Evaluation value of triacylglycerol-glucose index on fasting blood glucose metabolism status in overweight/obese adults

Lin Yuejun; Xu Lilin; Fang Fen; Chen Zhaoxia

doi:10.3969/j.issn.1674-7151.2023.04.002

Abstract：Objective To explore the incidence of impaired fasting glucose(IFG)and type 2 diabetes mellitus(T2DM)in overweight/obese adults,and to evaluate the diagnostic efficacy of different insulin resistance indicators on fasting glucose metabolism disorders,so as to provide a better evaluation index for glucose metabolism in overweight/obese adults.Methods A retrospective cohort study was used,and 1 939 healthy examiners in Xiamen Huli Guoyu Clinic from January to December 2015 were selected as research subjects.According to body mass index(BMI),the subjects were divided into normal weight group,overweight group and obesity group.The levels of height,body weight,blood pressure,triacylglycerol(TG),total cholesterol(TC)and fasting blood glucose(FBG)were detected every year.By 2019,the oral glucose tolerance test(OGTT)was used to evaluate the risk of IFG and T2MD in each group.The receiver operator characteristic(ROC)curve was drawn and area under ROC curve(AUC)was calculated to examine the predictive value of different insulin resistance indicators on fasting glucose metabolism disorders.Results Among the 1 939 subjects,1 390 cases(accounting for 71.69%)were males and 549 cases(accounting for 28.31%)were females.There were 1 063 cases(accounting for 54.82%)in normal weight group,694 cases(accounting for 35.79%)in overweight group and 182 cases(accounting for 9.39%)in obesity group.At 5 years,compared with normal weight group,the risk of diabetes was significantly higher in overweight and obesity groups,with hazard ratios(HR)of 3.06 and 9.35,respectively,and 95%confidence intervals(95%CI)of 1.44-6.51 and 4.31-20.27,respectively.The incidence of diabetes in normal weight group,overweight group and obesity group was 1.88,5.76 and 17.58 per 1 000 person-years respectively.Compared with the normal weight group,the risk of new IFG was significantly higher in overweight and obesity groups,HR was 2.00 and 3.46,and 95%CI was 1.29-3.10 and 2.02-5.91,respectively.The incidence rates of IFG in normal weight group,overweight group and obesity group were 6.40,12.39 and 20.88 per 1 000 person-years,respectively.ROC curve analysis showed that the AUC of glucose metabolism disorder in overweight/obese population evaluated by triglyceride-glucose(TyG)index was 0.741,95%CI was 0.695-0.786,the AUC of triacylglycerol/high-density lipoprotein cholesterol ratio(TG/HDL-C)was 0.628,95%CI was 0.577-0.679,and the AUC of BMI was 0.585,95%CI was 0.531-0.638.The truncation value of TyG index was 1.24,the sensitivity was 61.87%,and the specificity was 76.67%.The ability of evaluating glucose metabolism in overweight/obese population was superior to TG/HDL-C and BMI.Conclusions The risk of IFG and diabetes in overweight/obese people is significantly higher than that in normal weight people.The combination of BMI and TyG index could better assess the glucose metabolism status of overweight/obese people and guide health management.