Liu Ling, He Yunqiang, Wang Yan, Tao Juming, Wang Jiachen, Lu Fangzhou, Fu Qi, Yang Tao, Gao Jingyang, Zheng Shuai
Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, #300 Guangzhou Road, Nanjing, 210029, China.
Lipids Health Dis. 2025 Apr 1;24(1):125. doi: 10.1186/s12944-025-02534-5.
Identifying micro- and macrovascular damage through microalbuminuria and arterial stiffness is essential for preventing renal and cardiovascular complications in patients with type 2 diabetes mellitus (T2D). The primary goal of this research is to investigate the association of the phase angle (PA), triglyceride‒glucose (TyG) index, and homeostasis model assessment for insulin resistance (HOMA-IR) with microalbuminuria and arterial stiffness in patients with T2D.
In this retrospective cross-sectional study, 938 participants with T2D were enrolled. The PA was calculated from bioelectrical impedance analysis. Logistic regression was used to analyze the association of PA, the TyG index and HOMA-IR with microalbuminuria (urinary albumin-to-creatinine ratio [UACR] > 30 mg/g using overnight urine) and increased arterial stiffness (brachial-ankle pulse wave velocity [baPWV] > 1400 cm/s), respectively. Potential nonlinear relationships between PA, the TyG index, and the prevalence of microalbuminuria and increased arterial stiffness were assessed via restricted cubic splines (RCS). Subgroup analysis evaluated the robustness of the association.
PA was inversely correlated with the UACR (r = -0.29, P < 0.001) and baPWV (r = -0.37, P < 0.001). Confounder-adjusted analyses revealed that the highest tertile of PA was significantly associated with lower prevalences of both microalbuminuria and increased arterial stiffness than the lowest tertile, with ORs of 0.305 and 0.467 and P trends < 0.001 and 0.017, respectively. Conversely, the highest TyG tertile was associated with increased prevalences of microalbuminuria and increased arterial stiffness, with ORs of 1.727 and 1.625, respectively, but the P trends were not statistically significant. There were no significant associations between HOMA-IR and microalbuminuria and increased arterial stiffness. RCS analysis further confirmed a significant linear relationship between PA and both vascular complications. Subgroup analyses consistently demonstrated the association between PA and microalbuminuria across all subgroups stratified by sex, age, BMI, HbA1c, and duration of diabetes (all P < 0.01).
Compared with the TyG index and HOMA-IR, PA is independently and more strongly associated with microalbuminuria and increased arterial stiffness in patients with T2D.
通过微量白蛋白尿和动脉僵硬度来识别微血管和大血管损伤对于预防2型糖尿病（T2D）患者的肾脏和心血管并发症至关重要。本研究的主要目的是探讨相位角（PA）、甘油三酯-葡萄糖（TyG）指数和胰岛素抵抗稳态模型评估（HOMA-IR）与T2D患者微量白蛋白尿和动脉僵硬度之间的关联。
在这项回顾性横断面研究中，纳入了938例T2D患者。通过生物电阻抗分析计算PA。采用逻辑回归分别分析PA、TyG指数和HOMA-IR与微量白蛋白尿（过夜尿的尿白蛋白与肌酐比值[UACR]＞30mg/g）和动脉僵硬度增加（臂踝脉搏波速度[baPWV]＞1400cm/s）之间的关联。通过受限立方样条（RCS）评估PA、TyG指数与微量白蛋白尿患病率和动脉僵硬度增加之间的潜在非线性关系。亚组分析评估了这种关联的稳健性。
PA与UACR（r = -0.29，P＜0.001）和baPWV（r = -0.37，P＜0.001）呈负相关。经过混杂因素调整的分析显示，PA最高三分位数与微量白蛋白尿和动脉僵硬度增加的患病率均显著低于最低三分位数，比值比分别为0.305和0.467，P趋势分别＜0.001和0.017。相反，TyG最高三分位数与微量白蛋白尿患病率增加和动脉僵硬度增加相关，比值比分别为1.727和1.625，但P趋势无统计学意义。HOMA-IR与微量白蛋白尿和动脉僵硬度增加之间无显著关联。RCS分析进一步证实了PA与两种血管并发症之间存在显著的线性关系。亚组分析一致显示，在按性别、年龄、BMI、糖化血红蛋白（HbA1c）和糖尿病病程分层的所有亚组中，PA与微量白蛋白尿之间均存在关联（所有P＜0.01）。
与TyG指数和HOMA-IR相比，PA与T2D患者的微量白蛋白尿和动脉僵硬度增加独立且更密切相关。
