Wang Tao, Yu Chao, Yu Guo-Tao, Zhou Wei, Zhu Ling-Juan, Huang Xiao, Bao Hui-Hui, Cheng Xiao-Shu
Center for Prevention and Treatment of Cardiovascular Diseases,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China.
Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center,Nanchang 330006,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2023 Apr;45(2):206-212. doi: 10.3881/j.issn.1000-503X.15127.
Objective To explore the roles of different insulin resistance indexes[triglyceride-glucose (TyG),triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C),and metabolic score for insulin resistance (METS-IR)]and combinations of two indexes in predicting diabetes risk in hypertensive population. Methods The survey of hypertension was conducted for the residents in Wuyuan county,Jiangxi province from March to August in 2018.The basic information of hypertensive residents was collected by interview.Blood was drawn on an empty stomach in the morning and physical measurements were carried out.Logistic regression model was employed to analyze the relationship between different insulin resistance indexes and diabetes,and the area under the receiver operating characteristic curve was used for evaluating the predictive effects of each index on diabetes risk. Results A total of 14 222 hypertensive patients with an average age of (63.8±9.4) years old were included in this study,including 2616 diabetic patients.The diabetic hypertensive population had higher TyG (=50.323,<0.001),TG/HDL-C (=17.325,<0.001),and METS-IR (=28.839,<0.001) than the non-diabetic hypertensive population.Multivariate analysis showed that each insulin resistance index was positively correlated with diabetes risk.The area under curve of each insulin index was in a descending order of TyG (0.770)> METS-IR (0.673)> TG/HDL-C (0.620).The difference in the area under curve between two indexes was statistically significant[TyG TG/HDL-C (=42.325,<0.001);TyG METS-IR(=17.517,<0.001);METS-IR TG/HDL-C (=10.502,<0.001)]. Conclusions Elevated insulin resistance indexes can increase the risk of diabetes.TyG and the combination of indexes outperform TG/HDL-C and METS-IR in the prediction of diabetes.
目的 探讨不同胰岛素抵抗指数[甘油三酯-血糖(TyG)、甘油三酯(TG)/高密度脂蛋白胆固醇(HDL-C)和胰岛素抵抗代谢评分(METS-IR)]及两个指数的组合在预测高血压人群糖尿病风险中的作用。方法 2018年3月至8月对江西省婺源县居民进行高血压调查。通过访谈收集高血压居民的基本信息。早晨空腹采血并进行体格测量。采用Logistic回归模型分析不同胰岛素抵抗指数与糖尿病之间的关系,采用受试者工作特征曲线下面积评估各指数对糖尿病风险的预测效果。结果 本研究共纳入14222例高血压患者,平均年龄(63.8±9.4)岁,其中糖尿病患者2616例。糖尿病高血压人群的TyG(=50.323,<0.001)、TG/HDL-C(=17.325,<0.001)和METS-IR(=28.839,<0.001)高于非糖尿病高血压人群。多因素分析显示,各胰岛素抵抗指数与糖尿病风险呈正相关。各胰岛素指数曲线下面积由大到小依次为TyG(0.770)>METS-IR(0.673)>TG/HDL-C(0.620)。两个指数曲线下面积差异有统计学意义[TyG与TG/HDL-C(=42.325,<0.001);TyG与METS-IR(=17.517,<0.001);METS-IR与TG/HDL-C(=10.502,<0.001)]。结论 胰岛素抵抗指数升高会增加糖尿病风险。在糖尿病预测方面,TyG及指数组合优于TG/HDL-C和METS-IR。