新型血脂指数与深圳市居民患糖尿病风险的关联性  

Association between novel blood lipid indicators and risk of diabetes among Shenzhen residents

作　　者：杨宇超 吕德良[2] 吴肖冰[2] 谢凤珠[2] 尚庆刚 谢尉 赵志广 YANG Yuchao;LYU Deliang;WU Xiaobing;XIE Fengzhu;SHANG Qinggang;XIE Wei;ZHAO Zhiguang(School of Public Health,Guangdong Medical University,Dongguan 523000,China;Department of Cardiovascular and Cerebrovascular Diseases and Diabetes,Shenzhen Center for Chronic Disease Prevention and Control,Shenzhen 518020,China)

机构地区：[1]广东医科大学公共卫生学院流行病与卫生统计学系,东莞523000 [2]深圳市慢性病防治中心心脑血管疾病与糖尿病科,深圳518020

出　　处：《中华疾病控制杂志》2025年第2期139-144,242,共7页Chinese Journal of Disease Control & Prevention

基　　金：深圳市医疗卫生三名工程项目(SZSM202311019);深圳市医学重点学科建设经费项目(SZXK065)。

摘　　要：目的 探讨深圳市居民的新型血脂指数[如三酰甘油葡萄糖(triglyceride glucose, TyG)指数、脂质积累指数(lipid accumulation product, LAP)、内脏脂肪指数(visceral adiposity index, VAI)]与患糖尿病风险之间的关联,为糖尿病早期预测提供参考。方法 2021年4―10月于深圳市开展了一项居民心脑血管疾病及其危险因素的横断面调查,采用多阶段分层整群随机抽样,通过面对面问卷填写、体格检查和实验室检测的方法,收集腰围(waist circumference, WC)、BMI、空腹血糖(fasting plasma glucose, FPG)、三酰甘油(triglyceride, TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol, HDL-C)等指标。根据研究对象新型血脂指数四分位数间距将其分为Q1、Q2、Q3和Q4组。采用logistic回归分析模型计算新型血脂指数与患糖尿病风险的OR值95%CI,并采用限制性立方样条(restricted cubic spline, RCS)模型分析其潜在非线性的关联。结果 本研究最终选取5 324名居民,其中糖尿病患者378人(占7.10%),非糖尿病患者4 946人(占92.90%)。Logistic回归分析模型经调整潜在混杂因素后,对于TyG指数,Q4组(>8.94)比Q1组(≤8.16)患糖尿病风险更高(OR=8.85,95%CI:5.05~16.81);对于LAP,Q4组(>34.82)比Q1组(≤12.69)患糖尿病风险亦增加(OR=3.30,95%CI:1.85~6.23);对于VAI,Q4组(>1.85)患糖尿病风险为Q1组(≤0.93)的2.31倍(OR=2.31,95%CI:1.54~3.53)。RCS模型结果显示,TyG指数、LAP和VAI与患糖尿病风险呈非线性关系(P<0.05)。结论 TyG指数、LAP和VAI与患糖尿病风险呈正相关,可作为患糖尿病风险的评估指标。Objective This study aimed to explore the association between novel lipid indicators,triglyceride glucose(TyG)index,lipid accumulation product(LAP),and visceral adiposity index(VAI)and the risk of diabetes among residents in Shenzhen,providing a reference for the early prediction and warning of diabetes.Methods A cross-sectional survey on cardiovascular and cerebrovascular diseases and their risk factors among residents in Shenzhen was conducted from April to October 2021.Through multi-stage stratified cluster random sampling,face-to-face questionnaire filling,physical examinations,and laboratory tests were adopted to collect indicators such as waist circumference(WC),BMI,fasting plasma glucose(FPG),triglyceride(TG),and high-density lipoprotein cholesterol(HDL-C).According to the quartile intervals of the novel lipid indicators of the study subjects,they were divided into Q1,Q2,Q3,and Q4 groups.The odds ratio(OR)and its 95%confidence interval(95%CI)of the novel lipid indicators and diabetes were calculated using the logistic regression model,and the potential linear association was analyzed using the restricted cubic spline(RCS)model.Results Finally,5324 residents were selected in this study,among them,there were 378 diabetic patients(7.10%)and 4946 non-diabetic patients(92.90%).After adjusting for potential confounding factors in the logistic regression model,for TyG,compared with the Q1 group(≤8.16),the risk of diabetes in the Q4 group(>8.94)increased(OR=8.85,95%CI:5.05-16.81);for LAP,compared with the Q1 group(≤12.69),the risk of diabetes in the Q4 group(>34.82)also increased(OR=3.30,95%CI:1.85-6.23);for VAI,the risk of diabetes in the Q4 group(>1.85)was 1.31 times than that of the Q1 group(≤0.93)(OR=2.31,95%CI:1.54-3.53).The results of the RCS model showed that the associations of TyG,LAP,and VAI with the risk of diabetes were nonlinear(P<0.05).Conclusions TyG,LAP and VAI are positively correlated with the risk of diabetes and can be used as assessment indicators for the risk of diabetes.

关 键 词：糖尿病 三酰甘油葡萄糖指数 脂质累积指数 内脏脂肪指数 

分 类 号：R587.1[医药卫生—内分泌]