甘油三酯-葡萄糖指数与2型糖尿病肾病的相关性  

Correlation Between Triglycerides-Glucose Index and DiabeticNephropathy in Patients with Type 2 Diabetes Mellitus

作　　者：李隽 张莹[1] 倪会芳 丁源 吴文迅[1] LI Jun;ZHANG Ying;NI Huifang;DING Yuan;WU Wenxun(Department of Endocrinology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院内分泌科,河南郑州450052

出　　处：《河南医学研究》2021年第2期216-219,共4页Henan Medical Research

基　　金：河南省教育厅专项资金(18A320068)。

摘　　要：目的探讨甘油三酯-葡萄糖(TyG)指数与2型糖尿病肾病(DN)的相关性。方法选取2015年6月至2019年8月就诊于郑州大学第一附属医院内分泌科的2型糖尿病(T2DM)患者共460例,根据尿白蛋白/肌酐比值(UACR)结果分为临床糖尿病肾病组(CDN组)41例,早期糖尿病肾病组(EDN组)130例,单纯糖尿病组(SDM组)289例。统计各组病例的年龄、性别、糖尿病病史、体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、肾功能、血脂及UACR,计算TyG指数。采用Spearman秩相关分析TyG指数与UACR之间的相关性。采用二元logistic回归发现DN的风险因素,通过受试者操作特征曲线(ROC曲线)对甘油三酯(TG)、FBG、TyG指数诊断2型糖尿病肾病的诊断效能进行分析。结果(1)SDM组、EDN组、CDN组TyG指数依次增加,组间比较,差异有统计学意义(P<0.05)。(2)Spearman秩相关结果提示,TyG指数与UACR呈正相关(r=0.401,P<0.05)。(3)二元logistic回归分析显示DM病程、SBP、FBG、HbA1c、尿素(Urea)、TyG指数是DN的危险因素(P<0.05),其优势比(OR)分别为1.103、1.040、0.890、1.306、1.268、2.034。(4)ROC曲线提示TyG指数的曲线下面积(AUC)为0.713,较TG、FBG大。当TyG指数取Cut-off值8.725时,诊断的敏感性为0.708,特异性为0.635。结论T2DM患者DN的进展伴随着TyG指数的增加,且TyG指数是DN的危险因素,其对DN具有中等诊断价值。Objective To explore the relationship between triglycerides-glucose(TyG)index and diabetic nephropathy(DN)in type 2 diabetes mellitus(T2DM)patients.Methods This cross-sectional study enrolled 460 patients with T2DM hospitalized in the Endocrinology Department of the First Affiliated Hospital of Zhengzhou University from June 2015 to August 2019.According to the urinary albumin/creatinine ratio(UACR)results,the patients were divided into 3 groups,clinic diabetic nephropathy(CDN,n=41)group,early stage diabetic nephropathy(EDN,n=130)group,and simplicity diabetic nephropathy(SDM,n=289)group.The clinical and biochemical parameters of each group were counted,and TyG index was calculated.Spearman rank correlation was used to analyze the correlation.Binary logistic regression was used to find the risk factors of DN,and the diagnostic efficacy of triglyceride(TG),fasting blood glucose(FBG)and TyG index to type 2 diabetic nephropathy was analyzed by receiver operating characteristic curve(ROC curve).Results(1)The TyG index of the subjects in SDM group,EDN group and CDN group increased successively,and the comparison between groups were statistically significant(P<0.05).(2)Spearman rank correlation suggested that TyG index was positively correlated with UACR(r=0.401,P<0.05).(3)The binary logistic regression analysis showed that the course of DM,systolic blood pressure(SBP),FBG,glycated hemoglobin(HbA1c),Urea,TyG index were risk factors for DN(P<0.05),and the odds ratio(OR)were 1.103,1.040,0.890,1.306,1.268 and 2.034 respectively.(4)The ROC curve indicated that the area under the curve(AUC)of TyG index(0.713)was larger than TG and FBG.When the Cut-off value of TyG index was 8.725,the sensitivity of diagnosis was 0.708,and the specificity was 0.635.Conclusion The progression of DN in T2DM patients is accompanied by an increase in TyG index,and TyG index is a hazard influencing factor predicting DN,which providing moderate diagnostic value to DN.

关 键 词：甘油三酯-葡萄糖指数 2型糖尿病 糖尿病肾病 

分 类 号：R587.2[医药卫生—内分泌]