Unidad de Endocrinología Pediátrica, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain.
Servicio de Análisis Clínicos y Bioquímica Clínica, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain.
Endocrinol Diabetes Nutr (Engl Ed). 2021 May;68(5):296-303. doi: 10.1016/j.endien.2020.08.015. Epub 2021 Sep 6.
To examine the triglyceride/glucose index (TyG) as an insulin resistance marker in obese children and adolescents and its relation to clinical and biochemical parameters, body composition and lifestyle.
Sixty patients aged 7-16 years of age were enrolled. Anthropometric variables were recorded, together with pubertal stage, blood pressure and body composition assessed by bioimpedance. The TyG index was calculated as ln (fasting glucose (mg/dL) × triglycerides (mg/dL))/2 and the HOMA (homeostatic model assessment) index as fasting insulin (μU/mL) × fasting glucose (mmol/L)/22.5. Feeding habits were documented by adherence to the Mediterranean dietary pattern questionnaire, while physical activity was assessed using the International Sedentary Assessment Tool (ISAT), as well as accelerometry (Actigraph wGT3X+).
The mean TyG index was 4.45 ± 0.18, and proved higher in the pubertal group. We found a positive correlation with the HOMA index (r = 0.39; P = 0.03) and TG/HDL-c index (r = 0.53; P < 0.001). The best cut-off point of the TyG index for predicting insulin resistance was 4.21 in prepubertal children (sensitivity 84%, specificity 100%; AUC: 0.84) and 4.33 in pubertal children (sensitivity 89%, specificity 69%; AUC: 0.61). A positive correlation was found with screen time (r = 0.39; P = 0.01), as well as a negative correlation with caloric expenditure (Kcal/day) in the prepubertal group (r = -0.81; P = 0.005).
The TyG index could be a useful insulin resistance marker in the pediatric population. Moderate to vigorous physical activity should be encouraged, as well as restricting screen time for leisure purposes, mainly in the prepubertal group.
本研究旨在探讨甘油三酯/葡萄糖指数（TyG）作为肥胖儿童和青少年胰岛素抵抗标志物的作用，并分析其与临床和生化参数、身体成分和生活方式的关系。
共纳入 60 名 7-16 岁的肥胖儿童和青少年。记录了患者的各项人体测量学变量，同时还评估了其青春期阶段、血压和身体成分（通过生物阻抗法）。TyG 指数的计算方法为 ln（空腹血糖（mg/dL）×甘油三酯（mg/dL））/2，HOMA（稳态模型评估）指数的计算方法为空腹胰岛素（μU/mL）×空腹血糖（mmol/L）/22.5。通过地中海饮食模式问卷评估饮食习惯，通过国际久坐评估工具（ISAT）和加速度计（Actigraph wGT3X+）评估身体活动情况。
平均 TyG 指数为 4.45±0.18，且在青春期组中更高。我们发现其与 HOMA 指数呈正相关（r=0.39；P=0.03），与 TG/HDL-c 指数呈正相关（r=0.53；P<0.001）。在青春期前儿童中，TyG 指数预测胰岛素抵抗的最佳截断值为 4.21（灵敏度 84%，特异性 100%；AUC：0.84），在青春期儿童中为 4.33（灵敏度 89%，特异性 69%；AUC：0.61）。TyG 指数与屏幕时间呈正相关（r=0.39；P=0.01），与青春期前儿童的热量消耗（Kcal/天）呈负相关（r=-0.81；P=0.005）。
TyG 指数可能是儿童人群中一种有用的胰岛素抵抗标志物。应鼓励儿童和青少年进行中等至剧烈强度的身体活动，并限制闲暇时间的屏幕时间，尤其是在青春期前儿童中。
