TyG在糖尿病前期人群中对代谢综合征的预测价值

An effectiveness analysis of the triglyceride-glucose index for identifying the metabolic syndrome in a prediabetic population

目的分析新型胰岛素抵抗评价指标甘油三酯-葡萄糖指数(TyG)及其衍生指标在糖尿病前期人群中对代谢综合征(MS)的预测价值。方法纳入2019年12月-2021年1月兰州大学第一医院体检人群中的糖尿病前期患者309例,测量身高、体重、血压、颈围、腰围、臀围和甘油三酯、高密度脂蛋白胆固醇、空腹血糖及胰岛素,75 g葡萄糖负荷2 h后测血糖,计算TyG、TyG-体质量指数、TyG-腰围、TyG-腰臀比和TyG-颈围,分析各胰岛素抵抗指标与MS的相关性,评估各胰岛素抵抗指标在糖尿病前期人群中MS的预测价值。结果MS在总人群、男性、女性中分别占75.7%、82.4%、66.9%。TyG等新型胰岛素抵抗评价指标与MS的相关性高于传统的稳态模型胰岛素抵抗指数(HOMA-IR)(P<0.01),其中TyG-腰围与MS相关性最大。Logistic回归模型显示,TyG等新型胰岛素抵抗评价指标及HOMA-IR均为MS的危险因素(P<0.01)。结论新型胰岛素抵抗评价指标TyG-腰围在糖尿病前期总人群和女性组中,识别MS的预测价值优于HOMA-IR。

Objective To evaluate the ability of the triglyceride-glucose index(TyG),its derivative indicators and new insulin resistance assessment indicators,to distinguish the metabolic syndrome(MS)in a prediabetic population.Methods Altogether 309 participants with prediabetic population who underwent medical examination in The First Hospital of Lanzhou University from December 2019 to January 2021 were selected.Their height,weight,blood pressure,neck circumference,waist and hip circumference,triglyceride,highdensity lipoprotein-cholesterol,fasting plasma glucose,fasting insulin and 2 h plasma glucose were measured.Some new insulin resistance assessment indicators were also calculated,including TyG,TyG-body mass index,TyG-waist circumference(TyG-WC),TyG-waist-hip ratio and TyG-neck circumference,to analyze the correlation between each insulin resistance index and MS,and to evaluate the identification efficiency of each insulin resistance index in the prediabetic population.Results The prevalence of MS was 75.7%,while 82.4%was male and 66.9%female.The level of correlation between the new insulin resistance assessment indicators such as TyG and MS was higher than the homeostasis model assessment of insulin resistance(HOMA-IR)(all P<0.01),and TyG-WC had the strongest level of correlation with MS.Logistic regression analysis showed that new insulin resistance assessment indicators such as TyG and HOMA-IR were risk factors for MS(all P<0.01).Conclusions The new insulin resistance evaluation index TyG-WC was more effective than HOMA-IR for identifying MS in the prediabetic population and female group.