Appraisal of triglyceride-related markers as early predictors of metabolic outcomes in the PREVIEW lifestyle intervention: A controlled post-hoc trial

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt


  • Santiago Navas-Carretero
  • Rodrigo San-Cristobal
  • Pia Siig Vestentoft
  • Jennie C. Brand-Miller
  • Elli Jalo
  • Margriet Westerterp-Plantenga
  • Elizabeth J Simpson
  • Teodora Handjieva-Darlenska
  • Gareth Stratton
  • Maija Huttunen-Lenz
  • Tony Lam
  • Roslyn Muirhead
  • Sally Poppitt
  • Kirsi H Pietiläinen
  • Tanja Adam
  • Moira A Taylor
  • Svetoslav Handjiev
  • Melitta A McNarry
  • Sylvia Hansen
  • Shannon Brodie
  • Marta P Silvestre
  • Ian A Macdonald
  • Nadka Boyadjieva
  • Kelly A Mackintosh
  • Wolfgang Schlicht
  • Amy Liu
  • Thomas Meinert Larsen
  • Mikael Fogelholm
  • J Alfredo Martinez
Background: Individuals with pre-diabetes are commonly overweight and
benefit from dietary and physical activity strategies aimed at decreasing body weight and hyperglycemia. Early insulin resistance can be estimated via the triglyceride glucose index {TyG = Ln [TG (mg/dl) × fasting plasma glucose (FPG) (mg/dl)/2]} and the hypertriglyceridemic-high waist phenotype (TyG-waist), based on TyG x waist circumference (WC) measurements. Both indices may be useful for implementing personalized metabolic management. In this secondary analysis of a randomized controlled trial (RCT), we aimed to determine whether the differences in baseline TyG values and TyG-waist phenotype predicted individual responses to type-2 diabetes (T2D) prevention programs.
Methods: The present post-hoc analyses were conducted within the Prevention of Diabetes through Lifestyle intervention and population studies in Europe and around the world (PREVIEW) study completers (n = 899), a multi-center RCT conducted in eight countries (NCT01777893). The study aimed to reduce the incidence of T2D in a population with pre-diabetes during a 3-year randomized intervention with two sequential phases. The first phase was a 2-month weight loss intervention to achieve ≥8% weight loss. The second phase was a 34-month weight loss maintenance intervention with two diets providing different amounts of protein and different glycemic indices, and two physical activity programs with different exercise intensities in a 2 x 2 factorial design. On investigation days, we assessed anthropometrics, glucose/lipid metabolism markers,
and diet and exercise questionnaires under standardized procedures.
Results: Diabetes-related markers improved during all four lifestyle interventions. Higher baseline TyG index (p < 0.001) was associated with greater reductions in body weight, fasting glucose, and triglyceride (TG), while a high TyG-waist phenotype predicted better TG responses, particularly in those randomized to physical activity (PA) of moderate intensity.
Conclusions: Two novel indices of insulin resistance (TyG and TyG-waist) may allow for a more personalized approach to avoiding progression to T2D.
Clinical Trial Registration:
reference, identifier: NCT01777893.
TidsskriftFrontiers in Nutrition
Antal sider12
StatusUdgivet - 2021

Bibliografisk note

CURIS 2021 NEXS 340

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