PDF(Pubmed)
Abstract：
The triglyceride-glucose (TyG) index is a simple and inexpensive new marker of insulin resistance that is being increasingly used for the clinical prediction of metabolic syndrome (MetS). Nevertheless, there are only a few comparative studies on its predictive capacity for MetS versus those using the traditional homeostasis model assessment (HOMA). We conducted a cross-sectional study using a database from the National Health and Nutrition Examination Survey (1999 March to 2020 pre-pandemic period). Using statistical methods, we compared the predictive abilities of the TyG index and HOMA (including HOMA of insulin resistance [HOMA-IR] and HOMA of beta-cell function [HOMA-β]) for MetS. A total of 34,195 participants were enrolled and divided into the MetS group (23.1%) or no MetS group (76.9%) according to the International Diabetes Federation (IDF) diagnostic criteria. After applying weighted data, the baseline characteristics of the population were described. Following the exclusion of medication influences, the final count was 31,304 participants. Receiver operating characteristic curve analysis revealed that while distinguishing between MetS and no MetS, the TyG index had an area under the curve (AUC) of 0.827 (sensitivity = 71.9%, specificity = 80.5%), and the cutoff was 8.75, slightly outperforming HOMA-IR (AUC = 0.784) and HOMA-β (AUC = 0.614) with a significance of P < 0.01. The prevalence of MetS in the total population calculated using the TyG index cutoff value was 30.9%, which was higher than that reported in the IDF diagnostic criteria. Weighted data analysis using univariate and multivariate logistic regression displayed an independent association between elevated TyG and HOMA-IR with the risk of MetS. Subgroup analysis further revealed differences in the predictive ability of the TyG index among adult populations across various genders and ethnicities, whereas such differences were not observed for children and adolescents. The TyG index is slightly better than HOMA in predicting MetS and may identify more patients with MetS; thus, its applications in a clinical setting can be appropriately increased.
摘要：
甘油三酯-葡萄糖（TyG）指数是一种简单而廉价的胰岛素抵抗新标志物，正越来越多地用于代谢综合征（MetS）的临床预测。然而，关于MetS的预测能力与使用传统稳态模型评估（HOMA）的预测能力，只有很少的比较研究。我们使用国家健康和营养检查调查（1999年3月至2020年大流行前）的数据库进行了横断面研究。使用统计方法，我们比较了TyG指数和HOMA（包括胰岛素抵抗的HOMA[HOMA-IR]和β细胞功能的HOMA[HOMA-β]）对MetS的预测能力。根据国际糖尿病联合会（IDF）的诊断标准，共纳入34,195名参与者，分为MetS组（23.1％）或无MetS组（76.9％）。应用加权数据后，描述了人群的基线特征.在排除药物影响之后，最终人数为31,304人。接收器工作特性曲线分析显示，在区分MetS和无MetS时，TyG指数的曲线下面积（AUC）为0.827（灵敏度=71.9%，特异性=80.5%)，截止值为8.75，略优于HOMA-IR(AUC=0.784)和HOMA-β(AUC=0.614)，P<0.01。使用TyG指数截止值计算的总人口中MetS的患病率为30.9%,高于IDF诊断标准中报告的水平。使用单变量和多变量逻辑回归的加权数据分析显示了升高的TyG和HOMA-IR与MetS风险之间的独立关联。亚组分析进一步揭示了不同性别和种族的成年人群中TyG指数的预测能力的差异，而儿童和青少年没有观察到这种差异.TyG指数在预测MetS方面略优于HOMA，并且可以识别更多的MetS患者；因此，其在临床环境中的应用可以适当增加。
