| 结合肥胖指标的胰岛素抵抗替代指标与T2DM患者白蛋白尿的相关性分析 |
| 投稿时间：2024-10-10 修订日期：2024-11-27 点此下载全文 |
| 引用本文：姚鸿云,王婷婷,黄鑫茹,李明杰,邹军,简蔚霞.结合肥胖指标的胰岛素抵抗替代指标与T2DM患者白蛋白尿的相关性分析[J].医学研究杂志,2025,54(4):52-57 |
| DOI：
10.11969/j.issn.1673-548X.2025.04.011 |
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| 基金项目:国家自然科学基金资助项目(面上项目)(82270867) |
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| 中文摘要:目的 探讨结合肥胖指标的甘油三酯-葡萄糖指数(triglyceride-glucose index, TyG)作为胰岛素抵抗的新替代指标与2型糖尿病(type 2diabetes mellitus,T2DM)患者白蛋白尿的风险之间的相关性。方法 连续收集2020年1月～2023年3月内分泌科T2DM住院患者作为研究对象,分为无白蛋白尿组(n=246)和白蛋白尿组(n=221)。采用Spearman相关分析对TyG指数及其衍生指数与临床指标进行相关性分析,多因素Logistic回归分析结合肥胖指标的TyG指数与白蛋白尿的关系。结果T2DM患者白蛋白尿组的TyG指数及其肥胖衍生指数[TyG-体重指数(TyG-body mass index,TyG-BMI)、TyG-腰臀比(TyG-waist-to-hip ratio,TyG-WHR)、TyG-腰围身高比(TyG-waist to height ratio,TyG-WtHR)]显著高于无白蛋白尿组(P均<0.001)。随着4个指标三分位数分组的增高,白蛋白尿的发生率都逐渐增大(P均<0.001)。在多因素Logistic回归分析中,从连续变量的角度看,TyG指数(OR=1.50,95% CI:1.07～2.08,P=0.019)、TyG-BMI(OR=1.01,95% CI:1.00～1.01,P=0.009)、TyG-WHR(OR=1.45,95% CI:1.12～1.88,P=0.005)、TyG-WtHR(OR=1.39,95% CI:1.00～1.91,P=0.048)都是白蛋白尿的独立危险因素；从分类变量的角度看,以第1三分位数组(Q1)作为对照组,4个指标的第3三分位数组(Q3)都是白蛋白尿发生的危险因素,而与单纯TyG指数和其他结合肥胖指标的TyG指数比较,TyG-WHR的Q3组与白蛋白尿的关系更为明显(OR=2.55,95% CI:1.44～4.51,P=0.002)。结论 T2DM患者中,TyG指数及其与肥胖指标结合的衍生指数都与白蛋白尿显著相关。而且,在指数水平较高的患者中,相较于单一的TyG指数及其他衍生指标,高水平TyG-WHR患者白蛋白尿的风险要更高。所以TyG-WHR可能是预测T2DM患者发生DKD的新型生物学标志物。 |
| 中文关键词:2型糖尿病 糖尿病肾病 甘油三酯-葡萄糖指数 肥胖指标 白蛋白尿 |
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| Correlation Analysis of Insulin Resistance Alternative Index Combined with Obesity Index and Albuminuria in Type 2 Diabetes Mellitus Patients. |
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| Abstract:Objective To investigate the correlation between the triglyceride-glucose (TyG) index, its derivatives in combination with obesity indicators and the risk of albuminuria in patients with type 2diabetes mellitus (T2DM). Methods T2DM inpatients who were hospitalized in the Department of Endocrinology from January 2020 to March 2023 were consecutively collected as study subjects, and divided into the group with no albuminuria (n=246) and the group with albuminuria (n=221). Spearman correlation analysis was used to analyze the correlation between TyG index, its derivative index and clinical indicators, and multivariate Logistic regression was used to analyze the correlation between TyG index, its derivative indexes and albuminuria. Results The TyG index and its derived indices [TyG-body mass index (TyG-BMI), TyG-waist-to-hip ratio (TyG-WHR), TyG-waist-to-height ratio (TyG-WtHR)] were significantly higher in the albuminuric group of patients with T2DM than in the group without albuminuria (all P<0.001). The incidence of albuminuria gradually increased with increasing tertile groupings of all four indicators (all P<0.001). In multivariate Logistic regression analysis, after correcting for screened risk factors, the TyG index (OR = 1.50,95% CI:1.07-2.08, P = 0.019), TyG-BMI (OR=1.01,95% CI:1.00-1.01, P=0.009), TyG-WHR (OR=1.45,95% CI:1.12-1.88, P=0.005), and TyG-WtHR (OR=1.39,95% CI:1.00-1.91, P=0.048) were the independent risk factors for albuminuria. For categorical variables, using the 1st quartile group (Q1) as a control group, the 3rd quartile group (Q3) of all four indices were all risk factors for albuminuria, whereas the Q3group of TyG-WHR was more significantly associated with albuminuria compared to the TyG index alone and the other derived indices (OR=2.55,95% CI:1.44-4.51, P=0.002). Conclusion In patients with T2DM, both TyG index and its derivatives combined with obesity indicators were significantly associated with albuminuria, and in patients with higher index levels, the risk of albuminuria was higher in patients with high levels of TyG-WHR compared with single TyG index and other derivatives. Therefore, TyG-WHR may be a novel biological indicator to predict the development of DKD in T2DM patients. |
| keywords:Type 2diabetes mellitus (T2DM) Diabetic kidney disease (DKD) Triglyceride-glucose index(TyG) Obesity index Albuminuria |
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