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Evaluation of the relationship between mitral annular calcification and triglyceride-glucose index

Year 2023, Volume: 6 Issue: 5, 1114 - 1118, 28.09.2023
https://doi.org/10.32322/jhsm.1345325

Abstract

Aims: Mitral annular calcification (MAC) is an echocardiographic condition with a multicomponent etiopathogenesis, one of which is insulin resistance. Triglyceride-glucose (TyG) index is an excellent biochemical parameter that has proven itself in determining insulin resistance in recent years. This study aims to reveal the relationship between the TyG index and the presence of MAC.
Methods: The study included 159 patients with MAC and 167 control group. The control group has similar demographic characteristics such as age, gender, presence of hypertension (HT), and diabetes mellitus with the MAC group. TyG index was calculated as a formula: ln[fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2].
Results: The mean age of the patients was 74.2 and 48.2% of the patients were male. Coronary artery disease (CAD) (p: 0.031), glucose (p:0.001), total cholesterol (p:0.009), low-density lipoprotein (LDL) (p:0.004), triglyceride (TG) (p <0.001) levels and TyG index (p <0.001) were higher in MAC group. In the multivariate regression analysis, TG (p:0.004) and TyG index (p<0.001) were found to be independent risk factors. As a result of the ROC analysis, the cut-off value for estimating MAC was found to be 8.81 [(sensitivity: 77.3%, specificity: 76.5%, AUC (95% CI) 0.756 (0.704-0.807) p<0.001)].
Conclusion: In this study, a high TyG index was found to be an independent risk factor for MAC. The TyG index was found to be a better biomarker than TG and glucose alone in predicting MAC. Further extensive studies are necessary to determine the importance and use of TyG in MAC.

References

  • Fox E, Harkins D, Taylor H, et al. Epidemiology of mitral annular calcification and its predictive value for coronary events in African Americans: the Jackson Cohort of the Atherosclerotic Risk in Communities Study. Am Heart J. 2004;148(6):979-984. doi:10.1016/j.ahj.2004.05.048
  • Massera D, Kizer JR, Dweck MR. Mechanisms of mitral annular calcification. Trends Cardiovasc Med. 2020;30(5):289-295. doi:10.1016/j.tcm.2019.07.011
  • Fox CS, Guo CY, Larson MG, et al. Relations of inflammation and novel risk factors to valvular calcification. Am J Cardiol. 2006;97(10):1502-1505. doi:10.1016/j.amjcard.2005.11.086
  • Silbiger JJ. Anatomy, mechanics, and pathophysiology of the mitral annulus. Am Heart J. 2012;164(2):163-176. doi:10.1016/j.ahj.2012.05.014
  • Tsutsui RS, Banerjee K, Thomas JD, Kapadia S, Popovic Z. Predictors of mitral annular calcification progression. Circulation. 2017;136:A17614-A.
  • Grigorescu ED, Lăcătușu CM, Floria M, et al. Association of inflammatory and metabolic biomarkers with mitral annular calcification in type 2 diabetes patients. J Pers Med. 2022;12(9):1484. doi:10.3390/jpm12091484
  • Eleid MF, Foley TA, Said SM, Pislaru SV, Rihal CS. Severe mitral annular calcification: multimodality imaging for therapeutic strategies and interventions. JACC Cardiovasc Imaging. 2016;9(11):1318-1337. doi:10.1016/j.jcmg.2016.09.001
  • Higgins J, Mayo J, Skarsgard P. Cardiac computed tomography facilitates operative planning in patients with mitral calcification. Ann Thorac Surg. 2013;95(1):e9-e11. doi:10.1016/j.athoracsur.2012.07.059
  • Kanjanauthai S, Nasir K, Katz R, et al. Relationships of mitral annular calcification to cardiovascular risk factors: the Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis. 2010;213(2):558-562. doi:10.1016/j.atherosclerosis.2010.08.072
  • Fox CS, Vasan RS, Parise H, et al. Mitral annular calcification predicts cardiovascular morbidity and mortality: the Framingham Heart Study. Circulation. 2003;107(11):1492-1496. doi:10.1161/01.cir.0000058168.26163.bc
  • Barasch E, Gottdiener JS, Marino Larsen EK, Chaves PH, Newman AB. Cardiovascular morbidity and mortality in community-dwelling elderly individuals with calcification of the fibrous skeleton of the base of the heart and aortosclerosis (The Cardiovascular Health Study). Am J Cardiol. 2006;97(9):1281-1286. doi:10.1016/j.amjcard.2005.11.065
  • Völzke H, Haring R, Lorbeer R, et al. Heart valve sclerosis predicts all-cause and cardiovascular mortality. Atherosclerosis. 2010;209(2):606-610. doi:10.1016/j.atherosclerosis.2009.10.030
  • Thanassoulis G, Campbell CY, Owens DS, et al. Genetic associations with valvular calcification and aortic stenosis. N Engl J Med. 2013;368(6):503-512. doi:10.1056/NEJMoa1109034
  • Bortnick AE, Xu S, Kim RS, et al. Biomarkers of mineral metabolism and progression of aortic valve and mitral annular calcification: The Multi-Ethnic Study of Atherosclerosis. Atherosclerosis. 2019;285:79-86. doi:10.1016/j.atherosclerosis.2019.04.215
  • Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988;37(12):1595-1607. doi:10.2337/diab.37.12.1595
  • Tison GH, Blaha MJ, Budoff MJ, et al. The relationship of insulin resistance and extracoronary calcification in the multi-ethnic study of atherosclerosis. Atherosclerosis. 2011;218(2):507-510. doi:10.1016/j.atherosclerosis.2011.06.047
  • 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. doi:10.1089/met.2008.0034
  • Li S, Guo B, Chen H, et al. The role of the triglyceride (triacylglycerol) glucose index in the development of cardiovascular events: a retrospective cohort analysis. Sci Rep. 2019;9(1):7320. doi:10.1038/s41598-019-43776-5
  • Won KB, Park EJ, Han D, et al. Triglyceride glucose index is an independent predictor for the progression of coronary artery calcification in the absence of heavy coronary artery calcification at baseline. Cardiovasc Diabetol. 2020;19(1):34. doi:10.1186/s12933-020-01008-5
  • Xiong S, Chen Q, Long Y, et al. Association of the triglyceride-glucose index with coronary artery disease complexity in patients with acute coronary syndrome. Cardiovasc Diabetol. 2023;22(1):56. doi:10.1186/s12933-023-01780-0
  • 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. doi:10.1210/jc.2010-0288
  • Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14. doi:10.1016/j.echo.2014.10.003
  • Rossi A, Targher G, Zoppini G, et al. Aortic and mitral annular calcifications are predictive of all-cause and cardiovascular mortality in patients with type 2 diabetes. Diabetes Care. 2012;35(8):1781-1786. doi:10.2337/dc12-0134
  • Adler Y, Fink N, Spector D, Wiser I, Sagie A. Mitral annulus calcification--a window to diffuse atherosclerosis of the vascular system. Atherosclerosis. 2001;155(1):1-8. doi:10.1016/s0021-9150(00)00737-1
  • Elmariah S, Budoff MJ, Delaney JA, et al. Risk factors associated with the incidence and progression of mitral annulus calcification: the multi-ethnic study of atherosclerosis. Am Heart J. 2013;166(5):904-912. doi:10.1016/j.ahj.2013.08.015
  • Kurtoğlu E, Korkmaz H, Aktürk E, Yılmaz M, Altaş Y, Uçkan A. Association of mitral annulus calcification with high-sensitivity C-reactive protein, which is a marker of inflammation. Mediators Inflamm. 2012;2012:606207. doi:10.1155/2012/606207
  • Singh B, Saxena A. Surrogate markers of insulin resistance: A review. World J Diabetes. 2010;1(2):36-47. doi:10.4239/wjd.v1.i2.36
  • Sánchez-García A, Rodríguez-Gutiérrez R, Mancillas-Adame L, et al. Diagnostic accuracy of the triglyceride and glucose index for insulin resistance: a systematic review. Int J Endocrinol. 2020;2020:4678526. doi:10.1155/2020/4678526
Year 2023, Volume: 6 Issue: 5, 1114 - 1118, 28.09.2023
https://doi.org/10.32322/jhsm.1345325

Abstract

References

  • Fox E, Harkins D, Taylor H, et al. Epidemiology of mitral annular calcification and its predictive value for coronary events in African Americans: the Jackson Cohort of the Atherosclerotic Risk in Communities Study. Am Heart J. 2004;148(6):979-984. doi:10.1016/j.ahj.2004.05.048
  • Massera D, Kizer JR, Dweck MR. Mechanisms of mitral annular calcification. Trends Cardiovasc Med. 2020;30(5):289-295. doi:10.1016/j.tcm.2019.07.011
  • Fox CS, Guo CY, Larson MG, et al. Relations of inflammation and novel risk factors to valvular calcification. Am J Cardiol. 2006;97(10):1502-1505. doi:10.1016/j.amjcard.2005.11.086
  • Silbiger JJ. Anatomy, mechanics, and pathophysiology of the mitral annulus. Am Heart J. 2012;164(2):163-176. doi:10.1016/j.ahj.2012.05.014
  • Tsutsui RS, Banerjee K, Thomas JD, Kapadia S, Popovic Z. Predictors of mitral annular calcification progression. Circulation. 2017;136:A17614-A.
  • Grigorescu ED, Lăcătușu CM, Floria M, et al. Association of inflammatory and metabolic biomarkers with mitral annular calcification in type 2 diabetes patients. J Pers Med. 2022;12(9):1484. doi:10.3390/jpm12091484
  • Eleid MF, Foley TA, Said SM, Pislaru SV, Rihal CS. Severe mitral annular calcification: multimodality imaging for therapeutic strategies and interventions. JACC Cardiovasc Imaging. 2016;9(11):1318-1337. doi:10.1016/j.jcmg.2016.09.001
  • Higgins J, Mayo J, Skarsgard P. Cardiac computed tomography facilitates operative planning in patients with mitral calcification. Ann Thorac Surg. 2013;95(1):e9-e11. doi:10.1016/j.athoracsur.2012.07.059
  • Kanjanauthai S, Nasir K, Katz R, et al. Relationships of mitral annular calcification to cardiovascular risk factors: the Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis. 2010;213(2):558-562. doi:10.1016/j.atherosclerosis.2010.08.072
  • Fox CS, Vasan RS, Parise H, et al. Mitral annular calcification predicts cardiovascular morbidity and mortality: the Framingham Heart Study. Circulation. 2003;107(11):1492-1496. doi:10.1161/01.cir.0000058168.26163.bc
  • Barasch E, Gottdiener JS, Marino Larsen EK, Chaves PH, Newman AB. Cardiovascular morbidity and mortality in community-dwelling elderly individuals with calcification of the fibrous skeleton of the base of the heart and aortosclerosis (The Cardiovascular Health Study). Am J Cardiol. 2006;97(9):1281-1286. doi:10.1016/j.amjcard.2005.11.065
  • Völzke H, Haring R, Lorbeer R, et al. Heart valve sclerosis predicts all-cause and cardiovascular mortality. Atherosclerosis. 2010;209(2):606-610. doi:10.1016/j.atherosclerosis.2009.10.030
  • Thanassoulis G, Campbell CY, Owens DS, et al. Genetic associations with valvular calcification and aortic stenosis. N Engl J Med. 2013;368(6):503-512. doi:10.1056/NEJMoa1109034
  • Bortnick AE, Xu S, Kim RS, et al. Biomarkers of mineral metabolism and progression of aortic valve and mitral annular calcification: The Multi-Ethnic Study of Atherosclerosis. Atherosclerosis. 2019;285:79-86. doi:10.1016/j.atherosclerosis.2019.04.215
  • Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988;37(12):1595-1607. doi:10.2337/diab.37.12.1595
  • Tison GH, Blaha MJ, Budoff MJ, et al. The relationship of insulin resistance and extracoronary calcification in the multi-ethnic study of atherosclerosis. Atherosclerosis. 2011;218(2):507-510. doi:10.1016/j.atherosclerosis.2011.06.047
  • 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. doi:10.1089/met.2008.0034
  • Li S, Guo B, Chen H, et al. The role of the triglyceride (triacylglycerol) glucose index in the development of cardiovascular events: a retrospective cohort analysis. Sci Rep. 2019;9(1):7320. doi:10.1038/s41598-019-43776-5
  • Won KB, Park EJ, Han D, et al. Triglyceride glucose index is an independent predictor for the progression of coronary artery calcification in the absence of heavy coronary artery calcification at baseline. Cardiovasc Diabetol. 2020;19(1):34. doi:10.1186/s12933-020-01008-5
  • Xiong S, Chen Q, Long Y, et al. Association of the triglyceride-glucose index with coronary artery disease complexity in patients with acute coronary syndrome. Cardiovasc Diabetol. 2023;22(1):56. doi:10.1186/s12933-023-01780-0
  • 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. doi:10.1210/jc.2010-0288
  • Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14. doi:10.1016/j.echo.2014.10.003
  • Rossi A, Targher G, Zoppini G, et al. Aortic and mitral annular calcifications are predictive of all-cause and cardiovascular mortality in patients with type 2 diabetes. Diabetes Care. 2012;35(8):1781-1786. doi:10.2337/dc12-0134
  • Adler Y, Fink N, Spector D, Wiser I, Sagie A. Mitral annulus calcification--a window to diffuse atherosclerosis of the vascular system. Atherosclerosis. 2001;155(1):1-8. doi:10.1016/s0021-9150(00)00737-1
  • Elmariah S, Budoff MJ, Delaney JA, et al. Risk factors associated with the incidence and progression of mitral annulus calcification: the multi-ethnic study of atherosclerosis. Am Heart J. 2013;166(5):904-912. doi:10.1016/j.ahj.2013.08.015
  • Kurtoğlu E, Korkmaz H, Aktürk E, Yılmaz M, Altaş Y, Uçkan A. Association of mitral annulus calcification with high-sensitivity C-reactive protein, which is a marker of inflammation. Mediators Inflamm. 2012;2012:606207. doi:10.1155/2012/606207
  • Singh B, Saxena A. Surrogate markers of insulin resistance: A review. World J Diabetes. 2010;1(2):36-47. doi:10.4239/wjd.v1.i2.36
  • Sánchez-García A, Rodríguez-Gutiérrez R, Mancillas-Adame L, et al. Diagnostic accuracy of the triglyceride and glucose index for insulin resistance: a systematic review. Int J Endocrinol. 2020;2020:4678526. doi:10.1155/2020/4678526
There are 28 citations in total.

Details

Primary Language English
Subjects Cardiology
Journal Section Original Article
Authors

Gökhan Gökalp 0000-0002-4958-7266

Nail Burak Özbeyaz 0000-0002-7132-4286

Murat Oguz Özilhan 0000-0003-4801-966X

Early Pub Date September 26, 2023
Publication Date September 28, 2023
Published in Issue Year 2023 Volume: 6 Issue: 5

Cite

AMA Gökalp G, Özbeyaz NB, Özilhan MO. Evaluation of the relationship between mitral annular calcification and triglyceride-glucose index. J Health Sci Med / JHSM. September 2023;6(5):1114-1118. doi:10.32322/jhsm.1345325

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