甘油三酯葡萄糖-体重指数与2型糖尿病发病风险的关联  

Association of triglyceride glucose-Body Mass Index(TyG-BMI)and risk of developing type 2 diabetes mellitus

作　　者：张方芳 王云辉 刘星[3] 李静 阚云龙 张文翠[1] 唐敏华 奚超 ZHANG Fang-fang;WANG Yun-hui;LIU Xing;LI Jing;KAN Yun-long;ZHANG Wen-cui;TANG Min-hua;XI Chao

机构地区：[1]上海市松江区疾病预防控制中心,上海201620 [2]上海市松江区新桥社区卫生服务中心 [3]复旦大学公共卫生学院流行病学教研室/公共卫生安全教育部重点实验室 [4]上海市松江区中山街道社区卫生服务中心

出　　处：《现代预防医学》2024年第24期4591-4596,共6页Modern Preventive Medicine

基　　金：上海市加强公共卫生体系建设三年行动计划(2023-2025年)重点学科建设项目(GWVI-11.1-23)。

摘　　要：目的探索甘油三酯葡萄糖-体重指数(TyG-BMI)与2型糖尿病(T2DM)发病风险的关联。方法数据来源于2016年4月至2017年9月建立的上海郊区自然人群队列(松江子队列)。选取基线中20~74周岁、血糖水平正常的非糖尿病人群作为研究对象(29351名)。通过Cox比例风险回归模型和限制性立方样条模型评估基线TyG-BMI水平与T2DM发病风险之间的关联及剂量-反应关系。根据性别、年龄等协变量进行分层并分析其与TyG-BMI的交互作用。结果经历中位随访时间6.98年,共有584名男性和777名女性被初次诊断为T2DM。校正混杂因素后,Cox回归模型显示,TyG-BMI每增加1个SD,T2DM发病风险增加58%(HR=1.58,95%CI:1.50~1.66)。将TyG-BMI按四分位数进行分组后作为分类变量纳入Cox回归模型分析,以Q1组为对照,Q2、Q3、Q4组的T2DM发病风险逐渐增加,HR(95%CI)分别为1.42(1.15~1.75)、2.02(1.66~2.46)和3.47(2.88~4.19)(P趋势<0.001)。限制性立方样条图显示,TyG-BMI与T2DM发病风险存在非线性关联(P非线性=0.048)。此外,亚组分析结果显示,青中年(60岁以下)居民TyG-BMI与T2DM发病风险的关联显著高于老年居民(P交互<0.05)。结论在血糖水平正常的情况下,基线TyG-BMI与T2DM的发病风险呈正相关,且这种关联在青中年群体中更为显著。Objective To explore the association between Triglyceride Glucose-Body Mass Index(TyG-BMI)and the risk of developing type 2 diabetes mellitus(T2DM).Methods The data were obtained from the natural population cohort of Shanghai suburbs established from April 2016 to September 2017(Songjiang subcohort).29,351 nondiabetic subjects with normal blood glucose levels aged 20-74 years at baseline were included in the analysis.The association and dose-response relationship between baseline TyG-BMI level and the risk of developing T2DM were assessed by Cox proportional risk regression model and restricted cubic spline model.Covariates such as gender and age were stratified according to their covariates and their interaction with TyG-BMI was analyzed.Results A total of 584 men and 777 women were initially diagnosed with T2DM after a median follow-up time of 6.98 years.After correcting for confounders,the Cox regression model showed a 58%increase in the risk of T2DM incidence for every 1 SD increase in TyG-BMI(HR=1.58,95%CI:1.50-1.66).After grouping TyG-BMI by quartiles and then including it as a categorical variable in the Cox regression model analysis,the risk of T2DM incidence increased progressively in the Q2,Q3,and Q4 groups with HR(95%CI)of 1.42(1.15-1.75),2.02(1.66-2.46),and 3.47(2.88-4.19),respectively(Ptrend<0.001),using the Q1 group as the control.Restricted cubic spline plots showed a nonlinear association between TyG-BMI and the risk of T2DM incidence(Pnonlinear=0.048).In addition,subgroup analyses showed that the association between TyG-BMI and the risk of developing T2DM was significantly higher in young and middle-aged(less than 60 years old)residents than in older residents(Pinteraction<0.05).Conclusion Under normal blood glucose levels,baseline TyG-BMI was positively associated with the risk of developing T2DM,and this association was more significant in the young and middle-aged groups.

关 键 词：2型糖尿病 甘油三酯葡萄糖-体重指数 队列研究 

分 类 号：R587.1[医药卫生—内分泌]