TyG指数对2型糖尿病的预测作用分析

The predictive effect of TyG index on type 2 diabetes mellitus

目的在非糖尿病老年男性受试者中,比较由空腹血清三酰甘油(TG)分别与空腹血糖,餐后1 h血糖,餐后2 h血糖所得的三酰甘油葡萄糖指数(TyG)0 h,TyG 1 h,TyG 2 h对2型糖尿病的预测作用。方法回顾性共收集862名受试者,均进行口服75 g葡萄糖耐量试验,在空腹(0 h)和1、2 h后测量血糖水平,并检测空腹血脂和其他重要生化指标。空腹血清TG与空腹血糖,餐后1 h血糖,餐后2 h血糖所得的指数分别为TyG 0 h,TyG 1 h,TyG 2 h。随访20年。运用Cox风险比例回归模型和受试者特征工作(ROC)曲线评估TyG 0 h,TyG 1 h,TyG 2 h对2型糖尿病的预测作用。结果Cox回归模型结果显示,TyG 0 h、TyG 1 h和TyG 2 h在随访10年和20年时对2型糖尿病均有预测作用[随访10年,TyG 0 h的HR=1.538(95%CI 1.267~1.868),P<0.001;TyG 1 h的HR=2.224(95%CI 1.852~2.672),P<0.001;TyG 2 h的HR=2.117(95%CI 1.777~2.522),P<0.001;随访20年,TyG 0 h的HR=1.431(95%CI 1.204~1.700),P<0.001;TyG 1 h的HR=2.008(95%CI 1.705~2.364),P<0.001;TyG 2 h的HR=1.850(95%CI 1.582~2.163),P<0.001]。随访10年,TyG 0 h、TyG 1 h、TyG 2 h预测2型糖尿病的曲线下面积(AUC)分别为0.699、0.747、0.739。AUC比较,TyG 1 h和TyG 2 h>TyG 0 h。随访20年,TyG 0 h、TyG 1 h、TyG 2 h预测2型糖尿病AUC分别为0.671、0.723、0.705。AUC比较,TyG 1 h>TyG 2 h>TyG 0 h。结论TyG 1 h和TyG 2 h预测2型糖尿病的作用优于TyG 0 h,且TyG 1 h对2型糖尿病的远期预测作用优于TyG 2 h,可作为临床工作中评估2型糖尿病风险的参考指标。

Objective To investigate the predictive effects of triglyceride-glucose index(TyG)0 h,TyG 1 h,and TyG 2 h on type 2 diabetes mellitus(T2DM)in elderly male participants without diabetes.Methods A total of 862 subjects were selected and followed up for 20 years,retrospectively.At baseline,all subjects underwent 75 g oral glucose tolerance test(OGTT)and venous plasma glucose measurements were taken before OGTT(FPG),1 h and 2 h after OGTT(1 h-PG and 2 h-PG,respectively).Fasting blood lipids and other important biochemical indicators were also detected.The index of fasting serum triglycerides(TG)and FPG,1 h-PG,2 h-PG were TyG 0 h,TyG 1 h,TyG 2 h,respectively.Cox proportional hazards regression model and receiver operating characteristic(ROC)curve were used to evaluate the predictive effect of TyG 0 h,TyG 1 h,and TyG 2 h on T2DM.Results The results of Cox regression model indicated that TyG 0 h,TyG 1 h and TyG 2 h had predictive effects on T2DM at 10 and 20 years of follow-up[At 10 years of follow-up,TyG 0 h:HR=1.538(95%CI 1.267-1.868),P<0.001;TyG 1 h:HR=2.224(95%CI 1.852-2.672),P<0.001;TyG 2 h:HR=2.117(95%CI 1.777-2.522),P<0.001;and after follow-up for 20 years,TyG 0 h:HR=1.431(95%CI 1.204-1.700),P<0.001;TyG 1 h:HR=2.008(95%CI 1.705-2.364),P<0.001;TyG 2 h:HR=1.850(95%CI 1.582-2.163),P<0.001].After 10 years of follow-up,the area under the curve(AUC)of TyG 0 h,TyG 1 h,and TyG 2 h for predicting T2DM was 0.699,0.747,and 0.739,respectively.Comparison of AUC,TyG 1 h or TyG 2 h>TyG 0 h.After 20 years of follow-up,AUC of TyG 0 h,TyG 1 h,and TyG 2 h for predicting T2DM was 0.671,0.723,and 0.705,respectively.Comparison of AUC,TyG 1 h>TyG 2 h>TyG 0 h.Conclusion The predictive role of TyG 1 h and TyG 2 h in T2DM is superior to TyG 0 h,and TyG 1 h′s long-term predictive effect on T2DM is better than TyG 2 h,which can be used as a reference index to evaluate the risk of T2DM in clinical practice.