A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose.
A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose.
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DOI：
10.1038/nutd.2014.46
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发表时间：
2015-04-27
影响因子：
6.1
通讯作者：
Yoon KH
中科院分区：
文献类型：
--
作者：
Lee SH;Han K;Yang HK;Kim HS;Cho JH;Kwon HS;Park YM;Cha BY;Yoon KH
代谢性肥胖但正常体重（MONW）个体构成正常体重个体的亚组，其显示出受损的胰岛素敏感性，具有更高的发展糖尿病、心血管疾病和死亡率的风险。我们的目的是提出一个新的标准来定义MONW通过检查的有用性和截断值的TyG指数，产品的甘油三酯和葡萄糖的水平，在识别MONW个人。此外，评估了该标准在预测未来糖尿病发病率方面的表现。从2009-2010年进行的韩国国家健康和营养检查调查中，共选择了7541名非糖尿病、正常体重（体重指数<18.5且<25 kg m−2）受试者。另外3185名随访研究的参与者是从一项前瞻性社区队列研究中选出的。TyG指数计算为ln（空腹甘油三酯（mg dl−1）×空腹血糖（mg dl−1）/2）。TyG指数的高低与代谢综合征及其组分的患病率有关。根据受试者工作特征分析，反映MONW的TyG指数的截止值男性为8.82，女性为8.73，曲线下面积值分别为0.855和0.868。男性的敏感性和特异性分别为84.2%和77.6%，女性分别为69.1%和89.4%。被指定为MONW的个体，具有正常体重和高于截止值的TyG水平，显示出代谢不健康的表型，并且与代谢健康的正常体重受试者相比，发展糖尿病的风险大约高两倍。我们提出了一个简单的诊断标准MONW，这可能是用来区分高风险的代谢性疾病的主题。
Metabolically obese but normal weight (MONW) individuals constitute a subgroup of normal weight individuals that display impaired insulin sensitivity with a higher risk of developing diabetes, cardiovascular disease and mortality. We aimed to propose a novel criterion for defining MONW by examining the usefulness and the cutoff value of the TyG index, a product of the levels of triglycerides and glucose, in identifying MONW individuals. In addition, the performance of this criterion in predicting the future incidence of diabetes was assessed. A total of 7541 non-diabetic, normal weight (body mass index ⩾18.5 and <25 kg m−2) subjects were selected from the Korea National Health and Nutrition Examination Survey conducted in 2009–2010. Another 3185 participants with follow-up studies were selected from a prospective community-based cohort study. The TyG index was calculated as ln(fasting triglycerides (mg dl−1) × fasting glucose (mg dl−1)/2). The levels of the TyG index paralleled the prevalence of metabolic syndrome and its components. The cutoff value of the TyG index that reflected MONW based on the receiver operating characteristics analysis was 8.82 for men and 8.73 for women, with the area under the curve values being 0.855 and 0.868, respectively. The sensitivity and the specificity were 84.2 and 77.6% in men and 69.1 and 89.4% in women, respectively. Individuals designated as MONW, who have a normal weight and TyG levels higher than cutoff, displayed a metabolically unhealthy phenotype and an approximately twofold higher risk of developing diabetes compared with metabolically healthy normal weight subjects. We propose a simple diagnostic criterion of MONW, which might be used to discriminate subjects with a higher risk of metabolic diseases.