2型糖尿病患者甘油三酯-葡萄糖指数与代谢综合征风险之间的剂量反应关系：1560例病例的横断面分析

Dose-response relationship between the triglyceride-glucose index and metabolic syndrome risk in patients with type 2 diabetes: a cross-sectional analysis of 1,560 cases.

作者信息

Chen Feng, Gu Zixue, Peng Rong

机构信息

School of Basic Medical Sciences & School of Nursing, Chengdu University, Chengdu, Sichuan, China.

Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu University, Chengdu, Sichuan, China.

出版信息

Front Endocrinol (Lausanne). 2025 Sep 12;16:1615380. doi: 10.3389/fendo.2025.1615380. eCollection 2025.

DOI:10.3389/fendo.2025.1615380

PMID:41019320

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12463593/

Abstract

BACKGROUND

The triglyceride-glucose (TyG) index, as a novel biomarker for assessing insulin resistance, may possess predictive value for metabolic syndrome (MS) in patients with type 2 diabetes mellitus (T2DM). However, its dose-response relationship requires further investigation. Therefore, this cross-sectional study aimed to examine the association between the TyG index and MS, along with their dose-response relationship, in a T2DM population.

METHODS

This cross-sectional study enrolled patients with T2DM from a tertiary hospital in Chengdu between January 2018 and December 2023. Participants were stratified into quartiles (Q1-Q4) based on TyG index levels. We employed multivariable logistic regression to analyze associations between TyG index and MS and its components. Predictive performance was evaluated using receiver operating characteristic (ROC) curve analysis, while restricted cubic spline analysis was utilized to examine the dose-response relationship between TyG index and MS.

RESULTS

This study included a total of 1,560 patients with T2DM. With increasing TyG index levels, patients were significantly younger, had lower HDL-C levels, higher rates of current alcohol consumption, and elevated BMI, TG, TC, LDL-C and FPG values (all P<0.05). The prevalence of MS, overweight/obesity and dyslipidemia also progressively increased with higher TyG quartiles (all P<0.05). Pearson correlation analysis showed the TyG index was positively correlated with BMI, TG, TC, LDL-C and FPG (all P<0.001), while negatively correlated with HDL-C (P<0.001). After adjusting for confounding factors, multivariate logistic regression analysis revealed that compared with the Q1 group, the Q4 group had a significantly higher risk of MS (OR=26.994), overweight/obesity and dyslipidemia (all P<0.001). The area under the curve (AUC) for TyG index in predicting MS was 0.793,with a sensitivity of 0.864 and a specificity of 0.611. Furthermore, a nonlinear dose-response relationship was observed between TyG index and MS, with MS risk increasing progressively when TyG index exceeded 9.31.

CONCLUSION

The TyG index serves as an independent predictor of MS risk in patients with T2DM, demonstrating a significant dose-response relationship with MS.

摘要

背景

甘油三酯-葡萄糖（TyG）指数作为评估胰岛素抵抗的新型生物标志物，可能对2型糖尿病（T2DM）患者的代谢综合征（MS）具有预测价值。然而，其剂量反应关系仍需进一步研究。因此，这项横断面研究旨在探讨T2DM人群中TyG指数与MS之间的关联及其剂量反应关系。

方法

这项横断面研究纳入了2018年1月至2023年12月期间来自成都一家三级医院的T2DM患者。参与者根据TyG指数水平分为四分位数（Q1-Q4）。我们采用多变量逻辑回归分析TyG指数与MS及其组成成分之间的关联。使用受试者工作特征（ROC）曲线分析评估预测性能，同时利用受限立方样条分析来研究TyG指数与MS之间的剂量反应关系。

结果

本研究共纳入1560例T2DM患者。随着TyG指数水平的升高，患者明显更年轻，高密度脂蛋白胆固醇（HDL-C）水平更低，当前饮酒率更高，体重指数（BMI）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和空腹血糖（FPG）值升高（所有P<0.05）。MS、超重/肥胖和血脂异常的患病率也随着TyG四分位数的升高而逐渐增加（所有P<0.05）。Pearson相关性分析显示，TyG指数与BMI、TG、TC、LDL-C和FPG呈正相关（所有P<0.001），而与HDL-C呈负相关（P<0.001）。在调整混杂因素后，多变量逻辑回归分析显示，与Q1组相比，Q4组患MS（比值比[OR]=26.994）、超重/肥胖和血脂异常的风险显著更高（所有P<0.001）。TyG指数预测MS的曲线下面积（AUC）为0.793，敏感性为0.864，特异性为0.611。此外，观察到TyG指数与MS之间存在非线性剂量反应关系，当TyG指数超过9.31时，MS风险逐渐增加。