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2型糖尿病患者甘油三酯与高密度脂蛋白胆固醇比值与内脏型肥胖的相关性研究

Correlation between triglycerides to high-density lipoprotein cholesterol ratio and visceral obesity in patients with type 2 diabetes mellitus

    摘要
  • 摘要:
    目的 探讨甘油三酯与高密度脂蛋白胆固醇比值(TG/HDL-C)与内脏脂肪面积(VFA)的相关性, 评估TG/HDL-C预测2型糖尿病(T2DM)合并内脏型肥胖(VO)的应用价值。
    方法 纳入2018年6月—2021年9月在江苏大学附属医院内分泌科门诊就诊的T2DM患者共1 676例为研究对象。回顾性收集患者的基本临床资料、实验室检验指标、人体测量参数等。根据受试者VFA测定值的不同，将其分为VAF-L组(VFA < 100 cm2, n=1 051)和VO组(VFA≥100 cm2, n=625)。根据TG/HDL-C的四分位数将受试者分为A组(TG/HDL-C < 1.075)、B组(TG/HDL-C≥1.075~ < 1.739)、C组(TG/HDL-C≥1.739~ < 2.839)和D组(TG/HDL-C≥2.839), 每组419例。比较各组一般临床资料、生化指标、人体测量参数以及VO发生率。分析VFA与多个临床变量的相关性; 采用最小绝对收缩和选择操作(LASSO)回归以及多元线性回归模型筛选影响VFA的潜在独立预测因子。比较VAF-L组与VO组TG/HDL-C及相关临床参数的差异; 采用受试者工作特征(ROC)曲线评估TG/HDL-C预测T2DM合并VO的效能。
    结果 A组、B组、C组、D组合并VO患者比率依次为20.3%、36.3%、42.7%、49.9%, 差异有统计学意义(P < 0.05); T2DM患者合并VO发生率随着TG/HDL-C的升高而递增, TG/HDL-C与T2DM患者合并VO风险呈显著正相关(P < 0.05)。多元线性回归模型结果显示, TG/HDL-C与VFA有独立相关性, 且TG/HDL-C每增加1个单位, VFA增加0.737 cm2。ROC曲线分析显示，在总人群中, TG/HDL-C预测T2DM合并VO的曲线下面积为0.641(95%CI: 0.615~0.668, P < 0.01)。
    结论 在T2DM人群中，较高的TG/HDL-C水平预示更高的VO风险。该比值对T2DM合并VO具有一定预测价值，可作为简易的辅助风险评估指标。

     

    Abstract:
    Objective To investigate the correlation between triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) and visceral fat area (VFA), and to evaluate the application value of TG/HDL-C in predicting type 2 diabetes mellitus (T2DM) complicated with visceral obesity (VO).
    Methods A total of 1 676 T2DM patients in the Outpatient Department of Endocrinology of the Affiliated Hospital of Jiangsu University from June 2018 to September 2021 were included. Basic clinical data, laboratory indicators, and anthropometric parameters were retrospectively collected. According to the measured VFA values, they were divided into VAF-L group (VFA < 100 cm2, n=1 051) and VO group (VFA≥100 cm2, n=625). Based on the quartiles of TG/HDL-C, the subjects were divided into group A (TG/HDL-C < 1.075), group B (TG/HDL-C≥ 1.075- < 1.739), group C (TG/HDL-C≥1.739- < 2.839), and group D (TG/HDL-C≥2.839), with 419 cases in each group. General clinical data, biochemical indicators, anthropometric parameters, and the incidence of VO were compared among the groups. The correlation between VFA and multiple clinical variables was analyzed; the least absolute shrinkage and selection operator (LASSO) regression and a multivariate linear regression model were used to screen potential independent predictors affecting VFA. The differences in TG/HDL-C and related clinical parameters between theVAF-L group and the VO group were compared; the receiver operating characteristic (ROC) curve was used to evaluate the efficacy of TG/HDL-C in predicting T2DM complicated with VO.
    Results The proportions of patients with VO in group A, group B, group C, and group D were 20.3%, 36.3%, 42.7%, and 49.9%, respectively, with significant between-group differences (P < 0.05). The incidence of VO in T2DM patients increased with the elevation of TG/HDL-C, and TG/HDL-C was significantly positively correlated with the risk of VO in T2DM patients (P < 0.05). The results of the multivariate linear regression model showed that TG/HDL-C was independently correlated with VFA, and for each unit increase in TG/HDL-C, VFA increased by 0.737 cm2. ROC curve analysis showed that in the overall population, the area under the curve of TG/HDL-C for predicting T2DM complicated with VO was 0.641 (95% CI, 0.615 to 0.668, P < 0.01).
    Conclusion In the T2DM population, a higher TG/HDL-C level indicates a higher risk of VO. This ratio has certain clinical value in predicting T2DM complicated with VO, and can be used as a simple auxiliary risk assessment indicator.

     

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