TyG指数和UHR对2型糖尿病下肢动脉疾病的比较预测价值：一项回顾性分析。

Comparative Predictive Value of the TyG Index and UHR for Lower Extremity Artery Disease in Type 2 Diabetes: A Retrospective Analysis.

作者信息

Shao Chen, Fei Chengzhi, Gu Mingxue, Zha Xiujing, Li Juan, Zheng Delu, Wang Diwen, Wang Yanqiu, Hu Xiaolei

机构信息

Department of Endocrinology, The Second Affiliated Hospital of Bengbu Medical University, Bengbu, 233000, People's Republic of China.

Department of Nephrology, The Second Affiliated Hospital of Bengbu Medical University, Bengbu, 233000, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2025 Apr 29;18:1341-1351. doi: 10.2147/DMSO.S496727. eCollection 2025.

DOI:10.2147/DMSO.S496727

PMID:40321676

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12049115/

Abstract

OBJECTIVE

To compare the predictive value of triglyceride glucose index (TyG) and the ratio of serum uric acid (SUA) to high-density lipoprotein cholesterol (HDL-C) (UHR) for lower extremity atherosclerotic disease (LEAD) in type 2 diabetes (T2DM) patients.

METHODS

303 patients with T2DM were divided into LEAD group (n=192) and non-LEAD group (n=111) based on the results of lower extremity vascular color Doppler ultrasound. All patients were divided into a training set and a validation set at a 7:3 ratio. In the training set, Least absolute shrinkage and selection operator (LASSO) regression was applied to screen for predictive factors of LEAD, and a multivariate logistic regression model was constructed to analyze the predictive factors, with a nomogram being plotted. The discriminative ability and calibration of the model were evaluated using the receiver operating characteristic (ROC) curve area under the curve (AUC) and calibration curves in both the training and validation sets. Decision curve analysis (DCA) was used to evaluate the clinical net benefit.

RESULTS

The variables selected by the LASSO regression included age, pulse pressure difference (PP), TyG, and UHR. The multivariate logistic regression model indicated that age, PP, TyG, and UHR were predictive factors for LEAD in T2DM patients (P<0.05). ROC curve analysis suggested that the discriminatory ability was in the following order: the nomogram model (AUC=0.872), TyG (AUC=0.751), and UHR (AUC=0.709), which were greater than that of age and PP. TyG and UHR cut-off values were 9.836 and 216.248, respectively. The specificities of TyG and UHR were 0.760 and 0.547, and the sensitivities were 0.629 and 0.807, respectively. The calibration curve showed the model's predictions matched actual conditions. DCA verified the model's clinical benefit.

CONCLUSION

Both TyG and UHR have good predictive value and are suitable for screening LEAD in T2DM patients.

摘要

目的

比较甘油三酯葡萄糖指数（TyG）和血清尿酸（SUA）与高密度脂蛋白胆固醇（HDL-C）之比（UHR）对2型糖尿病（T2DM）患者下肢动脉粥样硬化疾病（LEAD）的预测价值。

方法

根据下肢血管彩色多普勒超声结果，将303例T2DM患者分为LEAD组（n = 192）和非LEAD组（n = 111）。所有患者按7:3的比例分为训练集和验证集。在训练集中，应用最小绝对收缩和选择算子（LASSO）回归筛选LEAD的预测因素，构建多因素logistic回归模型分析预测因素，并绘制列线图。使用受试者工作特征（ROC）曲线下面积（AUC）和训练集与验证集的校准曲线评估模型的判别能力和校准情况。采用决策曲线分析（DCA）评估临床净效益。

结果

LASSO回归选择的变量包括年龄、脉压差（PP）、TyG和UHR。多因素logistic回归模型表明，年龄、PP、TyG和UHR是T2DM患者LEAD的预测因素（P<0.05）。ROC曲线分析表明，判别能力顺序如下：列线图模型（AUC = 0.872）、TyG（AUC = 0.751）和UHR（AUC = 0.709），均大于年龄和PP。TyG和UHR的截断值分别为9.836和216.248。TyG和UHR的特异性分别为0.760和0.547，敏感性分别为0.629和0.807。校准曲线显示模型预测与实际情况相符。DCA验证了模型的临床效益。