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目的 研究中国正常空腹血糖成人中甘油三酯葡萄糖(triglyceride-glucose index, TyG)指数与糖尿病发病风险的关系。方法 自中国居民营养与健康状况监测(2010—2012年)和中国居民营养与健康状况随访研究(2021)数据选取2161名基线调查时未患糖尿病且空腹血糖<6.1 mmol/L的中国成人，收集其社会经济、生活行为、体格及血生化指标数据，定义为正常空腹血糖人群，并使用空腹血清甘油三酯及血糖计算TyG指数。使用基线(2010—2012年)时TyG指数，并以四分位法对调查对象进行分组(Q1～Q4)。采用逐步引入协变量进行校正的方法，使用多重Logistic回归分析TyG指数与糖尿病发病风险的关联性。并基于不同性别、年龄组和体质指数进行亚组分析。结果 在2161名调查对象中，不同TyG指数分组在年龄组、体质指数、家庭人均年收入的构成比以及收缩压、舒张压、空腹血糖、总胆固醇、甘油三酯和高密度脂蛋白胆固醇的水平差异有统计学意义(P<0.05)。经基线时的年龄、性别、体质指数、居住地区、文化程度、婚姻状况、家庭收入、目前吸烟、过量饮酒、休闲身体活动、糖尿病家族史、收缩压、舒张压、血清总胆固醇及高密度脂蛋白胆固醇水平后，与TyG指数最低组(Q1)相比，TyG指数最高组(Q4)的糖尿病发病风险高2.82倍(95%CI=1.65～4.84,Ptrend=0.007),且TyG指数每增加一个单位，糖尿病的发病风险将增加2.22倍(95%CI=1.61～3.06,P<0.001)。亚组分析结果显示，TyG指数与糖尿病发病风险的关联性在45岁及以上、不同性别以及不同体质指数的研究对象中均具有统计学显著性，且在60岁及以上、女性及体质指数<24人群中，二者关联性更强，但未观察到亚组因素与TyG指数的交互作用。结论 在中国正常空腹血糖成人中，TyG指数与糖尿病发病风险呈正向关联。
Abstract：OBJECTIVE To investigate the association between the triglyceride-glucose(TyG) index and the risk of diabetes among Chinese adults with normal fasting serum glucose levels.METHODS A total of 2161 participants were selected from China Nutrition and Health Surveillance(2010-2012) and China Nutrition and Health Follow-up Study(2021), who were not diabetes patients and fasting serum glucose<6.1 mmol/L at baseline. Information on socioeconomic status, lifestyle habits, physical examination, and laboratory examination was collected. TyG index was calculated by fasting serum triglyceride and glucose. Participants were categorized into quartiles based on their baseline TyG index(2010-2012). Multiple adjusted logistic regression analysis was used to explore the association between TyG index and the risk of new-onset type 2 diabetes. Subgroup analysis was conducted among participants stratified by sex, age group, and body mass index(BMI).RESULTS In 2161 participants, there were significant differences in age, BMI, household income, systolic and diastolic blood pressure, fasting serum total cholesterol, and high-density lipoprotein cholesterol across quartiles of the TyG index. After adjusting for potential confounders such as age, sex, BMI, living area, education level, marital status, household income, current smoking, excessive drinking, leisure physical activity level, family history of diabetes, systolic blood pressure, diastolic blood pressure, fasting serum total cholesterol, and high-density lipoprotein cholesterol, compared with the lowest quartile(Q1), the highest(Q4) showed a 2.82-fold increase in type 2 diabetes risk(95%CI=1.65-4.84,Ptrend=0.007). Considering TyG index as continuous variable, the risk for diabetes will be 2.22-fold higher with the per unit increase of TyG index(95%CI=1.61-3.06,P<0.001). Subgroup analysis showed that the association remained robust among participants over 45 years old, in males and females alike, and in people with different BMI. And the result showed to be more pronounced among those were over 60 years old, female, and BMI<24. No significant interactions between subgroups and TyG index were observed.CONCLUSION Among Chinese adults with normal fasting serum glucose, the TyG index was positively associated with the risk of new onset type 2 diabetes.
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基本信息:
DOI：10.19813/j.cnki.weishengyanjiu.2025.04.005
中图分类号:R587.1
引用信息:
[1]杨宇祥,苑弘弢,唐增煦等.正常空腹血糖人群中甘油三酯葡萄糖指数与糖尿病发病风险的关系[J].卫生研究,2025,54(04):557-565.DOI:10.19813/j.cnki.weishengyanjiu.2025.04.005.
基金信息:
国家财政项目(No.102393220020070000012); 国家建设高水平大学公派研究生项目(No.202408110159)