Liang Shichao, Yang Tengfei
Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China.
Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China.
Diabetes Metab Syndr Obes. 2024 Aug 24;17:3139-3150. doi: 10.2147/DMSO.S475067. eCollection 2024.
Longitudinal cohort analysis was performed to identify the association between changes in the gamma-glutamyl transferase (GGT)/high-density lipoprotein cholesterol (HDL-C) ratio trajectory and the risk of developing diabetes mellitus.
This was a retrospective cohort study. We analyzed the latent trajectory classes of changes in the GGT/HDL-C ratio by applying a latent class mixture model with healthy individuals who underwent medical checkups from January 2017 to December 2021 as the study subjects. To analyze the effect of the GGT/HDL-C ratio trajectory classes on new-onset diabetes mellitus, we then applied a multivariate Cox proportional risk regression model. Statistical analysis was performed using the R-software with the LCMM package.
The study cohort comprised 3410 participants. All participants were followed up for 5 years, and 95 developed diabetes (4-year incidence of 2.78%). By applying the latent class mixed model, we categorized participants into three trajectory groups: low-stability group (n = 2253), medium-increase group (n = 941), and high-increase group (n = 216). The Cox proportional risk regression model analysis showed that the hazard ratio (95% confidence interval) for the incidence of diabetes mellitus was 1.73 (1.04-2.87) in the medium-increase group and 3.96 (2.11-7.44) in the high-increase group. Moreover, we calculated the estimated model-based levels and linear slopes of the GGT/HDL-C ratios for each age group between 26 and 85 years at 10-year intervals, respectively. The results indicated the strongest correlation between the GGT/HDL-C ratio slope and diabetes in the 46-55 year age group, with an odds ratio of 1.51 (1.25-1.83).
A large increase in the GGT/HDL-C ratio was highly associated with the risk of developing diabetes mellitus. This result suggests that vigilance for changes in the GGT/HDL-C ratio trajectory during community health screening can help identify potential patients with diabetes, enabling early intervention and treatment.
进行纵向队列分析，以确定γ-谷氨酰转移酶（GGT）/高密度脂蛋白胆固醇（HDL-C）比值轨迹变化与患糖尿病风险之间的关联。
这是一项回顾性队列研究。我们以2017年1月至2021年12月接受体检的健康个体为研究对象，应用潜在类别混合模型分析GGT/HDL-C比值变化的潜在轨迹类别。为分析GGT/HDL-C比值轨迹类别对新发糖尿病的影响，我们随后应用了多变量Cox比例风险回归模型。使用带有LCMM软件包的R软件进行统计分析。
研究队列包括3410名参与者。所有参与者均随访5年，95人患糖尿病（4年发病率为2.78%）。通过应用潜在类别混合模型，我们将参与者分为三个轨迹组：低稳定性组（n = 2253）、中度升高组（n = 941）和高度升高组（n = 216）。Cox比例风险回归模型分析显示，中度升高组糖尿病发病率的风险比（95%置信区间）为1.73（1.04 - 2.87），高度升高组为3.96（2.11 - 7.44）。此外，我们分别计算了26至85岁各年龄组每10年间隔的基于模型估计的GGT/HDL-C比值水平和线性斜率。结果表明，46 - 55岁年龄组GGT/HDL-C比值斜率与糖尿病之间的相关性最强，优势比为1.51（1.25 - 1.83）。
GGT/HDL-C比值大幅升高与患糖尿病风险高度相关。这一结果表明，在社区健康筛查期间对GGT/HDL-C比值轨迹变化保持警惕，有助于识别潜在糖尿病患者，从而实现早期干预和治疗。
