Tang Yuchen, Li Li, Li Jialin
Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, China.
Front Endocrinol (Lausanne). 2024 Dec 17;15:1499120. doi: 10.3389/fendo.2024.1499120. eCollection 2024.
Insulin resistance (IR) contributes substantially to the development of cardiovascular disease (CVD) and metabolic disorders, particularly obesity. The homeostatic model assessment of IR is a prevalent IR indicator, but insulin measurement is quite impractical for widely use. Given its convenience and accessibility, the triglyceride-glucose (TyG) index, along with modified indices such as the triglyceride-glucose-waist circumference (TyG-WC) and triglyceride-glucose-waist-height ratio (TyG-WHtR), are gaining recognition as practical tools for assessing IR. This study aimed to investigate the specific correlation between the TyG index and its modified indices with arterial stiffness in an overweight or obese population and to explore novel, self-defined modified TyG indices for identifying individuals at elevated risk for such conditions.
This retrospective study included 1,143 overweight or obese individuals from 2021 to 2023. Medical data, including brachial-ankle pulse wave velocity (baPWV), were collected. Two novel modified TyG indices, TyG-1h and TyG-2h, were defined by substituting the fasting glucose level in the TyG formula with 1-hour and 2-hour post-load plasma glucose levels, respectively. Multivariate logistic regression analyses were conducted to identify parameters that demonstrated a statistically significant correlation with arterial stiffness, defined as a baPWV threshold of ≥ 1400 cm/s. Additionally, restricted cubic spline (RCS) modelling was employed to further explore these relationships in a visually interpretable manner. To evaluate and compare the diagnostic accuracy of the conventional TyG index and its novel modified versions, receiver operating characteristic (ROC) curve analyses were performed.
Our findings revealed that individuals with arterial stiffness presented significantly elevated TyG index and all its modified versions (P< 0.05). By utilizing a binary logistic regression model and adjusting for potential confounders, we determined that all TyG-related parameters independently correlated with an increased risk of developing arterial stiffness. Moreover, TyG-WHtR displayed the best correlation (OR 3.071, 95% CI 1.496-6.303) when stratified by quartiles, followed by TyG-1h (OR 2.298, 95% CI 1.248-4.234) and TyG-2h (OR 2.115, 95% CI 1.175-3.807). ROC curves suggested that TyG-1h and TyG-2h demonstrated superior diagnostic performance compared to TyG, with AUCs of 0.685, 0.679 and 0.673, respectively.
The modified TyG indices exhibited strong effectiveness in identifying arterial stiffness in Chinese overweight or obese individuals.
胰岛素抵抗（IR）在心血管疾病（CVD）和代谢紊乱尤其是肥胖症的发生发展中起重要作用。IR的稳态模型评估是一种常用的IR指标，但胰岛素测量在广泛应用中不太实用。鉴于其便利性和可及性，甘油三酯-葡萄糖（TyG）指数以及甘油三酯-葡萄糖-腰围（TyG-WC）和甘油三酯-葡萄糖-腰高比（TyG-WHtR）等改良指数正逐渐被认可为评估IR的实用工具。本研究旨在调查超重或肥胖人群中TyG指数及其改良指数与动脉僵硬度之间的具体相关性，并探索用于识别此类疾病高风险个体的新型、自定义改良TyG指数。
这项回顾性研究纳入了2021年至2023年的1143名超重或肥胖个体。收集了包括臂踝脉搏波速度（baPWV）在内的医学数据。通过分别用负荷后1小时和2小时血浆葡萄糖水平替代TyG公式中的空腹血糖水平，定义了两个新型改良TyG指数TyG-1h和TyG-2h。进行多变量逻辑回归分析以确定与动脉僵硬度（定义为baPWV阈值≥1400 cm/s）具有统计学显著相关性的参数。此外，采用受限立方样条（RCS）建模以直观可解释的方式进一步探索这些关系。为了评估和比较传统TyG指数及其新型改良版本的诊断准确性，进行了受试者工作特征（ROC）曲线分析。
我们的研究结果显示，动脉僵硬度个体的TyG指数及其所有改良版本均显著升高（P<0.05）。通过使用二元逻辑回归模型并调整潜在混杂因素，我们确定所有与TyG相关的参数均与动脉僵硬度发生风险增加独立相关。此外，按四分位数分层时，TyG-WHtR显示出最佳相关性（OR 3.071，95%CI 1.496-6.303），其次是TyG-1h（OR 2.298，95%CI 1.248-4.234）和TyG-2h（OR 2.115，95%CI 1.175-3.807）。ROC曲线表明，TyG-1h和TyG-2h的诊断性能优于TyG，其AUC分别为0.685、0.67
