摘要
目的 探讨我国社区人群甘油三酯葡萄糖乘积(TyG)指数与尿白蛋白/肌酐比值(UACR)的相关性,并比较不同胰岛素抵抗指数和肥胖指数对异常白蛋白尿预测价值的差异.方法 共纳入来自REACTION(中国糖尿病患者癌症风险评估)数据库的34 655例受试者,根据UACR值将其分为正常白蛋白尿组和异常白蛋白尿组,再根据TyG指数将其再分为TyG-Q1组～TyG-Q4组.收集所有受试者一般临床资料、实验室检查指标及各项指数并分组进行比较.采用多因素logistic回归分析评估TyG指数与UACR异常的相关性.采用受试者工作特征(ROC)曲线评估TyG指数等新型指标对异常白蛋白尿的预测效能.结果 Q2、Q3和Q4组受试者异常白蛋白尿发生率、体重、WC、HC、TC、ALT、AST、GGT、SBP、DBP均显著高于Q1组;Q3组受试者LDL-C显著高于Q1组;Q4组受试者身高显著高于Q1组(P＜0.001).多因素logistic回归分析结果显示,TyG指数作为连续变量时,TyG指数与UACR异常呈显著正相关;TyG指数为分类变量时,高TyG指数与UACR异常呈显著正相关(Q3组P=0.015,Q4组P＜0.001).ROC曲线分析结果显示,TyG指数、HOME-IR、METS-IR、CVAI、ABSI和BMI对异常白蛋白尿发生均具有预测价值(P＜0.001),TyG指数和CVAI的预测价值显著高于其他指标(P＜0.05),但两者的预测效能无明显差异(P＞0.05).结论 TyG指数升高与中国社区人群UACR异常显著相关,TyG指数和CVAI对异常白蛋白尿的发生预测价值最高,提示其在临床预测中具有潜在应用价值.
Abstract
Objective This study aims to explore the association between the triglyceride-glucose(TyG)index and the urinary albumin/creatinine ratio(UACR)in a Chinese community population and to compare the differences in predictive value of abnormal albuminuria between different insulin resistance indices and obesity indices.Methods A total of 34 655 subjects from the REACTION database were enrolled,which were divided into normal albuminuria and abnormal albuminuria groups according to the UACR value,and then subdivided into TyG-Q1 groups to TyG-Q4 groups according to TyG index.Multifactorial logistic regression analysis was used to assess the correlation between TyG index and abnormal UACR.The predictive efficacy of TyG index and other novel indexes for abnormal albuminuria was assessed using subject work characteristics(ROC)curves.Results The incidence of abnormal albuminuria,body weight,WC,HC,TC,ALT,AST,GGT,SBP and DBP of the participants in the Q2,Q3,and Q4 groups were significantly higher than those in the Q1 group;Participants in the Q3 group had significantly higher LDL-C than those in the Q,group;The height of participants in Q4 group was significantly higher than Q,group(P＜0.001).The results of multifactorial logistic regression analyses showed a significant positive correlation between TyG index and UACR abnormality when TyG index was a continuous variable(Q3 group P=0.015,Q4 group P＜0.001);The results of ROC curve analysis showed that TyG index,HOME-IR,METS-IR,CVAI,ABSI and BMI all had predictive value for the occurrence of abnormal albuminuria(P＜0.001),and the predictive value of TyG index and CVAI was significantly higher than that of the other indicators(P＜0.05),however the predictive efficacy of the two was not significantly different(P＞0.05).Conclusion Increased TyG index was significantly associated with abnormal UACR in a Chinese community population,and TyG index and CVAI had the highest predictive value for the occurrence of abnormal albuminuria,indicating their potential application in clinical prediction.
基金项目
北京市科委项目(Z201100005520014)
NETL
NSTL
万方数据