Relationship between new surrogate marks of insulin resistance and bone mineral content in adolescents
Objective To analyze the relationship between new surrogate marks of insulin resistance(IR)and bone mineral content(BMC)in adolescents,and predictive value of the new surrogate marks on low bone mass,so as to provide scientific basis for early identification and prevention of skeletal-related diseases in adolescents.Methods A total of 1 594 adolescents aged 12-18 years in Yinchuan City were selected by convenience sampling and stratified cluster random sampling from September 2017 to September 2020,and triglyceride and glucose index(TyG),triglyceride glucose-body mass index(TyG-BMI)and triglyceride/high-density lipoprotein cholesterol(TG/HDL-C)were calculated as new simplified IR index.The correlation between different simplified IR indexes and BMC level was analyzed by partial correlation.Binary Logistic regression was used to analyze the relation-ship between IR index and low bone mass,and receiver operating characteristic(ROC)curve was constructed to analyze its evalua-tion effect on low bone mass.Results After adjusting for confounding factors such as gender,age,smoking,drinking,family his-tory of hypertension,systolic blood pressure(SBP)and diastolic blood pressure(DBP),the new surrogate marks of IR were posi-tively correlated with BMC level(TyG:r=0.11,TyG-BMI:r=0.58,TG/HDL-C:r=0.21,P＜0.01).After further adjustment of body mass index(BMI),fat mass(FM)and lean mass(LM),the relationship between IR indexes and BMC turned into negative correlation(TyG:r=-0.20,TyG-BMI:r=-0.18,TG/HDL-C:r=-0.14,P＜O.Ol).After adjusting for confounding factors such as gender,age,smoking,drinking,family history of hypertension,SBP and DBP,Logistic regression results showed that the in-crease of TyG,TyG-BMI and TG/HDL-C levels reduced the possibility of low bone mass in adolescents(TyG:OR=0.63,95％CI=0.40-0.98,TyG-BMI:OR=0.94,95％CI=0.93-0.96,TG/HDL-C:OR=0.31,95％CI=0.17-0.58,P＜0.01).After adjusting BMI,FM and LM,the above results were completely reversed.Girls with high TyG and TG/HDL-C levels were 4.95 and 4.38 times more likely to have low bone mass than those with low TyG and TG/HDL-C levels(TyG:OR=4.95,95％CI=1.29-18.95,TG/HDL-C:OR=4.38,95％CI=1.04-18.50,P＜0.05).ROC curve showed that TyG-BMI had the best predictive value on low bone mass(AUC=0.80,95％CI=0.77-0.83,P＜0.01).Conclusion The new surrogate marks of IR in adolescents are negatively correlated with adolescent BMC,of which TyG-BMI is the best for assessing of low bone mass and can serving as a relia-ble indicator for early identification of low bone mass.
Insulin resistanceBone and bonesMineralsGrowth and developmentRegression analysisAdolescent
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