甘油三酯葡萄糖指数联合内脏脂肪面积检测对糖尿病前期和糖尿病的预测价值  

Predictive value of detection of triglyceride-glucose index combined with visceral fat area in prediabetes and diabetes

作　　者：伍丽娟[1] 倪许玲 陈心蓓 叶金连[1] 尹莲花[1,2] WU Lijuan;NI Xuling;CHEN Xinbei;YE Jinlian;YIN Lianhua(The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine,Fujian350003,China;Rehabilitation technology innovation center by joint collaboration of education and Fujian Province,Fujian University of traditional Chinese Medicine,Fujian350108,China)

机构地区：[1]福建中医药大学附属第二人民医院,福州350003 [2]福建中医药大学康复技术省部共建协同创新中心,福州350108

出　　处：《福建医药杂志》2025年第3期5-11,共7页Fujian Medical Journal

基　　金：福建省卫健委青年科研课题项目(2021QNB010);福建中医药大学康复技术省部共建协同创新中心(X2022011-协同)。

摘　　要：目的探讨甘油三酯-葡萄糖指数(TyG)、低密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比值(LDL-C/HDL-C)及内脏脂肪面积(VFA)检测对糖尿病前期和糖尿病的预测价值。方法回顾性分析于福建中医药大学附属第二人民医院健康管理中心(治未病)体检的255名受试者,按糖尿病前期和糖尿病诊断标准分为糖尿病前期组(n=100)、糖尿病组(n=79)、血糖正常组(n=76)。两两比较3组人群的理化指标,主要包括TG、TC、LDL-C、HDL-C、TyG、LDL-C/HDL-C、体重、BMI、脂肪量、肌肉量、体脂肪量(BF)、蛋白质、VFA、皮下脂肪含量(SFC)等,采用多因素logistic回归分析糖尿病前期和糖尿病的影响因素,使用受试者工作特征(ROC)曲线评估TyG、VFA以及TyG联合VFA对糖尿病前期和糖尿病的预测价值。结果糖尿病前期组和糖尿病组的TG、LDL-C、TyG、LDL-C/HDL-C均高于血糖正常组,HDL-C低于血糖正常组;糖尿病组的TyG高于糖尿病前期组,HDL-C低于糖尿病前期组(均P<0.05)。糖尿病前期组的体重、BMI、脂肪量、身体水分、BF、VFA、VFC、SFC高于血糖正常组;糖尿病组的体重、BMI、脂肪量、BF、VFA、VFC、浮肿指数均高于血糖正常组(均P<0.05)。TyG、VFA是糖尿病前期和糖尿病的影响因素(P<0.05),LDL-C/HDL-C不是糖尿病前期和糖尿病的影响因素(P>0.05)。对于糖尿病前期,TyG的AUC为0.719,最佳切点为7.225,VFA的AUC为0.667,最佳切点为53.5,TyG+VFA的AUC为0.743;对于糖尿病,TyG的AUC为0.817,最佳切点为7.218,VFA的AUC为0.683,最佳切点61.75,TyG+VFA的AUC为0.822。结论TyG、VFA是糖尿病前期和糖尿病的影响因素,两者联合检测对糖尿病前期和糖尿病具有更优的预测价值。Objective To explore the predictive value of the triglyceride-glucose index(TyG),the ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol(LDL-C/HDL-C),and visceral fat area(VFA)for prediabetes and diabetes.Methods A retrospective analysis was conducted on 255 subjects who underwent physical examination at the Health Management Center(Treat Before Illness)of the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine.They were divided into prediabetes group(n=100),diabetes group(n=79),and normal glucose group(n=76),according to the diagnostic criteria for prediabetes and diabetes.The physical and chemical indicators of the three groups were compared,including TG,TC,LDL-C,HDL-C,TyG,LDL-C/HDL-C,weight,BMI,fat mass,muscle mass,BF,protein,VFA,SFC,etc.Multiple factor logistic regression analysis was used to analyze the influencing factors of prediabetes and diabetes,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of TyG,VFA,and the combination of TyG and VFA for prediabetes and diabetes.Results The levels of TG,LDL-C,TyG,and LDL-C/HDL-C in the prediabetes group and diabetes group were higher than those in the normal glucose group,while HDL-C was lower than that in the normal glucose group(P<0.05).The TyG in the diabetes group was higher than that in the prediabetes group,and HDL-C was lower than that in the prediabetes group(P<0.05).The weight,BMI,fat mass,body water,BF,VFA,VFC,and SFC in the prediabetes group were higher than those in the normal glucose group;the weight,BMI,fat mass,BF,VFA,VFC,and edema index in the diabetes group were higher than those in the normal glucose group(all P<0.05).TyG and VFA were influence factors for prediabetes and diabetes(P<0.05),LDL-C and HDL-C were not influence factors for prediabetes and diabetes(P>0.05).For prediabetes,the AUC of TyG was 0.719,the optimal cut-off was 7.225,the AUC of VFA was 0.667,the optimal cut-off was 53.5,and the AUC of TyG and VFA was 0.743;for diabetes,the

关 键 词：糖尿病前期 糖尿病 甘油三酯-葡萄糖指数 内脏脂肪面积 

分 类 号：R587.1[医药卫生—内分泌]