1Center for Family and Community Medicine, Columbia University, New York, NY, USA.
Diabetes Care. 2013 Feb;36(2):342-7. doi: 10.2337/dc12-0355. Epub 2012 Oct 1.
Elevated plasma triglycerides (TGs) have been included in diabetes risk prediction models. This study examined whether elevated TGs predict risk for impaired fasting glucose (IFG).
This study used the baseline and longitudinal follow-up data from the Multi-Ethnic Study of Atherosclerosis (MESA). The analysis included non-Hispanic whites, African Americans, Hispanics, and Chinese Americans 45-84 years of age who had fasting glucose <100 mg/dL at baseline and who did not have clinically evident cardiovascular disease or diabetes. Cox proportional regression models were used to examine the association of elevated TGs with incidence of IFG adjusting for central obesity, low HDL cholesterol, elevated blood pressure, baseline fasting glucose, and BMI. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of elevated TGs in predicting IFG were calculated.
The incidence rate of developing IFG was 59.1 per 1,000 person-years during the median 4.75 years of follow-up. African Americans and Hispanics had a higher incidence rate of IFG compared with non-Hispanic whites among people with normal TG concentrations. Elevated TGs (>150 mg/dL) at baseline were independently associated with the incidence of IFG with an adjusted hazard ratio of 1.19 (95% CI 1.04-1.37). However, its predictive value for identifying people at risk for IFG was poor, with <57% AUC. Interactions of elevated TGs with race/ethnicity in predicting IFG were not statistically significant.
Elevated TGs were moderately associated with risk for IFG, and it was a poor risk prediction tool for IFG.
血浆甘油三酯（TGs）升高已被纳入糖尿病风险预测模型。本研究旨在探讨升高的 TGs 是否可预测空腹血糖受损（IFG）的发生风险。
本研究使用了动脉粥样硬化多民族研究（MESA）的基线和纵向随访数据。分析纳入了基线时空腹血糖<100mg/dL、无临床明显心血管疾病或糖尿病且年龄在 45-84 岁的非西班牙裔白人、非裔美国人、西班牙裔和华裔美国人。采用 Cox 比例风险回归模型，在校正中心性肥胖、低 HDL 胆固醇、血压升高、基线空腹血糖和 BMI 后，分析升高的 TGs 与 IFG 发病风险的相关性。计算了预测 IFG 的升高 TGs 的受试者工作特征曲线（ROC）下面积（AUC）、敏感性和特异性。
在中位 4.75 年的随访期间，IFG 的发病率为 59.1/1000 人年。与非西班牙裔白种人相比，TG 浓度正常的非裔美国人和西班牙裔人群 IFG 的发病率更高。基线时升高的 TGs（>150mg/dL）与 IFG 的发生独立相关，校正后的危险比为 1.19（95%CI 1.04-1.37）。然而，其预测 IFG 风险的价值较低，AUC<57%。升高的 TGs 与种族/民族在预测 IFG 方面的交互作用无统计学意义。
升高的 TGs 与 IFG 的发生风险中度相关，且其预测 IFG 的风险能力较差。
