甘油三酯-葡萄糖指数作为胃癌患者内脏肥胖的标志物

Triglyceride-glucose index as a marker for visceral obesity in patients with gastric cancer.

作者信息

Zuo Junbo, Huang Zhenhua, Ge Yan, Ding Xin, Wang Xiuhua, Huang Yan

机构信息

Department of General Surgery, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, China.

Department of Nutrition, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, China.

出版信息

Front Nutr. 2025 Jan 10;11:1515918. doi: 10.3389/fnut.2024.1515918. eCollection 2024.

DOI:10.3389/fnut.2024.1515918

PMID:39867563

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11757132/

Abstract

BACKGROUND

The triglyceride-glucose (TyG) index has emerged as a validated and cost-effective indicator of insulin resistance (IR). Given the significant association between visceral obesity and IR, this study aimed to investigate the utility of the TyG index in estimating visceral obesity in patients with gastric cancer (GC).

METHODS

The visceral fat area (VFA), subcutaneous fat area (SFA), and VFA-to-SFA ratio (VSR) were determined through the analysis of CT images at the lumbar 3 level. The definition of visceral obesity was established as VFA ≥ 100 cm. The association between the TyG index and visceral obesity was assessed using logistic regression analysis and restricted cubic splines. The diagnostic performance for identifying visceral obesity was evaluated by calculating the area under the Receiver Operating Characteristics curve (AUC).

RESULTS

The cross-sectional study enrolled a total of 314 patients with GC, among whom 159 (50.64%) were identified as having visceral obesity. The TyG index was positively correlated with VFA ( = 0.45,  < 0.001), SFA ( = 0.23,  < 0.001), and VSR ( = 0.35,  < 0.001). However, subsequent multivariate linear regression analysis demonstrated that the TyG index was significantly associated with VFA and VSR, but not SFA. After adjusting for potential confounding factors, the TyG index remained independently associated with visceral obesity (OR = 2.54, 95% CI: 1.32-4.89,  = 0.005) and demonstrated a significantly positive linear correlation with visceral obesity in patients with GC (-value for non-linearity = 0.116). TyG-BMI, the combination index of TyG and BMI, showed the highest predictive power in identifying visceral obesity in GC patients (AUC = 0.849, 95% CI: 0.807-0.890,  < 0.001). The subgroup analysis revealed a significantly stronger positive association between the TyG index and visceral obesity in patients with BMI ≥ 25 kg/m ( for interaction = 0.049).

CONCLUSION

The TyG index exhibited a significant association with visceral obesity and proved to be a valuable predictor for visceral obesity when combined with BMI in patients with GC.

摘要

背景

甘油三酯-葡萄糖（TyG）指数已成为一种经过验证且具有成本效益的胰岛素抵抗（IR）指标。鉴于内脏肥胖与IR之间存在显著关联，本研究旨在探讨TyG指数在评估胃癌（GC）患者内脏肥胖方面的效用。

方法

通过分析第3腰椎水平的CT图像来确定内脏脂肪面积（VFA）、皮下脂肪面积（SFA）以及VFA与SFA的比值（VSR）。内脏肥胖的定义为VFA≥100 cm²。使用逻辑回归分析和受限立方样条评估TyG指数与内脏肥胖之间的关联。通过计算受试者工作特征曲线（ROC曲线）下面积（AUC）来评估识别内脏肥胖的诊断性能。

结果

这项横断面研究共纳入314例GC患者，其中159例（50.64%）被确定为内脏肥胖。TyG指数与VFA（r = 0.45，P < 0.001）、SFA（r = 0.23，P < 0.001）和VSR（r = 0.35，P < 0.001）呈正相关。然而，随后的多因素线性回归分析表明，TyG指数与VFA和VSR显著相关，但与SFA无关。在调整潜在混杂因素后，TyG指数仍与内脏肥胖独立相关（OR = 2.54，95%CI：1.32 - 4.89，P = 0.005），并且在GC患者中与内脏肥胖呈显著正线性相关（非线性P值 = 0.116）。TyG-BMI，即TyG与BMI的联合指数，在识别GC患者内脏肥胖方面显示出最高的预测能力（AUC = 0.849，95%CI：0.807 - 0.890，P < 0.001）。亚组分析显示，在BMI≥25 kg/m²的患者中，TyG指数与内脏肥胖之间的正相关显著更强（交互作用P = 0.049）。