摘要
目的研究三酰甘油与高密度脂蛋白胆固醇比值(TG/HDL-C)与2型糖尿病(T2DM)发生、发展的关系,评估其作为T2DM早期标志物的可行性。方法根据1999年WHO糖尿病诊断和分型标准,纳入2015年1月至2021年1月在四川大学华西医院内分泌科就诊的553例住院患者,根据葡萄糖耐量试验(OGTT)和临床检查结果,将其分为正常糖耐量组(NGT组),空腹血糖受损组(IFG组),糖耐量异常组(IGT组),T2DM组以及T2DM伴并发症组。对各组患者临床资料与实验室指标进行统计分析,采用单因素回归分析筛选T2DM发生、发展的相关指标,通过多因素Logistic回归分析逐步调整年龄、性别、吸烟、饮酒等指标,探讨TG/HDL-C是否是糖尿病发生、发展的独立危险因素。结果TG/HDL-C在各组之间的趋势如下:NGT组0.91(0.62~1.54),IFG组1.32(0.89~2.00),IGT组1.33(0.81~2.43),T2DM组1.68(1.08~3.27)及T2DM伴并发症组1.67(1.00~2.61)。在TG/HDL-C与胰岛素抵抗指数(HOMA-IR)的受试者工作特征(ROC)曲线中,得到其曲线下面积(AUC)为0.707,当TG/HDL-C大于1.272时,预测胰岛素抵抗发生的灵敏度为68.4%,特异度为65.1%。在校正了年龄、性别、吸烟、饮酒、体质量指数(BMI)后,TG/HDL-C差异仍然有统计学意义(P<0.05)。其OR值分别为IFG组1.347(95%CI:1.100~1.648),IGT组1.313(95%CI:1.081~1.594),T2DM组1.456(95%CI:1.207~1.751)和T2DM伴并发症组1.404(95%CI:1.159~1.700)。结论TG/HDL-C是2型糖尿病发生、发展的独立危险因素,其相比于OGTT,检测更为简便,可作为预测T2DM的早期标志物。
Objective To investigate the relationship between the ratio of triglyceride to high-density lipoprotein cholesterol(TG/HDL-C)and the occurrence and development of type 2 diabetes mellitus(T2DM),and to evaluate its possibility as an early marker of T2DM.Methods According to the diagnostic criteria and classification criteria of WHO diabetes in 1999,553 hospitalized patients in Department of Endocrinology,West China Hospital of Sichuan University were enrolled from January 2015 to January 2021.According to glucose tolerance test(OGTT)and clinical examination results,they were divided into normal glucose tolerance group(NGT group),impaired fasting glucose group(IFG group)and impaired glucose tolerance group(IGT group).T2DM group and T2DM with complications group.The clinical data and laboratory indexes of each group were statistically analyzed.Single factor regression analysis was used to screen the relevant indicators for the occurrence and development of T2DM.Stepwise adjustment of age,gender,smoking,drinking and other indicators were conducted by multivariate Logistic regression analysis to explore whether TG/HDL-C was an independent risk factor for the development of diabetes mellitus.Results The trend of TG/HDL-C in each group was as follows:NGT group 0.91(0.62-1.54),IFG group 1.32(0.89-2.00),IGT group 1.33(0.81-2.43),T2DM group 1.68(1.08-3.27)and T2DM with complications group 1.67(1.00-2.61).In the receiver operating curve(ROC curve)of TG/HDL-C and HOMA-IR,the AUC was 0.707.When the TG/HDL-C ratio was greater than 1.272,the occurrence of insulin resistance could be predicted with 68.4%sensitivity and 65.1%specifity.After adjusting for age,sex,smoking,drinking and body mass index(BMI),the difference of TG/HDL-C was still statistically significant,the difference was statistically significant(P<0.05).The OR values were 1.347(95%CI:1.100-1.648)in IFG group,1.313(95%CI:1.081-1.594)in IGT group,1.456(95%CI:1.207-1.751)in T2DM group and 1.404(95%CI:1.159-1.700)in T2DM with complications group.Conclusion TG/HDL-C was
作者
童玲
梁如意
杨舒羽
陈奕君
干伟
TONG Ling;LIANG Ruyi;YANG Shuyu;CHEN Yijun;GAN Wei(Department of Laboratory Medicine,West China Hospital of Sichuan University,Chengdu,Sichuan 610041,China;Zigong Third People′s Hospital,Zigong,Sichuan 643020,China)
出处
《国际检验医学杂志》
CAS
2022年第5期568-573,共6页
International Journal of Laboratory Medicine
基金
四川省科学技术厅基金项目[2019YJ0061]。
