临床与病理杂志2025，Vol.45Issue(2)：186-193,8.DOI:10.11817/j.issn.2095-6959.2025.240804
胰岛素抵抗代替指标预测非糖尿病中老年人群骨质疏松症的价值
Predictive value of insulin resistance surrogates for osteoporosis in non-diabetic middle-aged and elderly population
摘要
Abstract
Objective:Osteoporosis(OP)is a chronic metabolic disease that severely affects quality of life.Early diagnosis is crucial for improving patient outcomes.Insulin resistance(IR)leads to internal environment disturbances and affects bone metabolism.The metabolic score for insulin resistance(METS-IR)and triglyceride glucose-body mass index(TyG-BMI)are effective surrogate indicators for IR.This study aims to explore the correlation of METS-IR and TyG-BMI with bone mineral density(BMD)at different anatomical sites and assess their predictive value for OP in non-diabetic middle-aged and elderly individuals. Methods:Clinical data from 430 non-diabetic middle-aged and elderly patients treated at Chengdu Medical College Affiliated First Hospital from January 2019 to December 2023 were retrospectively analyzed.According to the T-score of BMD,subjects were divided into the OP group(n=205)and non-OP group(n=225).Spearman correlation was used to analyze associations between METS-IR,TyG-BMI,and BMD at various sites.Binary logistic regression was applied to assess the relationship between METS-IR,TyG-BMI,and OP.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of METS-IR and TyG-BMI for OP. Results:Spearman correlation analysis showed that both METS-IR and TyG-BMI were positively correlated with lumbar spine BMD(r=0.266,P<0.001;r=0.101,P=0.036),femoral neck BMD(r=0.252,P<0.001;r=0.158,P=0.001),and total hip BMD(r=0.342,P<0.001;r=0.179,P<0.001).Binary logistic regression analysis revealed that METS-IR[OR=0.949(95%CI 0.916 to 0.984),P=0.004]and TyG-BMI[OR=0.989(95%CI 0.979 to 0.999),P=0.026]were protective factors against OP,while age[OR=1.062(95%CI 1.037 to 1.088),P<0.001]and female sex[OR=3.281(95%CI 1.865 to 5.771),P<0.001]were risk factors.ROC curve analysis showed that the AUC for METS-IR in predicting OP was 0.639(95%CI 0.587 to 0.692),with an optimal cutoff of 36.62,sensitivity of 53.2%,and specificity of 72.9%.For TyG-BMI,the AUC was 0.569(95%CI 0.515 to 0.623),with an optimal cutoff of 151.20,sensitivity of 40.0%,and specificity of 71.6%. Conclusion:METS-IR and TyG-BMI are positively correlated with BMD at multiple sites in non-diabetic middle-aged and elderly individuals.As independent protective factors against OP,both indicators have certain predictive value for OP in this population.关键词
胰岛素抵抗代替指标/骨密度/骨质疏松症/甘油三酯葡萄糖-体重指数/胰岛素抵抗代谢评分Key words
insulin resistance surrogates/bone mineral density/osteoporosis/triglyceride glucose-body mass index/metabolic score for insulin resistance引用本文复制引用
朱茜,周艳,孙思露,陶思敏,席小燕,蒋涛,张海宇,李慧..胰岛素抵抗代替指标预测非糖尿病中老年人群骨质疏松症的价值[J].临床与病理杂志,2025,45(2):186-193,8.基金项目
四川养老与老年健康协同创新中心联合基金项目(YLKYYB2208) （YLKYYB2208）
四川基层社会风险防控治理研究中心项目(JCFXFK23-02A) （JCFXFK23-02A）
四川省社会科学重点研究基地老龄事业与产业发展研究中心项目(XJLL2022020).This work was supported by the Joint Fund Project of Sichuan Collaborative Innovation Center for Elderly Care and Geriatric Health(YLKYYB2208),the Project of Sichuan Research Center for Grassroots Social Risk Prevention and Control(JCFXFK23-02A),and the Project of the Research Center for the Development of Elderly Care Undertakings and Industry,a Key Research Base of Social Sciences in Sichuan Province(XJLL2022020),China. （XJLL2022020）
