背景:甘油三酯-葡萄糖指数(TyG)已被鉴定为胰岛素抵抗(IR)的可靠且简单的指示标记。研究表明,大血管并发症与TyG之间存在相关性。然而,关于TyG与糖尿病微血管并发症之间关系的研究有限。因此,本研究的目的是探讨TyG与糖尿病肾病(DKD)和糖尿病周围神经病变(DPN)的关系.
方法:这是一个横截面,观察性研究。共有2048名患者来自同仁医院,上海交通大学医学院被录取。主要结果是DKD和DPN。分位数回归分析用于研究TyG四分位数的隐含因素。随后,基于内隐因素,建立Logistic回归模型,进一步检验TyG与DKD和DPN的关系。
结果:在基线中,TyG在DKD患者中表现出较高的值,DPN,2型糖尿病(T2D)中DKD和DPN共存(DKD+DPN)。单变量logistic回归表明,TyG升高与DKD风险增加之间存在显着关联(OR=1.842,[95%CI]1.317-2.578,P<0.01)。DPN(OR=1.516,[95%CI]1.114-2.288,P<0.05),DKD+DPN(OR=2.088,[95%CI]1.429-3.052,P为趋势<0.05)。多变量logistic回归模型表明DKD的风险有统计学意义的增加(OR=1.581,[95%CI]1.031-2.424,p<0.05),调整TyG四分位数内隐因子后的DKD+DPN(OR=1.779,[95%CI]1.091-2.903,p<0.05)。然而,在多元回归分析中,未观察到TyG和DPN之间的显著关系.
结论:TyG升高与T2D患者DKD风险增加显著相关,但与DPN无明显关系。这一发现为将TyG整合到糖尿病微血管并发症的初始评估中的临床意义提供了进一步的证据。
BACKGROUND: The triglyceride-glucose index (TyG) has been identified as a dependable and simple indicator marker of insulin resistance (IR). Research has demonstrated a correlation between macrovascular complications and TyG. However, limited research exists regarding the relationship between TyG and diabetic microvascular complications. Consequently, the objective of this study is to investigate the association between TyG and diabetic
kidney disease (DKD) and diabetic peripheral neuropathy (DPN).
METHODS: This is a cross-sectional, observational study. A total of 2048 patients from Tongren Hospital, Shanghai Jiao Tong University School of Medicine were enrolled. The primary outcomes are DKD and DPN. Quantile regression analysis was employed to investigate the implicit factors of TyG quartiles. Subsequently, based on implicit factors, logistic regression models were constructed to further examine the relationship between TyG and DKD and DPN.
RESULTS: In the baseline, TyG exhibited higher values across patients with DKD, DPN, and co-existence of DKD and DPN (DKD + DPN) in type 2 diabetes (T2D). Univariate logistic regressions demonstrated a significant association between an elevated TyG and an increased risk of DKD (OR = 1.842, [95% CI] 1.317-2.578, P for trend < 0.01), DPN (OR = 1.516, [95% CI] 1.114-2.288, P for trend < 0.05), DKD + DPN (OR = 2.088, [95% CI] 1.429-3.052, P for trend < 0.05). Multivariable logistic regression models suggested a statistically significant increase in the risk of DKD (OR = 1.581, [95% CI] 1.031-2.424, p < 0.05), DKD + DPN (OR = 1.779, [95% CI] 1.091-2.903, p < 0.05) after adjusting the implicit factors of TyG quartiles. However, no significant relationship was observed between TyG and DPN in the multivariable regression analysis.
CONCLUSIONS: Elevated TyG was significantly associated with an increased risk of DKD in T2D, but no significant relationship was shown with DPN. This finding provided further evidence for the clinical significance of integrating TyG into the initial assessment of diabetic microvascular complications.