Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, China.
Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, China.
BMC Endocr Disord. 2022 Mar 24;22(1):76. doi: 10.1186/s12902-022-00984-x.
Dyslipidaemia is a risk factor for abnormal blood glucose. However, studies on the predictive values of lipid markers in prediabetes and diabetes simultaneously are limited. This study aimed to assess the associations and predictive abilities of lipid indices and abnormal blood glucose.
A sample of 7667 participants without diabetes were enrolled in this cross-sectional study conducted in 2016, and all of them were classified as having normal glucose tolerance (NGT), prediabetes or diabetes. Blood glucose, blood pressure and lipid parameters (triglycerides, TG; total cholesterol, TC; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C; non-high-density lipoprotein cholesterol, non-HDL-C; and triglyceride glucose index, TyG) were evaluated or calculated. Logistic regression models were used to analyse the association between lipids and abnormal blood glucose. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to assess the discriminatory power of lipid parameters for detecting prediabetes or diabetes.
After adjustment for potential confounding factors, the TyG was the strongest marker related to abnormal blood glucose compared to other lipid indices, with odds ratios of 2.111 for prediabetes and 5.423 for diabetes. For prediabetes, the AUCs of the TG, TC, HDL-C, LDL-C, TC/HDL-C, TG/HDL-C, non-HDL-C and TyG indices were 0.605, 0.617, 0.481, 0.615, 0.603, 0.590, 0.626 and 0.660, respectively, and the cut-off points were 1.34, 4.59, 1.42, 2.69, 3.39, 1.00, 3.19 and 8.52, respectively. For diabetes, the AUCs of the TG, TC, HDL-C, LDL-C, TC/HDL-C, TG/HDL-C, non-HDL-C and TyG indices were 0.712, 0.679, 0.440, 0.652, 0.686, 0.692, 0.705, and 0.827, respectively, and the cut-off points were 1.35, 4.68, 1.42, 2.61, 3.44, 0.98, 3.13 and 8.80, respectively.
The TyG, TG and non-HDL-C, especially TyG, are accessible biomarkers for screening individuals with undiagnosed diabetes.
血脂异常是血糖异常的一个危险因素。然而，同时研究脂类标志物在糖尿病前期和糖尿病中的预测价值的研究是有限的。本研究旨在评估血脂指标与异常血糖之间的关联和预测能力。
本横断面研究于 2016 年纳入了 7667 名无糖尿病的参与者，他们均被分为正常糖耐量（NGT）、糖尿病前期或糖尿病组。评估或计算了血糖、血压和血脂参数（甘油三酯，TG；总胆固醇，TC；高密度脂蛋白胆固醇，HDL-C；低密度脂蛋白胆固醇，LDL-C；非高密度脂蛋白胆固醇，non-HDL-C；和甘油三酯葡萄糖指数，TyG）。使用 logistic 回归模型分析血脂与异常血糖之间的关系。使用受试者工作特征（ROC）曲线下面积（AUC）评估血脂参数对检测糖尿病前期或糖尿病的鉴别能力。
在调整了潜在混杂因素后，与其他血脂指标相比，TyG 是与异常血糖相关性最强的标志物，糖尿病前期和糖尿病的比值比分别为 2.111 和 5.423。对于糖尿病前期，TG、TC、HDL-C、LDL-C、TC/HDL-C、TG/HDL-C、non-HDL-C 和 TyG 指数的 AUC 分别为 0.605、0.617、0.481、0.615、0.603、0.590、0.626 和 0.660，截断点分别为 1.34、4.59、1.42、2.69、3.39、1.00、3.19 和 8.52。对于糖尿病，TG、TC、HDL-C、LDL-C、TC/HDL-C、TG/HDL-C、non-HDL-C 和 TyG 指数的 AUC 分别为 0.712、0.679、0.440、0.652、0.686、0.692、0.705 和 0.827，截断点分别为 1.35、4.68、1.42、2.61、3.44、0.98、3.13 和 8.80。
TyG、TG 和 non-HDL-C，特别是 TyG，是筛查未确诊糖尿病患者的便捷生物标志物。
