甘油三酯-葡萄糖指数作为糖尿病患者下肢动脉疾病预测指标的住院人群回顾性研究

Triglyceride-Glucose Index as a Predictor of Lower Extremity Arterial Disease in Patients with Diabetes: A Hospitalized Population Retrospective Study.

作者信息

Ning Peng, Zeng Jing, Feng Qiu, Chen Min, Cao Hongyi

机构信息

Department of Endocrine and Metabolism, Geriatric Diseases Institute of Chengdu, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, China.

出版信息

Ann Vasc Surg. 2024 Jan;98:173-181. doi: 10.1016/j.avsg.2023.08.013. Epub 2023 Oct 4.

DOI:10.1016/j.avsg.2023.08.013

PMID:37802143

Abstract

BACKGROUND

The triglyceride-glucose (TyG) index is a new, simple, and inexpensive marker of insulin resistance that is becoming increasingly important as a promising predictor of diseases such as atherosclerosis. Atherosclerosis is the main cause of lower extremity arterial disease (LEAD). In this study, we investigated the relationship between TyG index values and LEAD risk in patients with diabetes.

METHODS

Patients with diabetes hospitalized at the Endocrinology Department of our hospital from June 1, 2021, to May 31, 2022, were retrospectively included. Baseline data, biochemical indicators, and ankle-brachial index values were collected. Statistical methods were used to assess the relationship between TyG index values and the risk of LEAD.

RESULTS

A total of 1,040 hospitalized patients with diabetes were included, they were divided into the LEAD group with 168 patients and the no LEAD group with 872 patients. TyG index values in the LEAD group were higher than those in the no LEAD group (9.94 ± 0.78 vs. 9.36 ± 0.70, P < 0.001). TyG index values were independently correlated with LEAD risk in patients with diabetes (odds ratio = 3.92, 95% confidence interval (CI): 2.92-5.26, P < 0.001) in multivariate logistic regression analysis after adjusting for different risk factors (all P < 0.05). The area under the receiver operating characteristic curve was 0.72 (95% CI: 0.68-0.76) when TyG index values were used to diagnose LEAD in patients with diabetes. When Youden's index reached the maximum value of 0.34, the optimal TyG index threshold for predicting the onset of diabetic LEAD was 9.56, sensitivity was 71.1%, and specificity was 63.0%.

CONCLUSIONS

Increases in TyG index values were associated with the risk of LEAD in patients with diabetes and, thus, may be used as a predictor of LEAD in this patient population, especially in primary care institutions with relatively few resources.

摘要

背景

甘油三酯-葡萄糖（TyG）指数是一种新的、简单且经济的胰岛素抵抗标志物，作为动脉粥样硬化等疾病的一种有前景的预测指标，其重要性日益凸显。动脉粥样硬化是下肢动脉疾病（LEAD）的主要病因。在本研究中，我们调查了糖尿病患者的TyG指数值与LEAD风险之间的关系。

方法

回顾性纳入2021年6月1日至2022年5月31日在我院内分泌科住院的糖尿病患者。收集基线数据、生化指标和踝臂指数值。采用统计方法评估TyG指数值与LEAD风险之间的关系。

结果

共纳入1040例住院糖尿病患者，分为LEAD组168例和非LEAD组872例。LEAD组的TyG指数值高于非LEAD组（9.94±0.78 vs. 9.36±0.70，P<0.001）。在调整不同风险因素后（所有P<0.05），多因素logistic回归分析显示，TyG指数值与糖尿病患者的LEAD风险独立相关（比值比=3.92，95%置信区间（CI）：2.92-5.26，P<0.001）。当用TyG指数值诊断糖尿病患者的LEAD时，受试者工作特征曲线下面积为0.72（95%CI：0.68-0.76）。当约登指数达到最大值0.34时，预测糖尿病性LEAD发病的最佳TyG指数阈值为9.56，敏感性为71.1%，特异性为63.0%。