甘油三酯-葡萄糖指数与糖尿病视网膜病变进展风险的相关性  

The correlation between the triglyceride-glucose index and the risk of progression of diabetic retinopathy

作　　者：曹维 王婉莹 徐冲 陆小凡 孙宇 CAO Wei;WANG Wanying;XU Chong;LU Xiaofan;SUN Yu(Department of Endocrinology,the Affiliated Suqian Hospital of Xuzhou Medical University,Suqian 223800;Department of Endocrinology,Suzhou Mingji Hospital,Suzhou,215000,China)

机构地区：[1]徐州医科大学附属宿迁医院内分泌科,江苏宿迁223800 [2]苏州明基医院内分泌科,江苏苏州215000

出　　处：《南京医科大学学报(自然科学版)》2025年第4期560-567,共8页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省中医药科技发展计划面上项目(MS2021094);宿迁市重点研发计划重点项目(S202202)。

摘　　要：目的:探讨甘油三酯-葡萄糖(triglyceride-glucose,TyG)指数与糖尿病视网膜病变(diabetic retinopathy,DR)进展风险的相关性。方法:纳入2022年6月—2023年6月于徐州医科大学附属宿迁医院内分泌科住院的2型糖尿病患者521例为研究对象,根据DR诊断及分期标准将患者分为无糖尿病视网膜病变(no-diabetic retinopathy,NDR)组206例,非增生型糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)组159例和增生型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)组156例。比较各组患者一般资料和主要生化指标,计算TyG指数,分析TyG指数与DR进展风险的相关性。结果:多因素Logistic回归显示TyG指数是DR的独立危险因素,进一步行有序Logistic回归发现,矫正混杂因素包括性别、年龄、体重指数(body mass index,BMI)、病程、糖化血红蛋白(glycated hemoglobin,HbA1c)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、肌酐(creatinine,CR)、尿酸(uric acid,UA)、糖尿病性周围神经病变(diabetic peripheral neuropathy,DPN)阳性。根据TyG指数水平三分位数分组,结果显示TyG指数与DR进展风险存在显著相关性[Q3 vs.Q1,OR(95%CI)=4.179(2.552~6.848)],TyG指数越高,DR的进展风险越大。亚组分析显示,Q3组更容易出现严重DR。交互作用分析显示,TyG指数与年龄、BMI存在显著交互作用,年龄>60岁老年患者及BMI>24 kg/m2的超重患者发生DR的风险更高。结论:TyG指数是DR的独立危险因素,高TyG指数提示DR的进展风险高。老年及超重患者发生DR的风险更高。Objective:To investigate the correlation between the triglyceride-glucose(TyG)index and the risk of progression of diabetic retinopathy(DR).Methods:521 patients with type 2 diabetes mellitus hospitalized in the Department of Endocrinology of the Affiliated Suqian Hospital of Xuzhou Medical University from June 2022 to June 2023 were included.Based on the diagnosis and staging criteria of DR,the patients were classified into three groups:the no-diabetic retinopathy(NDR)group(n=206),non-proliferative diabetic retinopathy(NPDR)group(n=159),and proliferative diabetic retinopathy(PDR)group(n=156).General data and major biochemical indexes of each group were compared,the TyG index was calculated,and the correlation between the TyG index and the risk of DR progression was analyzed.Results:Multifactorial logistic regression showed that the TyG index was an independent risk factor for DR.Further ordinal logistic regression showed that after adjusting for confounding factors including sex,age,body mass index(BMI),disease duration,glycated hemoglobin(HbA1c),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),creatinine(CR),uric acid(UA),and diabetic peripheral neuropathy(DPN),the TyG index was significantly associated with the risk of DR progression[Q3 vs.Q1,OR(95%CI)=4.179(2.552-6.848)].A higher TyG index was associated with a greater risk of DR progression.Subgroup analysis showed that the Q3 group was still more likely to develop severe DR.The results of interaction analysis showed that there was a significant interaction between the TyG index and age as well as BMI,with patients aged>60 years and those with BMI>24 having a higher risk of DR.Conclusion:The TyG index is an independent risk factor for DR,and a high TyG index indicates the high risk of DR progression.Elderly and overweight patients are at a higher risk of developing DR.

关 键 词：甘油三酯-葡萄糖指数 糖尿病视网膜病变 进展风险 相关性 

分 类 号：R774.1[医药卫生—眼科]