TG/HDL-C与胰岛素抵抗的相关性研究

Association between TG/HDL-C and insulin resistance

目的探讨TG/HDL-C与胰岛素抵抗(IR)的相关性。方法选取杭州市某社区40~65岁的自然居民960例为研究对象,收集体格检查、实验室检测资料,计算稳态模型评估的IR指数(HOMA-IR)。分析IR影响因素以及其对IR的预测效能。结果960例受试者中,IR(HOMA-IR≥2.69)389例,非IR 571例。经单因素logistic回归分析显示,年龄、BMI、腰围、臀围、收缩压、舒张压、腹内脂肪面积(VFA)、皮下脂肪面积、TG、TC、HDL-C、LDL-C、TG/HDL-C、TC/HDL-C、LDL-C/HDL-C与IR有关(均P<0.05);经多因素logistic回归分析显示,腰围、收缩压、VFA、TG、TG/HDL-C是IR的独立影响因素(均P<0.05)。单独TG/HDL-C、TG预测IR的效能较低,AUC分别为0.674、0.664;TG/HDL-C、收缩压、腰围联合预测IR的AUC为0.755,TG、收缩压、腰围联合预测IR的AUC为0.751,较单独TG/HDL-C、TG预测IR的效能明显提升。结论TG/HDL-C是IR的独立影响因素,其与腰围、收缩压联合预测IR的效能较好。

Objective To investigate the relationship between triglyceride to high density lipoprotein cholesterol ratio(TG/HDL-C)and insulin resistance(IR).Methods A total of 960 community-dwelling individuals aged 40 to 65 in Hangzhou city were enrolled.Physical examination and laboratory data were collected,and the homeostasis model assessment of IR(HOMA-IR)was calculated.The influencing factors of IR and their predictive value were analyzed.Results There were 389 individuals with IR(HOMA-IR≥2.69,IR group)and 571 without IR(non-IR group).Univariate logistic regression analysis showed that age,BMI,waist circumference,hip circumference,systolic blood pressure,diastolic blood pressure,abdominal visceral fat area(VFA),subcutaneous fat area,triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),TG/HDL-C,total cholesterol/high-density lipoprotein cholesterol ratio(TC/HDL-C),low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio(LDL-C/HDL-C)were related to IR(all P<0.05).Multivariate logistic regression analysis showed that waist circumference,systolic blood pressure,VFA,TG,TG/HDL-C were independent risk factors of IR(all P<0.05).The AUC of TG/HDL-C and TG in predicting IR were 0.674 and 0.664,respectively.The AUC of TG/HDL-C combined with systolic blood pressure and waist circumference was 0.755,and the AUC of TG combined systolic blood pressure and waist circumference was 0.751,which were significantly higher than that of TG/HDL-C or TG alone.Conclusion TG/HDL-C is an independent influencing factor of IR.The combination of TG/HDL-C with waist circumference and systolic blood pressure can be more effective in predicting IR.