Sánchez-García Adriana, Rodríguez-Gutiérrez René, Mancillas-Adame Leonardo, González-Nava Victoria, Díaz González-Colmenero Alejandro, Solis Ricardo Cesar, Álvarez-Villalobos Neri Alejandro, González-González José Gerardo
Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Endocrinology Division, Av. Madero y Gonzalitos S/n, Mitras Centro, Monterrey 64460, Nuevo León, Mexico.
Universidad Autonoma de Nuevo Leon, Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Av. Madero y Gonzalitos S/n, Mitras Centro, Monterrey 64460, Nuevo León, Mexico.
Int J Endocrinol. 2020 Mar 10;2020:4678526. doi: 10.1155/2020/4678526. eCollection 2020.
. The triglyceride and glucose (TyG) index has been described as a biochemical marker of insulin resistance (IR); however, its diagnostic accuracy remains uncertain.
To summarize the evidence assessing the diagnostic accuracy of the TyG index regarding IR.
A comprehensive search in MEDLINE, EMBASE, Web of Science, and Scopus was performed without any language restriction. Studies assessing the diagnostic accuracy of the TyG index against the hyperinsulinemic-euglycemic clamp (HIEC) or any other IR biochemical were assessed independently and in duplicate. Diagnostic accuracy measures (sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios) were extracted independently and in duplicate. The QUADAS-2 tool was used to assess the risk of bias of independent studies.
We identified 15 eligible studies with 69,922 participants and an overall quality of low to moderate. The TyG index was evaluated by HIEC and HOMA as reference tests. The highest achieved sensitivity was 96% using HIEC, and the highest specificity was of 99% using HOMA-IR, with a cutoff value of 4.68. AUC values varied from 0.59 to 0.88. Cutoff values for IR were variable between studies, limiting its comparability.
In this systematic review, we found moderate-to-low quality evidence about the usefulness of the TyG index as a surrogate biochemical marker of IR. Due to the lack of a standardized IR definition and heterogeneity between studies, further validation and standardized cutoff values are needed to be used in clinical practice.
甘油三酯与葡萄糖（TyG）指数已被描述为胰岛素抵抗（IR）的生化标志物；然而，其诊断准确性仍不确定。
总结评估TyG指数对IR诊断准确性的证据。
在MEDLINE、EMBASE、科学网和Scopus中进行全面检索，无语言限制。评估TyG指数相对于高胰岛素正常血糖钳夹试验（HIEC）或任何其他IR生化指标诊断准确性的研究进行独立和重复评估。独立且重复地提取诊断准确性指标（敏感性、特异性、阳性预测值、阴性预测值和似然比）。使用QUADAS - 2工具评估独立研究的偏倚风险。
我们确定了15项符合条件的研究，共69922名参与者，总体质量为低到中等。TyG指数通过HIEC和HOMA作为参考试验进行评估。使用HIEC时达到的最高敏感性为96%，使用HOMA - IR时最高特异性为99%，临界值为4.68。AUC值在0.59至0.88之间变化。各研究之间IR的临界值各不相同，限制了其可比性。
在本系统评价中，我们发现关于TyG指数作为IR替代生化标志物有用性的证据质量为中到低。由于缺乏标准化的IR定义以及研究之间的异质性，临床实践中需要进一步验证和标准化临界值。
