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甘油三酯葡萄糖指数与老年人非酒精性脂肪性肝病发病率的关系:一项中国的回顾性队列研究

Relationship between triglyceride glucose index and the incidence of non-alcoholic fatty liver disease in the elderly: a retrospective cohort study in China.

作者信息

Huanan Chen, Sangsang Li, Amoah Adwoa Nyantakyiwaa, Yacong Bo, Xuejiao Chen, Zhan Shi, Guodong Wan, Jian Huang, Songhe Shi, Quanjun Lyu

机构信息

Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China.

Medical Record Room, Xinyang Central Hospital, Xinyang, China.

出版信息

BMJ Open. 2020 Nov 27;10(11):e039804. doi: 10.1136/bmjopen-2020-039804.

Abstract

OBJECTIVE

Non-alcoholic fatty liver disease (NAFLD) is one of the major causes of liver-related diseases but relationship between triglyceride glucose (TyG) and NAFLD in the elderly is not reported yet. In this study, we investigated the role of TyG index for predicting the incidence of NAFLD in the elderly.

DESIGN AND SETTING

This is a prospective cohort study in Henan, China, from 2011 to 2018.

PARTICIPANTS AND METHODS

In total, 46 693 elderly who participated in a routine physical examination programme from 2011 to 2018 were included in this study. TyG index was calculated as ln (fasting triglyceride (mg/dL)×fasting plasma glucose (mg/dL)/2), while NAFLD was defined as hepatic steatosis after excluding other causes based on the results of abdominal ultrasonography; Cox regression model was performed to explore the relationship between TyG index and NAFLD. Also, mediation effect was used to analyse the role of the TyG index in WHtR (waist-to-height ratio) and NAFLD.

RESULTS

During the 149 041 person-years follow-up, a total of 5660 NAFLD events occurred (3.80/100 person-years). After adjusting for potential confounding factors, quartiles 4 of TyG index significantly increased the incidence of NAFLD compared with quartile 1, the HRs and 95% CI were 1.314 (1.234 to 1.457). In addition, TyG index played a partial mediating role in the relationship between WHtR and NAFLD and indirect effect was 1.009 (1.006 to 1.011).

CONCLUSION

Higher TyG index was associated with higher risk of NAFLD in the aged, and therefore, TyG index may be a novel predictor for incidence of NAFLD. Further, regular examination and evaluation of the TyG index might be useful for controlling the occurrence of NAFLD.

摘要

目的

非酒精性脂肪性肝病(NAFLD)是肝脏相关疾病的主要病因之一,但甘油三酯葡萄糖(TyG)与老年人NAFLD之间的关系尚未见报道。在本研究中,我们调查了TyG指数在预测老年人NAFLD发病率中的作用。

设计与背景

这是一项于2011年至2018年在中国河南进行的前瞻性队列研究。

研究对象与方法

本研究共纳入了2011年至2018年参加常规体检项目的46693名老年人。TyG指数计算为ln(空腹甘油三酯(mg/dL)×空腹血糖(mg/dL)/2),而NAFLD根据腹部超声检查结果在排除其他病因后定义为肝脂肪变性;采用Cox回归模型探讨TyG指数与NAFLD之间的关系。此外,还使用中介效应分析TyG指数在腰高比(WHtR)与NAFLD之间的作用。

结果

在149041人年的随访期间,共发生5660例NAFLD事件(3.80/100人年)。在调整潜在混杂因素后,TyG指数的第4四分位数与第1四分位数相比,显著增加了NAFLD的发病率,HR及95%CI为1.314(1.234至1.457)。此外,TyG指数在WHtR与NAFLD的关系中起部分中介作用,间接效应为1.009(1.006至1.011)。

结论

较高的TyG指数与老年人患NAFLD的较高风险相关,因此,TyG指数可能是NAFLD发病率的一个新的预测指标。此外,定期检查和评估TyG指数可能有助于控制NAFLD的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e945/7703442/95538aad4213/bmjopen-2020-039804f01.jpg

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