利用TyG指数评估胰岛素抵抗及糖尿病的患病风险

Assessing the risk of insulin resistance and diabetes using TyG index

目的通过甘油三酯血糖指数(TyG指数)评估胰岛素抵抗及糖尿病患病风险。方法研究人群来自中国健康与营养调查(CHNS)数据库,以参加2009年调查的人群为研究样本,采用Spearman相关分析了解TyG指数与稳态模型胰岛素抵抗指数(HOMA-IR)之间的相关性,利用Logistic回归分析分析TyG指数与糖尿病的患病风险,采用ROC曲线分析TyG指数诊断胰岛素抵抗及糖尿病的效能。结果TyG指数与HOMA-IR、体质量指数(BMI)、腰围、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、血清胰岛素(INS)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血尿酸(UA)、超敏反应蛋白(hs-CRP)呈正相关(P<0.05),与高密度脂蛋白胆固醇(HDL-C)呈负相关(P<0.05);校正年龄、性别、体重指数后,TyG指数第2、3、4四分位数组糖尿病的患病风险相对于TyG指数第1四分位数组分别增至1.706、3.070、9.918倍;TyG指数诊断胰岛素抵抗的曲线下面积AUC(95%CI)为0.722(0.712~0.732),最佳切点值为3.797,敏感性为64.27%,特异性为69.20%,约登指数为0.335;TyG指数诊断糖尿病的曲线下面积AUC(95%CI)为0.774(0.765~0.783),最佳切点值为3.839,敏感性为72.39%,特异性为69.50%,约登指数为0.418。结论TyG指数可以评估胰岛素抵抗及糖尿病患病风险。

Objective To assess the risk of insulin resistance and diabetes by using the triglycerides and glucose(TyG)index.Methods Through the database of the China health and nutrition survey(CHNS),the participations in 2009 were chosen as the research sample.The spearman correlation test was used to analyze the correlation between the TyG index and homeostasis model insulin resistance index(HOMA-IR).The logistic regression analysis was used to analyze the risk of the TyG index and diabetes.The receiver operating characteristics(ROC)curve was used to evaluate the efficacy of TyG index in the diagnosis of insulin resistance and diabetes.Results The TyG index was positively correlated with HOMA-IR,body mass index(BMI),waist circumference,systolic blood pressure(SBP),diastolic blood pressure(DBP),cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterin(LDL-C),serum insulin(INS),fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),blood uric acid(UA),hypersensitive C-reactive protein(hs-CRP),and negatively correlated with high density lipoprotein cholesterol(HDL-C),P<0.05.After adjusting for age,gender and body mass index,the risk of diabetes in the second,third and fourth quartile of the TyG index increased to 1.706,3.070,and 9.918 times,respectively,compared with the first quartile of the TyG index.The area under the curve(AUC)(95% CI)of TyG index for diagnosing insulin resistance was 0.722(0.712-0.732),and the cut-off value was 3.797,with a corresponding sensitivity of 64.27%,a specificity of 69.20%,and a Yonden's index of 0.335.The AUC(95%CI)of TyG index for diagnosing diabetes was 0.774(0.765-0.783),and the cut off value was 3.839,with a corresponding sensitivity of 72.39%,a specificity of 69.50%,and a Yonden’s index of 0.418.Conclusion The TyG index can assess the risk of insulin resistance and diabetes.