Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T Augsburg, Augsburg, Germany.
The Institute of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University of Munich, Munich, Germany.
Sci Rep. 2019 Jul 4;9(1):9693. doi: 10.1038/s41598-019-46187-8.
The present study evaluated the ability of the visceral adiposity index (VAI), the lipid accumulation product (LAP), and product of triglycerides and glucose (TyG), three novel, insulin resistance-related markers, to discriminate prediabetes/diabetes in the general German population. Altogether 2,045 Germans (31-72 years, 53.3% women) without known diabetes and a history of Myocardial Infarction (MI)/stroke from the Cooperative Health Research in the Region of Augsburg (KORA) F4 Study were eligible. The discriminatory accuracy of the markers for oral glucose tolerance test (OGTT)-defined prediabetes/diabetes according to the American Diabetes Association (ADA) criteria was assessed by the area under the receiver operating characteristic (ROC) curve (AUC). The Youden Index (YI) was used to determine optimal cut-off values, and a non-parametric ROC regression was used to examine whether the discriminatory accuracy varied by sex and age. 365 men (38.2%) and 257 women (23.6%) were newly diagnosed with prediabetes/diabetes. AUCs for TyG, LAP and VAI were 0.762 (95% CI 0.740-0.784), 0.743 (95% CI 0.720-0.765), and 0.687 (95% CI 0.662-0.712), respectively. The optimal cut-off values for the LAP and TyG were 56.70 and 8.75 in men, and 30.40 and 8.53 in women. In conclusion, TyG and LAP provide good discrimination of persons with prediabetes/diabetes.
本研究评估了内脏脂肪指数(VAI)、脂联素蓄积产物(LAP)和甘油三酯与葡萄糖的乘积(TyG)这三种新的与胰岛素抵抗相关的标志物在德国普通人群中区分糖尿病前期/糖尿病的能力。共有 2045 名来自奥格斯堡合作健康研究(KORA)F4 研究的德国成年人(31-72 岁,53.3%为女性)无已知糖尿病和心肌梗死(MI)/中风病史,符合研究条件。采用受试者工作特征(ROC)曲线下面积(AUC)评估标志物对美国糖尿病协会(ADA)标准定义的口服葡萄糖耐量试验(OGTT)界定的糖尿病前期/糖尿病的鉴别准确性。采用约登指数(YI)确定最佳截断值,并采用非参数 ROC 回归检验性别和年龄对鉴别准确性的影响。365 名男性(38.2%)和 257 名女性(23.6%)被新诊断为糖尿病前期/糖尿病。TyG、LAP 和 VAI 的 AUC 分别为 0.762(95%CI 0.740-0.784)、0.743(95%CI 0.720-0.765)和 0.687(95%CI 0.662-0.712)。男性的最佳截断值 LAP 和 TyG 分别为 56.70 和 8.75,女性的最佳截断值 LAP 和 TyG 分别为 30.40 和 8.53。综上所述,TyG 和 LAP 对糖尿病前期/糖尿病患者具有良好的鉴别能力。