Zhang Fan, Sun Yan, Bai Yan, Wu Rong, Yang Hua
Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Cardiology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Lipids Health Dis. 2024 Dec 20;23(1):412. doi: 10.1186/s12944-024-02403-7.
Diabesity, a co-occurrence of diabetes and obesity, is a growing public health concern globally. The triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, has been associated with various metabolic disorders. This study aimed to investigate the association between TyG index and new-onset diabesity in a national longitudinal study.
We utilized data from the China Health and Retirement Longitudinal Study (CHARLS). Baseline data from the first wave (2011) and follow-up data from the third wave (2015) were analyzed. A Competing risks model based on Fine and Gray's subdistribution hazard approach was employed to examine the association between the TyG index and developing of three mutually exclusive outcomes: remaining free of diabetes and obesity, diabetes alone, and new-onset diabesity (co-occurrence of diabetes and obesity).
A total of 6,976 participants were included in the analysis. During a mean follow-up period of 4.0 years, a total of 557 diabetes and 155 diabesity were recorded, respectively. After adjusting for socio-demographic information, lifestyle and comorbidities, compared with participants in the lowest quartile of TyG, the corresponding adjusted subdistribution hazard ratios (HRs) with 95% confidence intervals (95% CIs) for participants in the second, third, and fourth quartiles were 2.112 (95% CI: 1.047-4.259; P-value = 0.037), 2.911 (95% CI: 1.481-5.722, P-value = 0.002), and 4.305 (95% CI: 2.220-8.346, P-value < 0.001). The association between TyG and diabetes alone was equally significant when diabesity treated as the competing risk. Sensitivity analyses proved the robustness of results.
This national longitudinal study in China provides evidence that a higher TyG index is associated with an increased risk of developing diabesity.
糖尿病肥胖症，即糖尿病与肥胖症并存，是全球日益受到关注的公共卫生问题。甘油三酯-葡萄糖（TyG）指数作为胰岛素抵抗的替代指标，与多种代谢紊乱有关。本研究旨在通过一项全国性纵向研究，探讨TyG指数与新发糖尿病肥胖症之间的关联。
我们使用了中国健康与养老追踪调查（CHARLS）的数据。分析了第一波（2011年）的基线数据和第三波（2015年）的随访数据。采用基于Fine和Gray的亚分布风险方法的竞争风险模型，来检验TyG指数与三种相互排斥的结局发展之间的关联：既无糖尿病也无肥胖症、仅患糖尿病、新发糖尿病肥胖症（糖尿病与肥胖症并存）。
共有6976名参与者纳入分析。在平均4.0年的随访期内，分别记录到557例糖尿病和155例糖尿病肥胖症。在调整了社会人口学信息、生活方式和合并症后，与TyG最低四分位数的参与者相比，第二、第三和第四四分位数参与者相应的调整后亚分布风险比（HRs）及95%置信区间（95% CIs）分别为2.112（95% CI：1.047 - 4.259；P值 = 0.037）、2.911（95% CI：1.481 - 5.722，P值 = 0.002）和4.305（95% CI：2.220 - 8.346，P值 < 0.001）。当将糖尿病肥胖症视为竞争风险时，TyG与仅患糖尿病之间的关联同样显著。敏感性分析证实了结果的稳健性。
这项中国的全国性纵向研究提供了证据，表明较高的TyG指数与发生糖尿病肥胖症的风险增加有关。
