Tu Zhihui, Du Juan, Ge Xiaoxu, Peng Wenfang, Shen Lisha, Xia Lili, Jiang Xiaohong, Hu Fan, Huang Shan
Department of Endocrinology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111, Xianxia Road, Changning District, Shanghai, China.
Shanghai Jiao Tong University School of Medicine, No. 227, Chongqing South Road, Huangpu District, Shanghai, China.
Diabetes Ther. 2024 Aug;15(8):1799-1810. doi: 10.1007/s13300-024-01609-3. Epub 2024 Jun 22.
The triglyceride-glucose index (TyG) has been identified as a dependable and simple indicator marker of insulin resistance (IR). Research has demonstrated a correlation between macrovascular complications and TyG. However, limited research exists regarding the relationship between TyG and diabetic microvascular complications. Consequently, the objective of this study is to investigate the association between TyG and diabetic kidney disease (DKD) and diabetic peripheral neuropathy (DPN).
This is a cross-sectional, observational study. A total of 2048 patients from Tongren Hospital, Shanghai Jiao Tong University School of Medicine were enrolled. The primary outcomes are DKD and DPN. Quantile regression analysis was employed to investigate the implicit factors of TyG quartiles. Subsequently, based on implicit factors, logistic regression models were constructed to further examine the relationship between TyG and DKD and DPN.
In the baseline, TyG exhibited higher values across patients with DKD, DPN, and co-existence of DKD and DPN (DKD + DPN) in type 2 diabetes (T2D). Univariate logistic regressions demonstrated a significant association between an elevated TyG and an increased risk of DKD (OR = 1.842, [95% CI] 1.317-2.578, P for trend < 0.01), DPN (OR = 1.516, [95% CI] 1.114-2.288, P for trend < 0.05), DKD + DPN (OR = 2.088, [95% CI] 1.429-3.052, P for trend < 0.05). Multivariable logistic regression models suggested a statistically significant increase in the risk of DKD (OR = 1.581, [95% CI] 1.031-2.424, p < 0.05), DKD + DPN (OR = 1.779, [95% CI] 1.091-2.903, p < 0.05) after adjusting the implicit factors of TyG quartiles. However, no significant relationship was observed between TyG and DPN in the multivariable regression analysis.
Elevated TyG was significantly associated with an increased risk of DKD in T2D, but no significant relationship was shown with DPN. This finding provided further evidence for the clinical significance of integrating TyG into the initial assessment of diabetic microvascular complications.
甘油三酯-葡萄糖指数（TyG）已被确认为胰岛素抵抗（IR）的一个可靠且简单的指标性标志物。研究表明大血管并发症与TyG之间存在关联。然而，关于TyG与糖尿病微血管并发症之间关系的研究有限。因此，本研究的目的是探讨TyG与糖尿病肾病（DKD）及糖尿病周围神经病变（DPN）之间的关联。
这是一项横断面观察性研究。纳入了上海交通大学医学院附属同仁医院的2048例患者。主要结局为DKD和DPN。采用分位数回归分析来研究TyG四分位数的潜在影响因素。随后，基于潜在影响因素构建逻辑回归模型，以进一步检验TyG与DKD和DPN之间的关系。
在基线时，2型糖尿病（T2D）患者中，DKD、DPN以及DKD与DPN共存（DKD+DPN）患者的TyG值更高。单因素逻辑回归显示，TyG升高与DKD风险增加显著相关（OR=1.842，[95%CI]1.317-2.578，趋势P<0.01）、DPN风险增加显著相关（OR=1.516，[95%CI]1.114-2.288，趋势P<0.05）、DKD+DPN风险增加显著相关（OR=2.088，[95%CI]1.429-3.052，趋势P<0.05）。多变量逻辑回归模型显示，在调整TyG四分位数的潜在影响因素后，DKD风险有统计学意义的增加（OR=1.581，[95%CI]1.031-2.424，P<0.05）、DKD+DPN风险有统计学意义的增加（OR=1.779，[95%CI]1.091-2.903，P<0.05）。然而，在多变量回归分析中未观察到TyG与DPN之间存在显著关系。
TyG升高与T2D患者DKD风险增加显著相关，但与DPN无显著关系。这一发现为将TyG纳入糖尿病微血管并发症初始评估的临床意义提供了进一步证据。
