2 型糖尿病住院患者糖尿病并发症与甘油三酯-血糖指数的关系。
Association between Diabetes Complications and the Triglyceride-Glucose Index in Hospitalized Patients with Type 2 Diabetes.
机构信息
Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Department of Endocrinology, Kunshan Hospital Affiliated to Jiangsu University, Kunshan, Jiangsu, China.
出版信息
J Diabetes Res. 2021 Oct 11;2021:8757996. doi: 10.1155/2021/8757996. eCollection 2021.
BACKGROUND
Triglyceride-glucose (TyG) index is a convenient indicator of insulin resistance. It has been shown to be associated with macrovascular and microvascular complications in nonhospitalized diabetic patients. However, whether TyG index is a risk factor of diabetes vascular complications in hospitalized type 2 diabetic patients is unclear. We sought to explore the association between TyG index and the risk of macrovascular and microvascular complications in a large Chinese cohort of hospitalized patients.
METHOD
A total of 4,721 patients with type 2 diabetes (T2D) who were hospitalized in the Department of Endocrinology, Kunshan Hospital Affiliated to Jiangsu University were enrolled between January 2015 and November 2020. TyG index was calculated as ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Measures of macrovascular complications included brachial-ankle pulse wave velocity (ba-PWV) and ankle-brachial index (ABI), whilst urine microalbumin (MAU), chronic kidney disease (CKD), and diabetic retinopathy (DR) were evaluated for microvascular complications. Logistic regressions were used to examine the association between TyG index and diabetes complications.
RESULTS
In univariate logistic regressions, higher TyG index was significantly ( < 0.002) associated with increased odds of MAU (OR = 1.39, 95% CI: [1.22~1.59]) and ABI (OR = 1.31, 95% CI: [1.10-1.57]) but not CKD, DR, or ba-PWV. After controlling for confounders such as age, sex, and body mass index (BMI), TyG index remained strongly ( < 0.002) associated with MAU and ABI. These associations were more pronounced ( < 0.001) in patients with poor glycemic control or in the elderly.
CONCLUSION
Hospitalized patients with an elevated TyG index were at a higher risk of lower limb vascular stenosis and nephric microvascular damage. Close monitoring of TyG index in patients with younger age or poor glycemic control could potentially reduce the burden of diabetes complications and prevent readmission.
背景
甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗的一个便捷指标。已证实它与非住院糖尿病患者的大血管和微血管并发症相关。然而，TyG 指数是否是住院 2 型糖尿病患者糖尿病血管并发症的一个危险因素尚不清楚。我们旨在探讨大型中国住院患者队列中 TyG 指数与大血管和微血管并发症风险之间的关系。
方法
共纳入 2015 年 1 月至 2020 年 11 月期间在江苏大学附属昆山医院内分泌科住院的 4721 例 2 型糖尿病（T2D）患者。TyG 指数计算方法为 ln[空腹甘油三酯（mg/dL）×空腹血糖（mg/dL）/2]。大血管并发症的测量指标包括肱踝脉搏波速度（ba-PWV）和踝臂指数（ABI），而尿微量白蛋白（MAU）、慢性肾脏病（CKD）和糖尿病视网膜病变（DR）则用于评估微血管并发症。采用 logistic 回归分析 TyG 指数与糖尿病并发症之间的关系。
结果
在单变量 logistic 回归中，TyG 指数升高与 MAU（OR=1.39，95%CI：[1.221.59]）和 ABI（OR=1.31，95%CI：[1.101.57]）的患病风险增加显著相关（<0.002），但与 CKD、DR 或 ba-PWV 无关。在校正年龄、性别和体重指数（BMI）等混杂因素后，TyG 指数与 MAU 和 ABI 仍显著相关（<0.002）。在血糖控制较差或年龄较大的患者中，这些相关性更为显著（<0.001）。
结论
TyG 指数升高的住院患者下肢血管狭窄和肾脏微血管损伤的风险更高。对于年轻或血糖控制不佳的患者，密切监测 TyG 指数可能有助于降低糖尿病并发症的负担并预防再次入院。
Zotero 插件