在 2 型糖尿病患者中，三酰甘油葡萄糖指数与动脉僵硬度的相关性强于 HOMA-IR：一项真实世界的单中心研究。
Stronger association of triglyceride glucose index than the HOMA-IR with arterial stiffness in patients with type 2 diabetes: a real-world single-centre study.
机构信息
Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Cardiovasc Diabetol. 2021 Apr 22;20(1):82. doi: 10.1186/s12933-021-01274-x.
BACKGROUND
The triglyceride-glucose index (TyG index) has been proposed as a simple and reliable alternative insulin resistance (IR) marker, while the homeostasis model assessment for IR (HOMA-IR) is the most frequently used index. Few studies have evaluated the role of IR assessed by the TyG index and HOMA-IR on arterial stiffness in a type 2 diabetes (T2D) population with a high risk of increased arterial stiffness. We aimed to investigate the association of the TyG index and HOMA-IR with arterial stiffness in patients with T2D.
METHODS
We recruited 3185 patients with T2D, who underwent brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness, but without previous cardiovascular disease. Increased arterial stiffness was defined as a baPWV value greater than the 75th percentile (18.15 m/s) in the present study. The TyG index was determined as ln(fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2), and the HOMA-IR was calculated as (fasting insulin [μIU/mL] × fasting glucose [mmol/L])/22.5.
RESULTS
The mean age of the study participants was 54.6 ± 12.0 years, and 1954 (61.4%) were men. Seemingly unrelated regression estimation analysis demonstrated that the TyG index had stronger associations with baPWV than the HOMA-IR (all P < 0.001). In the multivariable logistic analyses, each one-unit increase in the TyG index was associated with a 1.40-fold (95% CI 1.16-1.70, P < 0.001) higher prevalence of increased arterial stiffness, but the prominent association of the HOMA-IR with the prevalence of increased arterial stiffness was not observed. Subgroup analyses showed that a more significant association between the TyG index and the prevalence of increased arterial stiffness was detected in older patients with a longer duration of diabetes and poor glycaemic control (all P < 0.05).
CONCLUSIONS
Compared with the HOMA-IR, the TyG index is independently and more strongly associated with arterial stiffness in patients with T2D.
背景
三酰甘油-葡萄糖指数（TyG 指数）已被提出作为一种简单可靠的胰岛素抵抗（IR）替代标志物，而稳态模型评估的胰岛素抵抗（HOMA-IR）是最常用的指标。很少有研究评估 TyG 指数和 HOMA-IR 评估的 IR 在动脉僵硬风险增加的 2 型糖尿病（T2D）人群中的作用。我们旨在研究 T2D 患者的 TyG 指数和 HOMA-IR 与动脉僵硬的相关性。
方法
我们招募了 3185 名 T2D 患者，他们接受了肱踝脉搏波速度（baPWV）检查，这是动脉僵硬的一个指标，但没有先前的心血管疾病。在本研究中，动脉僵硬增加定义为 baPWV 值大于第 75 百分位（18.15 m/s）。TyG 指数被确定为 ln（空腹三酰甘油[mg/dL]×空腹血糖[mg/dL]/2），HOMA-IR 被计算为（空腹胰岛素[μIU/mL]×空腹血糖[mmol/L]）/22.5。
结果
研究参与者的平均年龄为 54.6±12.0 岁，1954 名（61.4%）为男性。似乎不相关的回归估计分析表明，TyG 指数与 baPWV 的相关性强于 HOMA-IR（均 P<0.001）。在多变量逻辑分析中，TyG 指数每增加一个单位，动脉僵硬增加的患病率增加 1.40 倍（95%CI 1.16-1.70，P<0.001），而 HOMA-IR 与动脉僵硬增加的患病率的显著相关性并未观察到。亚组分析显示，在年龄较大、糖尿病病程较长和血糖控制较差的患者中，TyG 指数与动脉僵硬增加的患病率之间的相关性更为显著（均 P<0.05）。
结论
与 HOMA-IR 相比，TyG 指数与 T2D 患者的动脉僵硬更为独立且密切相关。
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