Clinical Research Unit, Khoo Teck Puat Hospital, Singapore.
Transformation Office, Hospital Administration, Khoo Teck Puat Hospital, Singapore.
Diabetes Res Clin Pract. 2018 Sep;143:43-49. doi: 10.1016/j.diabres.2018.06.006. Epub 2018 Jun 21.
Triglyceride-Glucose (TyG) is an emerging surrogate indicator of insulin resistance. We explored the role of TyG in development of Type 2 Diabetes Mellitus (T2DM) and elucidated the mechanism for the relationship.
4109 subjects without baseline T2DM participated in a community screening programme in 2013-2016. TyG was calculated as Ln[fasting triglyceride level (mg/dl) × fasting plasma glucose (FPG) (mg/dl)/2]. Outcome was T2DM defined as FPG ≥ 7.0 mmol/l; current treatment with anti-diabetes medication; and/or self-reported diabetes on follow-up screening. We used Cox proportion-hazard model to assess risk of T2DM by TyG quartiles at baseline. Binary mediation analysis was performed to examine extent of mediation by TyG between Body Mass Index (BMI) and T2DM development.
After 5734.23 person-years of follow-up, T2DM developed in 117 subjects with an incidence of 20.40/1000 person-years. Risk of T2DM incidence was increased with quartiles 2, 3 and 4 versus quartile 1 of TyG (adjusted HR 1.79(95%CI 0.80-3.99), 2.54 (1.18-5.49) and 4.68(2.19-10.01), P < 0.001) across TyG quartiles. TyG accounted for 35.1% of association between BMI and T2DM development, having adjusted for potential cofounders (p < 0.001).
TyG is potentially useful for predicting T2DM in clinical practice. It is a potential mediator of association between BMI and T2DM development.
甘油三酯-葡萄糖（TyG）是一种新出现的胰岛素抵抗替代指标。我们探讨了 TyG 在 2 型糖尿病（T2DM）发展中的作用，并阐明了两者之间关系的机制。
在 2013-2016 年的社区筛查项目中，共有 4109 名无基线 T2DM 的受试者参与了该研究。TyG 通过以下公式计算：Ln[空腹甘油三酯水平（mg/dl）×空腹血糖（FPG）（mg/dl）/2]。结局为 FPG≥7.0mmol/l；目前使用抗糖尿病药物治疗；以及/或随访筛查时自述患有糖尿病。我们使用 Cox 比例风险模型评估基线 TyG 四分位间距时 T2DM 的发病风险。二元中介分析用于检验 TyG 在 BMI 与 T2DM 发展之间的中介作用程度。
在 5734.23 人年的随访后，117 名受试者发生 T2DM，发病率为 20.40/1000 人年。与 TyG 四分位间距 1 相比，T2DM 发病风险随 TyG 四分位间距 2、3 和 4 而增加（调整后的 HR 1.79（95%CI 0.80-3.99）、2.54（1.18-5.49）和 4.68（2.19-10.01），P<0.001）。在调整了潜在混杂因素后，TyG 解释了 BMI 与 T2DM 发展之间关联的 35.1%（p<0.001）。
TyG 可能有助于预测临床实践中的 T2DM。它是 BMI 与 T2DM 发展之间关联的潜在中介。
