Wang Kai, Xu Lu, Liu Lili, Zhan Siyan, Wang Shengfeng, Song Yongfeng
Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, China; Shandong Institute of Endocrine & Metabolic Diseases, Jinan, China.
Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
J Affect Disord. 2022 Nov 1;316:42-49. doi: 10.1016/j.jad.2022.08.014. Epub 2022 Aug 8.
Previous studies indicated that insulin resistance (IR) was related to cognitive decline. This study aimed to investigate whether triglyceride-glucose (TyG) as a surrogate marker of IR can detect the association between IR and cognitive decline, and explore sex-specific association between the longitudinal change in TyG index and cognitive decline in the middle-aged and elderly population in China.
Data from the China Health and Retirement Longitudinal Study, which include 2358 females and 2062 males, were used. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting blood glucose [mg/dL] / 2). Cognitive score was measured by word recall test and mental status test. Logistic regression was used to assess the association between change in TyG index and cognitive decline in men and women from 2011 to 2015, respectively. Subgroup analysis by age was also performed.
The fourth quartile of change in TyG index was significantly associated with the increased risk of decline in global cognition compared with the first quartile in men [odds ratio (OR) 1.32, 95 % CI 1.03 to 1.71]. Stratified by age groups, the significant association between TyG index and cognitive decline was only found in men aged under 60 years old (OR 1.51, 95 % CI 1.07 to 2.13).
We only observed the association between TyG index and cognitive decline, but not the severity of the decline.
The increased TyG index is related to the risk of cognitive decline in men. This study provided new evidence for formulating sex-specific prevention and treatment strategies for cognitive decline.
既往研究表明胰岛素抵抗（IR）与认知功能减退有关。本研究旨在探讨作为IR替代指标的甘油三酯-葡萄糖（TyG）是否能检测出IR与认知功能减退之间的关联，并探讨中国中老年人群中TyG指数的纵向变化与认知功能减退之间的性别特异性关联。
使用中国健康与养老追踪调查的数据，其中包括2358名女性和2062名男性。TyG指数的计算方法为ln（空腹甘油三酯[mg/dL]×空腹血糖[mg/dL]/2）。认知得分通过单词回忆测试和精神状态测试进行测量。采用逻辑回归分别评估2011年至2015年男性和女性TyG指数变化与认知功能减退之间的关联。还按年龄进行了亚组分析。
与男性第一四分位数相比，TyG指数变化的第四四分位数与整体认知功能减退风险增加显著相关[比值比（OR）1.32，95%置信区间1.03至1.71]。按年龄组分层后，仅在60岁以下男性中发现TyG指数与认知功能减退之间存在显著关联（OR 1.51，95%置信区间1.07至2.13）。
我们仅观察到TyG指数与认知功能减退之间的关联，而非减退的严重程度。
TyG指数升高与男性认知功能减退风险相关。本研究为制定认知功能减退的性别特异性防治策略提供了新证据。
