TyG指数对胰岛素抵抗及胰岛β细胞功能的双重评估

·临床论著·TyG指数对胰岛素抵抗及胰岛β细胞

功能的双重评估

张琴杨刚毅

【摘要】 目的 在不同糖耐量人群中，比较由空腹血清甘油三酯和血浆葡萄糖所得简易指数

（TyG）与稳态模型所得胰岛素抵抗指数（HOMA-IR）及胰岛β细胞功能指数（HOMA-β、DI）的

相关性，并分析前者评估胰岛素抵抗及胰岛β细胞功能的灵敏度与特异度。方法总共883例受试

者，其中正常糖耐量者（NGT）269例，新诊断糖调节受损者（IGR）242例，新诊断2型糖尿病患

者（T2DM）372例。均接受75 g口服葡萄糖耐量试验（OGTT），并检测空腹血清胰岛素（FINS）、

血脂谱及其他生化指标。由空腹血清甘油三酯及血浆葡萄糖计算TyG，由空腹血浆葡萄糖及血清胰

岛素计算HOMA-IR、HOMA-β、DI。结果Pearson相关分析显示，TyG与HOMA-IR（r＝0.567，

P＜0.01）显著正相关，TyG与HOMA-β（r＝－0.485，P＜0.01）、DI（r＝－0.633，P＜0.01）、

SQRT（HOMA-β）（r＝－0.526，P＜0.01）、LN（DI）（r＝－0.741，P＜0.01）显著负相关。与

HOMA-IR相比，TyG诊断胰岛素抵抗的最佳切点为4.92，ROC曲线上此值对应最高灵敏度（71.5%）、

特异度（79.7%；AUC＋0.803）和最大约登指数（0.512）；与HOMA-β相比，TyG诊断胰岛β细胞

功能缺陷的最佳切点为4.90，ROC曲线上此值对应最高灵敏度（63.6%）、特异度（74.6%；AUC＋0.750）

和最大约登指数（0.383）；与DI相比，TyG诊断胰岛β细胞功能缺陷的最佳切点仍为4.92，ROC

曲线上此值对应最高灵敏度（70.5%）、特异度（86.0%；AUC＋0.856）和最大约登指数（0.565）。

结论TyG可以作为评估空腹状态胰岛素抵抗及胰岛β细胞功能的简易指标。

【关键词】 空腹甘油三酯血糖指数；不同糖耐量人群；胰岛素抵抗；胰岛β细胞功能

TyG index for identifying insulin resistance and islet β cell function Zhang Qin, Yang Gangyi.

Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing

400010, China

Corresponding author: Yang Gangyi, Email:gangyiyang@

【Abstract】Objective In different glucose tolerance subjects, to evaluate the correlation, sensitivity and

specificity of a simple index(TyG), which was obtained from the product of fasting serum triglyceride and

plasma glucose, TyG was compared with homeostasis model assessment for insulin resistance

index(HOMA-IR) and beta cell function indices(HOMA-β,DI). Methods In the present study, a total

number of 883 subjects(269 normal glucose tolerance individuals, 242 newly diagnosed impaired glucose

regulation subjects, 372 newly diagnosed type 2 diabetes mellitus) were included.All subjects completed a

standard oral glucose tolerance test.Fasting serum insulin, lipid profiles and other biochemical markers

were measured.TyG index was derived from fasting serum triglyceride and plasma glucose. HOMA-IR,

HOMA-β and DI were derived from fasting serum insulin and plasma glucose. Results Pearson's correlation

analyses showed a positive correlation between TyG and HOMA-IR(r＝0.567, P＜0.01) and negative

correlations between TyG and HOMA-β, DI, SQRT(HOMA-β) and LN(DI)(r＝－0.485, r＝－0.633,

r＝－0.526, r＝－0.741, respectively; P＜0.01). When compared with HOMA-IR, the ROC scatter plot

revealed that the best value of the TyG index for diagnosis of insulin resistance corresponded to 4.92,

which showed the highest sensitivity(71.5%) and specificity(79.7%; AUC＋0.803) and the biggest Youden

DOI:10.3877/cma.j.issn.1674-0785.2014.02.012

作者单位：400010 重庆医科大学附属第二医院内分泌科

通讯作者：杨刚毅，Email: gangyiyang@