甘油三酯葡萄糖指数和血浆致动脉粥样硬化指数在预测无心血管疾病患者结直肠肿瘤中的应用
Triglyceride glucose index and Atherogenic index of plasma for predicting colorectal neoplasms in patients without cardiovascular diseases.
作者信息
Han Muzhou, Wang Hao, Yang Shuyue, Zhu Siying, Zhao Guiping, Shi Haiyun, Li Peng
机构信息
Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing, China.
Department of Clinical Epidemiology and Evidence-based Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
出版信息
Front Oncol. 2022 Nov 14;12:1031259. doi: 10.3389/fonc.2022.1031259. eCollection 2022.
BACKGROUND AND AIMS
Colorectal neoplasms (CRN) include colorectal cancer (CRC) and colorectal adenoma (CRA). The relationship between CRN and triglyceride-glucose (TyG) index or between CRN and atherogenic index of plasma (AIP) is unclear. This study aims to investigate the roles of TyG index and AIP in predicting CRN in people without cardiovascular disease (CVD).
METHODS
2409 patients without CVD underwent colonoscopy were enrolled. Clinical information and relevant laboratory test results of these patients were collected and recorded. According to endoscopic and pathological results, all participants were divided into a neoplasms group and a non-neoplasms group. The TyG index was calculated as ln (TGs×FPG/2), while AIP was calculated as log (TGs/HDL-C). We used uni- and multivariate logistic regression and restricted cubic spline (RCS) to analyze the association between the TyG inedx, AIP and CRN, develop predictive models and construct the nomograms. Receiver operating characteristic (ROC) curves were utilized to evaluate the predictive value for CRN.
RESULTS
Participants in the neoplasms group were more likely to be older, have higher TyG index, higher AIP and higher rates of fecal occult blood test positivity, and were more likely to be male, smokers and those with the family history of CRC ( < 0.05). The higher TyG index was related to the higher risk of CRN [OR (95% CI): 1.23 (1.08 - 1.41), = 0.003]. The higher AIP was related to the higher risk of CRN [OR (95% CI): 1.55 (1.16 - 2.06), = 0.003]. These two indicators are better for predicting CRN in women than men. The combined use of the TyG index and other independent risk factors (age, sex, smoking status, family history and FOBT) to distinguish CRN was effective, with a sensitivity of 61.0%, a specificity of 65.1% and an AUC of 0.669 (95%CI, 0.639 - 0.698). Likewise, the combined use of the AIP and other independent risk factors to distinguish CRN was also effective, the model had an overall 56.3% sensitivity and 68.7% specificity with an AUC of 0.667 (95%CI, 0.638 - 0.697).
CONCLUSION
This study showed that the TyG index and the AIP might be biomarkers that could be used to predict the risk of CRN in patients without CVD.
背景与目的
结直肠肿瘤（CRN）包括结直肠癌（CRC）和结直肠腺瘤（CRA）。CRN与甘油三酯 - 葡萄糖（TyG）指数之间或CRN与血浆致动脉粥样硬化指数（AIP）之间的关系尚不清楚。本研究旨在探讨TyG指数和AIP在预测无心血管疾病（CVD）人群的CRN中的作用。
方法
纳入2409例接受结肠镜检查的无CVD患者。收集并记录这些患者的临床信息和相关实验室检查结果。根据内镜和病理结果，将所有参与者分为肿瘤组和非肿瘤组。TyG指数计算为ln（甘油三酯×空腹血糖/2），而AIP计算为log（甘油三酯/高密度脂蛋白胆固醇）。我们使用单因素和多因素逻辑回归以及受限立方样条（RCS）分析TyG指数、AIP与CRN之间的关联，建立预测模型并构建列线图。采用受试者工作特征（ROC）曲线评估对CRN的预测价值。
结果
肿瘤组参与者年龄更大、TyG指数更高、AIP更高、粪便潜血试验阳性率更高，且更可能为男性、吸烟者以及有CRC家族史者（P<0.05）。较高的TyG指数与较高的CRN风险相关[比值比（95%可信区间）：1.23（1.08 - 1.41），P = 0.003]。较高的AIP与较高的CRN风险相关[比值比（95%可信区间）：1.55（1.16 - 2.06），P = 0.003]。这两个指标对预测女性CRN比男性更好。联合使用TyG指数和其他独立危险因素（年龄、性别、吸烟状况、家族史和粪便潜血试验）区分CRN是有效的，敏感性为61.0%，特异性为65.1%，曲线下面积（AUC）为0.669（95%可信区间，0.639 - 0.698）。同样，联合使用AIP和其他独立危险因素区分CRN也有效，该模型总体敏感性为56.3%，特异性为68.7%，AUC为0.667（95%可信区间，0.638 - 0.697）。
结论
本研究表明，TyG指数和AIP可能是可用于预测无CVD患者CRN风险的生物标志物。
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