甘油三酯-葡萄糖指数与中青年人群非酒精性脂肪性肝病发病风险的关联  

Association Between Triglyceride-glucose Index and Risk of Nonalcoholic Fatty Liver Disease in Young and Middle-aged Adults

作　　者：吴铮 齐祺 吴欣雨 于洁[2] 杨波 张雪朝 韩全乐[2] 王楠 吴寿岭[4] 李康博 WU Zheng;QI Qi;WU Xinyu;YU Jie;YANG Bo;ZHANG Xuechao;HAN Quanle;WANG Nan;WU Shouling;LI Kangbo(Department of Hepatobiliary Surgery,Tangshan Gongren Hospital,Tangshan 063000,China;Department of Cardiology,Tangshan Gongren Hospital,Tangshan 063000,China;Catheter Room,Tangshan Gongren Hospital,Tangshan 063000,China;Department of Cardiology,Kailuan Hospital,Tangshan 063000,China;School of Clinical Medicine,North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]唐山市工人医院肝胆外科,唐山063000 [2]唐山市工人医院心内科,唐山063000 [3]唐山市工人医院导管室,唐山063000 [4]开滦总医院心内科,唐山063000 [5]华北理工大学临床医学院,唐山063000

出　　处：《中国循环杂志》2025年第3期277-283,共7页Chinese Circulation Journal

基　　金：河北省医学课题重点研究计划项目(20231775)。

摘　　要：目的:探讨甘油三酯-葡萄糖(TyG)指数与中青年人群非酒精性脂肪性肝病(NAFLD)发病风险的关联。方法:选取2006年6月至2007年10月参加开滦集团职工健康体检,无其他类型肝病且资料完整的47675例参与者为研究对象。以TyG指数四分位数分为Q_(1)组(TyG指数≤8.08,n=11924)、Q_(2)组(8.083组(8.454组(8.881组(cum-TyG<32.51,n=11918)、cum-Q_(2)组(cum-TyG 32.51~33.75,n=11919)、cum-Q_(3)组(cum-TyG 33.76~36.46,n=11919)与cum-Q_(4)组(cum-TyG>36.46,n=11919),分析TyG指数、cum-TyG及暴露时间与NAFLD发病风险的关联。结果:47675例研究对象平均年龄为(44.3±8.7)岁,男性36345例(76.23%)。中位11.55(7.28,13.89)年随访期间,4635例(9.72%)罹患NAFLD。Cox回归分析显示,与Q_(1)组相比,Q_(2)组~Q_(4)组发生NAFLD的HR(95%CI)分别为1.328(1.191~1.480)、1.591(1.430~1.770)、2.106(1.861~2.384),P_(trend)<0.001。与cum-Q_(1)组相比,cum-Q_(2)组~cum-Q_(4)组发生NAFLD的HR(95%CI)分别为1.571(1.426~1.730)、2.123(1.935~2.330)、2.593(2.367~2.840),P_(trend)<0.001。与TyG指数累计暴露0年者相比,累积暴露2、4、6年者发生NAFLD的HR(95%CI)分别为1.333(1.196~1.486)、1.879(1.690~2.088)、3.184(2.860~3.545),P_(trend)<0.001。结论:TyG指数升高是中青年人群发生NAFLD的独立危险因素。Objectives:To investigate the association between the triglyceride-glucose(TyG)index and risk of non-alcoholic fatty liver disease(NAFLD)in young and middle-aged(<60 years)adults.Methods:From June 2006 to October 2007,47675 employees of Kailuan Group with no liver disease were selected as the study objects.Based on the TyG index quartile,participants were divided into Q_(1) group(TyG index≤8.08,n=11924),Q_(2) group(8.08<TyG index≤8.45,n=11915),Q_(3) group(8.45<TyG index≤8.88,n=11915),and Q_(4) group(8.88<TyG index≤12.25,n=11921).Based on the level of cumulative TyG(cum-TyG),participants were also divided into cum-Q_(1) group(cum-TyG<32.51,n=11918),cum-Q_(2) group(cum-TyG 32.51-33.75,n=11919),cum-Q_(3) group(cum-TyG 33.76-36.46,n=11919)and cum-Q_(4) group(cum-TyG>36.46,n=11919),the association between TyG index,cum-TyG and cumulative exposure time and the risk of NAFLD was analyzed.Results:The average age of the study population was(44.3±8.7)years,36345 participants were males(76.23%).During a median follow-up period of 11.55(7.28,13.89)years,4635(9.72%)participants developed new-onset NAFLD.After adjusting for confounders,cox regression analysis showed that compared with the Q_(1) group,the HR(95%CI)for NAFLD in the Q_(2) to Q_(4) groups were 1.328(1.191-1.480),1.591(1.430-1.770),and 2.106(1.861-2.384),respectively,P_(trend)<0.001.Compared with the cum-Q_(1) group,the HR(95%CI)for NAFLD in the cum-Q_(2) to cum-Q_(4) groups were 1.571(1.426-1.730),2.123(1.935-2.330)and 2.593(2.367-2.840),respectively,P_(trend)<0.001.Compared with the TyG index for 0 year,the HR(95%CI)of NAFLD for 2,4 and 6 years was 1.333(1.196-1.486),1.879(1.690-2.088)and 3.184(2.860-3.545),respectively,P_(trend)<0.001.Conclusions:Increased TyG index is an independent risk factor for the new-onset NAFLD in young and middle-aged population.

关 键 词：甘油三酯-葡萄糖指数 中青年人群 非酒精性脂肪性肝病 代谢综合征 胰岛素抵抗 

分 类 号：R54[医药卫生—心血管疾病]