甘油三酯-葡萄糖指数及肥胖指标与多种慢性病的关联：基于中国健康与养老追踪调查（CHARLS）的纵向队列研究

Association of the Triglyceride-Glucose Index and Obesity Indicators with Multiple Chronic Diseases: A Longitudinal Cohort Study Based on CHARLS.

作者信息

Lan Yincai, Qi Guangzi, Li Boya, Sooranna Suren Rao, Chen Dongshun, Rao Wenlian, Lin Yinxia, Pang Yaqin

机构信息

School of Public Health, Youjiang Medical University for Nationalities, Baise, Guangxi, 533000, People's Republic of China.

Life science and clinical research center, Youjiang Medical University for Nationalities, Baise 533000, Guangxi, China and Department of metabolism, digestion and reproduction, Imperial College London, Chelsea & Westminster Hospital, London, SW10 9NH, UK.

出版信息

J Multidiscip Healthc. 2025 Jan 16;18:171-182. doi: 10.2147/JMDH.S496304. eCollection 2025.

DOI:10.2147/JMDH.S496304

PMID:39834513

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11745049/

Abstract

OBJECTIVE

To explore the relationship between triglyceride glucose (TyG) and the obesity combined indexes and the occurrence of multiple chronic diseases (MCD), which will help to provide a basis for the prevention and treatment of this condition.

METHODS

3037 participants in the China Health and Retirement Longitudinal Study, which was conducted from 2011 to 2015 were selected for this study. They were divided into four groups (Q1, Q2, Q3, Q4) based on the quartiles of TyG, TyG-BMI, TyGWC and TyGWHtR in the baseline data. A Cox proportional hazard model was used to analyze the risk of MCD associated with TyG and its obesity-related combined indicators. Dose-response relationships were analyzed using restricted cubic spline regression, and the predictive ability for detection of MCD was analyzed using ROC curve.

RESULTS

At the end of the follow-up in 2015, 473 new cases of MCD were observed among the study population, with an incidence rate of 15.6%. After adjusting for confounding factors, the risk of MCD significantly increased in the Q4 TyG, TyG-BMI, TyG-WC and TyG-WHtR index groups compared to the Q1 groups (p<0.001 in all cases). A linear dose-response relationship was observed between the TyG index and the risk of MCD, indicating increased risks of CKD with higher TyG indexes. However, the TyG-BMI, TyG-WC and TyG-WHtR indexes exhibited nonlinear dose-response relationships with the risk of MCD (P-nonlinearity <0.0001 in all cases), indicating higher indexes were associated with higher risks of MCD. The areas under the ROC curves for the Cox regression models of TyG, TyG-BMI, TyG-WC and TyG-WHtR indices were 0.610, 0.590, 0.590 and 0.607, respectively.

CONCLUSION

The TyG, TyG-BMI, TyG-WC and TyG-WHtR indexes were found to be positively correlated with increased risk of developing MCD. Measurements and regulation of these indexes can be used to prevent and control the occurrence of MCD.

摘要

目的

探讨甘油三酯葡萄糖（TyG）与肥胖综合指数及多种慢性病（MCD）发生之间的关系，以期为该病的防治提供依据。

方法

选取2011年至2015年进行的中国健康与养老追踪调查中的3037名参与者作为研究对象。根据基线数据中TyG、TyG-BMI、TyGWC和TyGWHtR的四分位数将他们分为四组（Q1、Q2、Q3、Q4）。采用Cox比例风险模型分析TyG及其肥胖相关综合指标与MCD的关联风险。使用受限立方样条回归分析剂量反应关系，并使用ROC曲线分析检测MCD的预测能力。

结果

2015年随访结束时，研究人群中观察到473例MCD新发病例，发病率为15.6%。调整混杂因素后，与Q1组相比，Q4 TyG、TyG-BMI、TyG-WC和TyG-WHtR指数组中MCD的风险显著增加（所有情况p<0.001）。观察到TyG指数与MCD风险之间存在线性剂量反应关系，表明TyG指数越高，慢性肾脏病风险越高。然而，TyG-BMI、TyG-WC和TyG-WHtR指数与MCD风险呈现非线性剂量反应关系（所有情况P-非线性<0.0001），表明指数越高，MCD风险越高。TyG、TyG-BMI、TyG-WC和TyG-WHtR指数的Cox回归模型的ROC曲线下面积分别为0.610、0.590、0.590和0.607。