Sun Yongbing, Gu Yuang, Zhou Yang, Liu Ao, Lin Xinbei, Wang Xuan, Du Yawei, Lv Xue, Zhou Jing, Li Zhonglin, Wu Xiaoling, Zou Zhi, Dou Shewei, Zhang Michael, Zhu Jiadong, Shang Feifei, Li Fengli, Hu Yangxi, Li Hao, Li Yongli
Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, Henan, 450003, China.
Department of Medical Imaging, Henan Provincial People's Hospital, Xinxiang Medical College, Zhengzhou, Henan, 450003, China.
Diabetol Metab Syndr. 2024 Aug 8;16(1):193. doi: 10.1186/s13098-024-01434-5.
The triglyceride-glucose (TyG) index is linked to both the development and progression of diabetes, while obesity remains a significant risk factor for this disease. However, the relationship between the TyG index and overweight or obese diabetes remains unclear.
This study was a cross-sectional analysis of data from 40,633 participants with body mass index (BMI) ≥ 24 kg/m who were screened from January 2018 to December 2023 at Henan Provincial People's Hospital. Participants were divided into groups of overweight or obese individuals with diabetes and those without diabetes according to the diabetes diagnostic criteria. The TyG index, the dependent variable, was determined using the equation ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. We explored the association between TyG index and diabetes in overweight or obese individuals through multivariate logistic regression, subgroup analysis, generalized additive models, smoothed curve fitting, and analysis of threshold effects.
Patients who were overweight or obese and had diabetes had higher TyG index levels than those without diabetes. After adjusting for confounders, our findings indicated a significant association between the TyG index and the risk of diabetes in overweight or obese individuals [odds ratio (OR) = 7.38, 95% confidence interval (CI): 6.98-7.81]. There was a J-shaped nonlinear association between TyG index and diabetes. When TyG index was > 4.46, the risk of diabetes increased sharply. Notably, a high baseline TyG index (Q4 group) correlated with a notably greater risk of diabetes than did the Q1 group, with an OR of 22.72 (95% CI: 20.52-25.16). Subgroup analysis revealed that the association between TyG and diabetes was stronger in females than in males (OR = 7.57, 95% CI: 6.76-8.48,), more significant in individuals with a BMI of 24-28 kg/m than in those with a BMI ≥ 28 kg/m (OR = 8.40, 95% CI: 7.83-9.02), and increased with age (OR = 8.15, 95% CI: 7.25-9.17) (all P for interaction < 0.001).
Among overweight or obese individuals, a higher TyG index is associated with an elevated risk of diabetes, especially when TyG is > 4.46. Furthermore, factors such as sex, age, and BMI significantly influence the risk of diabetes in overweight or obese individuals. Specifically, older women with a BMI of 24-28 kg/m are at a greater risk of diabetes under similar TyG index conditions.
甘油三酯-葡萄糖（TyG）指数与糖尿病的发生和发展均相关，而肥胖仍然是该疾病的一个重要危险因素。然而，TyG指数与超重或肥胖型糖尿病之间的关系仍不明确。
本研究对2018年1月至2023年12月在河南省人民医院筛查的40633名体重指数（BMI）≥24kg/m²的参与者的数据进行了横断面分析。根据糖尿病诊断标准，将参与者分为超重或肥胖的糖尿病患者组和非糖尿病患者组。使用公式ln[空腹甘油三酯（mg/dL）×空腹血糖（mg/dL）/2]计算作为因变量的TyG指数。我们通过多因素logistic回归、亚组分析、广义相加模型、平滑曲线拟合和阈值效应分析，探讨了超重或肥胖个体中TyG指数与糖尿病之间的关联。
超重或肥胖且患有糖尿病的患者的TyG指数水平高于非糖尿病患者。在调整混杂因素后，我们的研究结果表明，超重或肥胖个体中TyG指数与糖尿病风险之间存在显著关联[比值比（OR）=7.38，95%置信区间（CI）：6.98-7.81]。TyG指数与糖尿病之间存在J形非线性关联。当TyG指数>4.46时，糖尿病风险急剧增加。值得注意的是，与Q1组相比，高基线TyG指数（Q4组）与显著更高的糖尿病风险相关，OR为22.72（95%CI：20.52-25.16）。亚组分析显示，TyG与糖尿病之间的关联在女性中比在男性中更强（OR=7.57，95%CI：6.76-8.48），在BMI为24-28kg/m²的个体中比在BMI≥28kg/m²的个体中更显著（OR=8.40，95%CI：7.83-9.02），并且随年龄增加而增加（OR=8.15，95%CI：7.25-9.17）（所有交互作用P<0.001）。
在超重或肥胖个体中，较高的TyG指数与糖尿病风险升高相关，尤其是当TyG>4.46时。此外，性别、年龄和BMI等因素显著影响超重或肥胖个体的糖尿病风险。具体而言，在相似的TyG指数条件下，BMI为24-28kg/m²的老年女性患糖尿病的风险更高。
