甘油三酯血糖指数及HOMA-IR与糖尿病肾病的相关性研究  

Relationship of early diabetic nephropathy with triglycerideglucose index and HOMA-IR in patients with type 2 diabetes mellitus

作　　者：李自平[1] 刘湛[1] LI Zi-ping;LIU Zhan(Clinical Lab,Puyang Peoples Hospital,Puyang,Henan 457000,China)

机构地区：[1]濮阳市人民医院检验科,河南濮阳457000

出　　处：《医药论坛杂志》2022年第1期67-70,共4页Journal of Medical Forum

摘　　要：目的在2型糖尿病(T2DM)患者中分析并比较甘油三酯血糖(TyG)指数及HOMA-IR与糖尿病肾病(DN)的相关性。方法选取濮阳市人民医院2018年1月—2021年2月收治的150例早期DN患者、160例T2DM患者和160例健康体检者为本研究的研究对象,测定所有入选者的空腹血糖、甘油三酯等,计算TyG指数,测定T2DM患者的空腹胰岛素,计算HOMA-IR。结果与单纯T2DM组和对照组相比,早期DN组TyG指数显著升高(8.36±0.88 vs 7.01±0.64 vs 5.97±0.54,P<0.05);尿白蛋白/肌酐与TyG指数(r=0.296,P<0.001)及HOMA-IR(r=0.274,P<0.001)均呈正相关;Logistic回归分析提示,校正一些混杂因素如年龄、HbA1c等,TyG指数(OR=3.861, 95%CI2.765~4.492,P<0.001)和HOMA-IR (OR=2.006, 95%CI 1.578~2.674,P=0.010)均是早期DN发生的独立危险因素;ROC曲线分析提示TyG指数对早期DN的发生的预测效能大于HOMA-IR,当TyG指数截断值取8.27时,其预测早期DN发生的敏感性为78.80%,特异性为69.20%。结论 TyG指数与DN的关联程度大于HOMA-IR,TyG指数可作为筛查DN高危人群的一种简易工具。Objective To investigate and compare the relationship of early diabetic nephropathy with triglyceride glucose(TyG) index and HOMA-IR in patients with type 2 diabetes mellitus(T2 DM).Methods Totally 150 early DN patients, 160 T2 DM patients and 160 healthy subjects were enrolled in our study. Fasting blood glucose and triglycerides were measured in all participants and then the TyG index was calculated. Fasting insulin levels were only measured in patients with T2 DM and then HOMA-IR was calculated.Results Compared with the T2 DM group and the control group, the TyG index in the early DN group was significantly increased(8.36±0.88 vs 7.01±0.64 vs 5.97±0.54, P<0.05). Urinary albumin/creatinine was positively correlated with the TyG index(r=0.296, P<0.001) and HOMA-IR(r=0.274, P<0.001). Logistic regression analysis suggested that the TyG index(OR=3.861, 95%CI 2.765~4.492, P<0.001) and HOMA-IR(OR=2.006, 95%CI 1.578~2.674, P=0.010) were independent risk factors for early DN after adjusting for some confounding factors such as age and HbA1 c. ROC curve analysis indicated that the predictive efficiency of TyG index on the occurrence of early DN was greater than that of HOMA-IR. When the cut-off value of TyG index was 8.27, the sensitivity and specificity of TyG index for predicting early DN were 78.80% and 69.20% respectively.Conclusion The correlation between TyG index and DN was greater than that with HOMA-IR. The TyG index could be used as a simple tool to screen high-risk of DN.

关 键 词：甘油三酯血糖指数 HOMA-IR 糖尿病肾病 早期 

分 类 号：R587.2[医药卫生—内分泌]