宁夏回族及汉族超重、肥胖人群甘油三酯及甘油三酯与高密度脂蛋白胆固醇的比值和胰岛素抵抗的关系

Relationship between triglyceride or ratio of triglyceride to HDL-C and insulin resistance in Hui and Han population with overweight and obesity of Ningxia

目的以脂代谢测量指标为切入点,以探索回族及汉族超重、肥胖人群IR的预测指标。方法采用分层整群抽样方法,选取宁夏农村地区年龄24~75岁且BMI≥24 kg/m^2的回族及汉族居民为研究对象。调查内容包括一般情况、体格检查及相关糖脂代谢指标的实验室测定。稳态模型评估胰岛素抵抗指数(HOMA-IR),并以该指数的最高四分位数作为IR的切点。结果回族超重、肥胖人群中,TG、TG/HDL-C是HOMA-IR的影响因素(β'分别为0.125、0.134,P<0.05),且可增加IR发生的风险,OR值分别为1.941(95%CI 1.210~3.025,P<0.01),1.500(95%CI 1.036~2.171,P<0.05),作为IR的预测指标,TG受试者工作特征曲线下面积(ROAUCs)为0.628(95%CI 0.563~0.694,P<0.001),界值为1.17,灵敏度为65.7%,特异度为53.9%;TG/HDL-C的ROAUCs为0.616(95%CI 0.551~0.682,P<0.01),界值为0.81,灵敏度为71.4%,特异度为44.6%。汉族超重、肥胖人群中,HDL-C、LDL-C/HDL-C、TC/HDL-C是HOMA-IR的影响因素(β'为-0.142、0.110、0.147,P<0.05)。结论在回族超重、肥胖人群中,TG、TG/HDL-C对IR有一定的预测价值。

Objective To find a surrogate marker to identify insulin resistance （IR） in Hui and Han ethnic group with overweight and obesity by lipid metabolism indicators. Methods Subjects aged 24~75 years old,and BMI≥24 kg/m^2 were enrolled in this study by the stratified cluster sampling method. Health questionnaires,physical examinations and blood biochemical tests were performed in this study. IR was evaluated by HOMA-IR,and the cut-off value of IR was determined by the 75th percentile of HOMA-IR values. Results In Hui population,TG and TG/HDL-C ratio were significantly associated with the HOMA-IR （standardized regression coefficients were 0.125,0.134,P〈0.05）,and also significantly increased the risk of IR and the OR values were 1.941（95%CI 1.210~3.025,P〈0.01） and 1.500（95%CI 1.036~2.171,P〈0.05） respectively. The areas under receiver operating characteristic curves（ROAUCs） of TG and TG/HDL-C ratio were 0.628（95%CI 0.563~0.694,P〈0.01） and 0.616（95%CI 0.551~0.682,P〈0.01） respectively. The cutoff values of TG and TG/HDL-C were 1.17 and 0.81. The corresponding sensitivity of TG and TG/HDL-C were 65.7% and 71.4%,and the specificity of TG and TG/HDL-C were 53.9% and 44.6% respectively. In Han population,HDL-C,LDL-C/HDL-C ratio and TC/HDL-C ratio were significantly associated with HOMA-IR （standardized regression coefficients were-0.142,0.110,0.147,P〈0.05）. Conclusion TG and TG/HDL-C ratio are valuable in identification of individuals with high risk of IR in Hui ethnic population with overweight and obesity.