美国成年人中甘油三酯葡萄糖和肥胖指数与慢性阻塞性肺疾病的关联：来自2013年至2018年美国国家健康与营养检查调查（NHANES）的数据。

Association of triglyceride glucose and obesity indices with chronic obstructive pulmonary disease in US adults: data from 2013 to 2018 NHANES.

作者信息

Chen Jinzhan, Chen Ayun, Yang Shuwen, Zhang Fuhan, Jiang Hongni, Liu Jiaxin, Xie Congyi

机构信息

Department of Pulmonary Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, 361000, Fujian, People's Republic of China.

The First Affiliated Hospital of Xiamen University, Xiamen, 361000, Fujian, People's Republic of China.

出版信息

BMC Pulm Med. 2025 May 28;25(1):268. doi: 10.1186/s12890-025-03738-2.

DOI:10.1186/s12890-025-03738-2

PMID:40437398

Abstract

BACKGROUND

The impact of insulin resistance (IR) on chronic obstructive pulmonary disease (COPD) has caught increasing attention, and the triglyceride-glucose (TyG) index and related indices are deemed reliable indicators for evaluating IR. Nevertheless, the potential associations of TyG and obesity-related indexes with COPD are currently understudied. Hence, this paper was to inspect the links of TyG and obesity-related indices with COPD.

METHODS

This was a cross-sectional study based on data from the NHANES 2013-2018. Weighted logistic regression (WLR), restricted cubic sample (RCS), and receiver operating characteristic (ROC) curves were leveraged to examine the links of the TyG index and obesity indices with COPD. The stability of the correlations was also assessed via subgroup analyses.

RESULTS

Data from 6383 participants were finally included, including 583 patients with COPD. WLR discovered positive associations of TyG, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), and TyG-waist height ratio (TyG-WHtR) with COPD regardless of covariate adjustment (p-value < 0.05, p for trend test < 0.05). After adjusting for all confounders, RCS analysis signaled notable linear links of TyG and obesity-related indices with COPD (p-value < 0.05, p for nonlinear > 0.05). TyG-WHtR showed the highest association with COPD among the indices tested, albeit with limited discriminative ability (AUC = 0.643, 95% CI: 0.619 ~ 0.665). Subgroup analyses further validated the stability and reliability of the results.

CONCLUSION

TyG and its combination with obesity-related indicators are associated with COPD. Among these, TyG-WHtR showed the strongest association with COPD, although causal relationships cannot be inferred and its discriminative ability remained modest. Further prospective studies are warranted to validate these findings.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

胰岛素抵抗（IR）对慢性阻塞性肺疾病（COPD）的影响已引起越来越多的关注，甘油三酯-葡萄糖（TyG）指数及相关指标被认为是评估IR的可靠指标。然而，目前TyG和肥胖相关指标与COPD之间的潜在关联研究较少。因此，本文旨在探讨TyG和肥胖相关指标与COPD之间的联系。

方法

这是一项基于2013 - 2018年美国国家健康与营养检查调查（NHANES）数据的横断面研究。采用加权逻辑回归（WLR）、受限立方样条（RCS）和受试者工作特征（ROC）曲线来研究TyG指数和肥胖指数与COPD之间的联系。还通过亚组分析评估了相关性的稳定性。

结果

最终纳入6383名参与者的数据，其中包括583例COPD患者。WLR发现，无论是否进行协变量调整，TyG、TyG体重指数（TyG-BMI）、TyG腰围（TyG-WC）和TyG腰高比（TyG-WHtR）与COPD均呈正相关（p值<0.05，趋势检验p值<0.05）。在调整所有混杂因素后，RCS分析表明TyG和肥胖相关指标与COPD之间存在显著的线性联系（p值<0.05，非线性p值>0.05）。在测试的指标中，TyG-WHtR与COPD的关联最强，但其判别能力有限（AUC = 0.643，95% CI：0.619 ~ 0.665）。亚组分析进一步验证了结果的稳定性和可靠性。