{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:59:07Z","timestamp":1790657947293,"version":"4.1.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The number of patients with atopic dermatitis (AD) who develop cardiovascular disease (CVD) has been increasing year by year. However, reliable biomarkers for identifying AD patients with a higher burden of prevalent CVD remain lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included patient data from the First Affiliated Hospital of Harbin Medical University from 2014 to 2023 and data from the U.S. National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression analyses were performed to evaluate the associations of triglyceride-glucose index (TyG), TyG-body mass index (TyG-BMI), C-reactive protein\u2013triglyceride-glucose index (CTI), and CTI-body mass index (CTI-BMI) with prevalent CVD in patients with AD. Restricted cubic spline (RCS) analyses, subgroup analyses, and sensitivity analyses were conducted to evaluate the robustness of the findings. Seven machine learning (ML) models and SHAP analysis were applied to assess the discriminative performance of these indices for prevalent CVD status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the real-world dataset, 145 patients had prevalent CVD, whereas 75 participants had prevalent CVD in the NHANES dataset. Multivariable logistic regression analyses showed that, after adjustment for clinical covariates, all four indices were significantly and positively associated with prevalent CVD among patients with AD. These associations remained consistent across most subgroup analyses. Restricted cubic spline analyses showed no evidence of nonlinear associations, and sensitivity analyses supported the robustness of the findings. Among the evaluated ML models, CTI-BMI demonstrated the highest discriminative performance for prevalent CVD status in both datasets and contributed most substantially to model discrimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrated that TyG, TyG-BMI, CTI, and CTI-BMI were significantly associated with prevalent CVD among patients with AD. CTI-BMI showed the strongest discriminative performance among the evaluated indices and provided modest incremental discrimination when incorporated into machine learning models. These findings suggest that these indices may serve as potential adjunctive markers for cardiovascular burden assessment in patients with AD; however, further prospective studies are required to determine their value for predicting future cardiovascular events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1903179","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:40:54Z","timestamp":1790656854000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between insulin resistance-related indices and cardiovascular disease in patients with atopic dermatitis: mutual validation using real-world and NHANES data"],"prefix":"10.3389","volume":"13","author":[{"given":"Yu","family":"An","sequence":"first","affiliation":[{"name":"Department of Dermatology, the First Affiliated Hospital of Harbin Medical University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Harbin Medical University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangjuan","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Dermatology, the First Affiliated Hospital of Harbin Medical University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1111\/all.13401","article-title":"Epidemiology of atopic dermatitis in adults: results from an international survey","volume":"73","author":"Barbarot","year":"2018","journal-title":"Allergy"},{"key":"B2","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/j.jaad.2014.03.030","article-title":"Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents","volume":"71","author":"Sidbury","year":"2014","journal-title":"J Am Acad Dermatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.jid.2016.08.022","article-title":"Increasing comorbidities suggest that atopic dermatitis is a systemic disorder","volume":"137","author":"Brunner","year":"2017","journal-title":"J Invest Dermatol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1111\/pde.12867","article-title":"Study of the atopic march: development of atopic comorbidities","volume":"33","author":"Schneider","year":"2016","journal-title":"Pediatr Dermatol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"231","DOI":"10.4168\/aair.2023.15.2.231","article-title":"Incidence of cardiovascular disease after atopic dermatitis development: a nationwide, population-based study","volume":"15","author":"Lee","year":"2023","journal-title":"Allergy Asthma Immunol Res"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2591","DOI":"10.2147\/CCID.S552485","article-title":"Inflamed skin, burdened heart: a multidisciplinary perspective on atopic dermatitis and cardiovascular health","volume":"18","author":"Ma","year":"2025","journal-title":"Clin Cosmet Investig Dermatol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"494","DOI":"10.23736\/S2784-8671.25.08041-7","article-title":"Atopic dermatitis, hypertension, and cardiovascular risk: an appraisal of the evidence","volume":"160","author":"Frolunde","year":"2025","journal-title":"Ital J Dermatol Venerol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1007\/s13671-017-0168-7","article-title":"Comorbidities of atopic dermatitis: beyond rhinitis and asthma","volume":"6","author":"Andersen","year":"2017","journal-title":"Curr Dermatol Rep"},{"key":"B9","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1016\/j.jaci.2014.11.023","article-title":"Eczema and cardiovascular risk factors in 2 US adult population studies","volume":"135","author":"Silverberg","year":"2015","journal-title":"J Allergy Clin Immunol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1821","DOI":"10.1016\/j.jaci.2018.11.030","article-title":"Atopic eczema and major cardiovascular outcomes: a systematic review and meta-analysis of population-based studies","volume":"143","author":"Ascott","year":"2019","journal-title":"J Allergy Clin Immunol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"6687","DOI":"10.1111\/dom.70844","article-title":"Body mass index and all-cause, cancer, and cardiovascular mortality in adults aged 16\u201350 years with and without type 2 diabetes: an analysis of primary care records in England","volume":"28","author":"Chen","year":"2026","journal-title":"Diabetes Obes Metab"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2074","DOI":"10.1161\/01.CIR.0000095272.67948.17","article-title":"Association of insulin resistance, hyperleptinemia, and impaired nitric oxide release with in-stent restenosis in patients undergoing coronary stenting","volume":"108","author":"Piatti","year":"2003","journal-title":"Circulation"},{"key":"B13","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/S0962-8924(01)02129-8","article-title":"Insulin resistance: a phosphorylation-based uncoupling of insulin signaling","volume":"11","author":"Zick","year":"2001","journal-title":"Trends Cell Biol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1111\/joim.13687","article-title":"Insulin resistance probability score and incident cardiovascular disease","volume":"294","author":"Louie","year":"2023","journal-title":"J Intern Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"101566","DOI":"10.1016\/j.diabet.2024.101566","article-title":"Insulin-based or non-insulin-based insulin resistance indicators and risk of long-term cardiovascular and all-cause mortality in the general population: a 25-year cohort study","volume":"50","author":"Lin","year":"2024","journal-title":"Diabetes Metab"},{"key":"B16","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1186\/s12933-024-02334-8","article-title":"Metabolic score for insulin resistance (METS-IR) predicts all-cause and cardiovascular mortality in the general population: evidence from NHANES 2001\u20132018","volume":"23","author":"Duan","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s12933-025-02618-7","article-title":"Assessment of six insulin resistance surrogate indexes for predicting stroke incidence in Chinese middle-aged and elderly populations with abnormal glucose metabolism: a nationwide prospective cohort study","volume":"24","author":"Jiang","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/s12933-022-01523-7","article-title":"Triglyceride glucose index for the detection of the severity of coronary artery disease in different glucose metabolic states in patients with coronary heart disease: a RCSCD-TCM study in China","volume":"21","author":"Su","year":"2022","journal-title":"Cardiovasc Diabetol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-026-03197-x","article-title":"Association of cumulative exposure and dynamic trajectories of the C-reactive protein-triglyceride-glucose and its modified indices with cardiovascular disease in individuals with cardiovascular-kidney-metabolic syndrome stages 0\u20133: a longitudinal analysis based on CHARLS","volume":"25","author":"Yin","year":"2026","journal-title":"Cardiovasc Diabetol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.20960\/nh.06533","article-title":"Associations of C-reactive protein-triglyceride-glucose index cumulative burden with incident cardiovascular disease in middle-aged and older Chinese adults with abnormal glucose metabolism","author":"Li","year":"2026","journal-title":"Nutr Hosp"},{"key":"B21","doi-asserted-by":"publisher","first-page":"100575","DOI":"10.1016\/j.jnha.2025.100575","article-title":"Oxidative stress and inflammation mediate the association between life\u2019s crucial 9 and biological ageing: a secondary analysis of two observational studies","volume":"29","author":"Wang","year":"2025","journal-title":"J Nutr Health Aging"},{"key":"B22","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1016\/j.jaad.2022.10.017","article-title":"Association between atopic dermatitis and thyroid disease among U.S. adults in the 2001\u20132006 national health and nutrition examination survey","volume":"88","author":"Smith","year":"2023","journal-title":"J Am Acad Dermatol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"2048","DOI":"10.2337\/dc12-0235","article-title":"Joint effects of obesity and vitamin D insufficiency on insulin resistance and type 2 diabetes: results from the NHANES 2001\u20132006","volume":"35","author":"Kabadi","year":"2012","journal-title":"Diabetes Care"},{"key":"B24","doi-asserted-by":"publisher","first-page":"40973","DOI":"10.1038\/s41598-025-24781-3","article-title":"Machine learning models with SHAP for performance prediction of eco-friendly fiber reinforced mortars with glass waste","volume":"15","author":"Rahmani","year":"2025","journal-title":"Sci Rep"},{"key":"B25","doi-asserted-by":"publisher","first-page":"40787","DOI":"10.1038\/s41598-025-24478-7","article-title":"Construction and validation of a risk prediction model for complications in patients with acute leukemia based on machine learning","volume":"15","author":"Xu","year":"2025","journal-title":"Sci Rep"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1111\/all.12685","article-title":"Association between adult atopic dermatitis, cardiovascular disease, and increased heart attacks in three population-based studies","volume":"70","author":"Silverberg","year":"2015","journal-title":"Allergy"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e2022165","DOI":"10.5826\/dpc.1204a165","article-title":"Association between atopic dermatitis and major cardiovascular outcomes: a two-sample Mendelian randomization study","volume":"12","author":"Qi","year":"2022","journal-title":"Dermatol Pract Concept"},{"key":"B28","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/j.jaci.2016.01.015","article-title":"Risk of myocardial infarction, ischemic stroke, and cardiovascular death in patients with atopic dermatitis","volume":"138","author":"Andersen","year":"2016","journal-title":"J Allergy Clin Immunol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e1032","DOI":"10.1111\/jdv.20813","article-title":"Subclinical atherosclerosis is increased in moderate-to-severe atopic dermatitis","volume":"39","author":"Berna-Rico","year":"2025","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"964","DOI":"10.3390\/life15060964","article-title":"The junction of allergic inflammation and atherosclerosis: pathways and clinical implications-a review","volume":"15","author":"Valcovici","year":"2025","journal-title":"Life"},{"key":"B31","doi-asserted-by":"publisher","first-page":"760","DOI":"10.5551\/jat.ED109","article-title":"Eczema and risk of cardiovascular disease: heightened awareness needed","volume":"26","author":"Fujiyoshi","year":"2019","journal-title":"J Atheroscler Thromb"},{"key":"B32","doi-asserted-by":"publisher","first-page":"990007","DOI":"10.3389\/fcvm.2022.990007","article-title":"IL-33\/ST2 immunobiology in coronary artery disease: a systematic review and meta-analysis","volume":"9","author":"Liu","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"B33","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1177\/1753944717711379","article-title":"Metabolic syndrome: pathophysiology, management, and modulation by natural compounds","volume":"11","author":"Rochlani","year":"2017","journal-title":"Ther Adv Cardiovasc Dis"},{"key":"B34","doi-asserted-by":"publisher","first-page":"5884","DOI":"10.3390\/ijms26125884","article-title":"Is atopic dermatitis associated with systemic metabolic disturbances? A systematic review","volume":"26","author":"Matwiejuk","year":"2025","journal-title":"Int J Mol Sci"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1644887","DOI":"10.3389\/fimmu.2025.1644887","article-title":"Positive associations between triglyceride-glucose (TyG) and TyG-body mass index (TyG-BMI) with cardiovascular disease in patients with psoriasis: cross-sectional results from the SPEECH","volume":"16","author":"Li","year":"2025","journal-title":"Front Immunol"},{"key":"B36","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1186\/s12933-025-02848-9","article-title":"C-reactive protein-triglyceride glucose index in evaluating cardiovascular disease and all-cause mortality incidence among individuals across stages 0\u20133 of cardiovascular-kidney-metabolic syndrome: a nationwide prospective cohort study","volume":"24","author":"Ou","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"e672","DOI":"10.1016\/S2468-2667(20)30191-2","article-title":"Cardiovascular risk factors in China: a nationwide population-based cohort study","volume":"5","author":"Li","year":"2020","journal-title":"Lancet Public Health"},{"key":"B38","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.jdin.2025.09.021","article-title":"Moderate-to-severe atopic dermatitis and systemic corticosteroids are associated with insulin resistance and metabolic syndrome","volume":"24","author":"Berna-Rico","year":"2026","journal-title":"JAAD Int"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1903179\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:41:05Z","timestamp":1790656865000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1903179\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":38,"alternative-id":["10.3389\/fcvm.2026.1903179"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1903179","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"article-number":"1903179"}}