Zhang Ming, Wang Bingyuan, Liu Yu, Sun Xizhuo, Luo Xinping, Wang Chongjian, Li Linlin, Zhang Lu, Ren Yongcheng, Zhao Yang, Zhou Junmei, Han Chengyi, Zhao Jingzhi, Hu Dongsheng
Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China.
The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
Cardiovasc Diabetol. 2017 Mar 1;16(1):30. doi: 10.1186/s12933-017-0514-x.
Risk of type 2 diabetes mellitus (T2DM) is increased in metabolically obese but normal-weight people. However, we have limited knowledge of how to prevent T2DM in normal-weight people. We aimed to evaluate the association between triglyceride glucose (TyG) index and incident T2DM among normal-weight people in rural China.
We included data from 5706 people with normal body mass index (BMI) (18.5-23.9 kg/m) without baseline T2DM in a rural Chinese cohort followed for a median of 6.0 years. A Cox proportional-hazard model was used to assess the risk of incident T2DM by quartiles of TyG index and difference in TyG index between follow-up and baseline (TyG-D), estimating hazard ratios (HRs) and 95% confidence intervals (CIs). A generalized additive plot was used to show the nonparametric smoothed exposure-response association between risk of T2DM and TyG index as a continuous variable. TyG was calculated as ln [fasting triglyceride level (mg/dl) × fasting plasma glucose level (mg/dl)/2].
Risk of incident T2DM was increased with quartiles 2, 3 and 4 versus quartile 1 of TyG index (adjusted HR [aHR] 2.48 [95% CI 1.20-5.11], 3.77 [1.83-7.79], and 5.30 [2.21-12.71], P < 0.001 across quartiles of TyG index). Risk of incident T2DM was increased with quartile 4 versus quartile 1 of TyG-D (aHR 3.91 [2.22-6.87]). The results were consistent when analyses were restricted to participants without baseline metabolic syndrome and impaired fasting glucose level. The generalized additive plot showed cumulative increased risk of T2DM with increasing TyG index.
Risk of incident T2DM is increased with increasing TyG index among rural Chinese people, so the index might be an important indicator for identifying people at high risk of T2DM.
代谢性肥胖但体重正常的人群患2型糖尿病（T2DM）的风险会升高。然而，我们对于如何在体重正常的人群中预防T2DM的了解有限。我们旨在评估中国农村体重正常人群中甘油三酯葡萄糖（TyG）指数与T2DM发病之间的关联。
我们纳入了来自中国农村队列中5706名体重指数（BMI）正常（18.5 - 23.9 kg/m²）且无基线T2DM的人群的数据，随访时间中位数为6.0年。采用Cox比例风险模型，通过TyG指数四分位数以及随访与基线之间的TyG指数差值（TyG-D）评估T2DM发病风险，估计风险比（HRs）和95%置信区间（CIs）。使用广义相加图展示T2DM风险与作为连续变量的TyG指数之间的非参数平滑暴露-反应关联。TyG的计算方法为ln[空腹甘油三酯水平（mg/dl）×空腹血糖水平（mg/dl）/2]。
与TyG指数第一四分位数相比，第二、第三和第四四分位数的T2DM发病风险升高（校正后HR[aHR]分别为2.48[95%CI 1.20 - 5.11]、3.77[1.83 - 7.79]和5.30[2.21 - 12.71]，TyG指数各四分位数间P < 0.001）。与TyG-D第一四分位数相比，第四四分位数的T2DM发病风险升高（aHR 3.91[2.22 - 6.87]）。当分析仅限于无基线代谢综合征和空腹血糖受损的参与者时，结果一致。广义相加图显示，随着TyG指数升高，T2DM的累积发病风险增加。
在中国农村人群中，T2DM发病风险随TyG指数升高而增加，因此该指数可能是识别T2DM高危人群的重要指标。
