| 张婷,李树法,孟凡东,等.血清三酰甘油 /高密度脂蛋白胆固醇比值在 2型糖尿病合并代谢综合征中预测价值[J].安徽医药,2021,25(8):1509-1513. |
| 血清三酰甘油 /高密度脂蛋白胆固醇比值在 2型糖尿病合并代谢综合征中预测价值 |
| The predictive value of serum TG/ HDL-C ratio in type 2 diabetes mellitus with metabolic syndrome |
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| DOI：10.3969/j.issn.1009-6469.2021.08.007 |
| 中文关键词: 代谢综合征 糖尿病， 2型 TG/HDL-C比值 |
| 英文关键词: Metabolic syndrome Diabetes mellitus, type 2 TG/HDL-C ratio |
| 基金项目:国家自然科学基金资助项目( 81570694) |
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| 中文摘要: |
| 目的探讨血清三酰甘油( TG)/高密度脂蛋白胆固醇( HDL-C)比值预测 2型糖尿病合并代谢综合征的价值。方法收集 2018年 9月至 2019年 7月徐州医科大学附属医院收治的 2型糖尿病病人 495例，根据是否合并代谢综合征( MS)，分为 MS组和非 MS组。比较两组性别、年龄、血脂、血压、体质量指数( BMI)、腰围( WC)等指标的水平，并计算 TG/HDL-C、胰岛素抵抗指数( HOMA-IR)。使用受试者工作曲线(ROC)得出 TG/HDL-C值预测 MS的最佳切点。结果两组性别、年龄、病程、吸烟史、饮酒史、总胆固醇( TC)、低密度脂蛋白胆固醇( LDL-C)、空腹血糖( FBG)、糖化血红蛋白( HbA1C)差异无统计学意义( P>0.05)非 MS组与 MS组高血压史( 14.0%比 51.4%)、 WC［(86.90±9.37)cm比( 96.82±9.27)cm］、 BMI［(23.46±3.12)kg/m2比( 27.43±3.19)，kg/m2］、收缩压( SBP)［( 123.12±13.20)mmHg比( 128.59±11.98)mmHg］、舒张压( DBP)［( 78.20±7.49)mmHg比( 82.77±8.12) mmHg］、尿酸( UA)［( 263.28±72.91)μmol/L比( 317.24±75.24)μmol/L］、 TG［( 1.49±1.36)mmol/L比( 2.82±2.35)mmol/L］、 HDL-C［( 1.29±0.32)mmol/L比( 1.07±0.26)mmol/L］、空腹胰岛素( FINS)［( 82.55±104.91)pmol/L比( 97.13±94.00)pmol/L］、 HOMA-IR［(4.35±5.16)比(5.55±6.32)］TG/HDL -C比值［(1.34±1.80)比(2.98±3.05)］比较，差异有统计学意义( P<0.05)。采用四分位法，根据 TG/HDL-C比值高低分组，、男性 2型糖尿病病人 BMI、WC、DBP、UA、TC、TG、MS患病率随 TG/HDL -C比值增加而增加，而年龄、 HDL -C随 TG/HDL -C比值增高而降低；而在女性病人中 BMI、WC、DBP、UA、TG、FINS、HOMA-IR、MS患病率呈上升趋势，而 HDL-C呈下降趋势( P<0.05)。 ROC曲线分析发现， 2型糖尿病病人中，当男性 TG/HDL -C比值达到 1.49时，对 MS的诊断效率最高( AUC为 0.817，95%CI:0.767~0.867，P<0.001)灵敏度为 74.8％、特异性为 78.8％；女性 TG/HDL -C比值取 1.36时，对 MS的诊断效率最高( AUC为 0.787，95%CI:0.724~0.851，P，<0.001)，灵敏度为 72.9％、特异度为 77.9％；结论 2型糖尿病合并代谢综合征 TG/HDL-C比值明显高于不合并 MS病人，并且随着 TG/HDL -C比值升高， 2型糖尿病合并代谢综合征患病率随之增加。因此 TG/HDL -C比值能够较好预测 2型糖尿病病人中代谢综合征发生。 |
| 英文摘要: |
| Objective To explore the value of serum triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio in predicting type 2 diabetes mellitus with metabolic syndrome.Methods Totally 495 patients with type 2 diabetes admitted to the Departmentof Endocrinology of The Affiliated Hospital of Xuzhou Medical University from September 2018 to July 2019 were collected as subjects.According to whether combined with metabolic syndrome (MS), the patients were assigned into MS group and non-MS group. The levelsof indicators such as gender, age, blood lipid, blood pressure, body mass index (BMI) and waist circumference (WC) in the two groupswere compared, and TG/ HDL-C and insulin resistance index (HOMA-IR) were calculated. Receiver operating characteristic curve (ROC) was used to obtain the optimal tangent point of TG/HDL-C prediction for MS.Results There were no statistically significant differences between the two groups in the subjects' gender, age, disease course, smoking history, drinking history, total cholesterol(TC),low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), and glycosylated hemoglobin (HbA1C) (P>0.05), and statistically significant differences were found between the non-MS group and the MS group in the history of hypertension(14.0% vs. 51.4%),WC [(86.90±9.37) cm vs. (96.82±9.27) cm], BMI [(23.46±3.12)kg/m2 vs. (27.43±3.19) kg/m2], systolic blood pressure (SBP) [(123.12± 13.20) mmHg vs.(128.59±11.98) mmHg], diastolic blood pressure (DBP) [(78.20±7.49) mmHg vs.(82.77±8.12) mmHg], uric acid (UA) [(263.28±72.91) μmol/L vs. (317.24±75.24) μmol/L], TG [(1.49±1.36) mmol/L vs.(2.82±2.35) mmol/L], HDL-C[(1.29±0.32) mmol/L vs. (1.07±0.26) mmol/L], fasting insulin (FINS) [(82.55±104.91) pmol/L vs. (97.13±94.00) pmol/L], HOMA– IR [(4.35±5.16) vs. (5.55± 6.32)], TG/HDL-C ratio [(1.34±1.80) vs. (2.98±3.05)] (P < 0.05). Patients were assigned into groups with quartile according to TG/HDLC ratio. The prevalence of BMI, WC, DBP, UA, TC, TG and MS in male patients with type 2 diabetes increased with the increase of TG/HDL-C ratio, while age and HDL-C decreased with the increase of TG/ HDL-C ratio. The prevalence of BMI, WC, DBP, UA, TG, FINS, HOMA-IR, and MS in female patients with type 2 diabetes increased while HDL-C decreased. ROC curve analysis showed that, when the TG/HDL-C ratio of male patients with type 2 diabetes reached 1.49, the diagnosis efficiency of MS reached the highest (AUC = 0.817, 95%CI:0.767-0.867, P<0.001) with a sensitivity of 74.8% and specificity of 78.8%. When the TG/HDL-C ratio of female patients with type 2 diabetes was 1.36, the diagnosis efficiency of MS reached the highest (AUC:0.787, 95%CI:0.724~0.851,P< 0.001), with a sensitivity of 72.9% and specificity of 77.9%.Conclusions The TG/HDL-C ratio of patients with type 2 diabetes combined withmetabolic syndrome was significantly higher than that of patients without MS, and the prevalence of type 2 diabetes combined with metabolic syndrome increased with the increase of TG/HDL-C ratio. Therefore, TG/ HDL-C ratio can predict the occurrence of metabolic syndrome in patients with type 2 diabetes. |
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