身体质量指数联合三酰甘油与高密度脂蛋白胆固醇比值预测2型糖尿病风险  

Combination of body mass index and the triacylglycerol to high-density lipoprotein cholesterol ratio predicts the risk of type 2 diabetes mellitus

作　　者：雷庆华[1] 李军华[1] 霍燕飞[1] 郭子静 李霞[1] 李宗虎 LEI Qinghua;LI Junhua;HUO Yanfei;GUO Zijing;LI Xia;LI Zonghu(Author Affiliation:Physical Examination Center,Handan Central Hospital,Handan,Hebei 056000,China)

机构地区：[1]邯郸市中心医院体检中心,河北邯郸056000

出　　处：《安徽医药》2024年第1期90-94,I0003,共6页Anhui Medical and Pharmaceutical Journal

基　　金：邯郸市科学技术研究与发展计划项目(22422083010ZC)。

摘　　要：目的利用体检指标中身体质量指数(BMI)和三酰甘油与高密度脂蛋白胆固醇比值(triglyceride to high-density lipoprotein cholesterol,TG/HDL-C)联合预测2型糖尿病(type 2 diabetes mellitus,T2DM)发病风险。方法基于瑞慈医疗集团2010—2016年体检人群的数据库,通过Cox比例风险模型观测不同BMI的人群基线TG/HDL-C对随访期间T2DM风险的影响,并分析TG/HDL-C与BMI是否存在交互作用。结果在随访期间,13685例研究对象中共有315例最终诊断为T2DM。以BMI=24 kg/m^(2)为界,将所有研究对象分成两个亚组。BMI<24 kg/m^(2)的亚组共有8238例研究对象,96例在随访结束时患T2DM,对潜在的混杂因素进行调整后,升高的TG/HDL-C导致T2DM事件的风险较高[HR 95%CI=1.47(1.23,1.74),P<0.001]。与最低五分位数(Q1)相比,升高的TG/HDL-C五分位数(Q2~Q5)T2DM发病率增加[HR 95%CI分别为:0.73(0.28,1.93)、2.75(1.29,5.85)、2.81(1.28,6.20)和3.91(1.51,10.11)]。BMI≥24 kg/m^(2)的亚组共有5447例研究对象,219例在随访结束时患T2DM。在两个亚组中,随着TG/HDL-C的增加,T2DM患病风险均呈非线性增加,这一变化在BMI<24 kg/m^(2)的亚组更为明显。绘制两个亚组TG/HDLC与3年和5年T2DM发病的ROC曲线,在BMI<24 kg/m^(2)的亚组中,ROC曲线下面积分别为0.72和0.77。在BMI≥24 kg/m^(2)的亚组中,ROC曲线下面积则分别为0.55和0.57。结论在BMI<24 kg/m^(2)的人群中,TG/HDL-C的升高提示T2DM患病风险显著增加。Objective To predict the risk of type 2 diabetes mellitus(T2DM)by combination of body mass index(BMI)and the triglyceride to high density lipoprotein cholesterol(TG/HDL-C)ratio in physical examination.Methods Based on the database of the 2010-2016 physical examination population of Rui Ci Medical Group,the effect of baseline TG/HDL-C on the risk of T2DM during the follow-up period was observed by Cox proportional risk modeling in people with different BMIs,and we analyzed whether there was an interaction between TG/HDL-C and BMI.Results A total of 315 of 13685 study subjects were ultimately diagnosed with T2DM during the follow-up period.All study subjects were divided into two subgroups using a BMI=24 kg/m^(2).The subgroup with a BMI<24 kg/m^(2) consisted of a total of 8,238 study subjects.96 had T2DM at the end of the follow-up period.Adjusting for potential confounders,the elevated TG/HDL-C resulted in a higher risk of incident T2DM[HR 95%CI=1.47(1.23,1.74),P<0.001].Compared with the lowest quintile(Q1),elevated TG/HDL-C quintiles(Q2 to Q5)had an increased prevalence of T2DM[HR 95%CI were 0.73(0.28,1.93),2.75(1.29,5.85),2.81(1.28,6.20)and 3.91(1.51,10.11)].There were 5447 study subjects in the subgroup with BMI≥24 kg/m^(2),and 219 developed T2DM at the end of follow-up.In both subgroups,the risk of developing T2DM increased nonlinearly with increasing TG/HDLC,and this change was more pronounced in the subgroup with BMI<24 kg/m^(2).When ROC curves were plotted for TG/HDL-C versus 3-and 5-year T2DM incidence in the two subgroups,the areas under the ROC curves were 0.72 and 0.77 in the subgroups with BMI<24 kg/m^(2),respectively,and 0.55 and 0.57 in the subgroups with BMI≥24 kg/m^(2),respectively.Conclusion In the subgroup with BMI<24 kg/m^(2),elevated TG/HDL-C suggests a significant increase in the risk of T2DM.

关 键 词：糖尿病 2型 身体质量指数 三酰甘油 高密度脂蛋白胆固醇 非线性关系 疾病风险 

分 类 号：R587.1[医药卫生—内分泌]