Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China.
Department of Cardiovascular Medicine, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region, Chengdu, China.
Endocrine. 2021 Apr;72(1):124-131. doi: 10.1007/s12020-020-02589-7. Epub 2021 Jan 12.
Triglyceride-glucose (TyG) index is an emerging surrogate predictor of incident type 2 diabetes mellitus (T2DM). The study aimed to examine the association between TyG index and incident T2DM in a prospective Chinese cohort.
The data were collected in 1992 and recollected in 2007 from the same group of 687 participants. The association between TyG index and T2DM was analysed.
During follow-up, 74 participants developed T2DM and the risk of T2DM increased with TyG index. The adjusted hazard ratio (HR) was 3.36 (95% CI: 1.52-7.39, P < 0.001) comparing the top TyG quartile to the bottom quartile. Smooth curve fitting revealed a nonlinear association and threshold effect between TyG index and incident T2DM with a nadir of risk when TyG index was around 8.51. For TyG ≤ 8.51, the risk of incident T2DM tended to decrease with per SD increase in TyG but no statistical significance was achieved (adjusted HR: 0.69, 95% CI: 0.43-1.12, P = 0.133). For TyG > 8.51, the risk of incident T2DM significantly increased by 38% with per SD increase in TyG (adjusted HR: 1.38, 95% CI: 1.14-1.67, P = 0.001). Time-dependent receiver operating curve suggested helpful discriminative power of TyG index for T2DM. It also significantly promoted the reclassification ability beyond the baseline risk model with net reclassification index of 0.159 (P = 0.020). Sensitivity analysis excluding participants with prediabetes demonstrated similar results.
The TyG index was a significant and independent predictor for future T2DM development. The shape of relationship will require further studies.
甘油三酯-葡萄糖（TyG）指数是 2 型糖尿病（T2DM）发生的新兴替代预测指标。本研究旨在检验 TyG 指数与中国前瞻性队列中 T2DM 发生的相关性。
数据于 1992 年收集，并于 2007 年从同一组 687 名参与者中重新收集。分析了 TyG 指数与 T2DM 之间的关系。
随访期间，74 名参与者发生了 T2DM，且 TyG 指数越高，T2DM 的发病风险越高。与 TyG 指数最低四分位数相比，TyG 指数最高四分位数的调整后风险比（HR）为 3.36（95%CI：1.52-7.39，P<0.001）。平滑曲线拟合显示，TyG 指数与 T2DM 之间存在非线性关联和阈值效应，当 TyG 指数约为 8.51 时风险最低。对于 TyG≤8.51，随着 TyG 每增加 1 个标准差，T2DM 发病风险呈下降趋势，但无统计学意义（调整后 HR：0.69，95%CI：0.43-1.12，P=0.133）。对于 TyG>8.51，TyG 每增加 1 个标准差，T2DM 发病风险显著增加 38%（调整后 HR：1.38，95%CI：1.14-1.67，P=0.001）。时间依赖性接收者操作特征曲线表明 TyG 指数对 T2DM 具有良好的区分能力。它还显著提高了基线风险模型的重新分类能力，净重新分类指数为 0.159（P=0.020）。排除糖尿病前期患者的敏感性分析显示了类似的结果。
TyG 指数是未来 T2DM 发生的一个显著且独立的预测因素。TyG 指数与 T2DM 之间的关系需要进一步研究。
