| 雷庆华,李军华,霍燕飞,等.身体质量指数联合三酰甘油与高密度脂蛋白胆固醇比值预测 2型糖尿病风险[J].安徽医药,2024,28(1):90-94. |
| 身体质量指数联合三酰甘油与高密度脂蛋白胆固醇比值预测 2型糖尿病风险 |
| Combination of body mass index and the triacylglycerol to high-density lipoprotein cholesterol ratio predicts the risk of type 2 diabetes mellitus |
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| DOI：10.3969/j.issn.1009-6469.2024.01.019 |
| 中文关键词: 糖尿病， 2型 身体质量指数 三酰甘油 高密度脂蛋白胆固醇 非线性关系 疾病风险 |
| 英文关键词: Diabetes mellitus, type 2 Body mass index Triacylglycerol High-density lipoprotein cholesterol Nonlinear rela- tionship Disease risk |
| 基金项目:邯郸市科学技术研究与发展计划项目( 22422083010ZC) |
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| 中文摘要: |
| 目的利用体检指标中身体质量指数( BMI)和三酰甘油与高密度脂蛋白胆固醇比值( triglyceride to high-density lipopro- tein cholesterol，TG/HDL-C)联合预测 2型糖尿病( type 2 diabetes mellitus，T2DM)发病风险。方法基于瑞慈医疗集团 2010— 2016年体检人群的数据库，通过 Cox比例风险模型观测不同 BMI的人群基线 TG/HDL-C对随访期间 T2DM风险的影响，并分析 TG/HDL-C与 BMI是否存在交互作用。结果在随访期间， 13 685例研究对象中共有 315例最终诊断为 T2DM。以 BMI=24 kg/ m2为界，将所有研究对象分成两个亚组。 BMI<24 kg/m2的亚组共有 8 238例研究对象， 96例在随访结束时患 T2DM，对潜在的混杂因素进行调整后，升高的 TG/HDL-C导致 T2DM事件的风险较高［HR 95%CI=1.47(1.23，1.74)P<0.001］。与最低五分位数(Q1)相比，升高的 TG/HDL-C五分位数( Q2~Q5)T2DM发病率增加［ HR 95%CI分别为: 0.73(0.28，1，.93)、 2.75(1.29，5.85)、 2.81(1.28，6.20)和 3.91(1.51，10.11)］。BMI≥24 kg/m2的亚组共有 5 447例研究对象， 219例在随访结束时患 T2DM。在两个亚组中，随着 TG/HDL-C的增加， T2DM患病风险均呈非线性增加，这一变化在 BMI<24 kg/m2的亚组更为明显。绘制两个亚组 TG/HDLC与 3年和 5年 T2DM发病的 ROC曲线，在 BMI<24 kg/m2的亚组中， ROC曲线下面积分别为 0.72和 0.77。在 BMI≥24 kg/m2的亚组中， ROC曲线下面积则分别为 0.55和 0.57。结论在 BMI<24 kg/m2的人群中， TG/HDL-C的升高提示 T2DM患病风险显著增加。 |
| 英文摘要: |
| Objective To predict the risk of type 2 diabetes mellitus (T2DM) by combination of body mass index (BMI) and the tri-glyceride to high density lipoprotein cholesterol (TG/HDL-C) ratio in physical examination. Methods Based on the database of the 2010-2016 physical examination population of Rui Ci Medical Group, the effect of baseline TG/HDL-C on the risk of T2DM during the follow-up period was observed by Cox proportional risk modeling in people with different BMIs, and we analyzed whether there was aninteraction between TG/HDL-C and BMI.Results A total of 315 of 13 685 study subjects were ultimately diagnosed with T2DM dur- ing the follow-up period. All study subjects were divided into two subgroups using a BMI=24 kg/m2. The subgroup with a BMI < 24 kg/ m2 consisted of a total of 8,238 study subjects.96 had T2DM at the end of the follow-up period. Adjusting for potential confounders, the elevated TG/HDL-C resulted in a higher risk of incident T2DM [HR 95%CI = 1.47 (1.23, 1.74), P < 0.001]. Compared with the lowest quintile (Q1), elevated TG/HDL-C quintiles (Q2 to Q5) had an increased prevalence of T2DM [HR 95%CI were 0.73 (0.28,1.93), 2.75(1.29,5.85), 2.81 (1.28,6.20) and 3.91 (1.51,10.11)]. There were 5 447 study subjects in the subgroup with BMI ≥ 24 kg/m2, and 219 de- veloped T2DM at the end of follow-up. In both subgroups, the risk of developing T2DM increased nonlinearly with increasing TG/HDLC, and this change was more pronounced in the subgroup with BMI < 24 kg/m2. When ROC curves were plotted for TG/HDL-C versus 3-and 5-year T2DM incidence in the two subgroups, the areas under the ROC curves were 0.72 and 0.77 in the subgroups with BMI < 24 kg/m2, respectively, and 0.55 and 0.57 in the subgroups with BMI ≥ 24 kg/m2, respectively. Conclusion In the subgroup with BMI < 24 kg/m2, elevated TG/HDL-C suggests a significant increase in the risk of T2DM. |
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