Relationship between four insulin resistance surrogates and regression to normoglycemia from prediabetes among Chinese adults: A longitudinal Cohort Study.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2024-12-01 Epub Date: 2024-07-04 DOI:10.1007/s12020-024-03947-5

Lijun Yang, Yanjing Feng, Yu Wang, Chang Liu, Dengfeng Gao

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引用次数: 0

Abstract

Purpose: We aimed to investigate the association of the triglyceride glucose-body mass index(TyG-BMI), metabolic score for insulin resistance (METS-IR) with regression to normoglycaemia, and further to compare the value of the four insulin resistance(IR) related indices(TyG-BMI, METS-IR, TyG and triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio) in identifying regressions to normoglycaemia from prediabetes.

Methods: A total of 15,025 patients with prediabetes from the DATA-DRYAD database were included. Cox proportional hazards regression models and restricted cubic spline functions were performed to explore the association and nonlinearity between the indices with the incidence rate of normoglycaemia. Sensitivity and subgroup analyses evaluated the robustness of our findings.

Results: Compared with the first quintile, TyG-BMI and METS-IR was negatively linked with the probability of regression to normoglycaemia from prediabetes, the adjusted effect size of the highest quintiles of METS-IR were the most obvious (HR:0.456,95% CI:0.4-0.519), followed by TG/HDL (HR:0.792, 95% CI:0.733-0.856), TyG-BMI (HR:0.816, 95% CI:0.73-0.911) and TyG (HR:0.841, 95% CI: 0.754-0.937) (all p for trend <0.001). A 1.0 SD increase in METS-IR induced a 43% decrease in the probability of regression to normoglycaemia, with 9.8% for TyG-BMI. There were nonlinear associations between TyG-BMI and METS-IR and outcomes, with the inflection point of the TyG-BMI being 218.2 and that of the METS-IR being 37.

Conclusions: The METS-IR might be the most superior indicator among the four non-insulin indices in identifying regressions to normoglycaemia from prediabetes in clinical application. The inflection points of the METS-IR and TyG-BMI may be instructive therapeutic points for assessing the status of prediabetes in advance and making more appropriate management and health care decisions.

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中国成年人中四种胰岛素抵抗替代物与从糖尿病前期向正常血糖回归之间的关系：纵向队列研究。

目的：我们旨在研究甘油三酯血糖体重指数（TyG-BMI）、胰岛素抵抗代谢评分（METS-IR）与血糖恢复正常之间的关系，并进一步比较四种胰岛素抵抗（IR）相关指数（TyG-BMI、METS-IR、TyG 和甘油三酯与高密度脂蛋白胆固醇（TG/HDL-C）比值）在识别糖尿病前期血糖恢复正常方面的价值。研究方法共纳入 DATA-DRYAD 数据库中的 15,025 名糖尿病前期患者。采用 Cox 比例危险度回归模型和受限立方样条函数来探讨这些指数与正常血糖发病率之间的关联性和非线性。敏感性分析和亚组分析评估了我们研究结果的稳健性：与第一五分位数相比，TyG-BMI 和 METS-IR 与从糖尿病前期转为正常血糖的概率呈负相关，METS-IR 的最高五分位数的调整效应大小最为明显（HR:0.456，95% CI:0.4-0.519），其次是TG/HDL（HR:0.792，95% CI:0.733-0.856）、TyG-BMI（HR:0.816，95% CI:0.73-0.911）和TyG（HR:0.841，95% CI:0.754-0.937）（均为p趋势结论）：在临床应用中，METS-IR 可能是四种非胰岛素指数中最能识别从糖尿病前期向正常血糖回归的指标。METS-IR和TyG-BMI的拐点可能是具有指导意义的治疗点，可用于提前评估糖尿病前期的状况，并做出更恰当的管理和医疗决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.