绝经后2型糖尿病患者血清RLP-C与TyG指数的相关性研究  

Correlation Study on Serum RLP-C Level and TyG Index in Patients with Postmenopausal Type 2 Diabetes

作　　者：杨美玲 黄本林 李才信 YANG Meiling;HUANG Benling;LI Caixin(Department of Clinical Laboratory,Ruili People’s Hospital,Yun’nan Dehong 678600,China;Department of Clinical Laboratory,the Second People’s Hospital of Qujing,Yun’nan Qujing 655000,China;Department of Clinical Laboratory,Chang Po,the Third People’s Hospital of Kunming/Yunnan Clinical Medical Center for Infectious Diseases,Kunming 650301,China)

机构地区：[1]瑞丽市人民医院检验科,云南德宏678600 [2]曲靖市第二人民医院检验科,云南曲靖655000 [3]昆明市第三人民医院/云南省传染性疾病临床医学中心长坡检验科,昆明650301

出　　处：《现代检验医学杂志》2024年第6期195-200,共6页Journal of Modern Laboratory Medicine

基　　金：曲靖医学高等专科学校校级课题(2023Z007)。

摘　　要：目的探讨绝经后2型糖尿病(type 2 diabetes,T2DM)患者血清残余脂蛋白胆固醇(residual lipoprotein cholesterol,RLP-C)与三酰甘油葡萄糖(triglyceride glucose,TyG)指数之间的相关性。方法选取2019年5月~2023年5月就诊于瑞丽市人民医院的389例绝经后T2DM患者为研究对象,计算RLP-C和TyG指数,以TyG指数中位数(9.23)为界限将研究对象分为低TyG指数组(n=194)和高TyG指数组(n=195)。比较两组患者一般临床资料、代谢相关指标间的差异;相关性分析采用Spearman等级相关;影响因素分析采用单/多因素Logistic回归;诊断价值分析采用ROC曲线。结果与低TyG指数组相比,高TyG指数组患者高血压史(79.49%vs 70.62%)、高脂血症史占比(22.05%vs 13.40%)、血红蛋白(Hb)(120.34±19.96g/L vs 114.97±21.32g/L)、空腹血糖(FBG)[3.97(3.03,5.10)mmol/L vs 3.64(2.99,4.74)mmol/L]、总胆固醇(TC)[5.00(4.40,5.95)mmol/L vs 4.36(3.78,5.30)mmol/L]、三酰甘油(TG)[2.11(1.60,3.00)mmol/L vs 1.20(0.91,1.54)mmol/L]、低密度脂蛋白-胆固醇(LDL-C)[2.99(2.43,3.93)mmol/L vs 2.71(2.13,3.38)mmol/L]、非高密度脂蛋白-胆固醇(nonHDL-C)[3.94(3.22,4.82)mmol/L vs 3.15(2.53,3.94)mmol/L]、RLP-C浓度[0.76(0.52,1.08)mmol/L vs 0.44(0.29,0.59)mmol/L]升高,高密度脂蛋白-胆固醇(HDL-C)[1.08(0.91,1.25)mmol/L vs 1.17(1.00,1.43)mmol/L]浓度降低,差异具有统计学意义(χ^(2)=4.09,4.99;t=-2.56;Z=-2.34,-5.15,-12.08,-3.04,-6.23,-9.15,-3.99,均P<0.05)。Spearman相关性分析显示,总体而言,TyG与TC,TG,LDL-C,RLP-C,nonHDL-C呈显著正相关(r=0.304,0.769,0.179,0.386,0.571,均P<0.001),与HDL-C呈显著负相关(r=-0.306,P<0.001);在高TyG指数组中,TyG与TC,LDL-C之间相关性不具有统计学意义(均P>0.05)。单因素Logistic回归分析结果显示,高血压史、高脂血症、HDL-C,LDL-C和RLP-C是TyG水平的影响因素[OR(95%CI)=1.61(1.01~2.51),1.83(5.71~30.37),0.28(0.14~0.54),1.21(1.02~1.43),17.58(8.11~38.11),均P<0.05];多因素回归分析结果显示,仅RLP-C是TyG升高的独立危险Objective To explore the correlation between serum residual lipoprotein cholesterol(RLP-C)and triglyceride glucose(TyG)index in postmenopausal type 2 diabetes(T2DM)patients.Methods A total of 389 postmenopausal T2DM patients who attended Ruili People’s Hospital from May 2019 to May 2023 were included.RLP-C and TyG index were calculated,and the study subjects were divided into the low TyG index group(n=194)and the high TyG index group(n=195)based on the median of TyG index(9.23).Differences in general clinical data and metabolism-related indexes between the two groups of patients were compared,and Spearman rank correlation was performed to explore their correlation.Single-factor and multivariate Logistic regressions were used to explore their influencing factors,and ROC curve was used to analyze their diagnostic value.Results Compared with the low TyG index group,the history of hypertension(79.49%vs 70.62%),hyperlipidemia(22.05%vs 13.40%),hemoglobin(Hb)(120.34±19.96g/L vs 114.97±21.32g/L),fasting blood glucose(FBG)[3.97(3.03,5.10)mmol/L vs 3.64(2.99,4.74)mmol/L],total cholesterol(TC)[5.00(4.40,5.95)mmol/L vs 4.36(3.78,5.30)mmol/L],triacylglycerol(TG)[2.11(1.60,3.00)mmol/L vs 1.20(0.91,1.54)mmol/L],low-density lipoprotein(LDL-C)[2.99(2.43,3.93)mmol/L vs 2.71(2.13,3.38)mmol/L],non-high-density lipoprotein(nonHDL-C)[3.94(3.22,4.82)mmol/L vs 3.15(2.53,3.94)mmol/L]and RLP-C concentration[0.76(0.52,1.08)mmol/L vs 0.44(0.29,0.59)mmol/L]of the high TyG index group were higher,while high-density lipoprotein(HDL-C)concentration was lower,and the differences were statistically significant(χ^(2)=4.09,4.99;t=-2.56;Z=-2.34,-5.15,-12.08,-3.04,-6.23,-9.15,-3.99,all P<0.05).Spearman correlation analysis showed that TyG in all samples was positively correlated with TC,TG,LDL-C,RLP-C and nonHDL-C(r=0.304,0.769,0.179,0.386,0.571,all P<0.001),but was negatively correlated with HDL-C(r=-0.306,P<0.001).The correlations between TyG and TC,LDL-C in the high TyG index group were not significant(all P>0.05).Single-actor logistic regre

关 键 词：2型糖尿病 残余脂蛋白胆固醇 三酰甘油葡萄糖 

分 类 号：R587.1[医药卫生—内分泌] R446.112[医药卫生—内科学]