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超重或肥胖人群合并非酒精性脂肪性肝病与TyG的相关性研究
引用本文:杨丹,周小燕,江毅敏,雷蓉,柳弥. 超重或肥胖人群合并非酒精性脂肪性肝病与TyG的相关性研究[J]. 国际医药卫生导报, 2022, 28(1): 90-95. DOI: 10.3760/cma.j.issn.1007-1245.2022.01.022
作者姓名:杨丹  周小燕  江毅敏  雷蓉  柳弥
作者单位:1川北医学院附属医院健康管理中心,南充 637000; 2川北医学院附属医院健康管理研究室,南充 637000
摘    要:目的 探讨伴或不伴非酒精性脂肪性肝病(NAFLD)的超重或肥胖人群与三酰甘油-葡萄糖指数(TyG)的关系。方法 本文研究设计类型属于横断面研究。选取2020年1月至10月于川北医学院附属医院健康管理中心体检的年龄18岁以上的男性和女性共5 685例,根据体质量指数(BMI)分为正常体质量组(NG组,2 397例)和超重或肥胖组(OG组,3 288例)。同时依据是否合并NAFLD把OG组分为无NAFLD组(Non-NAFLD组,1 670例)以及合并NAFLD组(NAFLD组,1 618例),计算TyG,比较各组间TyG、一般资料及临床生化指标的差异。符合正态分布的计量资料以均数±标准差(x±s)表示,不符合正态分布的计量资料数据使用MP25,P75)表示,组间比较采用独立样本t检验或非参数秩和检验,相关性采用Pearson或Spearman相关分析和多元线性逐步回归分析,二元logistic回归分析超重或肥胖人群合并NAFLD的影响因素。结果 与NG组和Non-NAFLD组比较,OG组及NAFLD组的年龄、腰臀比(WHR)、血压、空腹血糖(FPG)、糖化血红蛋白(HbA1C)、肝肾功能、血脂和TyG水平比较差异均有统计学意义(均P<0.05)。相关性分析发现,TyG与年龄、收缩压(SBP)、舒张压(DBP)、FPG、HbA1C、门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)、总蛋白、白蛋白、肌酐(Cr)、尿酸(UA)、三酰甘油(TG)、总胆固醇(TC)和极低密度脂蛋白胆固醇(VLDL-C)呈正相关(r=0.044、0.190、0.245、0.512、0.449、0.144、0.232、0.183、0.392、0.081、0.187、0.075、0.256、0.836、0.355、0.718,均P<0.05),而与球蛋白(r=-0.040,P=0.021)和高密度脂蛋白胆固醇(HDL-C)(r=-0.408,P<0.001)呈负相关。多元线性逐步回归分析发现,年龄、DBP、FPG、GGT、白蛋白、UA、TG、TC、HDL-C和VLDL-C均是TyG的独立影响因素;二元logistic回归分析显示,TyG、HbA1C、ALT、白蛋白、UA和LDL-C均是超重或肥胖人群合并NAFLD的危险因素(均OR>1,均P<0.05),而FPG、Cr和TC均是其保护因素(均OR<1,均P<0.05)。结论 TyG与超重或肥胖合并NAFLD关系密切。

关 键 词:超重或肥胖  非酒精性脂肪性肝病  胰岛素抵抗  三酰甘油-葡萄糖指数  
收稿时间:2021-08-05

Correlation between non-alcoholic fatty liver disease and TyG in overweight or obese people
Yang Dan,Zhou Xiaoyan,Jiang Yimin,Lei Rong,Liu Mi. Correlation between non-alcoholic fatty liver disease and TyG in overweight or obese people[J]. International Medicine & Health Guidance News, 2022, 28(1): 90-95. DOI: 10.3760/cma.j.issn.1007-1245.2022.01.022
Authors:Yang Dan  Zhou Xiaoyan  Jiang Yimin  Lei Rong  Liu Mi
Affiliation:1Health Management Center, Affiliated Hospital of North Sichuan MedicalCollege, Nanchong 637000, China;  2Laboratory of Health Management,Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
Abstract:Objective:To investigate the correlation between the triglyceride glucose index (TyG) and overweight or obese people with or without non-alcoholic fatty liver disease (NAFLD).Methods:A total of 5 685 over 18 years old males and females who underwent physical examination in Affiliated Hospital of North Sichuan Medical College from January to October 2020 were selected and divided into a normal body mass group (an NG group; 2 397 cases) and an overweight or obese group (an OG group; 3 288 cases) according to body mass index (BMI). At the same time, the OG group was divided into a non-NAFLD group (1 670) and an NAFLD group (1 618) according to whether they had NAFLD or not. TyG was calculated and the differences in TyG, general data and clinical biochemical indexes were compared between the groups. The measurement data of normal distribution were expressed as ( xˉ±s) and compared between the groups by independent-sample t test. The measurement data not of normal distribution were expressed as M ( P25, P75) and compared between the groups by Mann-Whitney U test. The correlations were analyzed by Pearson correlation analysis, Spearman correlation analysis, or stepwise linear regression analysis. The influencing factors of overweight or obese people with NAFLD were analyzed by binary logistic regression analysis. Results:Compared with those in the NG group and the non-NAFLD group, the ages, waist-hip ratios (WHR), blood pressures, fasting blood glucose (FPG), glycated hemoglobin (HbA 1C), liver and kidney function, blood lipid and TyG levels in the OG group and the NAFLD group were statistically different (all P<0.05). Correlation analysis showed that TyG was positively correlated with age, systolic blood pressure (SBP), diastolic blood pressure (DBP), FPG, HbA 1C, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), glutamyl transpeptidase (GGT), total protein, albumin, creatinine (Cr), uric acid (UA), triglyceride (TG), total cholesterol (TC), and very low density lipoprotein cholesterol (VLDL-C) ( r=0.044, 0.19, 0.245, 0.512, 0.449, 0.144, 0.232, 0.183, 0.392, 0.081, 0.187, 0.075, 0.256, 0.836, 0.355, and 0.718; all P<0.05), and negatively with globulin ( r=-0.04, P=0.021) and high density lipoprotein cholesterol (HDL-C) ( r=-0.408, P<0.001). Multiple linear stepwise regression analysis showed that age, DBP, FPG, GGT, albumin, UA, TG, TC, VLDL-C, and HDL-C were the independent influencing factors of TyG. Binary logistic regression analysis showed that TyG, HbA 1C, ALT, albumin, UA and LDL-C were the risk factors for NAFLD in the overweight or obese patients (all OR>1, all P<0.05), while FPG, Cr, and TC were the protective factors (all OR<1, all P<0.05). Conclusion:TyG is closely related to overweight or obesity combined with NAFLD.
Keywords:Overweight or obese  Non-alcoholic fatty liver disease  Insulin resistance  Triglyceride glucose index
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