1044 https://oamjms.eu/index.php/mjms/index
Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia
Open Access Macedonian Journal of Medical Sciences. 2021 Oct 01; 9(B):1044-1047.
https://doi.org/10.3889/oamjms.2021.7075
eISSN: 1857-9655
Category: B - Clinical Sciences
Section: Endocrinology
Concordance between Triglyceride Glucose Index and Admission
Insulin Resistance Index in Non-diabetic Subjects of Acute
Coronary Syndrome
Andi Irham
1
, Husaini Umar
2
*, Fabiola Maureen Shinta Adam
2
, Idar Mappangara
3
, Syakib Bakri
4
, Risna Halim
5
, Alfan Zainuddin
6
1
Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia;
2
Department of Internal
Medicine, Division of Endocrine Metabolic and Diabetes, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia;
3
Department of Internal Medicine, Division of Cardiology and Vascular Medicine, Faculty of Medicine, Hasanuddin University,
Makassar, Indonesia;
4
Department of Internal Medicine, Division of Nephrology and Hypertension, Faculty of Medicine,
Hasanuddin University, Makassar, Indonesia;
5
Department of Internal Medicine, Division of Tropical Medicine and Infectious
Disease, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia;
6
Department of Biostatistics, Faculty of Public
Health, Hasanuddin University, Makassar, Indonesia
Abstract
BACKGROUND: Acute coronary syndrome (ACS) is the leading cause of death in the world and is closely related
to insulin resistance (IR). The examination of the triglyceride glucose (TyG) Index and admission IR index (AIRI) can
be an alternative examination to assess IR.
AIM: The aim of the study was to analyze the concordance between the TyG index and AIRI in assessing IR in
nondiabetic subjects of ACS.
METHODS: This study was a cross-sectional study using secondary data from ACS patient medical records in
Wahidin Sudirohusodo Hospital Makassar from September 2020 until April 2021. An examination of RBG, TyG, and
fasting insulin was performed. The statistical test results were considered signifcant if the p < 0.05.
RESULTS: This study included 67 subjects, of which 54 were male and 13 were female, there were 24 people aged
<50 years, 43 people aged 50 years old, with a mean of 55.15 ± 12.71 years, a diagnosis of ST-elevation myocardial
infarction (STEMI) 25 people, non STEMI 34 people and unstable angina pectoris 8 people, p < 0.05. The receiver
operating characteristic curve showed that the cut-of value of the TyG index in predicting AIRI was 3141, with a
sensitivity of 88.98% and specifcity of 59.09%. The OR value revealed that subjects with a TyG index of >9.06
indicated an 11-time greater risk for IR than subjects with a TyG index ≤9.06.
CONCLUSIONS: There was a signifcant concordance between the TyG index and the AIRI in non-diabetic acute
coronary syndrome patient.
Edited by: Ksenija Bogoeva-Kostovska
Citation: Irham A, Umar H, Adam FMS, Mappangara I,
Bakri S, Halim R, Zainuddin A. Concordance between
Triglyceride Glucose Index and Admission Insulin
Resistance Index in Non-diabetic Subjects of Acute
Coronary Syndrome.
OpenAccess Maced J Med Sci. 2021 Oct 01; 9(B):1044-1047.
https://doi.org/10.3889/oamjms.2021.7075
Keywords: Insulin resistance; Triglyceride glucose index;
Admission insulin resistance index; Non-diabetic of acute
coronary syndrome
*Correspondence: Husaini Umar, Division of Endocrine
Metabolic and Diabetes, Department of Internal Medicine,
Faculty of Medicine, Hasanuddin University, Makassar,
Indonesia.
E-mail: husaini_umar65@yahoo.co.id
Received: 16-Aug-2021
Revised: 04-Sep-2021
Accepted: 21-Sep-2021
Copyright: © 2021 Andi Irham, Husaini Umar,
Fabiola Maureen Shinta Adam, Idar Mappangara,
Syakib Bakri, Risna Halim, Alfan Zainuddin
Funding: This research did not receive any fnancial
support
Competing Interests: The authors declare that they have
no competing interests.
Open Access: This is an open-access article distributed
under the terms of the Creative Commons Attribution-
NonCommercial 4.0 International License (CC BY-NC 4.0)
Introduction
Cardiovascular disease is the leading cause of
death in the world and is often associated with various
comorbidities such as obesity, abnormal lipid profle,
and insulin resistance (IR) [1], [2]. The most common
cardiovascular disease is acute coronary syndrome
(ACS). ACS is divided into three groups, namely,
ST-elevation myocardial infarction (STEMI), non STEMI
(NSTEMI), and unstable angina (UA) [3].
The high population with chronic disease
associated with IR has been widely reported
worldwide [4]. The mechanism of IR in the heart is
complex and multifactorial. Impaired insulin-stimulated
glucose absorption is still a common problem, changes
in signaling kinases can be increased or decreased,
thus impacting cardiac structure and function. IR
generally occurs mainly as a result of obesity, excess
calories, lack of physical activity, genetics, and age.
IR is associated with many serious medical conditions
such as type 2 diabetes mellitus, hypertension,
atherosclerosis, and metabolic syndrome (MetS) [5].
Systemic infammation also contributes
to IR, proinfammatory cytokines induce IR which can
afect glucose and fatty acid utilization by inducing IR,
infammation increases the heart’s dependence on
triglycerides from the liver and free fatty acids from
adipose tissue for energy [6]. Obesity can increase
circulating concentrations of infammatory cytokines, such
as interleukin-6 tumor necrosis factor-α and leptin [2].
Hyperinsulinemia Euglycemic Clamp is still
the gold standard to diagnose IR, but this method is
expensive, invasive, and difcult to perform in health