AUTHOR=Navas-Carretero Santiago , San-Cristobal Rodrigo , Siig Vestentoft Pia , Brand-Miller Jennie C. , Jalo Elli , Westerterp-Plantenga Margriet , Simpson Elizabeth J. , Handjieva-Darlenska Teodora , Stratton Gareth , Huttunen-Lenz Maija , Lam Tony , Muirhead Roslyn , Poppitt Sally , Pietiläinen Kirsi H. , Adam Tanja , Taylor Moira A. , Handjiev Svetoslav , McNarry Melitta A. , Hansen Sylvia , Brodie Shannon , Silvestre Marta P. , Macdonald Ian A. , Boyadjieva Nadka , Mackintosh Kelly A. , Schlicht Wolfgang , Liu Amy , Larsen Thomas M. , Fogelholm Mikael , Raben Anne , Martinez J. Alfredo 

TITLE=Appraisal of Triglyceride-Related Markers as Early Predictors of Metabolic Outcomes in the PREVIEW Lifestyle Intervention: A Controlled Post-hoc Trial

JOURNAL=Frontiers in Nutrition

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2021.733697

DOI=10.3389/fnut.2021.733697

ISSN=2296-861X

ABSTRACT=<p><bold>Background:</bold> 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 <italic>via</italic> 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.</p><p><bold>Methods:</bold> The present <italic>post-hoc</italic> analyses were conducted within the Prevention of Diabetes through Lifestyle intervention and population studies in Europe and around the world (PREVIEW) study completers (<italic>n</italic> = 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.</p><p><bold>Results:</bold> Diabetes-related markers improved during all four lifestyle interventions. Higher baseline TyG index (<italic>p</italic> &lt; 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.</p><p><bold>Conclusions:</bold> Two novel indices of insulin resistance (TyG and TyG-waist) may allow for a more personalized approach to avoiding progression to T2D.</p><p><bold>Clinical Trial Registration:</bold><ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT01777893" xmlns:xlink="http://www.w3.org/1999/xlink">https://clinicaltrials.gov/ct2/show/NCT01777893</ext-link> reference, identifier: NCT01777893.</p>