三酰甘油-葡萄糖指数与2型糖尿病动脉粥样硬化的相关性

Correlation between triglyceride-glucose index and atherosclerosis in type 2 diabetes mellitus

目的 探讨三酰甘油-葡萄糖(TyG)指数在临床中的应用及其与2型糖尿病(T2DM)动脉粥样硬化的相关性。方法 从2020年1月至2022年12月南京江北医院住院及体检人群中筛选出T2DM患者499例,将所有研究对象按照有无合并动脉粥样硬化斑块进行分组,其中T2DM合并斑块组共249例,T2DM无斑块组共250例。对入选人员进行病史采集、体格检查、血清生化指标等检查,计算TyG,并对TyG指数与常见T2DM动脉粥样硬化因素的相关性进行分析。结果 T2DM无斑块组年龄、收缩压(SBP)、三酰甘油(TG)、总胆固醇(TC)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、载脂蛋白A均低于T2DM合并斑块组,舒张压(DBP)高于T2DM合并斑块组(P<0.05)。T2DM合并斑块组TyG指数高于T2DM无斑块组,差异有统计学意义(11.52±0.37 vs 9.34±0.48,t=56.803,P<0.01)。TyG指数与年龄、DBP、TG、TC、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)和HbA1c呈正相关,与高密度脂蛋白胆固醇(HDL-C)、空腹C肽呈负相关(P<0.05)。TyG指数预测T2DM发生动脉粥样硬化的ROC曲线下面积为0.611,最佳临界值为10.21,对应的敏感度为84.8%,特异度为62.2%。结论 TyG指数与T2DM动脉粥样硬化的多种危险因素密切相关,TyG指数结合动脉粥样硬化危险因素能更全面评估T2DM患者动脉粥样硬化发生的风险。

Objective To investigate the the clinical application of triglyceride-glucose(TyG) index and its correlation with atherosclerosis in patients with type 2 diabetes mellitus(T2DM).Methods From January 2020 to December 2022,499 patients with T2DM were screened from the inpatients and physical examination populations of Nanjing Jiangbei Hospital.Based on the presence or absence of atherosclerotic plaques,the subjects were divided into T2DM with plaques group(n=249) and T2DM without plaques group(n=250).The subjects underwent medical history collection,physical examination,and serum biochemical testing.The TyG index was calculated,and the correlation between TyG and common risk factors for T2DM atherosclerosis was statistically analyzed.Results The age,systolic blood pressure(SBP),triglyceride(TG),total cholesterol(TC),fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),and apolipoprotein A of the T2DM without plaques group were lower than those in the T2DM with plaques group,the diastolic blood pressure(DBP) was higher than that in the T2DM with plaques group(P<0.05).The TyG index in the T2DM with plaques group was higher than that in the T2DM without plaques group(11.52±0.37 vs 9.34±0.48,t=56.803,P<0.01).TyG index was positively correlated with age,SBP,TG,TC,low-density lipoprotein cholesterol(LDL-C),uric acid(UA),and HbA1c(P<0.05),and negatively correlated with high-density lipoprotein cholesterol(HDL-C) and fasting C-peptide(P<0.05).The area under ROC curve of TyG index for predicting T2DM atherosclerosis was 0.611,with a best cut-off value of 10.21,sensitivity of 84.8%,and specificity of 62.2%.Conclusion TyG index is closely related to multiple risk factors for atherosclerosis in patients with T2DM.TyG index combined with risk factors for atherosclerosis can comprehensively assess the risk of T2DM atherosclerosis development.