解放军医学杂志2024，Vol.49Issue(2)：137-143,7.DOI:10.11855/j.issn.0577-7402.2265.2023.0915
新型简化胰岛素抵抗评价指标对T2DM患者左心室亚临床收缩功能受损的预测价值
Comparison of the predictive value of new simplified insulin resistance assessment indexes in identifying left ventricular subclinical dysfunction in T2DM patients
摘要
Abstract
Objective To investigate the predictive value of new simplified insulin resistance(IR)assessment indexes in identifying subclinical left ventricular systolic function impairment in patients with type 2 diabetes mellitus(T2DM).Methods A total of 150 T2DM patients with preserved left ventricular ejection fraction(LVEF≥50%)who were admitted to Department of Endocrinology of the First Affiliated Hospital of Air Force Medical University from June 2021 to December 2021 were retrospectively analyzed.All patients underwent two-dimensional speckle tracking echocardiography to measure left ventricular global longitudinal strain(GLS).According to GLS value,the subjects were divided into the normal group(GLS≥18%group,n=80)and the impaired group(GLS<18%group,n=70).Some new simplified IR assessment indicators were calculated and compared between the two groups,including body mass index(BMI),TG/HDL-C ratio,triglyceride-glucose(TyG)index,TyG-BMI index,TyG-WHR and metabolic score for IR(METS-IR).Correlation between the GLS and the new simplified IR assessment indexes was analyzed.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of different simplified IR assessment indexes,with the area under the curve(AUC)calculated.Furthermore,according to whether the subjects were complicated with hypertension,binary logistics regression analysis was performed to explore the independent correlation between the simplified IR assessment index and GLS<18%.Results Total 150 were included with aged(54.5±13.7)years with 96(64.0%)men and 54(36.0%)women.Compared with the GLS≥18%group,the TG/HDL-C ratio,TyG index,TyG-BMI,and METS-IR of subjects in the GLS<18%group were significantly increased(P<0.05).Pearson correlation analysis showed that TG/HDL-C ratio,TyG index,TyG-BMI,TyG-WHR,and METS-IR were negatively correlated with GLS(P<0.05).ROC analysis showed that TyG index had a certain predictive value for the evaluation of GLS<18%(AUC=0.678,95%CI 0.591-0.765,P<0.001).Stratification based on hypertension and further adjusting for confounding factors,TyG index remains significantly associated with GLS<18%(OR=3.249,95%CI 1.045-10.103,P=0.042).Conclusions The novel simplified insulin resistance evaluation indexes are closely associated with left ventricular subclinical systolic dysfunction in T2DM patients with preserved ejection fraction.TyG index is an effective index to identify left ventricular subclinical dysfunction in these populations.关键词
糖尿病,2型/胰岛素抵抗/三酰甘油-葡萄糖指数/左心室整体纵向应变Key words
diabetes mellitus,type 2/insulin resistance/triglyceride glucose index/left ventricular global longitudinal strain分类
医药卫生引用本文复制引用
陈艳艳,刘丽文,李泽平,李晓苗,李梦颖,周洁,付建芳,张颖,王奕,王铖,刘向阳,拓胜军..新型简化胰岛素抵抗评价指标对T2DM患者左心室亚临床收缩功能受损的预测价值[J].解放军医学杂志,2024,49(2):137-143,7.基金项目
This work was supported by the National Natural Science Foundation of China(82070839),and the Natural Science Basic Research Program of Shaanxi Province (2020JZ-31)国家自然科学基金面上项目(82070839) （82070839）
陕西省基础研究计划重点项目(2020JZ-31)Program of Shaanxi Province(2020JZ-31) （2020JZ-31）
