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Asthmatics With Increased Triglyceride-Glucose Index Are at Elevated Risk of Exacerbations Independent of Type 2
Ke Deng1, Ji Wang1, Si Yang Gao1
1Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, Sichuan University, Chengdu, Sichuan, China.
Background:
The triglyceride-glucose (TyG) index is a new alternative marker for insulin resistance and metabolic dysfunction, which has recently been linked to lung health. However, the link among the TyG index, type 2 (T2) inflammation, and asthma is largely unexplored.
Objectives:
To explore clinical, inflammatory characteristics and exacerbations in patients with asthma grouped by the TyG index with or without T2 inflammation.
Methods:
This was a prospective cohort study with 12-month follow-up based on the Australasian Severe Asthma Network. Patients with stable asthma were divided into the TyGlow and TyGhigh groups by the 75th percentile values of the TyG index. Subgroups were analyzed based on T2 status. All participants with stable asthma (n = 626) underwent multidimensional assessment and sputum induction. Univariate and multivariable negative binomial regression analyses were used to examine the relationship between asthma exacerbations and TyG index with or without T2 inflammation.
Results:
Patients with asthma in the TyGhigh group (n = 156) had higher body mass index, worse metabolic function and airway obstruction, more comorbidities including diabetes and metabolic syndrome, and increased risk of exacerbations independent of T2 inflammation, compared with the TyGlow group (n = 470). Furthermore, the TyGhigh T2low group was at significantly increased risk of moderate-to-severe exacerbations (adjusted incidence rate ratio [IRR] = 2.54, 95% confidence interval [CI] = [1.56, 4.15], P < .001), emergency visits (adjusted IRR = 7.88, 95% CI = [2.71, 22.92], P < .001), and unscheduled visits (adjusted IRR = 2.87, 95% CI = [1.65, 4.98], P < .001).
Conclusions:
The TyG index is a promising biomarker of asthma exacerbations, highlighting the clinical relevance of assessing the TyG index in asthma management.
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