甘油三酯-葡萄糖指数与血清神经丝轻链之间的关系：2013 - 2014年美国国家健康与营养检查调查结果

The relationship between triglyceride-glucose index and serum neurofilament light chain: Findings from NHANES 2013-2014.

作者信息

Chen Tong, Zheng Wei, Zhang Yan, Xu Qian

机构信息

Department of Neurology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China.

Department of Outpatient, Xuzhou Medical University, Xuzhou, Jiangsu, China.

出版信息

PLoS One. 2025 Apr 10;20(4):e0321226. doi: 10.1371/journal.pone.0321226. eCollection 2025.

DOI:10.1371/journal.pone.0321226

PMID:40208889

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11984729/

Abstract

BACKGROUND

The Triglyceride-Glucose (TyG) index has become a reliable indicator for evaluating the level of insulin resistance, a pivotal factor in both metabolic and neurodegenerative disorders. Serum neurofilament light chain (sNfL) serves as a responsive biomarker for detecting neuroaxonal injury. Despite this, the interplay between the TyG index and sNfL levels has not been sufficiently investigated. The aim of this research is to scrutinize the correlation between TyG index and sNfL levels across a substantial, population-based cohort.

METHODS

Our study involved an examination of the dataset from the 2013-2014 round of the National Health and Nutrition Examination Survey (NHANES), encompassing a total of 2029 enrolled subjects. The TyG index was calculated using fasting triglycerides and glucose levels. Multivariable linear regression models were conducted to evaluate the relationship between TyG index and sNfL levels, adjusting for potential confounders such as age, sex, race, BMI, hypertension, stroke, congestive heart failure, alcohol consumption and NHHR (Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio). Nonlinear associations were investigated using regression models based on restricted cubic splines (RCS).

RESULTS

Both the unadjusted and adjusted regression analyses revealed a substantial positive correlation between the TyG index and ln-sNfL levels. After accounting for all covariates, each unit increase in the TyG index was associated with a 0.15 (95% CI: 0.02-0.27, p = 0.04) increase in ln-sNfL levels. RCS analysis revealed a nonlinear relationship, with a threshold around a TyG index value of 9.63, beyond which ln-sNfL levels increased more rapidly. The association was consistent across subgroups.

CONCLUSION

Our study links higher TyG index with increased sNfL levels, indicating insulin resistance's role in neuroaxonal injury. The nonlinear relationship implies a heightened risk of neurodegeneration beyond a certain insulin resistance threshold. This underscores the need for early metabolic interventions to prevent neurodegenerative processes.

摘要

背景

甘油三酯-葡萄糖（TyG）指数已成为评估胰岛素抵抗水平的可靠指标，胰岛素抵抗是代谢紊乱和神经退行性疾病的关键因素。血清神经丝轻链（sNfL）是检测神经轴突损伤的反应性生物标志物。尽管如此，TyG指数与sNfL水平之间的相互作用尚未得到充分研究。本研究的目的是在一个基于人群的大型队列中仔细研究TyG指数与sNfL水平之间的相关性。

方法

我们的研究涉及对2013 - 2014年全国健康与营养检查调查（NHANES）数据集的检查，共有2029名登记受试者。TyG指数使用空腹甘油三酯和血糖水平计算。进行多变量线性回归模型以评估TyG指数与sNfL水平之间的关系，并对年龄、性别、种族、体重指数、高血压、中风、充血性心力衰竭、饮酒和NHHR（非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值）等潜在混杂因素进行调整。使用基于受限立方样条（RCS）的回归模型研究非线性关联。

结果

未调整和调整后的回归分析均显示TyG指数与ln - sNfL水平之间存在显著正相关。在考虑所有协变量后，TyG指数每增加一个单位，ln - sNfL水平增加0.15（95%CI：0.02 - 0.27，p = 0.04）。RCS分析显示存在非线性关系，TyG指数值约为9.63时为阈值，超过该值ln - sNfL水平增加更快。该关联在各亚组中一致。