Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstr. 20, D-04103, Leipzig, Germany.
Medical Faculty, University of Leipzig, Leipzig, Germany.
J Cancer Res Clin Oncol. 2024 Aug 24;150(8):399. doi: 10.1007/s00432-024-05919-8.
This study explored the association between triglyceride-glucose (TyG), TyG index with body mass index (TyG-BMI), triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C), metabolic score for insulin resistance (IR) (METS-IR) and the risk of esophageal cancer.
A total of 388,900 participants from the United Kingdom Biobank from 2006 to 2010 were included. Fine-Gray models, restricted cubic spline (RCS), and receiver operating characteristic (ROC) curves were used to assess the association between the four IR surrogates and the risk of esophageal cancer, specifically, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC).
Ten years after recruitment, 0.16% (95%CI 0.11-0.26%) had esophageal cancer and 4.17% (95%CI 3.86-4.46%) are deceased. For each standard deviation increase in the TyG index, TyG-BMI, TG/HDL-C, and METS-IR, the risk of EAC increased by Hazard ratios (HR)1.16, 1.37, 1.08, and 1.36, respectively (all P < 0.05), while the risk of ESCC decreased by HRs 0.80, 0.67, 0.77, and 0.65, respectively. RCS analysis indicated that most relationships were nonlinear (P < 0.05). ROC curves showed that METS-IR had a more robust diagnostic efficacy than TyG, TyG-BMI, and TG/HDL-C.
TyG index, TyG-BMI, TG/HDL-C, and METS-IR were closely associated with the risk of EAC and ESCC. Additionally, METS-IR surpassed the other three IR indices in predicting and diagnosing the risks of EAC and ESCC. The METS-IR is expected to become a more effective metric for identifying populations at early risk of esophageal cancer and for improving risk stratification.
本研究旨在探讨甘油三酯-葡萄糖（TyG）、TyG 指数与体重指数（TyG-BMI）、甘油三酯/高密度脂蛋白胆固醇比值（TG/HDL-C）、胰岛素抵抗代谢评分（METS-IR）与食管癌风险之间的关系。
本研究共纳入了来自英国生物银行（2006 年至 2010 年）的 388900 名参与者。采用 Fine-Gray 模型、限制性三次样条（RCS）和受试者工作特征（ROC）曲线评估了四种 IR 替代指标与食管癌（特别是食管腺癌（EAC）和食管鳞状细胞癌（ESCC））风险之间的关联。
在招募后 10 年，0.16%（95%CI 0.11-0.26%）发生食管癌，4.17%（95%CI 3.86-4.46%）死亡。TyG 指数、TyG-BMI、TG/HDL-C 和 METS-IR 每增加一个标准差，EAC 的风险分别增加 1.16、1.37、1.08 和 1.36（均 P<0.05），而 ESCC 的风险分别降低 0.80、0.67、0.77 和 0.65（均 P<0.05）。RCS 分析表明，大多数关系是非线性的（P<0.05）。ROC 曲线显示，METS-IR 的诊断效能优于 TyG、TyG-BMI 和 TG/HDL-C。
TyG 指数、TyG-BMI、TG/HDL-C 和 METS-IR 与 EAC 和 ESCC 的风险密切相关。此外，METS-IR 在预测和诊断 EAC 和 ESCC 风险方面优于其他三种 IR 指标。METS-IR 有望成为一种更有效的指标，用于识别食管癌早期风险人群，并改善风险分层。
