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甘油三酯葡萄糖相关指标及脂质蓄积产物——中国人群胰岛素抵抗的可靠标志物

Triglyceride glucose-related indexes and lipid accumulation products-reliable markers of insulin resistance in the Chinese population.

作者信息

Liu Lei, Luo Yufang, Liu Min, Tang Chenyi, Liu Hong, Feng Guo, Wang Meng, Wu Jinru, Zhang Wei

机构信息

Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China.

Department of Clinical Nutrition, The Third Xiangya Hospital of Central South University, Changsha, China.

出版信息

Front Nutr. 2024 Jul 3;11:1373039. doi: 10.3389/fnut.2024.1373039. eCollection 2024.

Abstract

BACKGROUND

Insulin resistance (IR) is a pivotal pathogenic component of metabolic diseases. It is crucial to identify convenient and reliable indicators of insulin resistance for its early detection. This study aimed at assessing the predictive ability of seven novel obesity and lipid-related indices.

METHODS

A total of 5,847 female and 3,532 male healthy subjects were included in the study. The triglyceride glucose (TyG) index, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), lipid accumulation products (LAP), body roundness index (BRI), body adiposity index (BAI), and visceral adiposity index (VAI) were measured and calculated using the established formulae. IR was diagnosed using the homeostatic model assessment of insulin resistance (HOMA-IR) index over the third quantile.

RESULTS

The levels of all seven lipid-related indices were significantly higher in subjects with higher HOMA-IR values than in those with lower HOMA-IR values. These indices displayed moderate to high effectiveness [receiver operating characteristic (ROC) curve-area under the curve (AUC) > 0.6] in predicting IR. Among them, TyG-BMI (AUC: 0.729), LAP (AUC: 0.708), and TyG-WC (AUC: 0.698) showed the strongest association with HOMA-IR. In the female population, the AUC for TyG-BMI, LAP, and TyG-WC in predicting IR was 0.732, 0.705, and 0.718, respectively. Logistic regression analysis showed the optimal cut-off values of those indicators in predicting IR as follows: TyG-BMI: male subjects - 115.16 [odds ratio (OR) = 6.05, 95% CI: 5.09-7.19], female subjects - 101.58 (OR = 4.55, 95% CI: 4.00-5.16); LAP: male subjects - 25.99 (OR = 4.53, 95% CI: 3.82-5.38), female subjects - 16.11 (OR = 3.65, 95% CI: 3.22-4.14); and TyG-WC: male subjects - 409.43 (OR = 5.23, 95% CI: 4.48-6.24), female subjects - 342.48 (OR = 4.07, 95% CI: 3.59-4.61).

CONCLUSION

TyG-index-related parameters and LAP appear to be effective predictors of IR in the Chinese population. Specifically, TyG-BMI may be the most appropriate predictor of IR.

摘要

背景

胰岛素抵抗(IR)是代谢性疾病的关键致病因素。识别方便可靠的胰岛素抵抗指标对于早期检测至关重要。本研究旨在评估七种新型肥胖和脂质相关指标的预测能力。

方法

本研究共纳入5847名女性和3532名男性健康受试者。使用既定公式测量并计算甘油三酯葡萄糖(TyG)指数、TyG体重指数(TyG-BMI)、TyG腰围(TyG-WC)、脂质蓄积产物(LAP)、体圆度指数(BRI)、体脂指数(BAI)和内脏脂肪指数(VAI)。采用胰岛素抵抗稳态模型评估(HOMA-IR)指数超过第三四分位数来诊断胰岛素抵抗。

结果

HOMA-IR值较高的受试者中,所有七种脂质相关指标的水平均显著高于HOMA-IR值较低的受试者。这些指标在预测胰岛素抵抗方面显示出中度至高有效性[受试者工作特征(ROC)曲线下面积(AUC)>0.6]。其中,TyG-BMI(AUC:0.729)、LAP(AUC:0.708)和TyG-WC(AUC:0.698)与HOMA-IR的关联最强。在女性人群中,TyG-BMI、LAP和TyG-WC预测胰岛素抵抗的AUC分别为0.732、0.705和0.718。逻辑回归分析显示这些指标预测胰岛素抵抗的最佳截断值如下:TyG-BMI:男性受试者 - 115.16[比值比(OR)=6.05,95%置信区间(CI):5.09-7.19],女性受试者 - 101.58(OR =4.55,95%CI:4.00-5.16);LAP:男性受试者 - 25.99(OR =4.53,95%CI:3.82-5.38),女性受试者 - 16.11(OR =3.65,95%CI:3.22-4.14);TyG-WC:男性受试者 - 409.43(OR =5.23,95%CI:4.48-6.24),女性受试者 - 342.48(OR =4.07,95%CI:3.59-4.61)。

结论

TyG指数相关参数和LAP似乎是中国人群中胰岛素抵抗的有效预测指标。具体而言,TyG-BMI可能是胰岛素抵抗最合适的预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59e9/11253805/8172fd8d19c9/fnut-11-1373039-g0001.jpg

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