Metabolic Syndrome and Insulin Resistance in Romania

Abstract

Metabolic syndrome (MetS) represents a huge burden on the health system. This study aimed to investigate the association between MetS and certain indirect insulin resistance (IR) indicators according to gender. The triglyceride-glucose index (TyG), TyG-body mass index (TyG-BMI), the TyG-waist-to-height ratio (TyG-WHtR), TyG-waist circumference (TyG-WC), the triglyceride to high-density-lipoprotein cholesterol index (TG/HDL-c) and recently proposed indicators such as the metabolic score for IR (MetS-IR), TyG-neck circumference (TyG-NC) and the TyG-neck-circumference-to-height ratio (TyG-NHtR) were evaluated in 2594 subjects enrolled in the PREDATORR study. Univariate and multivariate logistic regression was performed to identify the association between MetS and the indirect IR indicators, as well as the risk factors. The participants were divided into two groups, according to gender. Data were analyzed using SPSS version 26.0. TyG, TyG-WC, TyG-NC, TyG-NHtR and TG/HDL-c had higher values in the male group, while TyG-BMI, TyG-WHtR and MetS-IR had approximately equal values in the two studied groups, but also statistically significantly higher values in MetS (+) vs. MetS (-) subjects (p < 0.001). For both studied groups, the multivariate logistic regression analysis demonstrated that TyG and MetS-IR were independent predictors for MetS. Both in the female and in the male group, TyG had the largest area under the receiver operating characteristic (AUROC) curve. Thus, in females, the TyG AUROC curve was 0.890; 95% CI 0.873-0.907; p < 0.001; cut-off value 8.51, with 81.4% sensitivity and 80.0% specificity. In males, the TyG AUROC curve was 0.880; 95% CI 0.861-0.899; p < 0.001; cut-off value 8.69, with 78.5% sensitivity and 84.6% specificity. All of the analyzed indirect IR indicators had statistically significantly higher values in MetS (+) vs. MetS (-) subjects. TyG and MetS-IR are independent predictive factors for MetS, regardless of the subject's gender.

Keywords: PREDATORR study; Romania; insulin resistance; metabolic syndrome.

Figure 1

The ROC curve analysis for the indirect IR indicators in females. ROC: receiver operating characteristic; TyG: triglyceride–glucose; TyG–BMI: TyG–body mass index; TyG–WC: TyG–waist circumference; TyG–WHtR: TyG–waist-to-height ratio; TyG–NC: TyG-neck circumference; TyG–NHtR: TyG-neck-circumference-to-height ratio; TG/HDL-c: triglyceride to high-density-lipoprotein cholesterol; MetS-IR: metabolic score for insulin resistance.

Figure 2

The ROC curve analysis for the indirect IR indicators in males. ROC: receiver operating characteristic; TyG: triglyceride–glucose; TyG–BMI: TyG–body mass index; TyG–WC: TyG–waist circumference; TyG–WHtR: TyG–waist-to-height ratio; TyG–NC: TyG-neck circumference; TyG–NHtR: TyG-neck-circumference-to-height ratio; TG/HDL-c: triglyceride to high-density-lipoprotein cholesterol; MetS-IR: metabolic score for insulin resistance.

Figure 3

The ROC curve analysis for HOMA-IR in the female group and the male group. ROC: receiver operating characteristic; HOMA-IR: homeostatic model assessment for IR. Blue line: AUROC values; Red line: Reference line.