Triglyceride-glycaemic index: Insights into predicting fetal macrosomia and its interaction with gestational diabetes mellitus: A cohort study of Chinese pregnant women

IF 4.4 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Clinical Investigation Pub Date : 2024-08-13 DOI:10.1111/eci.14300

Dan Zhao, Sanbao Chai, Ning Yuan, Jianbin Sun, Xin Zhao, Xiaomei Zhang

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引用次数: 0

Abstract

Objective

This study investigates the association between a new insulin resistance indicator, the triglyceride-glucose (TyG) index, and the risk of macrosomia.

Design

This is a prospective cohort study.

Methods

This study included 1332 women who delivered at Peking University International Hospital between October 2017 and August 2019. Participants were divided equally into three groups based on the TyG index. Logistic regression and restricted cubic spline (RCS) analyses were used to evaluate the relationship between the TyG index and macrosomia and conducted subgroup analyses. The TyG index's ability to predict macrosomia was assessed using the receiver operating characteristic (ROC) curve.

Results

Multivariable logistic regression analysis revealed that the TyG index is an independent risk factor for macrosomia (Odds ratio [OR] 1.84, 95% confidence interval [CI] 1.02–3.30, p < .05). RCS analysis indicates that the risk of macrosomia increases with the rise of the TyG index (p for nonlinearity <.001) when the TyG index is >6.53. Subgroup analysis showed a synergistic additive interaction between the TyG index and gestational diabetes mellitus (GDM) of macrosomia. The area under the ROC curve for the predictive model was 0.733 (95% CI 0.684, 0.781), with a sensitivity of 76.4% and specificity of 66.9%. Incorporating the TyG index alongside traditional risk factors notably enhances macrosomia prediction (p < .05).

Conclusions

The TyG index independently predicts macrosomia, and exhibits an additive interaction with GDM in its occurrence. Integrating the TyG index with traditional risk factors improves the prediction of macrosomia.

Trial Registry

Clinical trials. gov [NCT02966405].

Abstract Image

查看原文本刊更多论文

甘油三酯-血糖指数：预测胎儿巨大儿及其与妊娠糖尿病相互作用的见解：一项针对中国孕妇的队列研究。

研究目的本研究探讨了一种新的胰岛素抵抗指标--甘油三酯-葡萄糖（TyG）指数与巨型畸形风险之间的关联：设计：这是一项前瞻性队列研究：本研究纳入了2017年10月至2019年8月期间在北京大学国际医院分娩的1332名产妇。根据 TyG 指数将参与者平均分为三组。采用逻辑回归和限制性立方样条（RCS）分析评估TyG指数与巨畸症之间的关系，并进行亚组分析。使用接收者操作特征曲线（ROC）评估了TyG指数预测巨畸形的能力：多变量逻辑回归分析显示，TyG指数是巨型畸形的独立风险因素（Odds ratio [OR] 1.84，95%置信区间[CI] 1.02-3.30，P 6.53）。亚组分析表明，TyG 指数与妊娠糖尿病（GDM）之间存在协同相加作用。预测模型的 ROC 曲线下面积为 0.733（95% CI 0.684，0.781），灵敏度为 76.4%，特异度为 66.9%。将TyG指数与传统的风险因素结合在一起可显著提高巨型畸形的预测能力（P 结论：TyG指数可独立预测巨型畸形：TyG指数可独立预测巨型畸形，并在巨型畸形的发生中与GDM表现出相加的相互作用。将 TyG 指数与传统的风险因素相结合可提高对巨型畸形的预测能力：临床试验.gov [NCT02966405]。

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来源期刊

European Journal of Clinical Investigation 医学-医学：内科

CiteScore

9.50

自引率

3.60%

发文量

192

审稿时长

1 months

期刊介绍： EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.