Lee S-H, Han K, Yang H K, Kim H-S, Cho J-H, Kwon H-S, Park Y-M, Cha B-Y, Yoon K-H
1] Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea [2] Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St Mary's Hospital, Seoul, Korea.
Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Nutr Diabetes. 2015 Apr 27;5(4):e149. doi: 10.1038/nutd.2014.46.
Metabolically obese but normal weight (MONW) individuals constitute a subgroup of normal weight individuals that display impaired insulin sensitivity with a higher risk of developing diabetes, cardiovascular disease and mortality. We aimed to propose a novel criterion for defining MONW by examining the usefulness and the cutoff value of the TyG index, a product of the levels of triglycerides and glucose, in identifying MONW individuals. In addition, the performance of this criterion in predicting the future incidence of diabetes was assessed.
SUBJECTS/METHODS: A total of 7541 non-diabetic, normal weight (body mass index ⩾18.5 and <25 kg m(-)(2)) subjects were selected from the Korea National Health and Nutrition Examination Survey conducted in 2009-2010. Another 3185 participants with follow-up studies were selected from a prospective community-based cohort study. The TyG index was calculated as ln(fasting triglycerides (mg dl(-1)) × fasting glucose (mg dl(-1))/2).
The levels of the TyG index paralleled the prevalence of metabolic syndrome and its components. The cutoff value of the TyG index that reflected MONW based on the receiver operating characteristics analysis was 8.82 for men and 8.73 for women, with the area under the curve values being 0.855 and 0.868, respectively. The sensitivity and the specificity were 84.2 and 77.6% in men and 69.1 and 89.4% in women, respectively. Individuals designated as MONW, who have a normal weight and TyG levels higher than cutoff, displayed a metabolically unhealthy phenotype and an approximately twofold higher risk of developing diabetes compared with metabolically healthy normal weight subjects.
We propose a simple diagnostic criterion of MONW, which might be used to discriminate subjects with a higher risk of metabolic diseases.
代谢性肥胖但体重正常（MONW）个体是体重正常个体中的一个亚组，其胰岛素敏感性受损，患糖尿病、心血管疾病和死亡的风险更高。我们旨在通过研究甘油三酯与葡萄糖水平乘积的TyG指数在识别MONW个体中的有用性和临界值，提出一种定义MONW的新标准。此外，还评估了该标准在预测糖尿病未来发病率方面的表现。
受试者/方法：从2009 - 2010年进行的韩国国民健康与营养检查调查中选取了7541名非糖尿病、体重正常（体重指数⩾18.5且<25 kg·m⁻²）的受试者。另外，从一项基于社区的前瞻性队列研究中选取了3185名进行随访研究的参与者。TyG指数计算为ln（空腹甘油三酯（mg·dl⁻¹）×空腹血糖（mg·dl⁻¹）/2）。
TyG指数水平与代谢综合征及其组分的患病率平行。基于受试者工作特征分析反映MONW的TyG指数临界值，男性为8.82，女性为8.73，曲线下面积值分别为0.855和0.868。男性的敏感性和特异性分别为84.2%和77.6%，女性分别为69.1%和89.4%。被指定为MONW的个体，体重正常但TyG水平高于临界值，与代谢健康的体重正常受试者相比，表现出代谢不健康的表型，患糖尿病的风险高出约两倍。
我们提出了一种简单的MONW诊断标准，可用于鉴别代谢疾病风险较高的受试者。
