[1]杨美玲,黄本林,李才信.绝经后2型糖尿病患者血清RLP-C与TyG 指数的相关性研究[J].现代检验医学杂志,2024,39(06):195-200.[doi:10.3969/j.issn.1671-7414.2024.06.034]
　YANG Meiling,HUANG Benling,LI Caixin.Correlation Study on Serum RLP-C Level and TyG Index in Patients with Postmenopausal Type 2 Diabetes[J].Journal of Modern Laboratory Medicine,2024,39(06):195-200.[doi:10.3969/j.issn.1671-7414.2024.06.034]
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绝经后2型糖尿病患者血清RLP-C与TyG 指数的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年06期
页码:
195-200
栏目:
论著
出版日期:
2024-11-15

文章信息/Info

Title:
Correlation Study on Serum RLP-C Level and TyG Index in Patients with Postmenopausal Type 2 Diabetes
文章编号:
1671-7414（2024）06-195-06
作者:
杨美玲1; 黄本林2; 李才信3
（1. 瑞丽市人民医院检验科，云南德宏 678600；2. 曲靖市第二人民医院检验科，云南曲靖 655000；3. 昆明市第三人民医院/ 云南省传染性疾病临床医学中心长坡检验科，昆明 650301）
Author(s):
YANG Meiling1; HUANG Benling2;  LI Caixin3
（1. Department of Clinical Laboratory, Ruili People’s Hospital, Yun’nan Dehong 678600,China；2. Department of Clinical Laboratory, the Second People’s Hospital of Qujing,Yun’nan Qujing 655000, China；3. Department of Clinical Laboratory, Chang Po, the Third People’s Hospital of Kunming/ Yunnan Clinical Medical Center for Infectious Diseases, Kunming 650301,China）
关键词:
2 型糖尿病; 残余脂蛋白胆固醇; 三酰甘油葡萄糖
分类号:
R587.1； R446.112
DOI:
10.3969/j.issn.1671-7414.2024.06.034
文献标志码:
A
摘要:
目的 探讨绝经后2 型糖尿病（type 2 diabetes，T2DM）患者血清残余脂蛋白胆固醇（residual lipoproteincholesterol，RLP-C）与三酰甘油葡萄糖（triglyceride glucose，TyG）指数之间的相关性。方法 选取2019 年5 月~2023 年5 月就诊于瑞丽市人民医院的389 例绝经后T2DM 患者为研究对象，计算RLP-C 和TyG 指数，以TyG 指数中位数（9.23）为界限将研究对象分为低TyG 指数组（n=194）和高TyG 指数组（n=195）。比较两组患者一般临床资料、代谢相关指标间的差异；相关性分析采用Spearman 等级相关；影响因素分析采用单/ 多因素Logistic 回归；诊断价值分析采用ROC 曲线。结果 与低TyG 指数组相比，高TyG 指数组患者高血压史（79.49% vs 70.62%）、高脂血症史占比（22.05% vs 13.40%）、血红蛋白（Hb）（120.34±19.96g/L vs 114.97±21.32g/L）、空腹血糖（FBG）[3.97（3.03，5.10）mmol/L vs 3.64（2.99，4.74）mmol/L]、总胆固醇（TC）[5.00（4.40，5.95）mmol/L vs 4.36（3.78，5.30）mmol/L]、三酰甘油（TG）[2.11（1.60，3.00）mmol/L vs 1.20（0.91，1.54）mmol/L]、低密度脂蛋白- 胆固醇（LDL-C）[2.99（2.43，3.93）mmol/L vs 2.71（2.13，3.38）mmol/L]、非高密度脂蛋白- 胆固醇（nonHDL-C）[3.94（3.22，4.82）mmol/L vs 3.15（2.53，3.94）mmol/L]、RLP-C 浓度[0.76（0.52, 1.08）mmol/L vs 0.44（0.29, 0.59）mmol/L] 升高，高密度脂蛋白- 胆固醇（HDL-C）[1.08（0.91，1.25）mmol/L vs 1.17（1.00，1.43）mmol/L] 浓度降低，差异具有统计学意义（χ2=4.09，4.99；t=-2.56；Z=-2.34，-5.15，-12.08，-3.04，-6.23，-9.15，-3.99，均P<0.05）。Spearman 相关性分析显示，总体而言，TyG 与TC，TG，LDL-C，RLP-C，nonHDL-C 呈显著正相关（r=0.304，0.769，0.179，0.386，0.571，均P <0.001），与HDL-C 呈显著负相关（r=-0.306，P<0.001）；在高TyG 指数组中，TyG 与TC，LDL-C 之间相关性不具有统计学意义（均P >0.05）。单因素Logistic 回归分析结果显示，高血压史、高脂血症、HDL-C，LDL-C 和RLP-C 是TyG 水平的影响因素[OR（95%CI）]=1.61（1.01~2.51），1.83（5.71~30.37），0.28（0.14~0.54），1.21（1.02~1.43），17.58（8.11~38.11），均P <0.05）；多因素回归分析结果显示，仅RLP-C 是TyG 升高的独立危险因素[OR（95%CI）=13.17（5.71~30.37）P<0.001）]。ROC 曲线分析结果显示，RLP-C 诊断TyG 指数升高的曲线下面积(95% 置信区间)[AUC（95%CI）] 为0.768（95%CI：0.721~0.816），截断值为0.59mmol/L 时，敏感度和特异度分别为69.71% 和75.77%。结论 RLP-C 是绝经后T2DM 患者TyG 升高的独立危险因素，在预测胰岛素抵抗方面具有一定临床价值。
Abstract:
Objective To explore the correlation between serum residual lipoprotein cholesterol (RLP-C) and triglyceride glucose (TyG) index in postmenopausal type 2 diabetes (T2DM) patients. Methods A total of 389 postmenopausal T2DM patients who attended Ruili People’s Hospital from May 2019 to May 2023 were included. RLP-C and TyG index were calculated, and the study subjects were divided into the low TyG index group (n=194) and the high TyG index group (n=195) based on the median of TyG index(9.23). Differences in general clinical data and metabolism-related indexes between the two groups of patients were compared,and Spearman rank correlation was performed to explore their correlation. Single-factor and multivariate Logistic regressions were used to explore their influencing factors, and ROC curve was used to analyze their diagnostic value. Results Compared with the low TyG index group, the history of hypertension(79.49% vs 70.62%), hyperlipidemia(22.05% vs 13.40%), hemoglobin (Hb)(120.34±19.96g/L vs 114.97±21.32g/L), fasting blood glucose (FBG)[3.97(3.03, 5.10)mmol/L vs 3.64(2.99, 4.74)mmol/L], total cholesterol (TC) [5.00(4.40, 5.95)mmol/L vs 4.36(3.78, 5.30)mmol/L], triacylglycerol (TG)[2.11(1.60，3.00)mmol/L vs 1.20(0.91，1.54)mmol/L], low-density lipoprotein (LDL-C)[[2.99(2.43，3.93)mmol/L vs 2.71(2.13，3.38)mmol/L], non-high-density lipoprotein (nonHDL-C)[3.94(3.22，4.82)mmol/L vs 3.15(2.53，3.94)mmol/L] and RLP-C concentration [0.76 (0.52, 1.08) mmol/L vs 0.44 (0.29, 0.59) mmol/L] of the high TyG index group were higher, while high-density lipoprotein (HDL-C) concentration was lower, and the differences were statistically significant(χ2=4.09, 4.99; t=-2.56; Z=-2.34, -5.15, -12.08, -3.04, -6.23,-9.15,-3.99, all P<0.05). Spearman correlation analysis showed that TyG in all samples was positively correlated with TC, TG, LDL-C, RLP-C and nonHDL-C (r=0.304, 0.769, 0.179, 0.386, 0.571, all P<0.001), but was negatively correlated with HDL-C (r=-0.306, P<0.001). The correlations between TyG and TC, LDL-C in the high TyG index group were not significant (all P>0.05). Singleactor logistic regression analysis showed that history of hypertension, hyperlipidemia, HDL-C, LDL-C, and RLP-C were the factors influencing TyG levels [OR(95%CI)=1.61(1.01~2.57), 1.83(1.07~3.12), 0.28(0.14~0.54), 1.21(1.02~1.43), 17.58(8.11~38.11), all P < 0.05], while the multivariate regression analysis showed that only RLP-C was an independent risk factor for elevated TyG [OR(95%CI)=13.17(5.71~30.37), P<0.001). ROC curves showed that the AUC(95%CI) for the diagnosis of TyG index elevation by RLP-C was 0.768 (95% CI: 0.721~0.816), with the cutoff value of 0.59 mmol/L. The sensitivity and specificity were 69.71% and 75.77%, respectively. Conclusion RLP-C is an independent risk factor for elevated TyG in postmenopausal T2DM patients, which has some clinical value in predicting insulin resistance.

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备注/Memo

备注/Memo:
基金项目：曲靖医学高等专科学校校级课题（2023Z007）。
作者信息：杨美玲（1971-），女，本科，副主任检验技师，主要从事临床检验工作，E-mail：2501869564@qq.com。
通讯作者： 黄本林（1993-），男，彝族，硕士，主治医师，从事临床检验诊断学研究，E-mail：h1390222982@163.com。
李才信（1982-），男，本科，副主任技师，主要从事临床微生物研究工作，E-mail:954003892@qq.com。
更新日期/Last Update: 2024-11-15