TyG指数及TG/HDL-C是2型糖尿病患者血糖控制的有效预测指标

Triglyceride Glucose Index and Triglyceride High-density Lipoprotein Ratio are Powerful Predictors of Type 2 Diabetes Mellitus Control

目的分析2型糖尿病(type 2 diabetes mellitus, T2DM)患者的甘油三酯葡萄糖指数(triglyceride-glucose index, TyG指数)以及甘油三酯/高密度脂蛋白比值(triglyceride/high-density lipoprotein ratio, TG/HDL-C)与糖化血红蛋白(glycated hemoglobin, HbA1c)的相关性。方法选取2型糖尿病患者356例,根据糖化血红蛋白值(HbA1c)分为两组:血糖控制良好组HbA1c<7%(n=118)以及血糖控制不佳组HbA1c≥7%(n=238),分别进行询问病史、体格检查、生化检查,并计算TyG指数、TG/HDL-C。结果与T2DM HbA1c<7%组的T2DM患者比较,T2DM HbA1c≥7%组患者的FPG、HbA1c、TG、TC、LDL-C、年龄、收缩压和病程水平显著升高,HDL-C水平显著降低;HbA1c≥7%的T2DM患者的TG/HDL-C、TyG指数以及两者衍生指数TyG-BMI、TG/HDL-C-BMI显著高于HbA1c<7%T2DM患者;Spearman相关分析中,TyG指数和TG/HDL-C均与HbA1c呈正相关;在线性回归中,即使控制了年龄、性别、收缩压、舒张压、饮酒、TC,HbA1c仍与TG/HDL-C、TyG指数独立相关;通过ROC分析表明,血糖控制不佳组在识别血糖控制方面,与TG/HDL-C、TyG-BMI、TG/HDL-C-BMI比较,TyG指数具有更好的性能。结论除了HbA1c外,TG/HDL-C和TyG指数都可以作为监控血糖控制的良好替代指标。

Objective To analyze the relationship between triglyceride-glucose index(TyG index)and triglyceride/high-density lipoprotein ratio(TG/HDL-C)and glycosylated hemoglobin(HbA1c)in patients with type 2 diabetes mellitus.Methods Totally 356 patients with type 2 diabetes mellitus were selected and divided into two groups according to HbA1c:HbA1c with good glycemic control<7%(n=118)and poor glycemic control group HbA1c≥7%(n=238),respectively.Medical history,physical examination,biochemical examination,and calculated TyG index,TG/HDL-C were asked for.Results Compared with T2DM patients with T2DM HbA1c<7%group,the levels of TyG index,TG/HDL-C,TyG-BMI,TG/HDL-C-BMI,FPG,HbA1c,TG,TC,LDL-C,age,systolic blood pressure,and course of disease were significantly increased in patients with T2DM HbA1c≥7%,and HDL-C levels were significantly reduced.In Spearman correlation analysis,TyG index and TG/HDL-C were positively correlated with HbA1c.In linear regression,even if age,sex,systolic blood pressure,diastolic blood pressure,alcohol consumption,TC were controlled,HbA1c was still independently related to TG/HDL-C and TyG index.In the group with poor blood glucose control,in terms of identifying blood sugar control,ROC analysis showed that the TyG index had better performance than TG/HDL-C、TyG-BMI and TG/HDL-C-BMI.Conclusion In addition to HbA1c,both TG/HDL-C and TyG index can be used as a good surrogate for monitoring glycemic control.