Wang Yixiao, Kong Wenzhi, Geng Yuning, Xu Chunyu, Miao Jinwei
Department of Gynecologic Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China.
Laboratory for Clinical Medicine, Capital Medical University, Beijing, China.
Front Endocrinol (Lausanne). 2025 Jun 5;16:1571693. doi: 10.3389/fendo.2025.1571693. eCollection 2025.
The triglyceride-glucose (TyG) index, a promising biomarker for insulin resistance, is linked to the risk of various metabolic-related cancers. However, to date, data on the association of TyG index with different subtypes of endometrial cancers and the potential mediating role of clinical factors remain limited.
Data was collected from the Beijing Obstetrics and Gynecology Hospital, Capital Medical University spanning from 2014 to 2024. Female participants with complete data on the TyG index were included in the analysis. Multivariate logistic regression analyses were used to assess the association of TyG index with endometrial cancer risk, adjusted by series of confounders. Mediation effects were evaluated using Valeri and VanderWeele's method.
A total of 1,194 eligible participants were enrolled, with 597 (50%) women diagnosed with endometrial cancer. The fully adjusted multivariate logistic regression model revealed a significant association between the TyG index and the risk of endometrial cancer (odds ratio [OR]: 1.93, 95% confidence interval [CI]: 1.37-2.73; for trend=0.028). Notably, BMI exhibited significant mediation effects on this association, even after adjusted by potential confounders ( for trend<0.001). The proportion of the effect mediated by BMI was 25% in the crude analysis (95% CI: 0.15, 0.37; <0.001) and increased to 41% in the adjusted analysis (95% CI: 0.24, 0.76; <0.001). However, no correlation was found between TyG index and the clinical characteristics of endometrial cancer (>0.05). Moreover, BMI is associated with the risk of different endometrial cancers.
This cross-sectional study demonstrated that a higher TyG index, representing higher level of insulin resistance, was associated with a higher risk of endometrial cancer. Importantly, we found that BMI acted as a significant mediator in this relationship. Prospective studies are needed to further validate these findings.
甘油三酯-葡萄糖（TyG）指数是一种很有前景的胰岛素抵抗生物标志物，与各种代谢相关癌症的风险有关。然而，迄今为止，关于TyG指数与子宫内膜癌不同亚型之间的关联以及临床因素的潜在中介作用的数据仍然有限。
收集了首都医科大学附属北京妇产医院2014年至2024年的数据。分析纳入了TyG指数数据完整的女性参与者。采用多因素逻辑回归分析评估TyG指数与子宫内膜癌风险的关联，并对一系列混杂因素进行校正。使用Valeri和VanderWeele的方法评估中介效应。
共纳入1194名符合条件的参与者，其中597名（50%）女性被诊断为子宫内膜癌。完全校正的多因素逻辑回归模型显示TyG指数与子宫内膜癌风险之间存在显著关联（比值比[OR]：1.93，95%置信区间[CI]：1.37 - 2.73；趋势P值 = 0.028）。值得注意的是，即使在对潜在混杂因素进行校正后，BMI对这种关联仍表现出显著的中介效应（趋势P值<0.001）。在粗分析中，BMI介导的效应比例为25%（95%CI：0.15，0.37；P<0.001），在调整分析中增加到41%（95%CI：0.24，0.76；P<0.001）。然而，未发现TyG指数与子宫内膜癌的临床特征之间存在相关性（P>0.05）。此外，BMI与不同类型子宫内膜癌的风险相关。
这项横断面研究表明，较高的TyG指数代表较高的胰岛素抵抗水平，与较高的子宫内膜癌风险相关。重要的是，我们发现BMI在这种关系中起显著的中介作用。需要进行前瞻性研究以进一步验证这些发现。
