Triglyceride-glucose index levels in patients with congenital hypogonadotropic hypogonadism and the relationship with endothelial dysfunction and insulin resistance
, 1, 2, 2, 2, 2, 3, 1, 2, 2
Abstract
Introduction: The risk of cardiometabolic diseases is increased in patients with hypogonadism. The triglyceride-glucose (TyG) index is a novel surrogate marker of insulin resistance and is associated with cardiovascular diseases. We investigated the TyG index levels and the relationship with endothelial dysfunction and insulin resistance in patients with congenital hypogonadotropic hypogonadism (CHH).
Material and methods: A total of 98 patients with CHH (mean age 21.66 ± 1.99 years) and 98 healthy control subjects (mean age 21.69 ± 1.21 years) were enrolled. The demographic parameters, TyG index, asymmetric dimethylarginine (ADMA), high-sensitivity C-reactive protein (hs-CRP), and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured for all participants.
Results: The patients had higher waist circumference (p < 0.001), triglycerides (p = 0.001), insulin (p = 0.003), HOMA-IR (p = 0.002), ADMA (p < 0.001), and TyG index (p < 0.001) levels and lower HDL-C (p = 0.044) and total testosterone (p < 0.001) levels compared to healthy control subjects. TyG index levels significantly correlated with the ADMA (r = 0.31, p = 0.003) and HOMA-IR (r = 0.32, p < 0.001) levels. TyG index was also determinant of HOMA-IR levels (ß = 0.20, p = 0.018).
Conclusion: The results of the present study show that patients with CHH had increased TyG index levels. Also, the TyG index is independently associated with insulin resistance in patients with CHH. Long-term follow-up studies are warranted to find out the role of the TyG index in determining cardiometabolic risk in patients with hypogonadism.
Keywords: triglyceride-glucose indexhypogonadismADMAinsulin resistancecongenital hypogonadotropic hypogonadismcardiovascular risk
References
- Sonmez A, Haymana C, Bolu E, et al. Metabolic syndrome and the effect of testosterone treatment in young men with congenital hypogonadotropic hypogonadism. Eur J Endocrinol. 2011; 164(5): 759–764.
- Laaksonen DE, Niskanen L, Punnonen K, et al. Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men. Diabetes Care. 2004; 27(5): 1036–1041.
- Traish AM, Saad F, Feeley RJ, et al. The dark side of testosterone deficiency: III. Cardiovascular disease. J Androl. 2009; 30(5): 477–494.
- Holmboe SA, Jensen TK, Linneberg A, et al. Low Testosterone: A Risk Marker Rather Than a Risk Factor for Type 2 Diabetes. J Clin Endocrinol Metab. 2016; 101(8): 3180–3190.
- Akishita M, Hashimoto M, Ohike Y, et al. Low testosterone level is an independent determinant of endothelial dysfunction in men. Hypertens Res. 2007; 30(11): 1029–1034.
- Laaksonen DE, Niskanen L, Punnonen K, et al. Sex hormones, inflammation and the metabolic syndrome: a population-based study. Eur J Endocrinol. 2003; 149(6): 601–608.
- Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008; 6(4): 299–304.
- Vasques AC, Novaes FS, de Oliveira Md, et al. TyG index performs better than HOMA in a Brazilian population: a hyperglycemic clamp validated study. Diabetes Res Clin Pract. 2011; 93(3): e98–e9e100.
- Guerrero-Romero F, Villalobos-Molina R, Jiménez-Flores JR, et al. Fasting Triglycerides and Glucose Index as a Diagnostic Test for Insulin Resistance in Young Adults. Arch Med Res. 2016; 47(5): 382–387.
- Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010; 95(7): 3347–3351.
- Zhang M, Wang B, Liu Yu, et al. Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study. Cardiovasc Diabetol. 2017; 16(1): 30.
- Jian S, Su-Mei N, Xue C, et al. Association and interaction between triglyceride-glucose index and obesity on risk of hypertension in middle-aged and elderly adults. Clin Exp Hypertens. 2017; 39(8): 732–739.
- Zhang S, Du T, Zhang J, et al. The triglyceride and glucose index (TyG) is an effective biomarker to identify nonalcoholic fatty liver disease. Lipids Health Dis. 2017; 16(1): 15.
- Sánchez-Íñigo L, Navarro-González D, Fernández-Montero A, et al. The TyG index may predict the development of cardiovascular events. Eur J Clin Invest. 2016; 46(2): 189–197.
- Sonmez A, Haymana C, Aydogdu A, et al. Endothelial dysfunction, insulin resistance and inflammation in congenital hypogonadism, and the effect of testosterone replacement. Endocr J. 2015; 62(7): 605–613.
- Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972; 18(6): 499–502.
- Kupelian V, Page ST, Araujo AB, et al. Low sex hormone-binding globulin, total testosterone, and symptomatic androgen deficiency are associated with development of the metabolic syndrome in nonobese men. J Clin Endocrinol Metab. 2006; 91(3): 843–850.
- Cattabiani C, Basaria S, Ceda GP, et al. Relationship between testosterone deficiency and cardiovascular risk and mortality in adult men. J Endocrinol Invest. 2012; 35(1): 104–120.
- Akishita M, Hashimoto M, Ohike Y, et al. Low testosterone level is an independent determinant of endothelial dysfunction in men. Hypertens Res. 2007; 30(11): 1029–1034.
- Dandona P, Dhindsa S, Chandel A, et al. Hypogonadotropic hypogonadism in men with type 2 diabetes. Postgrad Med. 2009; 121(3): 45–51.
- Böger RH, Maas R, Schulze F, et al. Asymmetric dimethylarginine (ADMA) as a prospective marker of cardiovascular disease and mortality--an update on patient populations with a wide range of cardiovascular risk. Pharmacol Res. 2009; 60(6): 481–487.
- Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7): 412–419.
- Meric C, Sonmez A, Aydogdu A, et al. Osteoprotegerin, fibroblast growth factor 23, and vitamin D3 levels in male patients with hypogonadism. Horm Metab Res. 2014; 46(13): 955–958.
- Zheng R, Mao Y. Triglyceride and glucose (TyG) index as a predictor of incident hypertension: a 9-year longitudinal population-based study. Lipids Health Dis. 2017; 16(1): 175.
- Zhang K, Chen Yi, Liu L, et al. The Triglycerides and Glucose Index rather than HOMA-IR is more associated with Hypogonadism in Chinese men. Sci Rep. 2017; 7(1): 15874.
