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甘油三酯与血糖指数(TyG)、TyG体重指数(TyG-BMI)和代谢综合征胰岛素抵抗指数(METS-IR)在老年男性骨质疏松症风险中的作用:一项回顾性队列研究。

Role of TyG, TyG-BMI and METS-IR in osteoporosis risk among older men: a retrospective cohort study.

作者信息

Zeng Jing, Li Ting, Pan Zimo, Liu Qianqian, He Jinfu, Cai Xiaoyan, Gong Meiliang, Deng Xinli, Gong Yanping, Li Nan, Li Chunlin

机构信息

Department of Endocrinology, the Second Medical Center and National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, China.

National Key Laboratory of Kidney Disease, Chinese PLA General Hospital, Beijing, China.

出版信息

Asia Pac J Clin Nutr. 2025 Jun;34(3):477-485. doi: 10.6133/apjcn.202506_34(3).0021.

Abstract

BACKGROUND AND OBJECTIVES

Obese and diabetic individuals tend to have insulin resistance, but are less like-ly to develop osteoporosis. The association of triglyceride-glucose (TyG) related indices with osteoporosis remains controversial, and longitudinal evidence exploring the male osteoporosis (MOP) is limited. This study aims to examine TyG, TyG-body mass index (TyG-BMI) and the metabolic score for insulin resistance (METS-IR) with osteoporosis risk among older men.

METHODS AND STUDY DESIGN

A cohort study based on 1622 middle-aged and older men in 2015 was conducted, and followed up until 2022. Participants with oste-oporosis and admittedly secondary risk factors were excluded. TyG, TyG-BMI, METS-IR and corresponding quantiles were calculated. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) and 95% confidence interval (CI). Receiver operating characteristic (ROC) curve was applied to estimate their performance in osteoporosis screening.

RESULTS

72 of 1622 participants were newly developed OP during the 9317 person-years. The adjusted HRs of TyG, TyG-BMI, and METS-IR for MOP were 0.573 (95%CI 0.336-0.976), 0.991 (95%CI 0.984-0.999) and 0.929 (95%CI 0.892-0.968), respectively, and pre-sented at linear dose-response relationships. Subgroup analysis showed that the estimated benefit for MOP incidence was consistent among participants aged more than 70 years and related to BMI and eating mount of milk, fresh fruit and vegetables. No difference was found in the area under ROC curve for screening osteo-porosis, ranging from 0.585 to 0.617.

CONCLUSIONS

TyG and relevant indices were associated with the inci-dence of osteoporosis in the senile men, and the relationship was thought to correlate with BMI and nutritional behaviors.

摘要

背景与目的

肥胖和糖尿病患者往往存在胰岛素抵抗,但患骨质疏松症的可能性较小。甘油三酯-葡萄糖(TyG)相关指标与骨质疏松症的关联仍存在争议,且探索男性骨质疏松症(MOP)的纵向证据有限。本研究旨在探讨老年男性中TyG、TyG体重指数(TyG-BMI)和胰岛素抵抗代谢评分(METS-IR)与骨质疏松症风险的关系。

方法与研究设计

基于2015年的1622名中老年男性进行队列研究,并随访至2022年。排除患有骨质疏松症及公认的继发性危险因素的参与者。计算TyG、TyG-BMI、METS-IR及其相应的分位数。采用Cox比例风险回归模型评估风险比(HRs)和95%置信区间(CI)。应用受试者工作特征(ROC)曲线评估它们在骨质疏松症筛查中的性能。

结果

在9317人年期间,1622名参与者中有72人新发生骨质疏松症。TyG、TyG-BMI和METS-IR对MOP的调整后HR分别为0.573(95%CI 0.336-0.976)、0.991(95%CI 0.984-0.999)和0.929(95%CI 0.892-0.968),并呈现线性剂量反应关系。亚组分析表明,70岁以上参与者中MOP发病率的估计获益一致,且与BMI以及牛奶、新鲜水果和蔬菜的摄入量有关。筛查骨质疏松症的ROC曲线下面积在0.585至0.617之间,未发现差异。

结论

TyG及相关指标与老年男性骨质疏松症的发生率相关,且这种关系被认为与BMI和营养行为有关。

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