Yao Litong, Wang Xinyu, Zhong Yifan, Wang Yan, Wu Jingyang, Geng Jin, Zhou Yun, Chen Jun, Guan Peng, Xu Yingying, Chen Lei, Liu Lei, Hu Yuedong
Department of Breast Surgery, First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China.
China Medical University, Shenyang, 110001, People's Republic of China.
Diabetes Metab Syndr Obes. 2021 Apr 9;14:1547-1555. doi: 10.2147/DMSO.S294408. eCollection 2021.
This study aimed to investigate the association between the triglyceride-glucose (TyG) index and diabetic retinopathy (DR) in Chinese patients with type 2 diabetes.
In this nested case-control study, all diabetic participants were registered hospitalizations during 2012-2018, including 596 with DR as cases and three matching controls per case. DR was assessed using Early Treatment Diabetic Retinopathy Study criteria. The TyG index was calculated: Ln (fasting blood glucose [mg/dL] × fasting triglycerides [mg/dL] ÷ 2). Multivariate logistic regression, a receiver-operating characteristic (ROC) curve, linear regression models, and mediation analysis were used to explore associations.
The TyG index was lower in DR and decreased as its severity advanced among 2,112 subjects (=0.005). After confounders (sex, duration of diabetes, use of antidiabetic agents, heart rate, systolic blood pressure, pulse pressure, height, weight, body-mass index, and glycated hemoglobin) had been accounted for, there were significant associations between the TyG index and any-severity DR (OR 0.83, 95% CI 0.73-0.95; =0.006), as well as vision-threatening DR (VTDR; OR 0.53, 95% CI 0.36-0.76; =0.001). ROC analysis indicated that the TyG index showed significant discriminatory ability in any-severity DR (area under curve [AUC] 0.534, =0.015) and VTDR (AUC 0.624, =0.001).
The TyG index was associated with the presence and severity of DR. Our findings suggest that the TyG index may become a useful biomarker in evaluating and following the presence of DR and VTDR.
本研究旨在探讨中国2型糖尿病患者中甘油三酯-葡萄糖(TyG)指数与糖尿病视网膜病变(DR)之间的关联。
在这项巢式病例对照研究中,所有糖尿病参与者均为2012年至2018年期间登记的住院患者,其中596例患有DR作为病例组,每组病例匹配3名对照。采用糖尿病视网膜病变早期治疗研究标准评估DR。计算TyG指数:Ln(空腹血糖[mg/dL]×空腹甘油三酯[mg/dL]÷2)。使用多因素逻辑回归、受试者工作特征(ROC)曲线、线性回归模型和中介分析来探讨关联。
在2112名受试者中,DR患者的TyG指数较低,且随着病情严重程度的增加而降低(P=0.005)。在调整了混杂因素(性别、糖尿病病程、使用抗糖尿病药物、心率、收缩压、脉压、身高、体重、体重指数和糖化血红蛋白)后,TyG指数与任何严重程度的DR(OR 0.83,95%CI 0.73-0.95;P=0.006)以及威胁视力的DR(VTDR;OR 0.53,95%CI 0.36-0.76;P=0.001)之间存在显著关联。ROC分析表明,TyG指数在任何严重程度的DR(曲线下面积[AUC] 0.534,P=0.015)和VTDR(AUC 0.624,P=0.001)中显示出显著的鉴别能力。
TyG指数与DR的存在和严重程度相关。我们的研究结果表明,TyG指数可能成为评估和随访DR及VTDR存在情况的有用生物标志物。