Association Between Triglyceride-glucose Index and Gastric Carcinogenesis: a Health Checkup Cohort Study

Overview

Journal Gastric Cancer

Specialties Gastroenterology
Oncology

Date 2021 Aug 6

PMID 34355281

Citations 19

Authors

Young Min Kim

Jie-Hyun Kim

Jong Suk Park

Su Jung Baik

Jaeyoung Chun

Young Hoon Youn

Hyojin Park

Affiliations

Soon will be listed here.

Abstract

Background: We aimed to investigate the association between the triglyceride-glucose (TyG) index and gastric carcinogenesis, including precancerous conditions such as dysplasia, atrophic gastritis, and intestinal metaplasia.

Methods: Patients who received an upper endoscopic assessment at a medical center were included. The enrolled patients were divided into four categories according to their TyG index quartile (Q). To evaluate the relationship between increase of TyG index and gastric cancer, we analyzed the patients who received a health checkup twice. Moreover, receiver-operating characteristic curve analysis was used to establish cut-off value of the TyG index for gastric cancer.

Results: Of 127,564 enrolled patients, 43,525 (34.1%) and 186 (0.1%) were diagnosed with precancerous conditions and gastric cancer, respectively. The odds ratios (ORs) of precancerous conditions given TyG index progressively increased across quartiles: using Q1 as the reference: Q2 (OR = 1.403, P < 0.001), Q3 (OR = 1.646, P < 0.001), and Q4 (OR = 1.656, P < 0.001). The ORs of gastric cancer also increased according to the quartiles: Q2 (OR = 1.619, P = 0.045), Q3 (OR = 2.180, P = 0.004), and Q4 (OR = 2.363, P = 0.001). Moreover, the increase in TyG index between baseline and follow-up tests was more significant in gastric cancer group than in control group (P = 0.001). The optimal cut-off value for predicting gastric cancer was 9.73.

Conclusions: The TyG index may be a novel predictive biomarker for gastric carcinogenesis. Notably, increase in the TyG index is significantly associated with gastric cancer.

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References

Sitarz R, Skierucha M, Mielko J, Offerhaus G, Maciejewski R, Polkowski W . Gastric cancer: epidemiology, prevention, classification, and treatment. Cancer Manag Res. 2018; 10:239-248. PMC: 5808709. DOI: 10.2147/CMAR.S149619. View

Zabaleta J . Multifactorial etiology of gastric cancer. Methods Mol Biol. 2012; 863:411-35. PMC: 3625139. DOI: 10.1007/978-1-61779-612-8_26. View

Rugge M . Gastric cancer risk: between genetics and lifestyle. Lancet Oncol. 2020; 21(10):1258-1260. DOI: 10.1016/S1470-2045(20)30432-0. View

Ishaq S, Nunn L . Helicobacter pylori and gastric cancer: a state of the art review. Gastroenterol Hepatol Bed Bench. 2015; 8(Suppl 1):S6-S14. PMC: 4495426. View

Yang H, Kang D, Chang Y, Ahn J, Ryu S, Cho J . Diabetes mellitus is associated with an increased risk of gastric cancer: a cohort study. Gastric Cancer. 2019; 23(3):382-390. DOI: 10.1007/s10120-019-01033-8. View

Jin G, Lv J, Yang M, Wang M, Zhu M, Wang T . Genetic risk, incident gastric cancer, and healthy lifestyle: a meta-analysis of genome-wide association studies and prospective cohort study. Lancet Oncol. 2020; 21(10):1378-1386. DOI: 10.1016/S1470-2045(20)30460-5. View

Rochlani Y, Pothineni N, Kovelamudi S, Mehta J . Metabolic syndrome: pathophysiology, management, and modulation by natural compounds. Ther Adv Cardiovasc Dis. 2017; 11(8):215-225. PMC: 5933580. DOI: 10.1177/1753944717711379. View

Kim Y, Kim J, Baik S, Chun J, Youn Y, Park H . Sarcopenia and Sarcopenic Obesity as Novel Risk Factors for Gastric Carcinogenesis: A Health Checkup Cohort Study. Front Oncol. 2019; 9:1249. PMC: 6868021. DOI: 10.3389/fonc.2019.01249. View

Correa P . Human gastric carcinogenesis: a multistep and multifactorial process--First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res. 1992; 52(24):6735-40. View

10.

Correa P, Piazuelo M . The gastric precancerous cascade. J Dig Dis. 2011; 13(1):2-9. PMC: 3404600. DOI: 10.1111/j.1751-2980.2011.00550.x. View

11.

Huang P . A comprehensive definition for metabolic syndrome. Dis Model Mech. 2009; 2(5-6):231-7. PMC: 2675814. DOI: 10.1242/dmm.001180. View

12.

Braun S, Bitton-Worms K, LeRoith D . The link between the metabolic syndrome and cancer. Int J Biol Sci. 2011; 7(7):1003-15. PMC: 3164150. DOI: 10.7150/ijbs.7.1003. View

13.

Shimoyama S . Diabetes mellitus carries a risk of gastric cancer: a meta-analysis. World J Gastroenterol. 2013; 19(40):6902-10. PMC: 3812492. DOI: 10.3748/wjg.v19.i40.6902. View

14.

DeFronzo R, Tobin J, Andres R . Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol. 1979; 237(3):E214-23. DOI: 10.1152/ajpendo.1979.237.3.E214. View

15.

Bergman R, Prager R, Volund A, Olefsky J . Equivalence of the insulin sensitivity index in man derived by the minimal model method and the euglycemic glucose clamp. J Clin Invest. 1987; 79(3):790-800. PMC: 424201. DOI: 10.1172/JCI112886. View

16.

Bonora E, Targher G, Alberiche M, Bonadonna R, Saggiani F, Zenere M . Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care. 2000; 23(1):57-63. DOI: 10.2337/diacare.23.1.57. View

17.

Simental-Mendia L, Rodriguez-Moran 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. View

18.

Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7):412-9. DOI: 10.1007/BF00280883. View

19.

Sanchez-Inigo L, Navarro-Gonzalez D, Fernandez-Montero A, Pastrana-Delgado J, Martinez J . The TyG index may predict the development of cardiovascular events. Eur J Clin Invest. 2015; 46(2):189-97. DOI: 10.1111/eci.12583. View

20.

Low S, Khoo K, Irwan B, Sum C, Subramaniam T, Lim S . The role of triglyceride glucose index in development of Type 2 diabetes mellitus. Diabetes Res Clin Pract. 2018; 143:43-49. DOI: 10.1016/j.diabres.2018.06.006. View