Triglyceride Glucose-Body Mass Index Is a Simple and Clinically Useful Surrogate Marker for Insulin Resistance in Nondiabetic Individuals.
Triglyceride Glucose-Body Mass Index Is a Simple and Clinically Useful Surrogate Marker for Insulin Resistance in Nondiabetic Individuals.
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DOI：
10.1371/journal.pone.0149731
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Ko YL
中科院分区：
文献类型：
--
作者：
Er LK;Wu S;Chou HH;Hsu LA;Teng MS;Sun YC;Ko YL
胰岛素抵抗（IR）和代偿性高胰岛素血症的后果是一系列代谢异常的致病因素，这些代谢异常有助于糖尿病和心血管疾病的发展。我们比较了传统的血脂水平和比率，并将其与空腹血糖（FPG）水平或肥胖状态相结合，以确定其作为IR独立危险因素的效率。我们招募了511名台湾人进行分析。各种参数的临床有用性-如传统的脂质水平和比率;内脏脂肪指标，内脏脂肪指数（VAI）和脂质累积乘积（TG）;甘油三酯（TG）和FPG的乘积（TyG指数）; TyG伴肥胖状态（TyG-体重指数[BMI]）和TyG-腰围指数[WC]）;以及脂肪因子水平和比率-以鉴定IR。对于所有脂质比率，TG/高密度脂蛋白胆固醇（HDL-C）比值在胰岛素抵抗的稳态模型评估中具有最高的额外变异百分比（HOMA-IR; 7.0%）;对于所有相关变量，TyG-BMI和瘦素-脂联素比值（LAR）与HOMA-IR密切相关，变异性分别为16.6%和23.2%。Logistic回归分析显示了类似的模式。受试者工作特征（ROC）曲线分析表明，TG/HDL-C比其他血脂变量或比值是更有效的IR指标。VAI（0.734）和TyG（0.708）的ROC曲线下面积（AUC）大于TG/HDL-C（0.707）。TyG-BMI和LAR的AUC最大（分别为0.801和0.801）。TyG-BMI是一种简单、有效且临床上有用的替代标记物，可用于早期识别IR。
Insulin resistance (IR) and the consequences of compensatory hyperinsulinemia are pathogenic factors for a set of metabolic abnormalities, which contribute to the development of diabetes mellitus and cardiovascular diseases. We compared traditional lipid levels and ratios and combined them with fasting plasma glucose (FPG) levels or adiposity status for determining their efficiency as independent risk factors for IR. We enrolled 511 Taiwanese individuals for the analysis. The clinical usefulness of various parameters—such as traditional lipid levels and ratios; visceral adiposity indicators, visceral adiposity index (VAI), and lipid accumulation product (LAP); the product of triglyceride (TG) and FPG (the TyG index); TyG with adiposity status (TyG-body mass index [BMI]) and TyG-waist circumference index [WC]); and adipokine levels and ratios—was analyzed to identify IR. For all lipid ratios, the TG/high-density lipoprotein cholesterol (HDL-C) ratio had the highest additional percentage of variation in the homeostasis model assessment of insulin resistance (HOMA-IR; 7.0% in total); for all variables of interest, TyG-BMI and leptin-adiponectin ratio (LAR) were strongly associated with HOMA-IR, with 16.6% and 23.2% of variability, respectively. A logistic regression analysis revealed similar patterns. A receiver operating characteristic (ROC) curve analysis indicated that TG/HDL-C was a more efficient IR discriminator than other lipid variables or ratios. The area under the ROC curve (AUC) for VAI (0.734) and TyG (0.708) was larger than that for TG/HDL-C (0.707). TyG-BMI and LAR had the largest AUC (0.801 and 0.801, respectively). TyG-BMI is a simple, powerful, and clinically useful surrogate marker for early identification of IR.