肥胖与非肥胖成年人的甘油三酯-葡萄糖指数与颈动脉内膜中层厚度的关系。
Association between triglyceride glucose index and carotid intima-media thickness in obese and nonobese adults.
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 Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
J Diabetes. 2022 Sep;14(9):596-605. doi: 10.1111/1753-0407.13312. Epub 2022 Sep 7.
BACKGROUND
The triglyceride glucose (TyG) index is closely associated with subclinical atherosclerosis. However, the association remains inconclusive among obese and nonobese individuals.
METHODS
This prospective study was conducted in 5751 adults with normal carotid intima-media thickness (CIMT) at baseline. We divided the population into four groups based on the TyG index, which was calculated by the following formula: Ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2). Information on CIMT was acquired by ultrasonography. Incident elevated CIMT was defined as IMT values greater than 0.9 mm at follow-up. Odds ratios (ORs) and 95% confidence intervals (CIs) of the associations between TyG index and elevated CIMT were estimated using multivariable logistic regression models.
RESULTS
After a median follow-up of 4.3 years, 722 (12.6%) individuals had progressed to elevated CIMT. Compared with the second quartile of the TyG index, the first and fourth quartile both conferred higher risks of elevated CIMT after adjusting for potential confounders. In the total population, the ORs for the first and fourth quartile were 1.29 (95% CI, 1.00-1.66) and 1.42 (95% CI, 1.11-1.83), respectively. Restricted cubic splines demonstrated an approximately U-shaped association between TyG index and elevated CIMT among the total and nonobese adults (P for nonlinearity <.05), but not in those with general or abdominal obesity.
CONCLUSIONS
A U-shaped association was observed between TyG index and elevated CIMT only among nonobese Chinese adults.
背景
甘油三酯-葡萄糖（TyG）指数与亚临床动脉粥样硬化密切相关。然而，在肥胖和非肥胖个体中，这种关联仍存在争议。
方法
本前瞻性研究纳入了基线时颈动脉内膜中层厚度（CIMT）正常的 5751 名成年人。我们根据 TyG 指数将人群分为四组，该指数通过以下公式计算得出：Ln（空腹甘油三酯[mg/dL]×空腹血糖[mg/dL]/2）。通过超声获取 CIMT 信息。在随访中，当 IMT 值大于 0.9mm 时，定义为发生 CIMT 升高。使用多变量逻辑回归模型估计 TyG 指数与 CIMT 升高之间的关联的比值比（OR）和 95%置信区间（CI）。
结果
在中位随访 4.3 年后，722 名（12.6%）患者进展为 CIMT 升高。与 TyG 指数的第二四分位相比，在调整了潜在混杂因素后，第一和第四四分位均与 CIMT 升高的风险增加相关。在总人群中，第一和第四四分位的 OR 分别为 1.29（95%CI，1.00-1.66）和 1.42（95%CI，1.11-1.83）。受限立方样条分析表明，在总人群和非肥胖成年人中，TyG 指数与 CIMT 升高之间存在近似 U 型关联（P ＜.05），但在普通肥胖或腹型肥胖患者中不存在这种关联。
结论
仅在非肥胖的中国成年人中观察到 TyG 指数与 CIMT 升高之间存在 U 型关联。
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