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三酰甘油-葡萄糖指数切点可准确预测肥胖白种人群代谢综合征的患病率。

Triglyceride-Glucose Index Cutoff Point Is an Accurate Marker for Predicting the Prevalence of Metabolic Syndrome in Obese Caucasian Subjects.

机构信息

Endocrinology and Nutrition Department, Hospital Clínico Universitario de Valladolid, Investigation Centre on Endocrinology and Nutrition (IEN), University of Valladolid, Valladolid, Spain.

出版信息

Ann Nutr Metab. 2023;79(2):238-245. doi: 10.1159/000526988. Epub 2022 Oct 7.

Abstract

BACKGROUND

Recently, the triglyceride-glucose (TyG) index has been suggested as a surrogate insulin resistance marker. This index could act as an early screening marker in individuals with a high risk of metabolic syndrome (MS) such as obese subjects.

AIMS

The objective of this work was to detect the cutoff point of the TyG index for the diagnosis of MS according to ATPIII criteria on obese subjects and to compare with HOMA-IR.

METHODS

We conducted a cross-sectional study in 1,494 obese subjects. Measurements of adiposity parameters, blood pressure, fasting blood glucose, insulin concentration, insulin resistance (HOMA-IR), lipid profile, C-reactive protein, adipokines, and the prevalence of MS were determined. The TyG index was calculated from the next equation: Ln (fasting triglycerides (mg/dL) × fasting glucose (mg/dL))/2.

RESULTS

A total of 1,494 subjects were recruited, 421 males (28.1%) and 1,073 females (71.8%), with an average age of 45.8 ± 15.3 years (range: 29-62). A total of 677 subjects had MS (45.5%) and 817 did not show MS (54.6%). The averages of HOMA-IR and TyG index values increased as the components of MS were aggregated, and both indexes were higher in subjects with MS. The area under the curve (AUC) of the TyG index according to ATPIII criteria showed values of 0.746 (0.721-0.771; p = 0.001). The cutoff point according to the Youden index was 4.72, with sensitivity and specificity of 87% and 88.2%, respectively. For the HOMA-IR, AUC showed values of 0.682 (0.654-0.710; p = 0.01). The cutoff point was 3.23, with sensitivity and specificity of 78% and 70.1%, respectively.

CONCLUSIONS

The TyG index is more powerful for predicting MS than HOMA-IR in Caucasian obese subjects.

摘要

背景

最近,甘油三酯-葡萄糖(TyG)指数被认为是胰岛素抵抗的替代标志物。该指数可作为代谢综合征(MS)高危人群(如肥胖人群)的早期筛查标志物。

目的

本研究旨在检测根据 ATPIII 标准,TyG 指数对肥胖人群 MS 的诊断切点,并与 HOMA-IR 进行比较。

方法

我们进行了一项横断面研究,共纳入 1494 名肥胖受试者。测量体脂参数、血压、空腹血糖、胰岛素浓度、胰岛素抵抗(HOMA-IR)、血脂谱、C 反应蛋白、脂肪因子和 MS 的患病率。TyG 指数由以下公式计算得出:Ln(空腹甘油三酯(mg/dL)×空腹血糖(mg/dL))/2。

结果

共纳入 1494 名受试者,其中男性 421 名(28.1%),女性 1073 名(71.8%),平均年龄为 45.8±15.3 岁(范围:29-62)。共有 677 名受试者患有 MS(45.5%),817 名受试者未患 MS(54.6%)。随着 MS 成分的聚集,HOMA-IR 和 TyG 指数的平均值增加,且 MS 患者的这两个指数均较高。根据 ATPIII 标准,TyG 指数的曲线下面积(AUC)为 0.746(0.721-0.771;p=0.001)。根据 Youden 指数的切点为 4.72,其敏感性和特异性分别为 87%和 88.2%。对于 HOMA-IR,AUC 值为 0.682(0.654-0.710;p=0.01)。切点为 3.23,其敏感性和特异性分别为 78%和 70.1%。

结论

在白种肥胖人群中,TyG 指数预测 MS 的能力优于 HOMA-IR。

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