甘油三酯和高密度脂蛋白胆固醇比值与胰岛素抵抗的关系

目的分析甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）的浓度比值与胰岛素抵抗的关系,为筛查胰岛素抵抗的高危人群提供依据。方法利用2012年江苏省慢性病及危险因素监测流动人口专题调查资料,采用问卷调查、体格测量、实验室检测等方法收集人口统计学信息、慢性病防治情况、行为危险因素情况及血脂等信息。采用多元线性回归分析指标的影响大小,采用受试者工作特征曲线（ROC）及非条件logistic回归分析指标的筛查价值。结果 TG/HDL-C比值对空腹胰岛素水平具有显著影响（标准化偏回归系数：男性为0.243,女性为0.254,P〈0.01）,对于胰岛素抵抗的ROC曲线下面积：男性为0.73（95%CI：0.69-0.77）,女性为0.63（95%CI：0.58-0.67）。以TG/HDL-C比值男性≥1.12、女性≥0.71作为筛查胰岛素抵抗的适宜切点,比值高于切点人群的胰岛素抵抗患病率是比值低于切点人群的2.43倍,患病风险是低于切点人群的2.7倍（95%CI：2.1-3.5）。结论 TG/HDL-C比值与空腹胰岛素水平密切相关,对于在成年非糖尿病人群中筛查胰岛素抵抗具有一定价值。

The association of triglyceride and high-density lipoprotein cholesterol ratio with insulin resistance among Chinese adults

Objective To analyze the association of triglyceride（TG） and high-density lipoprotein cholesterol（HDL-C） ratio with insulin resistance（IR） and to provide the base for screening population with high risk of IR. Methods Questionnaire investigation, anthropometric measurement and laboratory examination were used to collect the data of demography, chronic disease prevention, risk factors of behaviors and blood lipid. Multiple linear regression method was utilized to analyze the influence of indexes, and receiver operating characteristic（ROC） curve and non-conditional logistic regression analysis were used to analyze the screening values of indexes. Results TG/HDL-C ratio was closely associated with fasting serum insulin（FSI）（standardized regression coefficients were 0.243 for males and 0.254 for females, P〈0.01）, the areas under curve（AUC） of ROC were 0.73（95%CI： 0.69-0.77） for males and 0.63（95%CI： 0.58-0.67） for females. The TG/HDL-C ratio≥1.12 for males and ≥0.71 for females served as cutoff point of screening IR, the morbidity and risk of IR in residents with TG/HDL-C ratio higher than the cutoff point were 2.43 and 2.7 folds（95%CI： 2.1-3.5） than those in residents with TG/HDL-C ratio lower than the cutoff point. Conclusion The TG/HDL-C ratio is closely associated with FSI and it is valuable to screen population with high risk of IR among healthy adults.