Zhang Manli, Hu Feng, Miao Ling, Li Fan, Rao Min
Department of Hepatology and Gastroenterology, The First Hospital of Jilin University, Changchun, China.
Front Immunol. 2025 Aug 27;16:1548444. doi: 10.3389/fimmu.2025.1548444. eCollection 2025.
Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is a chronic inflammatory condition with rising global incidence. This study examines the association between the triglyceride-glucose (TyG) index, a marker of insulin resistance, and both the risk and prognosis of IBD.
This study analyzed data from 327,089 participants in the UK Biobank. The TyG index was calculated based on fasting triglyceride and glucose levels, and participants were categorized into quartiles. Cox proportional hazards models, restricted cubic splines (RCS), subgroup analyses, and mediation analyses were employed to explore the association between TyG and the risk of UC and CD. Covariates were adjusted for age, sex, race, socioeconomic and lifestyle factors, physical activity, common chronic diseases, and polygenic risk scores. Multiple sensitivity analyses were conducted to ensure the robustness of the results.
An elevated TyG index was significantly associated with an increased risk of IBD. For each unit increase in TyG, the risk of UC increased by 14.3% (HR: 1.143, 95% CI: 1.053-1.241), while the risk of CD increased by 13.8% (HR: 1.138, 95% CI: 1.006-1.286). Participants in the highest TyG quartile had a 28.0% higher risk of CD (HR: 1.280, 95% CI: 1.050-1.560) and a 17.8% higher risk of UC (HR: 1.178, 95% CI: 1.028-1.351) compared to those in the lowest quartile. Mediation analysis revealed that the association between TyG and the incidence of CD and UC was mediated by multiple factors, including white blood cell count, mean corpuscular hemoglobin, C-reactive protein, total bilirubin, neutrophil count, reticulocyte percentage, and high-light scatter reticulocyte percentage. The proportion of mediation effects ranged from 1.44% to 30.97%.
This study is the first to systematically investigate the relationship between the TyG index and both the risk and prognosis of IBD, using a large cohort from the UK Biobank. The findings reveal a significant positive association between the TyG index and the risk of developing UC and CD, suggesting that a higher TyG index may serve as an independent predictor of IBD risk.
炎症性肠病（IBD），包括溃疡性结肠炎（UC）和克罗恩病（CD），是一种全球发病率不断上升的慢性炎症性疾病。本研究探讨胰岛素抵抗标志物甘油三酯-葡萄糖（TyG）指数与IBD的风险及预后之间的关联。
本研究分析了英国生物银行中327,089名参与者的数据。根据空腹甘油三酯和血糖水平计算TyG指数，并将参与者分为四分位数。采用Cox比例风险模型、限制性立方样条（RCS）、亚组分析和中介分析来探讨TyG与UC和CD风险之间的关联。对年龄、性别、种族、社会经济和生活方式因素、身体活动、常见慢性病和多基因风险评分进行协变量调整。进行了多项敏感性分析以确保结果的稳健性。
TyG指数升高与IBD风险增加显著相关。TyG每增加一个单位，UC风险增加14.3%（HR：1.143，95%CI：1.053 - 1.241），而CD风险增加13.8%（HR：1.138，95%CI：1.006 - 1.286）。与最低四分位数组相比，TyG最高四分位数组的CD风险高28.0%（HR：1.280，95%CI：1.050 - 1.560），UC风险高17.8%（HR：1.178，95%CI：1.028 - 1.351）。中介分析显示，TyG与CD和UC发病率之间的关联由多种因素介导，包括白细胞计数、平均红细胞血红蛋白、C反应蛋白、总胆红素、中性粒细胞计数、网织红细胞百分比和高荧光散射网织红细胞百分比。中介效应比例在1.44%至30.97%之间。
本研究首次利用英国生物银行的大型队列系统地研究了TyG指数与IBD风险及预后之间的关系。研究结果揭示了TyG指数与UC和CD发病风险之间存在显著正相关，表明较高的TyG指数可能是IBD风险的独立预测指标。
