谷氨酰转移酶与高密度脂蛋白胆固醇比值：预测 2 型糖尿病发病的有价值指标。
Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio: A valuable predictor of type 2 diabetes mellitus incidence.
机构信息
Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Gastrointestinal Surgery, Anqing First People's Hospital, Anhui Medical University, Anqing, China.
出版信息
Front Endocrinol (Lausanne). 2022 Sep 29;13:1026791. doi: 10.3389/fendo.2022.1026791. eCollection 2022.
BACKGROUND
Gamma-glutamyl transferase (GGT) and high-density lipoprotein cholesterol (HDL-C) have been proven to be valuable predictors of type 2 diabetes mellitus (T2DM). The aim of this study was to investigate the association between GGT/HDL-C ratio and incident T2DM.
METHODS
The study retrospectively analyzed 15453 participants from 2004 to 2015. Cox proportional hazards regression models and Kaplan-Meier curves were used to elucidate the effect of GGT/HDL-C ratio on T2DM. Restricted cubic spline (RCS) analysis was performed to explore any non-linear correlation between GGT/HDL-C ratio and the risk of T2DM. The predictive performance of GGT, HDL-C and GGT/HDL-C ratio for T2DM was evaluated utilizing receiver-operating-characteristic (ROC) curves.
RESULTS
During a median follow-up of 5.39 years, 373 cases of incident T2DM were observed. Kaplan-Meier curves showed that the cumulative probabilities of T2DM increased in the participants with higher GGT/HDL-C ratio significantly (P < 0.001). Cox models further clarified that high GGT/HDL-C ratio was an independent risk factor for T2DM (HR = 1.01, 95% CI = 1.00-1.01, P = 0.011). Linear positive correlation between GGT/HDL-C ratio and the risk of T2DM was demonstrated through RCS analysis. In the ROC analysis, GGT/HDL-C ratio (AUC = 0.75, 95% CI = 0.73-0.77) showed competitive role in the prediction of T2DM compared with single GGT and HDL-C.
CONCLUSIONS
The GGT/HDL-C ratio could serve as a valuable predictor of T2DM, and the risk of T2DM increases in the condition of higher GGT/HDL-C ratio.
背景
γ-谷氨酰转移酶（GGT）和高密度脂蛋白胆固醇（HDL-C）已被证明是 2 型糖尿病（T2DM）的有价值的预测指标。本研究旨在探讨 GGT/HDL-C 比值与 T2DM 发病风险之间的关系。
方法
本研究回顾性分析了 2004 年至 2015 年期间的 15453 名参与者。采用 Cox 比例风险回归模型和 Kaplan-Meier 曲线阐明 GGT/HDL-C 比值对 T2DM 的影响。采用限制性三次样条（RCS）分析探讨 GGT/HDL-C 比值与 T2DM 风险之间的非线性关系。利用受试者工作特征（ROC）曲线评估 GGT、HDL-C 和 GGT/HDL-C 比值对 T2DM 的预测性能。
结果
在中位随访 5.39 年期间，观察到 373 例 T2DM 事件。Kaplan-Meier 曲线显示，随着 GGT/HDL-C 比值的升高，T2DM 的累积概率显著增加（P < 0.001）。Cox 模型进一步阐明，高 GGT/HDL-C 比值是 T2DM 的独立危险因素（HR = 1.01，95%CI = 1.00-1.01，P = 0.011）。RCS 分析表明，GGT/HDL-C 比值与 T2DM 风险之间呈线性正相关。在 ROC 分析中，GGT/HDL-C 比值（AUC = 0.75，95%CI = 0.73-0.77）在预测 T2DM 方面与单一 GGT 和 HDL-C 相比具有竞争力。
结论
GGT/HDL-C 比值可作为 T2DM 的有价值的预测指标，随着 GGT/HDL-C 比值的升高，T2DM 的发病风险增加。
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