| 李居一,王郡华,王晓倩,等.三酰甘油葡萄糖指数与早发2型糖尿病合并非酒精性脂肪性肝病的关系[J].中国临床保健杂志,2025,28(4):500-507. |
| 三酰甘油葡萄糖指数与早发2型糖尿病合并非酒精性脂肪性肝病的关系 |
| Correlation between TyG index and early-onset type 2 diabetes mellitus with non-alcoholic fatty liver disease |
| 投稿时间：2025-01-18 |
| DOI：10.3969/J.issn.1672-6790.2025.04.013 |
| 中文关键词: 糖尿病,2型 非酒精性脂肪性肝病 三酰甘油葡萄糖 危险因素 |
| 英文关键词: Diabetes mellitus,type 2 Non-alcoholic fatty liver disease TyG Risk factors |
| 基金项目:国家自然科学基金项目(82274468)；安徽省高校科学研究项目(2023AH040103)；安徽中医药大学临床科研项目(2021yfylc49) |
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| 中文摘要: |
| 目的 探讨三酰甘油葡萄糖(TyG)指数与早发2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)之间的关系。方法 回顾性分析2023年1月至2024年6月在安徽中医药大学第一附属医院住院的506例T2DM患者的临床资料。将早发T2DM并有NAFLD的患者归为早发T2DM合并NAFLD组(51例),其余T2DM患者归为对照组(455例)。506例中,早发T2DM患者共109例,根据是否合并NAFLD分为合并NAFLD组(51例)和未合并NAFLD组(58例),观察2组临床资料。采用多因素logistic回归探究早发T2DM合并NAFLD的影响因素；限制性立方样条曲线(RCS)计算TyG指数与早发T2DM合并NAFLD的剂量反应关系,受试者工作特征(ROC)曲线评价TyG指数的诊断效能。结果 早发T2DM合并NAFLD组和对照组患者的性别、年龄、体重指数(BMI)、TyG、TyG-BMI、舒张压(DBP)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FIns)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、白蛋白(Alb)、γ-谷氨酰转移酶(GGT)、尿素氮(BUN)、尿酸(UA)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)差异均有统计学意义(均P＜0.05)。早发T2DM合并NAFLD组和未合并NAFLD组患者的病程、BMI、TyG、TyG-BMI、收缩压(SBP)、DBP、FPG、FIns、空腹C肽(FCP)、ALT、AST、GGT、BUN、UA、TG、HDL-C、糖尿病肾脏病(DKD)的发生率比较,差异均有统计学意义(均P＜0.05)。logistic回归分析显示,TyG指数是早发T2DM合并NAFLD发生的独立危险因素。在男性、肥胖、ALT≥18 U/L、UA≥326 μmol/L、尿白蛋白肌酐比≥30 mg/g的亚组中,TyG指数与早发T2DM合并NAFLD患病风险的关联能观察到类似结果(均P<0.05)。RCS显示,TyG指数与早发T2DM合并NAFLD的患病风险存在线性剂量反应关系(P-overall<0.05、P-nonlinear=0.397)。ROC曲线下面积为0.728(95%CI:0.634~0.821),最佳截断值为7.520,灵敏度74.5%,特异度62.1%。结论 早发T2DM合并NAFLD的发病风险随TyG指数的升高而增加,TyG指数可作为早发T2DM合并NAFLD的有效预测指标。 |
| 英文摘要: |
| Objective To explore the relationship between triglyceride glucose(TyG) index and early-onset type 2 diabetes mellitus(T2DM) with non-alcoholic fatty liver disease.Methods The medical records of 506 T2DM patients hospitalized in the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2023 to June 2024 were collected.Patients with early-onset type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) were classified into the group of early-onset T2DM complicated with NAFLD (51 cases),and the remaining T2DM patients were classified into the control group(455 cases).Among them,109 patients with early-onset T2DM were divided into the T2DM with NAFLD group(51 cases) and T2DM without NAFLD group(58 cases) according to whether they were combined with NAFLD or not,and the clinical data of the two groups were observed.Multivariate logistic regression was used to investigate the influencing factors of early-onset T2DM with NAFLD;restricted cubic spline(RCS) curves were used to calculate the dose-response relationship between TyG index and early-onset T2DM with NAFLD,and the receiver operating characteristic(ROC) curve was used to evaluate the diagnostic efficacy of TyG index.Results The differences between the early-onset T2DM with NAFLD group and the control group were statistically significant in terms of gender,age,body mass index(BMI),TyG,TyG-BMI,diastolic blood pressure(DBP),FPG,HbA1c,fastin insulin(FIns),alanine transaminase(ALT),aspartate transaminase(AST),albumin(Alb),gamma glutamyl transferase (GGT),blood urea nitrogen(BUN),uric acid(UA),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)(P<0.05).The differences in the incidence of disease duration,Body Mass Index(BMI),TyG,TyG-BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),FIns,fasting C-peptide(FCP),ALT,AST,GGT,BUN,UA,TG,HDL-C,UCr and the incidence of DKD were statistically significant between the group of early-onset T2DM combined with NAFLD and the group of early-onset T2DM without NAFLD(P<0.05).Logistic regression analysis showed that TyG index was an independent risk factor for the development of early-onset T2DM with NAFLD.In the subgroups of men,obesity,ALT≥18 U/L,UA≥326 μmol/L,UACR≥30 mg/g,statistically significant associations between TyG index and the risk of developing early-onset T2DM combined with NAFLD were observed(P<0.05).The RCS demonstrated that there was a linear dose-response relationship between TyG index and the risk of developing early-onset T2DM combined with NAFLD(P-overall<0.05,P-nonlinear=0.397).The area under the ROC curve(AUC) was 0.728(95%CI:0.634-0.821),with an optimal cut-off value of 7.520,a sensitivity of 74.5% and a specificity of 62.1%.Conclusions The risk of developing early-onset T2DM with NAFLD increases with elevated TyG levels,and TyG index is an effective predictor for early-onset T2DM with NAFLD. |
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