Li Haibo, Miao Chong, Liu Wenjuan, Gao Haiyan, Li Wei, Wu Zhengqin, Cao Hua, Zhu Yibing
Division of Birth Cohort Study, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People's Republic of China.
Department of Information, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People's Republic of China.
Diabetes Metab Syndr Obes. 2022 Nov 28;15:3705-3715. doi: 10.2147/DMSO.S378964. eCollection 2022.
To evaluate the relationships of the triglyceride-glucose (TyG) index with pregnancy-related complications (PRCs) and to clarify the predictability of the TyG index for PRCs.
Totally of 11,387 women with a singleton pregnancy were prospectively followed until after delivery. Maternal fasting lipids and glucose concentration were measured in the first trimester (11 weeks gestation on average). The TyG index was calculated as ln [triglyceride (mg/dL) × fasting plasma glucose (mg/dL)/2]. We used generalized linear models to calculate the relative risks and 95% confidence intervals. Receiver-operating characteristic curve analysis was employed to assess the ability of the TyG index to predict the risks of PRCs.
Smooth spline reveals that the probability of gestational diabetes mellitus (GDM) is intensified with the increasing TyG index. Multivariate logistic regression adjusted for risk factors demonstrates a 1-unit and a 1-SD increment in the TyG index raises the risk of GDM by 3.63 and 1.57 times, respectively. Identically, the risk of GDM maximizes in the TyG quintile 5 (OR: 3.14; 95% CI: 2.55~3.85) relative to the lowest TyG index group. However, no association between TyG index and the risk of other PRCs was observed after full adjustment. The area under receiver operating characteristic curves is 0.647 (95% CI: 0.632-0.66) for GDM, and the optimal predictive cut-off is 8.55, with a specificity of 0.679 and sensitivity of 0.535.
The first-trimester TyG index is significantly associated with the risk of incident GDM, while the relationships between the TyG index and other PRCs need further exploration.
评估甘油三酯-葡萄糖（TyG）指数与妊娠相关并发症（PRC）之间的关系，并阐明TyG指数对PRC的预测能力。
前瞻性随访了11387名单胎妊娠妇女直至分娩后。在孕早期（平均妊娠11周）测量孕妇空腹血脂和血糖浓度。TyG指数计算为ln[甘油三酯（mg/dL）×空腹血糖（mg/dL）/2]。我们使用广义线性模型计算相对风险和95%置信区间。采用受试者工作特征曲线分析来评估TyG指数预测PRC风险的能力。
平滑样条图显示，妊娠糖尿病（GDM）的发生概率随TyG指数升高而增加。经风险因素调整的多变量逻辑回归显示，TyG指数每增加1个单位和1个标准差，GDM风险分别增加3.63倍和1.57倍。同样，相对于TyG指数最低组，TyG五分位数5组的GDM风险最高（OR：3.14；95%CI：2.553.85）。然而，在完全调整后，未观察到TyG指数与其他PRC风险之间的关联。GDM的受试者工作特征曲线下面积为0.647（95%CI：0.6320.66），最佳预测临界值为8.55，特异性为0.679，敏感性为0.535。
孕早期TyG指数与新发GDM风险显著相关，而TyG指数与其他PRC之间的关系有待进一步探索。
