TG/HDL-C、 TyG、 non-HDL-C预测中老年女性代谢综合征价值

doi:10.3969/j.issn.1004-583X.2021.09.005

摘要/Abstract

摘要：

目的评价甘油三酯/高密度脂蛋白胆固醇(TG/HDL-C)、甘油三酯葡萄糖简易指数(TyG指数)、非高密度脂蛋白胆固醇(non-HDL-C)对中老年女性代谢综合征(MS)发病风险的预测价值。方法 2011年-2014年开展队列研究,纳入40周岁及以上大连社区女性居民2 098例。通过二元Logistic回归模型分析TG/HDL-C、TyG指数、non-HDL-C与新诊断MS的关系,通过受试者工作特征(ROC)曲线分析3个指标对MS发病的预测价值。结果随访新诊断MS 363例(17.30%)。二元Logistic回归分析显示TG/HDL-C、TyG指数、non-HDL-C升高均是MS发生的独立危险因素(OR=2.297,95%CI 1.822~2.897,OR=3.370,95%CI 2.515~4.516,OR=1.555, 95%CI 1.367~1.770,均P<0.01)。ROC曲线分析显示3个指标预测MS发病的AUC分别为0.721、0.708、0.614(均P<0.05),合适切点为0.70、8.49、4.06。TG/HDL-C、TyG指数的AUC大于non-HDL-C(Z=6.113,Z=5.819,均P<0.01)。结论中老年女性TG/HDL-C、TyG指数、non-HDL-C升高是3年后MS发病的独立危险因素,TG/HDL-C、TyG指数对MS发病有较好的预测价值。

关键词: 代谢综合征, 甘油三酯类, 胆固醇, HDL, 因素分析, 统计学

Abstract:

Objective To investigate the predictive values of TG/HDL-C,TyG index and non-HDL-C for incidence risk of metabolic syndrome(MS) in middle-aged and elderly women. Methods A cohort study was performed from 2011 to 2014 in communities in Dalian by recruiting 2,098 female residents aged ≥40 years. Binary logistic regression model was used to analyze the relationship between TG/HDL-C, TyG index, non-HDL-C and MS of new diagnosis. ROC curve was built in three indicators for their predictive values in MS. Results Totally 363 MS cases(17.30%) were diagnosed from follow-up participants(n=2,098). Binary logistic regression analysis showed that elevated TG/HDL-C, TyG index and non-HDL-C were independent risk factors in MS (OR=2.297, 95%CI 1.822-2.897, OR=3.370, 95%CI 2.515-4.516, OR=1.555, 95%CI 1.367-1.770, P<0.01). AUC of three indicators was 0.721, 0.708 and 0.614 respectively in predicting MS(P<0.05), and optimal cut-off value was 0.70, 8.49 and 4.06. AUC was larger in both TG/HDL-C and TyG index than in non-HDL-C (Z=6.113, Z=5.819, all P<0.01). Conclusion Higher TG/HDL-C, TyG index and non-HDL-C for three years were independent risks of MS in middle-aged and elderly women. TG/HDL-C and TyG index showed good predictions for MS.

Key words: metabolic syndrome, triglycerides, cholestero, HDL, factor analysis, statistical

中图分类号:

R589

赵薇, 罗兰, 李珅, 董莹莹, 李欣宇, 高政南. TG/HDL-C、 TyG、 non-HDL-C预测中老年女性代谢综合征价值[J]. 临床荟萃, 2021, 36(9): 790-794.

Zhao Wei, Luo Lan, Li Shen, Dong Yingying, Li Xinyu, Gao Zhengnan. TG/HDL-C, TyG and non-HDL-C in predition of metabolic syndrome incidence in middle-aged and elderly women[J]. Clinical Focus, 2021, 36(9): 790-794.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.09.005

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I9/790

图/表 7

参考文献 21

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项目	基线	随访	统计值	P值
年龄(岁)	55.08±7.18	58.67±7.22	t=16.174	<0.01
吸烟[例(%)]	38(1.81)	23(1.10)	χ²=3.743	0.053
饮酒[例(%)]	310(14.78)	201(9.58)	χ²=26.475	<0.01
BMI(kg/m²)	24.48±3.37	24.25±3.47	t=2.133	0.033
腰围(cm)	85.12±9.26	84.33±8.92	t=2.820	0.005
收缩压(mmHg)	132.69±19.31	123.43±17.78	t=16.167	<0.01
舒张压(mmHg)	76.75±11.10	73.21±9.78	t=10.957	<0.01
FPG(mmol/L)	5.39(5.12,5.70)	5.21(4.98,5.54)	Z=11.390	<0.01
2 hPG(mmol/L)	6.38(5.60,7.23)	6.41(5.50,7.46)	Z=0.606	0.544
TC(mmol/L)	5.44(4.83,6.12)	5.50(4.87,6.12)	Z=1.241	0.215
TG(mmol/L)	1.04(0.80,1.37)	1.26(0.94,1.69)	Z=14.738	<0.01
HDL-C(mmol/L)	1.51(1.32,1.72)	1.36(1.19,1.55)	Z=15.810	<0.01
LDL-C(mmol/L)	3.23(2.73,3.79)	3.24(2.74,3.76)	Z=0.304	0.761
TG/HDL-C	0.69(0.49,0.96)	0.92(0.64,1.34)	Z=17.521	<0.01
TyG指数	8.41(8.13,8.69)	8.56(8.26,8.88)	Z=11.381	<0.01
non-HDL-C	3.91(3.33,4.56)	4.08(3.51,4.72)	Z=6.414	<0.01

项目	基线	随访	统计值	P值
年龄(岁)	55.08±7.18	58.67±7.22	t=16.174	<0.01
吸烟[例(%)]	38(1.81)	23(1.10)	χ²=3.743	0.053
饮酒[例(%)]	310(14.78)	201(9.58)	χ²=26.475	<0.01
BMI(kg/m²)	24.48±3.37	24.25±3.47	t=2.133	0.033
腰围(cm)	85.12±9.26	84.33±8.92	t=2.820	0.005
收缩压(mmHg)	132.69±19.31	123.43±17.78	t=16.167	<0.01
舒张压(mmHg)	76.75±11.10	73.21±9.78	t=10.957	<0.01
FPG(mmol/L)	5.39(5.12,5.70)	5.21(4.98,5.54)	Z=11.390	<0.01
2 hPG(mmol/L)	6.38(5.60,7.23)	6.41(5.50,7.46)	Z=0.606	0.544
TC(mmol/L)	5.44(4.83,6.12)	5.50(4.87,6.12)	Z=1.241	0.215
TG(mmol/L)	1.04(0.80,1.37)	1.26(0.94,1.69)	Z=14.738	<0.01
HDL-C(mmol/L)	1.51(1.32,1.72)	1.36(1.19,1.55)	Z=15.810	<0.01
LDL-C(mmol/L)	3.23(2.73,3.79)	3.24(2.74,3.76)	Z=0.304	0.761
TG/HDL-C	0.69(0.49,0.96)	0.92(0.64,1.34)	Z=17.521	<0.01
TyG指数	8.41(8.13,8.69)	8.56(8.26,8.88)	Z=11.381	<0.01
non-HDL-C	3.91(3.33,4.56)	4.08(3.51,4.72)	Z=6.414	<0.01

因素	例数	MS	χ²值	P值
年龄
40岁~	486	64(13.17)^*
50岁~	1 199	207(17.26)^*	103.783	<0.01
60岁~	326	65(19.94)^*
70岁~	87	27(31.03)
月经
未绝经绝经	556 1 542	81(14.57) 282(18.29)	3.951	0.047
糖尿病家族史
有无	473 1 625	81(17.12) 282(17.35)	0.013	0.908
吸烟史
有无	38 2 060	5(13.16) 358(17.38)	0.465	0.496
饮酒史
有无	312 1 786	57(18.27) 306(17.13)	0.240	0.625

因素	例数	MS	χ²值	P值
年龄
40岁~	486	64(13.17)^*
50岁~	1 199	207(17.26)^*	103.783	<0.01
60岁~	326	65(19.94)^*
70岁~	87	27(31.03)
月经
未绝经绝经	556 1 542	81(14.57) 282(18.29)	3.951	0.047
糖尿病家族史
有无	473 1 625	81(17.12) 282(17.35)	0.013	0.908
吸烟史
有无	38 2 060	5(13.16) 358(17.38)	0.465	0.496
饮酒史
有无	312 1 786	57(18.27) 306(17.13)	0.240	0.625

组别	例数	MS
T1	525	23(4.38)
T2	525	58(11.05)^*
T3	524	102(19.47)^*#
T4	524	180(34.35)^*#△
χ²值		183.774
P值		<0.01