Rodríguez-Morán M, Simental-Mendía L E, Guerrero-Romero F
Biomedical Research Unit of the Mexican Social Security Institute, Durango, Mexico.
Acta Paediatr. 2017 Jun;106(6):979-983. doi: 10.1111/apa.13789. Epub 2017 Mar 20.
Although recognising insulin resistance (IR) in children is particularly important, the gold standard test used to diagnose it, the euglyceamic glucose clamp, is costly, invasive and is not routinely available in our clinical settings in Mexico. This study evaluated whether the triglyceride-glucose (TyG) index would provide a useful alternative.
A total of 2779 school children aged seven to 17 years, from Durango, Mexico, were enrolled during 2015-2016. The gold standard euglyceamic-hyperinsulinemic clamp test was performed in a randomly selected subsample of 125 children, and diagnostic concordance between the TyG index and the homoeostasis model assessment of IR was evaluated in all of the 2779 enrolled children.
The best cut-off values for recognising IR using the TyG index were 4.65 for prepubertal girls and boys, 4.75 for pubertal girls and 4.70 for pubertal boys. Concordance between the TyG index and the homoeostasis model assessment of IR was 0.910 and 0.902 for the prepubertal girls and boys, 0.932 for the pubertal girls and 0.925 for the pubertal boys.
The TyG index was useful for recognising IR in both prepubertal and pubertal children and could provide a feasible alternative to the costly and invasive gold standard test for IR in resource-limited settings.
尽管认识到儿童胰岛素抵抗（IR）尤为重要，但用于诊断它的金标准试验——正常血糖胰岛素钳夹试验成本高、具有侵入性，且在墨西哥的临床环境中并非常规可用。本研究评估了甘油三酯-葡萄糖（TyG）指数是否能提供一种有用的替代方法。
2015年至2016年期间，从墨西哥杜兰戈招募了总共2779名7至17岁的在校儿童。对随机抽取的125名儿童子样本进行了金标准正常血糖-高胰岛素钳夹试验，并在所有2779名入组儿童中评估了TyG指数与IR的稳态模型评估之间的诊断一致性。
使用TyG指数识别IR的最佳截断值，青春期前女孩和男孩为4.65，青春期女孩为4.75，青春期男孩为4.70。青春期前女孩和男孩中，TyG指数与IR的稳态模型评估之间的一致性分别为0.910和0.902，青春期女孩为0.932，青春期男孩为0.925。
TyG指数有助于识别青春期前和青春期儿童的IR，并且在资源有限的环境中，可为成本高且具有侵入性的IR金标准试验提供一种可行的替代方法。
