Cao Changchun, Zan Yibing, Han Yong, Hu Haofei, Long Jianjun, Wang Yulong
Department of Rehabilitation, Longgang E.N.T Hospital & Shenzhen Key Laboratory of E.N.T, Institute of Ear Nose Throat (E.N.T), Shenzhen, 518000, Guangdong Province, China.
Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China.
Sci Rep. 2025 Jul 1;15(1):20898. doi: 10.1038/s41598-025-05786-4.
Early detection of individuals at elevated risk for type 2 diabetes (T2D) is critical for effective prevention strategies. We developed a novel metabolic marker, the triglyceride-glycated hemoglobin index (TyH-i), which integrates lipid and glycemic parameters to improve T2D risk prediction. This study sought to evaluate the relationship between TyH-i and T2D risk and to examine its predictive performance with the triglyceride-glucose index (TyG-i). A large-scale retrospective cohort study was conducted using data from 15,464 Japanese adults without T2D at baseline. The TyH-i was calculated as Ln[glycated hemoglobin index (%)×triglycerides (mg/dL)/2], and its association with incident T2D was assessed using Cox proportional hazards models and smooth curve fitting and cubic spline functions. The predictive performance of the TyH-i was compared with the TyG-i using receiver operating characteristic curves. Over a median follow-up of 5.39 years, 373 participants developed T2D. After accounting for confounders, the TyH-i was significantly associated with T2D risk (HR: 1.55, 95% CI: 1.22-1.97, P = 0.00031). Additionally, a J-shaped relationship between the TyH-i and incident T2D was identified. A significant positive correlation was identified between TyH-i and T2D only when TyH-i levels were above 4.92 (HR: 1.73, 95%CI: 1.35-2.23, P < 0.0001). Furthermore, TyH-i and TyG-i possess comparable discriminatory ability in predicting incident T2D (AUC: 0.751 vs. 0.750, P = 0.8873). Moreover, TyH-i yielded lower Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) values than TyG-i (AIC: 3211.60 vs. 3211.91; BIC: 3226.89 vs. 3227.20), indicating a more parsimonious model with better overall model fit. The TyH-i is a novel and effective predictor of T2D risk, exhibiting a non-linear relationship with T2D. Furthermore, TyH-i and TyG-i exhibit comparable discriminatory abilities in predicting incident T2D. These results highlight the potential of TyH-i as a valuable instrument for T2D risk stratification, particularly in individuals with elevated TyH-i levels.
早期发现2型糖尿病（T2D）高危个体对于有效的预防策略至关重要。我们开发了一种新型代谢标志物，即甘油三酯糖化血红蛋白指数（TyH-i），它整合了脂质和血糖参数以改善T2D风险预测。本研究旨在评估TyH-i与T2D风险之间的关系，并检验其与甘油三酯-葡萄糖指数（TyG-i）相比的预测性能。我们使用15464名基线时无T2D的日本成年人的数据进行了一项大规模回顾性队列研究。TyH-i的计算方法为Ln[糖化血红蛋白指数（%）×甘油三酯（mg/dL）/2]，并使用Cox比例风险模型、平滑曲线拟合和三次样条函数评估其与新发T2D的关联。使用受试者工作特征曲线将TyH-i的预测性能与TyG-i进行比较。在中位随访5.39年期间，373名参与者发生了T2D。在考虑混杂因素后，TyH-i与T2D风险显著相关（HR：1.55，95%CI：1.22-1.97，P = 0.00031）。此外，还发现TyH-i与新发T2D之间存在J形关系。仅当TyH-i水平高于4.92时，才发现TyH-i与T2D之间存在显著正相关（HR：1.73，95%CI：1.35-2.23，P < 0.0001）。此外，TyH-i和TyG-i在预测新发T2D方面具有相当的鉴别能力（AUC：0.751对0.750，P = 0.8873）。此外，TyH-i产生的赤池信息准则（AIC）和贝叶斯信息准则（BIC）值低于TyG-i（AIC：3211.60对3211.91；BIC：3226.89对3227.20），表明其模型更简约，整体模型拟合更好。TyH-i是一种新型且有效的T2D风险预测指标，与T2D呈非线性关系。此外，TyH-i和TyG-i在预测新发T2D方面具有相当的鉴别能力。这些结果突出了TyH-i作为T2D风险分层有价值工具的潜力，特别是在TyH-i水平升高的个体中。
