美国人群中甘油三酯-葡萄糖相关指标与结直肠癌风险的关联：一项横断面研究。

Association of triglyceride-glucose related indices with colorectal cancer risk among the US population: a cross-sectional study.

作者信息

Niu Sen, Jiang Chenshan, Miao Xiaofei, Zhang Ye, Li Zengyao, Wang Tong

机构信息

Department of General Surgery, Wuxi Medical Center, Nanjing Medical University, Wuxi, China.

Department of General Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.

出版信息

BMC Cancer. 2025 Jul 18;25(1):1186. doi: 10.1186/s12885-025-14625-8.

DOI:10.1186/s12885-025-14625-8

PMID:40681985

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12273461/

Abstract

BACKGROUND

The predictive value of the triglyceride-glucose (TyG)-related indices for colorectal cancer (CRC) occurrence remains unclear. This study aims to establish the association between the TyG-related index and the risk of CRC among the US population.

METHODS

The TyG index, along with the Triglyceride glucose-body mass index (TyG-BMI), Triglyceride glucose-waist circumference (TyG-WC), and Triglyceride glucose-waist-to-height ratio (TyG-WHtR), were calculated using data from CRC patients in the National Health and Nutrition Examination Surveys (NHANES) spanning 1999 to 2020. Weighted multivariate logistic regression and generalized additive models assessed the independent associations between these indices and CRC risk. Subgroup analyses and sensitivity tests evaluated the robustness and reliability of the findings. Receiver operating characteristic curve (ROC) was performed for predicting CRC risk using different TyG-related indices.

RESULTS

Among 18,418 participants with an average age of 47.7 years, 126 were diagnosed with CRC. After adjusting for key confounding covariates, the TyG index was not significantly associated with CRC risk (OR = 1.32, 95% CI: 0.90-1.95, P = 0.1553), whereas significant positive associations remained for TyG-BMI, TyG-WC, and TyG-WtHR when analyzed as continuous variables. When categorized into quartiles, individuals in the highest quartile exhibited elevated CRC prevalence compared to the reference group (TyG: OR = 1.88, 95% CI: 0.86-4.12, P = 0.1632; TyG-BMI: OR = 2.80, 95% CI: 1.29-6.05, P = 0.0155; TyG-WC: OR = 2.71, 95% CI: 1.06-6.92, P = 0.0154; TyG-WtHR: OR = 3.62, 95% CI: 1.22-10.75, P = 0.0046), with statistically significant associations persisting for TyG-BMI, TyG-WC, and TyG-WtHR (all P < 0.05). Subgroup and interaction tests indicated that sex, age, hypertension, and diabetes did not significantly influence the association between TyG related indices and CRC risk (all P > 0.05). ROC analysis demonstrated that TyG-WtHR (AUC: 0.644, 95% CI: 0.6014-0.6917) outperformed other indices in CRC risk prediction (P < 0.001).

CONCLUSIONS

In the U.S. adult population, elevated TyG-WHtR index levels are significantly associated with a higher risk of developing CRC.

摘要

背景

甘油三酯-葡萄糖（TyG）相关指标对结直肠癌（CRC）发生的预测价值尚不清楚。本研究旨在确定美国人群中TyG相关指标与CRC风险之间的关联。

方法

利用1999年至2020年国家健康与营养检查调查（NHANES）中CRC患者的数据，计算TyG指数以及甘油三酯葡萄糖-体重指数（TyG-BMI）、甘油三酯葡萄糖-腰围（TyG-WC）和甘油三酯葡萄糖-腰高比（TyG-WHtR）。加权多因素逻辑回归和广义相加模型评估了这些指标与CRC风险之间的独立关联。亚组分析和敏感性检验评估了研究结果的稳健性和可靠性。采用受试者工作特征曲线（ROC），利用不同的TyG相关指标预测CRC风险。

结果

在18418名平均年龄为47.7岁的参与者中，126人被诊断为CRC。在调整关键混杂协变量后，TyG指数与CRC风险无显著关联（OR = 1.32，95%CI：0.90-1.95，P = 0.1553），而当作为连续变量分析时，TyG-BMI、TyG-WC和TyG-WtHR仍存在显著正相关。当分为四分位数时，与参照组相比，最高四分位数组个体的CRC患病率升高（TyG：OR = 1.88，95%CI：0.86-4.12，P = 0.1632；TyG-BMI：OR = 2.80，95%CI：1.29-6.05，P = 0.0155；TyG-WC：OR = 2.71，95%CI：1.06-6.92，P = 0.0154；TyG-WtHR：OR = 3.62，95%CI：1.22-10.75，P = 0.0046），TyG-BMI、TyG-WC和TyG-WtHR的关联具有统计学意义（均P < 0.05）。亚组和交互检验表明，性别、年龄、高血压和糖尿病对TyG相关指标与CRC风险之间的关联无显著影响（均P > 0.05）。ROC分析表明，TyG-WtHR（AUC：0.644，95%CI：0.6014-0.6917）在CRC风险预测方面优于其他指标（P < 0.001）。