空腹甘油三酯和葡萄糖指数作为诊断青年人群胰岛素抵抗的指标。
Fasting Triglycerides and Glucose Index as a Diagnostic Test for Insulin Resistance in Young Adults.
机构信息
Biomedical Research Unit, Mexican Social Security Institute, Durango, Mexico, and Research Group on Diabetes and Chronic Illnesses, Durango, Mexico.
Faculty of Higher Studies Iztacala, National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
出版信息
Arch Med Res. 2016 Jul;47(5):382-387. doi: 10.1016/j.arcmed.2016.08.012.
BACKGROUND AND AIMS
Although the Glucose and Triglyceride levels (TyG) index is useful for identification of insulin resistance (IR) in different ethnic groups, it has not been evaluated in young adults. We undertook this study to evaluate the TyG index as a diagnostic test for IR in young adults.
METHODS
A total of 5,538 healthy young adults, 3,795 (68.5%) non-pregnant women and 1,743 (31.5%) men, with an average age of 19.2 ± 1.4 years, were enrolled in a population-based cross-sectional study. To estimate diagnostic characteristics of the TyG index, a randomized subsample of the target population (n = 75) was under euglycemic-hyperinsulinemic clamp test. Using the cutoff values obtained in the clamp study, the diagnostic concordance between TyG index and HOMA-IR was evaluated in the overall population. The TyG index was calculated as the Ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)]/2.
RESULTS
Normal weight, overweight, and obesity were identified in 3,632 (65.6%), 1,355 (24.5%), and 551 (9.9%) participants. A total of 346 (9.1%) men and 278 (15.9%) women exhibited IR. The best cutoff value of TyG index for diagnosis of IR was 4.55 (sensitivity 0.687, negative predictive value (NPV) 0.844, and negative likelihood ratio (NLR) 0.47) for women and 4.68 (sensitivity 0.673, NPV 0.900, and NLR 0.45) for men. In normal-weight individuals the diagnostic concordance between TyG index and HOMA-IR was 0.934 and 0.915, in the overweight subjects was 0.908 and 0.895 and, in the obese participants 0.916 and 0.950, for men and women, respectively.
CONCLUSIONS
TyG index may be useful for screening IR in young adults.
背景与目的
虽然葡萄糖-甘油三酯（TyG）指数在不同种族的胰岛素抵抗（IR）识别中很有用，但尚未在年轻人中进行评估。我们进行这项研究是为了评估 TyG 指数作为年轻人 IR 的诊断测试。
方法
一项基于人群的横断面研究共纳入了 5538 名健康的年轻成年人，其中 3795 名（68.5%）为非孕妇，1743 名（31.5%）为男性，平均年龄为 19.2±1.4 岁。为了估计 TyG 指数的诊断特征，在目标人群中随机抽取了一个亚样本（n=75）进行了 euglycemic-hyperinsulinemic 钳夹试验。在钳夹研究中获得的截断值的基础上，评估了 TyG 指数和 HOMA-IR 之间的总体人群诊断一致性。TyG 指数的计算方法为 Ln[空腹甘油三酯（mg/dL）×空腹血糖（mg/dL）]/2。
结果
在参与者中，正常体重、超重和肥胖分别为 3632 名（65.6%）、1355 名（24.5%）和 551 名（9.9%）。346 名男性（9.1%）和 278 名女性（15.9%）存在 IR。对于女性，TyG 指数诊断 IR 的最佳截断值为 4.55（敏感性 0.687、阴性预测值（NPV）0.844 和负似然比（NLR）0.47），对于男性为 4.68（敏感性 0.673、NPV 0.900 和 NLR 0.45）。在正常体重的个体中，TyG 指数与 HOMA-IR 的诊断一致性分别为 0.934 和 0.915，在超重个体中分别为 0.908 和 0.895，在肥胖个体中分别为 0.916 和 0.950，男女分别为 0.934 和 0.915。
结论
TyG 指数可能有助于筛查年轻人的 IR。
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