Insulin resistance mediates obesity-related risk of cardiovascular disease: a prospective cohort study

Cardiovascular Diabetology

Research

Shouling Wu¹  Shuohua Chen¹  Yanxia Luo²  Penglian Wang³  Qin Xu⁴  Anxin Wang⁴  Yijun Zhang⁵  Xue Tian⁵ 

[1] Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, 57 Xinhua East Road, 063000, Tangshan, China;Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China;Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China;Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Beijing Tiantan Hospital, China National Clinical Research Center for Neurological Diseases, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, 100070, Beijing, China;Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Beijing Tiantan Hospital, China National Clinical Research Center for Neurological Diseases, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, 100070, Beijing, China;Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China;Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Beijing Tiantan Hospital, China National Clinical Research Center for Neurological Diseases, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, 100070, Beijing, China;Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China;Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China;

关键词: General obesity;    Central obesity;    Insulin resistance;    The triglyceride-glucose index;    Cardiovascular disease;    Mediation analysis;   

DOI  :  10.1186/s12933-022-01729-9

 received in 2022-11-09, accepted in 2022-12-16,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThe mechanisms linking obesity to cardiovascular disease (CVD) are still not clearly defined. Individuals who are overweight or obese often develop insulin resistance, mediation of the association between obesity and CVD through the insulin resistance seems plausible and has not been investigated. This study aimed to evaluate whether and to what extend the effect of general and central obesity on cardiovascular disease (CVD) is mediated by insulin resistance.MethodsA total of 94,136 participants without CVD at baseline were recruited from the Kailuan study. Insulin resistance was evaluated by the triglyceride-glucose (TyG) index, calculating as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Mediation analysis using a new 2-stage regression method for survival data proposed by Valeri and VanderWeele was to explore the mediating effects of the TyG index on the association between obesity and CVD.ResultsDuring a median follow-up of 13.01 years, we identified 7327 cases of CVD. Mediation analyses showed that 47.81% of the total association (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.12–1.24) between overweight and CVD was mediated through the TyG index (HR [indirect association], 1.07; 95% CI, 1.07–1.09), and the proportion mediated was 37.94% for general obesity. For central obesity, analysis by waist circumference, waist/hip, and waist/height categories yielded an attenuated proportion mediated of 32.01, 35.02, and 31.06% for obesity, taken normal weight as reference.ConclusionsThe association between obesity and CVD was mediated by TyG index, suggesting proper control of insulin resistance can be effective to reduce the effects of obesity on CVD.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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Fig. 1