The triglyceride glucose (TyG) index is an inexpensive clinical surrogate marker for insulin resistance. However, the relationship between TyG index and atherosclerotic cardiovascular disease (CVD) ...remains unclear. We evaluated the relationship between TyG index and CVD using a large-scale population dataset from the National Health Information Database (NHID).
We performed a retrospective observational cohort study of 5,593,134 persons older than 40 years from 2009 to 2017 using the NHID. We divided the participants into TyG index quartiles. Outcome variables were stroke, myocardial infarction, and both. The incidence of outcomes was estimated for each TyG quartile over the total follow-up period. All outcomes were analyzed by Cox proportional hazards regression analysis while controlling for baseline covariates.
During 8.2 years of mean follow-up, stroke was diagnosed in 89,120 (1.59%), MI in 62,577 (1.12%), and both stroke and MI in 146,744 (2.62%) participants. Multivariate-adjusted hazard ratios (HRs) for patients in the highest TyG index quartile demonstrated that these patients were at higher risk for stroke (HR = 1.259; 95% confidence interval CI 1.233-1.286), for MI (HR = 1.313; 95% CI 1.28-1.346), and for both (HR = 1.282; 95% CI 1.261-1.303) compared with participants in the lowest TyG index quartile. These effects were independent of age, sex, smoking, alcohol consumption, physical activity, body mass index, systolic blood pressure, and total cholesterol.
In our large population study, TyG index, a simple measure reflecting insulin resistance, was potentially useful in the early identification of individuals at high risk of experiencing a cardiovascular event.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
High‐energy and long cycle lithium–sulfur (Li–S) pouch cells are limited by the insufficient capacities and stabilities of their cathodes under practical electrolyte/sulfur (E/S), ...electrolyte/capacity (E/C), and negative/positive (N/P) ratios. Herein, an advanced cathode comprising highly active Fe single‐atom catalysts (SACs) is reported to form 320.2 W h kg−1 multistacked Li–S pouch cells with total capacity of ≈1 A h level, satisfying low E/S (3.0), E/C (2.8), and N/P (2.3) ratios and high sulfur loadings (8.4 mg cm−2). The high‐activity Fe SAC is designed by manipulating its local environments using electron‐exchangeable binding (EEB) sites. Introducing EEB sites comprising two different types of S species, namely, thiophene‐like‐S (–S) and oxidized‐S (–SO2), adjacent to Fe SACs promotes the kinetics of the Li2S redox reaction by providing additional binding sites and modulating the Fe d‐orbital levels via electron exchange with Fe. The –S donates the electrons to the Fe SACs, whereas –SO2 withdraws electrons from the Fe SACs. Thus, the Fe d‐orbital energy level can be modulated by the different –SO2/–S ratios of the EEB site, controlling the electron donating/withdrawing characteristics. This desirable electrocatalysis is maximized by the intimate contact of the Fe SACs with the S species, which are confined together in porous carbon.
The introduction of electron exchangeable binding sites comprising thiophene S and oxidized S, adjacent to Fe single atom electrocatalysts, improves Li2S redox kinetics by modulating d‐orbital level of Fe single atom via electron exchange. These specially designed electrocatalysts enable realization of a 1 A h level Li–S pouch cell with high gravimetric energy density and long cycle stability.
Insulin resistance is suggested to have negative effects on cognition; however, results from large population studies are lacking. In this study, the potential relationships between the triglyceride ...glucose (TyG) index, a simple surrogate marker of insulin resistance, and dementia were evaluated using a large-scale population dataset.
This was a retrospective, observational, cohort study using data from the National Health Information Database from 2009 to 2015 and included 5,586,048 participants 40 years age or older. The TyG index was used as a measure of insulin resistance, and participants were divided into quartiles based on TyG index. The incidence of dementia was assessed using hazard ratios (HRs) estimated with Cox proportional hazard modeling.
During a median follow-up of 7.21 years, dementia was diagnosed in 142,714 (2.55%) participants. Alzheimer's disease (AD) and vascular dementia (VD) were diagnosed in 74.3% and 12.5% of the participants. Multivariate-adjusted HRs for patients in the TyG index 4th quartile were higher for dementia (HRs = 1.14; 95% confidence interval CI 1.12-1.16), AD (HRs = 1.12; 95% CI 1.09-1.14), and VD (HRs = 1.18; 95% CI 1.12-1.23) compared with the 1st quartile of TyG index; however, this had a small effect size (Cohen's d = 0.10, 0.08, and 0.13, respectively). These effects were independent of age, sex, smoking status, physical activity, body mass index, systolic blood pressure, and total cholesterol.
In this large population study, TyG index was associated with an increased risk of dementia, including AD and VD, that was independent of traditional cardiovascular risk factors, although the effect size of the TyG index was small.
The Triglyceride Glucose Index (TyG index) is considered a surrogate marker of insulin resistance. The aim of this study is to investigate whether the TyG index has a predictive role in identifying ...individuals with a high risk of incident diabetes and to compare it with other indicators of metabolic health. A total 2900 non-diabetic adults who attended five consecutive annual health check-ups at Kangbuk Samsung Hospital was divided into four subgroups using three methods: (1) baseline TyG index; (2) obesity status (body mass index ≥25 kg/m2) and cutoff value of TyG index; (3) obesity status and metabolic health, defined as having fewer than two of the five components of high blood pressure, fasting blood glucose, triglyceride, low high-density lipoprotein cholesterol, and highest decile of homeostasis model assessment-insulin resistance. The development of diabetes was assessed annually using self-questionnaire, fasting glucose, and glycated hemoglobin. We compared the risk of incident diabetes using multivariate Cox analysis. During 11623 person-years there were 101 case of incident diabetes. Subjects with high TyG index had a high risk of diabetes. For TyG index quartiles, hazard ratios (HRs) of quartiles 3 and 4 were 4.06 (p = 0.033) and 5.65 (p = 0.006) respectively. When the subjects were divided by obesity status and cutoff value of TyG index of 8.8, the subgroups with TyG index ≥ 8.8 regardless of obesity had a significantly high risk for diabetes (HR 2.40 p = 0.024 and 2.25 p = 0.048). For obesity status and metabolic health, the two metabolically unhealthy subgroups regardless of obesity had a significantly high risk for diabetes (HRs 2.54 p = 0.024 and 2.73 p = 0.021). In conclusion, the TyG index measured at a single time point may be an indicator of the risk for incident diabetes. The predictive value of the TyG index was comparable to that of metabolic health.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
AbstractObjectiveTo investigate the risk of non-alcoholic fatty liver disease (NAFLD) for cardiovascular disease and all cause death in patients with type 2 diabetes mellitus (T2DM).DesignNationwide ...population based study.SettingLongitudinal cohort study in Korea.Participants7 796 763 participants in the National Health Screening Programme in 2009 were divided into three groups based on NAFLD status: no NAFLD (fatty liver index<30); grade 1 NAFLD (30≤fatty liver index<60); and grade 2 NAFLD (fatty liver index≥60). Median follow-up was 8.13 years.Main outcome measuresThe primary outcome was incident cardiovascular disease (myocardial infarction, ischaemic stroke) or all cause death.ResultsOf 7 796 763 participants, 6.49% (n=505 763) had T2DM. More patients with T2DM had grade 1 NAFLD (34.06%) and grade 2 NAFLD (26.73%) than those without T2DM (grade 1 NAFLD: 21.20%; grade 2 NAFLD: 10.02%). The incidence rate (per 1000 person years) of cardiovascular disease and all cause death increased in the order of no NAFLD, grade 1 NAFLD, and grade 2 NAFLD, and the incidence rates in patients with T2DM were higher than those in patients without T2DM. The five year absolute risk for cardiovascular disease and all cause death increased in the order of no NAFLD, grade 1 NAFLD, and grade 2 NAFLD in patients without and with T2DM (no NAFLD, without T2DM: 1.03, 95% confidence interval 1.02 to 1.04, and 1.25, 1.24 to 1.26, respectively; grade 1 NAFLD, without T2DM: 1.23, 1.22 to 1.25, and 1.50, 1.48 to 1.51, respectively; grade 2 NAFLD, without T2DM: 1.42, 1.40 to 1.45, and 2.09, 2.06 to 2.12, respectively; no NAFLD, with T2DM: 3.34, 3.27 to 3.41, and 3.68, 3.61 to 3.74, respectively; grade 1 NAFLD, with T2DM: 3.94, 3.87 to 4.02, and 4.25, 4.18 to 4.33, respectively; grade 2 NAFLD, with T2DM: 4.66, 4.54 to 4.78, and 5.91, 5.78 to 6.05, respectively). Patients with T2DM and without NAFLD had a higher five year absolute risk for cardiovascular disease and all cause death than those without T2DM and with grade 2 NAFLD. Risk differences for cardiovascular disease and all cause death between no NAFLD and grade 1 or grade 2 NAFLD were higher in patients with T2DM than in those without T2DM.ConclusionsNAFLD in patients with T2DM seems to be associated with a higher risk of cardiovascular disease and all cause death, even in patients with mild NAFLD. Risk differences for cardiovascular disease and all cause death between the no NAFLD group and the grade 1 or grade 2 NAFLD groups were higher in patients with T2DM than in those without T2DM.
The phase composition of self-healing products generated in cracks affects self-healing performance. This study investigated the self-healing products of cementitious materials using supplementary ...cementitious materials (SCMs), a calcium sulfoaluminate (CSA) expansion agent, and crystalline additives (CAs). Ground-granulated blast-furnace slag (GGBFS), fly ash (FA), and silica fume (SF) were used as SCMs, and anhydrite, Na2SO4, Na2CO3, and MgCO3 were used as crystalline additives (CAs). An artificial crack method was used to collect the self-healing products in the crack of the paste. The phase composition of the self-healing products was analyzed through X-ray diffraction (XRD)/Rietveld refinements and thermogravimetry/differential thermogravimetry (TG/DTG) analysis, and their morphology and ion concentration were examined through scanning electron microscopy with energy dispersive spectroscopy (SEM–EDS). From the results, the main compound of self-healing products was found to be calcite. GGBFS and FA decreased the content of portlandite, and the use of CAs led to the formation of alkali sulfate and alkali carbonate. The SEM–EDS analysis results showed that when GGBFS and FA were used, a large proportion of the self-healing products contained C-S-H and C-A-H, and the use of CSA led to the formation of monosulfate and ettringite.
Insulin resistance in insulin target tissues including liver, skeletal muscle and adipose tissue is an early step in the progression towards type 2 diabetes. Accurate diagnostic parameters reflective ...of insulin resistance are essential. Longstanding tests for fasting blood glucose and HbA1c are useful and although the hyperinsulinemic euglycemic clamp remains a "gold standard" for accurately determining insulin resistance, it cannot be implemented on a routine basis. The study of adipokines, and more recently myokines and hepatokines, as potential biomarkers for insulin sensitivity is now an attractive and relatively straightforward approach. This review discusses potential biomarkers including adiponectin, RBP4, chemerin, A-FABP, FGF21, fetuin-A, myostatin, IL-6, and irisin, all of which may play significant roles in determining insulin sensitivity. We also review potential future directions of new biological markers for measuring insulin resistance, including metabolomics and gut microbiome. Collectively, these approaches will provide clinicians with the tools for more accurate, and perhaps personalized, diagnosis of insulin resistance.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
8.
A Class of Quasi-Switched Boost Inverters Nguyen, Minh-Khai; Le, Tuan-Vu; Park, Sung-Jun ...
IEEE transactions on industrial electronics (1982),
03/2015, Letnik:
62, Številka:
3
Journal Article
Recenzirano
A switched boost inverter (SBI) can replace a Z-source inverter (ZSI) in low-power applications because it has one less LC pair than the ZSI. This paper presents a class of quasi-SBIs (qSBIs) that ...offers several advantages when compared with a conventional SBI, including reducing the voltage stress on the capacitor, increasing the boost voltage factor, and improving input current profiles. Operating principles, steady-state analysis, and comparisons with conventional inverters are presented. A prototype based on a TMS320F28335 digital signal processor is built to verify the operating principle of the proposed qSBIs.
Aim
To evaluate the efficacy of intermittent short‐term use of a real‐time continuous glucose monitoring (RT‐CGM) system in non‐insulin–treated patients with type 2 diabetes (T2D) uncontrolled with ...oral antidiabetic drugs (OADs).
Materials and Methods
In this multicentre, randomized prospective study, 61 participants were randomly assigned to treatment group 1 (one session of RT‐CGM), treatment group 2 (two sessions of RT‐CGM with a 3‐month interval between sessions) and a control group. All participants used blinded continuous glucose monitoring for up to 6 days with education before randomization, and RT‐CGM was additionally applied for 1 week in the intervention groups. The primary outcome was change in HbA1c at 6 months.
Results
Among 61 participants, 48 subjects completed the study (baseline HbA1c 8.2% ± 0.5%). At 3 months, a significant HbA1c reduction was observed in treatment group 1 (adjusted difference = −0.60%, P = .044) and treatment group 2 (adjusted difference = −0.64%, P = .014) compared with the control group. However, at 6 months, only treatment group 2 achieved a significant HbA1c reduction (adjusted difference = −0.68%, P = .018). Especially in the treatment groups, patients performing self‐monitoring of blood glucose (SMBG) at least 1.5 times/day showed a significant HbA1c improvement, at both 3 and 6 months, but those performing SMBG less than 1.5 times/day showed no significant improvement.
Conclusions
In non‐insulin–treated patients with T2D uncontrolled with OADs, intermittent short‐term use of RT‐CGM was an effective method for glucose control, especially in those performing SMBG frequently.
The properties of a single-phase quasi Z-source inverter (qZSI) and a single-phase quasi-switched boost inverter (qSBI), both of which are single-stage buck-boost inverters, are investigated and ...compared. For the same operating conditions, qSBI has the following advantages over qZSI: 1) Three capacitors are saved; 2) the current rating on both of its switches and diodes is lower; 3) its boost factor is higher with an equivalent parasitic effect; and 4) its efficiency is higher. However, qSBI has one more active switch and one more diode than Z-source/ qZSIs. In addition, the capacitor voltage stress of qSBI is higher than that of qZSI. The dc and ac component circuit analysis, impedance design with low-frequency and high-frequency ripples, component stresses, and power loss calculation are presented. A prototype based on a TMS320F28335 DSP is built in order to compare the operating principle of qSBI and qZSI.
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