Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
Division of Biostatistics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
Diabetes Res Clin Pract. 2024 Apr;210:111640. doi: 10.1016/j.diabres.2024.111640. Epub 2024 Mar 26.
We explored the role of the triglyceride-glucose (TyG) index as an early and superior predictor of type 2 diabetes mellitus (T2DM) in individuals with normal glucose tolerance (NGT) using a community-based Korean cohort over 18 years.
We retrospectively examined 6,072 adults with NGT from the Korean Genome and Epidemiology Study. Cox proportional hazard regression models were employed to evaluate the risk of incidence of T2DM and receiver operating characteristic analysis was used to calculate the area under the curve (AUC).
At baseline, the TyG index correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) and the composite insulin sensitivity index (ISI) (β: 0.045, p < 0.001; β: -0.105, p < 0.001, respectively). Over the 18-year follow-up period, 999 individuals developed T2DM. An increase in the TyG quartile independently predicted the incidence of T2DM [hazard ratio, 2.36 (1.9-2.93) for Q4]. The AUC value of the TyG index was 0.642, the highest value among HOMA-IR and OGTT-derived insulin sensitivity and secretion markers.
The TyG index is associated with HOMA-IR and composite ISI even with NGT. The TyG index demonstrated independent predictability for T2DM incidence in individuals with NGT, better than OGTT-derived insulin sensitivity and secretion markers.
我们通过一项基于社区的韩国队列研究，探讨了甘油三酯-葡萄糖（TyG）指数在血糖正常（NGT）个体中作为 2 型糖尿病（T2DM）早期和优越预测指标的作用，随访时间超过 18 年。
我们回顾性分析了韩国基因组与流行病学研究中 6072 名 NGT 成年人的数据。采用 Cox 比例风险回归模型评估 T2DM 发病的风险，并用受试者工作特征曲线分析计算曲线下面积（AUC）。
在基线时，TyG 指数与稳态模型评估的胰岛素抵抗（HOMA-IR）和综合胰岛素敏感指数（ISI）相关（β：0.045，p<0.001；β：-0.105，p<0.001）。在 18 年的随访期间，999 人发生了 T2DM。TyG 四分位间距的增加独立预测了 T2DM 的发生[风险比，2.36（1.9-2.93），Q4]。TyG 指数的 AUC 值为 0.642，在 HOMA-IR 和 OGTT 衍生的胰岛素敏感性和分泌标志物中是最高的。
即使在 NGT 个体中，TyG 指数也与 HOMA-IR 和综合 ISI 相关。TyG 指数在 NGT 个体中对 T2DM 发病具有独立的预测能力，优于 OGTT 衍生的胰岛素敏感性和分泌标志物。
