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甘油三酯葡萄糖指数及甘油三酯与高密度脂蛋白比值与2型糖尿病患者血糖水平、微血管及大血管并发症的关联

Association of triglyceride glucose index and triglyceride HDL ratio with glucose levels, microvascular and macrovascular complications in Diabetes Mellitus Type-2.

作者信息

Jabeen Wajiha Mah, Jahangir Basmah, Khilji Saba, Aslam Aqsa

机构信息

Wajiha Mah Jabeen, MBBS, Mphil, PhD Professor of Pathology, HITEC-Institute of Medical Sciences, Taxila, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan.

Basmah Jahangir, BS MLT Department of medical laboratory Technology, Islamabad Medical and Dental College, Islamabad, Pakistan.

出版信息

Pak J Med Sci. 2023 Sep-Oct;39(5):1255-1259. doi: 10.12669/pjms.39.5.7389.

Abstract

OBJECTIVE

To find out the role of triglyceride glucose index (TGI) and triglyceride HDL ratio (THR) as predictors of insulin resistance and control of glucose status in type two diabetes mellitus (T2DM).

METHOD

This cross-sectional study was conducted in Dr. Akbar Niazi Teaching Hospital, January-April 2022. A total of 56 individuals, both males and females aged 30-75 years having T2DM with fasting blood glucose ≥ 110 mg/dl and HbA1c ≥ 5.7% were included. Biochemical markers were estimated by applying standard methods. Independent sample t-test, Fisher exact test, and linear regression were applied.

RESULTS

TGI and triglyceride HDL ratio were significantly raised (p=0.01) in patients with poor glycemic control as compared to controlled glucose levels (17.8 ± 4.7vs7.3 ± 1.75) and (3.84 ± 1.3vs2.12 ± 0.64) respectively. These two indices have a significant association (p=0.01) with HbA1c (r=0.963, r=0.757), fasting blood glucose (r=0.964, r=0.748), and HOMA-IR (r=0.955, r=0.718) respectively. Moreover, TGI and THR were found to have a more significant association with the development of cardiovascular disease (CVD) (r=0.717, r=0.555) and a significant but weak association with nephropathy (r=0.385, r=0.302) respectively. Regression analysis revealed that both TGI and THR have significant predictive ability for HbA1c, fasting blood glucose, HOMA-IR and CVD (delta R=0.738vs 0.408, 0.740vs0.395, 0.725vs0.362, 0.354vs0.170) respectively, after controlling all confounding variables.

CONCLUSIONS

TGI and THR have a strong association and predictive capability to identify insulin resistance and detect the development and progression of T2DM. Moreover, TGI can be more precisely used for prediction analysis as compared to THR.

摘要

目的

探讨甘油三酯葡萄糖指数(TGI)和甘油三酯与高密度脂蛋白比值(THR)作为2型糖尿病(T2DM)胰岛素抵抗和血糖状态控制预测指标的作用。

方法

本横断面研究于2022年1月至4月在阿克巴·尼亚齐博士教学医院进行。纳入了56名年龄在30 - 75岁之间的男性和女性T2DM患者,其空腹血糖≥110mg/dl且糖化血红蛋白≥5.7%。采用标准方法测定生化指标。应用独立样本t检验、Fisher精确检验和线性回归分析。

结果

与血糖控制良好的患者相比,血糖控制不佳的患者TGI和甘油三酯与高密度脂蛋白比值显著升高(p = 0.01),分别为(17.8 ± 4.7 vs 7.3 ± 1.75)和(3.84 ± 1.3 vs 2.12 ± 0.64)。这两个指标分别与糖化血红蛋白(p = 0.01,r = 0.963,r = 0.757)、空腹血糖(p = 0.01,r = 0.964,r = 0.748)和稳态模型评估胰岛素抵抗指数(HOMA - IR)(p = 0.01,r = 0.955,r = 0.718)有显著相关性。此外,发现TGI和THR分别与心血管疾病(CVD)的发生有更显著的相关性(r = 0.717,r = 0.555),与肾病有显著但较弱的相关性(r = 0.385,r = 0.302)。回归分析显示,在控制所有混杂变量后,TGI和THR对糖化血红蛋白、空腹血糖、HOMA - IR和CVD均具有显著的预测能力(ΔR分别为0.738 vs 0.408、0.740 vs 0.395、0.725 vs 0.362、0.354 vs 0.170)。

结论

TGI和THR与胰岛素抵抗以及T2DM的发生发展具有很强的相关性和预测能力。此外,与THR相比,TGI可更精确地用于预测分析。

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