: a Mendelian randomization study. Hepatology, 58 (6):2133-41.
8. Scragg RK, Calvert GD, Oliver JR (1984). Plasma lipids and insulin in gall stone disease: a case-control study. Br Med J (Clin Res Ed), 289 (6444):521-5.
9. Nepokroeff CM, Lakshmanan MR, Ness GC, et al (1974). Regulation of the diurnal rhythm of rat liver beta-hydroxy-beta-methylglutaryl coenzmye A reductase activity by insulin, glucagon, cyclic AMP and hydrocortisone. Arch Biochem Biophys, 160 (2):387-96.
10. Ruhl CE, Everhart JE (2000). Association of diabetes, serum insulin, and C-peptide with gallbladder disease. Hepatology, 31 (2):299-303.
11. Du T, Yuan G, Zhang M, et al (2014). Clinical usefulness of lipid ratios, visceral adiposity indicators, and the triglycerides and glucose index as risk markers of insulin resistance. Cardiovasc Diabetol, 13:146.
12. Abbasi F, Reaven GM (2011). Comparison of two methods using plasma triglyceride concentration as a surrogate estimate of insulin action in nondiabetic subjects: triglycerides × glucose versus triglyceride/high-density lipoprotein cholesterol. Metabolism, 60 (12):1673-6.
13. Khan SH, Sobia F, Niazi NK, et al (2018). Metabolic clustering of risk factors: evaluation of Triglyceride-glucose index (TyG index) for evaluation of insulin resistance. Diabetol Metab Syndr, 10:74.
14. Committee ADAPP (2022). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2022. Diabetes Care, 45 (Suppl 1):S17-S38.
15. Ayoub NM, Yaghan RJ, Abdo NM, et al (2019). Impact of Obesity on Clinicopathologic Characteristics and Disease Prognosis in Pre- and Postmenopausal Breast Cancer Patients: A Retrospective Institutional Study. J Obes, 2019:3820759.
16. Babic N, Valjevac A, Zaciragic A, et al (2019). The Triglyceride/HDL Ratio and Triglyceride Glucose Index as Predictors of Glycemic Control in Patients with Diabetes Mellitus Type 2. Med Arch, 73 (3):163-168.
17. Cleland C, Ferguson S, Ellis G, Hunter RF (2018). Validity of the International Physical Activity Questionnaire (IPAQ) for assessing moderate-to-vigorous physical activity and sedentary behaviour of older adults in the United Kingdom. BMC Med Res Methodol, 18 (1):176.
18. Méndez-Sánchez N, Chavez-Tapia NC, Motola-Kuba D, et al (2005). Metabolic syndrome as a risk factor for gallstone disease. World J Gastroenterol, 11 (11):1653-7.
19. Biddinger SB, Haas JT, Yu BB, et al (2008). Hepatic insulin resistance directly promotes formation of cholesterol gallstones. Nat Med, 14 (7):778-82.
20. Almobarak AO, Jervase A, Fadl AA, et al (2020). The prevalence of diabetes and metabolic syndrome and associated risk factors in Sudanese individuals with gallstones: a cross sectional survey. Transl Gastroenterol Hepatol, 5:14.
21. Sasazuki S, Kono S, Todoroki I, et al (1999). Impaired glucose tolerance, diabetes mellitus, and gallstone disease: an extended study of male self-defense officials in Japan. Eur J Epidemiol, 15 (3):245-51.
22. Misciagna G, Guerra V, Di Leo A, et al (2000). Insulin and gall stones: a population case control study in southern Italy. Gut, 47 (1):144-7.
23. Kim SS, Lee JG, Kim DW, et al (2011). Insulin resistance as a risk factor for gallbladder stone formation in Korean postmenopausal women. Korean J Intern Med, 26 (3):285-93.
24. Chen CH, Huang MH, Yang JC, et al (2006). Prevalence and risk factors of gallstone disease in an adult population of Taiwan: an epidemiological survey. J Gastroenterol Hepatol, 21 (11):1737-43.
25. Angelico F, Del Ben M, Barbato A, et al (1997). Ten-year incidence and natural history of gallstone disease in a rural population of women in central Italy. The Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO). Ital J Gastroenterol Hepatol, 29 (3):249-54.
26. Chen JY, Hsu CT, Liu JH, Tung TH (2014). Clinical predictors of incident gallstone disease in a Chinese population in Taipei, Taiwan. BMC Gastroenterol, 14:83.
27. Halldestam I, Kullman E, Borch K (2009). Incidence of and potential risk factors for gallstone disease in a general population sample. Br J Surg, 96 (11):1315-22.
28. Festi D, Dormi A, Capodicasa S, et al (2008). Incidence of gallstone disease in Italy: results from a multicenter, population-based Italian study (the MICOL project). World J Gastroenterol, 14 (34):5282-9.
29. Ruhl CE, Everhart JE (2001). Relationship of serum leptin concentration and other measures of adiposity with gallbladder disease. Hepatology, 34 (5):877-83.
30. Wang H, So H, Ko SW, et al (2022). Gallstone Is Associated with Metabolic Factors and Exercise in Korea. Healthcare (Basel), 10 (8):1372.
31. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, et al (2010). The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab, 95 (7):3347-51.
32. Wang J, Shen S, Wang B, et al (2020). Serum lipid levels are the risk factors of gallbladder stones: a population-based study in China. Lipids Health Dis, 19 (1):50.
33. Chen LY, Qiao QH, Zhang SC, et al (2012). Metabolic syndrome and gallstone disease. World J Gastroenterol, 18 (31):4215-20.
34. Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F (2008). The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord, 6 (4):299-304.
35. Lee SH, Han K, Yang HK, et al (2015). A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose. Nutr Diabetes, 5 (4):e149.
36. Selvi NMK, Nandhini S, Sakthivadivel V, et al (2021). Association of Triglyceride-Glucose Index (TyG index) with HbA1c and Insulin Resistance in Type 2 Diabetes Mellitus. Maedica (Bucur), 16 (3):375-381.
| Files | ||
| Issue | Vol 53 No 4 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v53i4.15565 | |
| Keywords | ||
| Gallstones Triglyceride-glucose index Body mass index Insulin resistance | ||
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How to Cite
1.
Ozkan Ozturk S. Comparison of Triglyceride-Glucose Index between Patients with Gallstone and Healthy Individuals. Iran J Public Health. 2024;53(4):888-894.
