甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL）而非甘油三酯与葡萄糖乘积（TyG）指数，与糖尿病前期的动脉僵硬度相关。

Triglycerides to high density lipoprotein cholesterol ratio (TG/HDL), but not triglycerides and glucose product (TyG) index, is associated with arterial stiffness in prediabetes.

作者信息

Di Marco Maurizio, Scilletta Sabrina, Miano Nicoletta, Capuccio Stefania, Musmeci Marco, Di Mauro Stefania, Filippello Agnese, Scamporrino Alessandra, Bosco Giosiana, Di Giacomo Barbagallo Francesco, Scicali Roberto, Piro Salvatore, Purrello Francesco, Wagner Robert, Di Pino Antonino

机构信息

Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.

Department of Medicine and Surgery, "Kore" University of Enna 94100 Enna, Italy.

出版信息

Diabetes Res Clin Pract. 2025 Jun;224:112189. doi: 10.1016/j.diabres.2025.112189. Epub 2025 Apr 17.

DOI:10.1016/j.diabres.2025.112189

PMID:40252776

Abstract

AIMS

Prediabetes (preD) carries increased risk of cardiovascular (CV) events than normal-glucose-tolerance (NGT). Insulin resistance, a hallmark of preD, is closely linked to CV-risk, making its assessment crucial. Triglycerides-to-high-density-lipoprotein-cholesterol-ratio (TG/HDL) and triglycerides-and-glucose-product (TyG) have emerged as surrogate of insulin resistance. We aimed to evaluate the association of these indexes with CV-risk assessed through arterial stiffness in preD.

METHODS

377 individuals without diagnosis of diabetes underwent: (1) complete biochemistry and oral-glucose-tolerance-test; (2) CV-risk assessment through arterial stiffness (pulsed-wave-velocity - PWV - and augmentation-index - AugI) and intima-media-thickness (IMT). Participants were split according to current guidelines: NGT (n = 100), preD (n = 216), and newly-diagnosed-type-2-diabetes (ND-T2D) (n = 61).

RESULTS

TG/HDL and TyG were higher in preD than NGT, with no difference between preD and ND-T2D regarding TG/HDL. PreD showed higher PWV, AugI, and IMT than NGT. In preD group, after adjusting for major confounders, PWV was correlated with TG/HDL (β = 0.16; P = 0.03), but not with TyG, and there was a trend of association with HOMA-IR (β = 0.19, P = 0.07). In logistic regression, being in the higher tertile of TG/HDL was associated with higher PWV (odds-ratio 2.51, 95 %CI 1.01-6.29, P = 0.048).

CONCLUSIONS

In preD, TG/HDL was independently associated with PWV, suggesting its possible role as a simple, cost-effective tool for assessing CV risk.

摘要

目的

与糖耐量正常（NGT）相比，糖尿病前期（preD）发生心血管（CV）事件的风险更高。胰岛素抵抗是糖尿病前期的一个标志，与心血管风险密切相关，因此对其进行评估至关重要。甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL）和甘油三酯与葡萄糖乘积（TyG）已成为胰岛素抵抗的替代指标。我们旨在评估这些指标与通过动脉僵硬度评估的糖尿病前期CV风险之间的关联。

方法

377名未诊断出糖尿病的个体接受了：（1）完整的生化检查和口服葡萄糖耐量试验；（2）通过动脉僵硬度（脉搏波速度 - PWV - 和增强指数 - AugI）以及内膜中层厚度（IMT）进行CV风险评估。参与者根据现行指南进行分组：NGT（n = 100）、preD（n = 216）和新诊断的2型糖尿病（ND-T2D）（n = 61）。

结果

糖尿病前期的TG/HDL和TyG高于NGT，糖尿病前期与新诊断的2型糖尿病在TG/HDL方面无差异。糖尿病前期的PWV、AugI和IMT高于NGT。在糖尿病前期组，在调整主要混杂因素后，PWV与TG/HDL相关（β = 0.16；P = 0.03），但与TyG无关，并且与稳态模型评估的胰岛素抵抗（HOMA-IR）存在关联趋势（β = 0.19，P = 0.07）。在逻辑回归中，处于TG/HDL较高三分位数与较高的PWV相关（优势比2.51，95%CI 1.01 - 6.29，P = 0.048）。