克拉玛依健康体检人群甘油三酯葡萄糖生成指数与2型糖尿病发病风险的队列分析研究

A cohort analysis study on the relationship and mechanism between the triglycerides and glucose index and risk of type 2 diabetes in Karamay health check-up population

目的探讨克拉玛依健康体检人群甘油三酯葡萄糖生成指数(TyG指数)与2型糖尿病(T2DM)发病风险的关联性。方法选取2018年在克拉玛依市人民医院体检中心参加职工健康体检、符合入选和排除标准的3293名企事业职工作为研究对象。对研究对象进行一般情况调查、体格检查、实验室检查和腹部B超为主要内容的基线调查,之后通过2019年和2020年体检,调查研究人群的T2DM发病情况。T2DM发病的危险因素及其与T2DM发病风险的关联性采用COX回归模型和Kaplan-Meier生存分析法进行分析研究。结果COX多因素回归分析结果显示TyG指数、非酒精性脂肪肝(NAFLD)和年龄是T2DM发病的独立危险因素,其中以TyG指数Q4与T2DM发病的风险比(HR)最高,为4.854(2.330-10.114)。Kaplan-Meier生存分析结果显示TyG指数Q4的“生存”时间最短,年发病率最高。结论TyG指数可用于评估胰岛素抵抗和T2DM的发病风险。当TyG≥6.08时,发生T2DM的风险显著增加,且女性发生T2DM的风险要高于男性、BMI<25 kg/m^(2)人群发生T2DM的风险要高于BMI≥25 kg/m^(2)人群。

Objective To explore the relationship between the the triglycerides and glucose index(TyG index)and the risk of type 2 diabetes mellitus(T2DM)in the population of Karamay health examination.Methods A total of 3293 employees of enterprises and institutions who participated in the physical examination of employees in the physical examination center of Karamay City People's Hospital in 2018 and met the selection and exclusion criteria were selected as the research objects.Conduct general surveys,physical examinations,laboratory examinations,and abdominal ultrasound as the main content of the baseline surveys.when the subjects participate in the 2019 and 2020 employee physical examinations organized by enterprises and institutions,they pass the physical examination again the same content of the baseline survey,follow-up investigation of the incidence of T2DM in the study population.The risk factors of T2DM and their association with the risk of T2DM were analyzed and studied by COX regression model and Kaplan-Meier survival analysis method.Results The COX multivariate regression analysis showed that TyG index,NAFLD and age are independent risk factors for the T2DM.Among them,the hazard ratio(HR)of TyG index Q4 was the highest,which was 4.854(2.330-10.114).Kaplan-Meier survival analysis showed that TyG index Q4 had the shortest"survival"time and the highest annual incidence.Conclusions Integrated glucose management could effectively control the perioperative blood glucose level of patients undergoing minimally invasive spine surgery combined with diabetes,reduced their daily insulin use and the incidence of postoperative complications,and could be widely promoted and applied in clinical practice.