Utility of three novel insulin resistance-related lipid indices for predicting type 2 diabetes mellitus among people with normal fasting glucose in rural China
Utility of three novel insulin resistance-related lipid indices for predicting type 2 diabetes mellitus among people with normal fasting glucose in rural China
复制标题
三种新型胰岛素抵抗相关血脂指数在中国农村空腹血糖正常人群中预测 2 型糖尿病的效用
DOI：
10.1111/1753-0407.12642
复制
发表时间：
2018-08-01
影响因子：
4.5
通讯作者：
Hu, Dongsheng
中科院分区：
文献类型：
--
作者：
Wang, Bingyuan;Zhang, Ming;Hu, Dongsheng
中国农村地区2型糖尿病(T2 DM)的早期预测需要廉价、易测量的指标。本研究的目的是比较甘油三酯血糖、内脏肥胖症和脂肪累积产物与传统的个体测量方法及其预测T2 DM的比率。方法对中国农村队列中11113名基线空腹血糖正常的人的数据进行中位数6.0年的跟踪调查。用COX比例风险回归计算协变量调整危险比(AHRS)和95%可信区间(95%CI)，用受试者操作特性分析比较传统方法与基线时TYG、VAI和LAP预测T2 DM的能力。在所有的血脂比例中，甘油三酯(TG)与高密度脂蛋白胆固醇(HDLC)的比例升高与T2 DM的关联最大。与TYG、VAI和LAP的前四分位数相比，男性(AHR分别为3.54[95%CI 2.08-6.03]、2.89[1.72-4.87]和5.02[2.85-8.85])和女性(6.15[3.48-10.85]、4.40[2.61-7.42]和6.49[3.48-12.12])与T2 DM相关。在预测T2 DM风险方面，TYG、VAI和LAP大多优于TG/HDLc比值，但与空腹血糖和WC无明显差异。结论TYG、VAI和LAP对T2 DM的预测作用不明显于空腹血糖或WC。因此，TYG、VAI和LAP可能不是预测农村中国人中T2 DM的廉价工具。
BackgroundInexpensive and easily measured indices are needed for the early prediction of type 2 diabetes mellitus (T2DM) in rural areas of China. The aim of this study was to compare triglyceride glucose (TyG), visceral adiposity (VAI), and lipid accumulation product (LAP) with traditional individual measures and their ratios for predicting T2DM.MethodsData for 11113 people with baseline normal fasting glucose in a rural Chinese cohort were followed for a median of 6.0years. Cox proportional hazards regression was used to calculate covariate-adjusted hazard ratios (aHRs) and 95% confidence intervals (95% CIs) and receiver operating characteristic analysis was used to compare the ability of traditional measures and TyG, VAI, and LAP at baseline to predict T2DM at follow-up.ResultsAmong individual measures, fasting plasma glucose (FPG) and waist circumference (WC) were strongly associated with T2DM. Of all lipid ratios, an elevated triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio was associated the most with T2DM. Compared with the first quartiles of TyG, VAI, and LAP, their fourth quartiles were associated with T2DM for men (aHR 3.54 [95% CI 2.08-6.03], 2.89 [1.72-4.87], and 5.02 [2.85-8.85], respectively) and women (6.15 [3.48-10.85], 4.40 [2.61-7.42], and 6.49 [3.48-12.12], respectively). For predicting T2DM risk, TyG, VAI, and LAP were mostly superior to the TG:HDL-C ratio, but did not differ from FPG and WC.ConclusionsPrediction of T2DM was not improved by TyG, VAI, and LAP versus FPG or WC alone. Therefore, TyG, VAI, and LAP may not be inexpensive tools for predicting T2DM in rural Chinese people.