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1型糖尿病成年患者甘油三酯-葡萄糖指数与糖尿病肾病风险的相关性

Correlation between triglyceride-glucose index and diabetic kidney disease risk in adults with type 1 diabetes mellitus.

作者信息

Lei Mengyun, Ling Ping, Zhou Yongwen, Lv Jing, Ni Ying, Deng Hongrong, Wang Chaofan, Yang Daizhi, Yang Xubin, Xu Wen, Yan Jinhua

机构信息

Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.

出版信息

Diabetol Metab Syndr. 2024 Oct 1;16(1):239. doi: 10.1186/s13098-024-01468-9.

Abstract

BACKGROUND

The triglyceride-glucose (TyG) index is identified as an alternative indicator of insulin resistance (IR) and is associated with macro- and micro-vascular diseases among patients with type 2 diabetes mellitus. The relationship between the TyG index and IR and its impact on diabetic kidney disease (DKD) remains unclear among adults with type 1 diabetes mellitus(T1DM).

METHODS

This study comprised a cross-sectional analysis using data from the Guangdong T1DM Translational Medicine Study (GTT) and a longitudinal analysis using data from the type 1 diabetes (T1D) Exchange registry study. Correlation analysis was used to investigate the association between the TyG index and IR. Logistic regression and Cox proportional hazards regression were performed to explore the impact of the TyG index on DKD risk.

RESULTS

The GTT Study included 836 adults (216 with DKD and 620 without DKD). A significant correlation existed between the TyG index and the estimated glucose disposal rate (r=-0.64, p < 0.01). The TyG index was a risk factor for DKD after confounder adjustment (OR = 1.34, 95% CI:1.03-1.74). The T1D Exchange registry study included 8,771 adults (2,050 with DKD and 6,721 without DKD). After adjusting confounding factors, the TyG index was identified as an independent risk factor for DKD at enrollment, with the highest risk of DKD incidence observed in the highest TyG tertile group (OR = 1.92, 95%CI:1.67-2.20). During a median follow-up of 44.58(21.84, 67.09) months, the risk of developing DKD was increased by 32% at every 1 SD increase of the TyG index over time among participants without DKD at enrollment.

CONCLUSIONS

The TyG index could be used to assess IR and was identified as an independent risk factor of DKD among adults with T1DM.

摘要

背景

甘油三酯-葡萄糖(TyG)指数被确定为胰岛素抵抗(IR)的替代指标,且与2型糖尿病患者的大血管和微血管疾病相关。在1型糖尿病(T1DM)成人患者中,TyG指数与IR之间的关系及其对糖尿病肾病(DKD)的影响仍不清楚。

方法

本研究包括一项使用来自广东T1DM转化医学研究(GTT)数据的横断面分析和一项使用来自1型糖尿病(T1D)交换注册研究数据的纵向分析。采用相关性分析来研究TyG指数与IR之间的关联。进行逻辑回归和Cox比例风险回归以探讨TyG指数对DKD风险的影响。

结果

GTT研究纳入了836名成年人(216名患有DKD,620名未患DKD)。TyG指数与估计的葡萄糖处置率之间存在显著相关性(r = -0.64,p < 0.01)。在调整混杂因素后,TyG指数是DKD的一个危险因素(OR = 1.34,95%CI:1.03 - 1.74)。T1D交换注册研究纳入了8771名成年人(2050名患有DKD,6721名未患DKD)。在调整混杂因素后,TyG指数被确定为入组时DKD的独立危险因素,在TyG三分位数最高组中观察到DKD发病风险最高(OR = 1.92,95%CI:1.67 - 2.20)。在中位随访44.58(21.84,67.09)个月期间,入组时未患DKD的参与者中,随着时间推移,TyG指数每增加1个标准差,发生DKD的风险增加32%。

结论

TyG指数可用于评估IR,并被确定为T1DM成人患者中DKD的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ec0/11443788/bdbbe3bad682/13098_2024_1468_Fig1_HTML.jpg

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