Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China.
Department of Endocrinology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.
Lipids Health Dis. 2020 Oct 15;19(1):226. doi: 10.1186/s12944-020-01401-9.
Prediabetes has become a pandemic. This study aimed to identify a better predictor for the incidence of prediabetes, which we hypothesize to be the triglyceride-glucose (TyG) index, a simplified insulin resistance index. We compared its predictive value with the other common risk factors of prediabetes.
The participants of this analysis were derived from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study. A total of 4543 participants without initial prediabetes or diabetes were followed up for 3.25 years. Using multivariate logistic regression model, the associations between baseline obesity, lipid profiles and non-insulin-based insulin resistance indices with the incidence of prediabetes were analyzed. To assess which is better predictor for the incidence of prediabetes, the area under curves (AUCs) calculated from the receiver operating characteristic curve analyses were used to evaluate and compare with the predictive value of the different indices.
During the 3.25 years, 1071 out of the 4543 participants developed prediabetes. Using the logistic regression analysis adjusted for some potential confounders, the risk of incidence of prediabetes increased 1.38 (1.28-1.48) fold for each 1-SD increment of TyG index. The predictive ability (assessed by AUCs) of TyG index for predicting prediabetes was 0.60 (0.58-0.62), which was superior to the indices of obesity, lipid profiles and other non-insulin-based insulin resistance indices. Although the predictive ability of the TyG index was overall similar to fasting plasma glucose (FPG) (P = 0.4340), TyG index trended higher than FPG in females (0.62 (0.59-0.64) vs. 0.59 (0.57-0.61), P = 0.0872) and obese subjects (0.59 (0.57-0.62) vs. 0.57 (0.54-0.59), P = 0.1313). TyG index had superior predictive ability for the prediabetic phenotype with isolated impaired glucose tolerance compared with FPG (P < 0.05) and other indices. Furthermore, TyG index significantly improved the C statistic (0.62 (0.60-0.64)), integrated discrimination improvement (1.89% (1.44-2.33%)) and net reclassification index (28.76% (21.84-35.67%)) of conventional model in predicting prediabetes than other indices.
TyG could be a potential predictor to identify the high risk individuals of prediabetes.
糖尿病前期已成为一种全球性疾病。本研究旨在寻找一种更好的预测糖尿病前期发生的指标，我们假设该指标是甘油三酯-葡萄糖（TyG）指数，这是一种简化的胰岛素抵抗指数。我们将其预测价值与其他常见的糖尿病前期危险因素进行了比较。
本分析的参与者来自中国糖尿病患者癌症风险评估：一项纵向（REACTION）研究。共有 4543 名无初始糖尿病前期或糖尿病的参与者随访 3.25 年。使用多变量逻辑回归模型，分析基线肥胖、血脂谱和非胰岛素基础胰岛素抵抗指数与糖尿病前期发生的关系。为了评估哪种方法是预测糖尿病前期发生的更好指标，我们使用来自接受者操作特征曲线分析的曲线下面积（AUC）来评估和比较不同指标的预测价值。
在 3.25 年期间，4543 名参与者中有 1071 名发生了糖尿病前期。使用调整了一些潜在混杂因素的逻辑回归分析，TyG 指数每增加 1 个标准差，糖尿病前期发生的风险增加 1.38 倍（1.28-1.48）。TyG 指数预测糖尿病前期的能力（通过 AUCs 评估）为 0.60（0.58-0.62），优于肥胖、血脂谱和其他非胰岛素基础胰岛素抵抗指数的指标。尽管 TyG 指数的预测能力总体上与空腹血糖（FPG）相似（P=0.4340），但在女性（0.62（0.59-0.64）比 0.59（0.57-0.61），P=0.0872）和肥胖者（0.59（0.57-0.62）比 0.57（0.54-0.59），P=0.1313）中，TyG 指数的预测能力更高。与 FPG（P<0.05）和其他指数相比，TyG 指数对单纯糖耐量受损的糖尿病前期表型具有更好的预测能力。此外，与其他指数相比，TyG 指数显著提高了传统模型预测糖尿病前期的 C 统计量（0.62（0.60-0.64））、综合判别改善（1.89%（1.44-2.33%））和净重新分类指数（28.76%（21.84-35.67%））。
TyG 可能是一种潜在的预测糖尿病前期的指标。
