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甘油三酯-葡萄糖指数与中国成年人糖尿病前期风险之间的非线性关系:一项二次回顾性队列研究。

Non-linear connection between the triglyceride-glucose index and prediabetes risk among Chinese adults: a secondary retrospective cohort study.

机构信息

Department of Rehabilitation, Shenzhen Second People's Hospital Dapeng New District Nan'ao Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong, China.

Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong, China.

出版信息

Eur J Med Res. 2024 Nov 5;29(1):529. doi: 10.1186/s40001-024-02121-x.

Abstract

BACKGROUND

The triglyceride-glucose (TyG) index has garnered recognition as a surrogate marker for insulin resistance, a pivotal factor in the pathogenesis of various metabolic disorders. Despite its emerging role, the empirical evidence delineating its association with prediabetes mellitus (Pre-DM) remains scant. This research aims to clarify the link between the TyG index and the likelihood of Pre-DM development within a Chinese demographic.

METHODS

This investigation was structured as a retrospective cohort analysis, encompassing a sample of 179,177 Chinese adults. These individuals underwent medical examinations at the Rich Healthcare Group over a period spanning from 2010 to 2016. To ascertain the relationship between the TyG index and the incidence of Pre-DM, this study employed Cox regression analysis complemented by sensitivity and subgroup assessments. Furthermore, Cox proportional hazards regression with cubic spline functions and smooth curve fitting was incorporated to explore the existence of any non-linear connection within this association.

RESULTS

Upon adjusting for a comprehensive array of confounding variables, a statistically significant positive correlation between the TyG index and the risk of Pre-DM was identified (HR: 1.60, 95%CI 1.56-1.65, P < 0.001). The analysis illuminated a non-linear relationship, with an inflection point at a TyG index value of 8.78. For TyG index values below and above this inflection point, the HR was calculated to be 1.94 (95%CI 1.86-2.03) and 1.26 (95%CI 1.20-1.33), respectively. Sensitivity analyses further fortified the reliability of these findings.

CONCLUSIONS

This comprehensive examination delineated a significantly positive, non-linear correlation between the TyG index and the risk of Pre-DM within a Chinese population. Individuals with TyG index values below 8.78 have a significantly increased risk of developing prediabetes. These findings underscore the TyG index's potential efficacy as a predictive tool for assessing Pre-DM risk in clinical practice.

摘要

背景

三酰甘油-葡萄糖(TyG)指数已被认可为胰岛素抵抗的替代标志物,而胰岛素抵抗是各种代谢紊乱发病机制中的关键因素。尽管它的作用越来越受到重视,但关于它与糖尿病前期(Pre-DM)之间关联的经验证据仍然很少。本研究旨在阐明 TyG 指数与中国人群中 Pre-DM 发病风险之间的联系。

方法

本研究采用回顾性队列分析,纳入了 179177 名中国成年人的样本。这些个体在 2010 年至 2016 年期间在瑞和医疗集团接受了体检。为了确定 TyG 指数与 Pre-DM 发生率之间的关系,本研究采用 Cox 回归分析,并进行了敏感性和亚组评估。此外,还采用 Cox 比例风险回归和三次样条函数及平滑曲线拟合来探讨这种关联中是否存在非线性关系。

结果

在调整了一系列混杂因素后,发现 TyG 指数与 Pre-DM 风险之间存在显著的正相关关系(HR:1.60,95%CI 1.56-1.65,P<0.001)。分析表明存在非线性关系,拐点位于 TyG 指数值为 8.78 处。对于低于和高于这个拐点的 TyG 指数值,HR 分别计算为 1.94(95%CI 1.86-2.03)和 1.26(95%CI 1.20-1.33)。敏感性分析进一步证实了这些发现的可靠性。

结论

本研究全面分析了中国人群中 TyG 指数与 Pre-DM 风险之间存在显著的正、非线性关系。TyG 指数值低于 8.78 的个体发生 Pre-DM 的风险显著增加。这些发现强调了 TyG 指数作为评估临床实践中 Pre-DM 风险的预测工具的潜在有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8ef/11536673/e8a7f29465e7/40001_2024_2121_Fig1_HTML.jpg

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