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Triglyceride and Glucose (TyG) Index is a Clinical Surrogate Marker for the Diagnosis of Metabolic Syndrome
Biomed Sci Letters 2017;23:348-354
Published online December 31, 2017;  https://doi.org/10.15616/BSL.2017.23.4.348
© 2017 The Korean Society For Biomedical Laboratory Sciences.

Kyung-A Shin

Department of Clinical Laboratory Science, Shinsung University, Chungnam 31801, Korea
Correspondence to: Kyung-A Shin. Department of Clinical Laboratory Science, Shinsung University, 1 Daehak-Ro, Dangjin-Si 31801, Korea. Tel: +82-41-350-1408, Fax: +82-41-350-1355, e-mail: mobitz2@shinsung.ac.kr
Received September 6, 2017; Revised October 19, 2017; Accepted October 20, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract

TyG (triglyceride and glucose) index using triglyceride and fasting blood glucose is recommended as a useful marker for insulin resistance. The present study evaluated the usefulness of TyG index in diagnosing metabolic syndrome and suggested an optimal cut-off value. The subjects of this study were adult 4,415 adults aged 20 to 80 years who underwent health screening at J General Hospital from January 2016 to January 2017. Metabolic syndrome was based on AHA/NHLBI (American Heart Association/National Heart, Lung, and Blood Institute) criteria. TyG index correlated with metabolic syndrome risk factors including HOMA-IR. Compared with the participants in the lowest quartile of TyG index, odds ratios and 95% confidence intervals for metabolic syndrome were 8.5 (3.005~23.903), 20.0 (17.190~23.407) for those in the third, and the fourth quartile of TyG index. The optimal cut-off value of the metabolic syndrome was 8.81 for TyG index (sensitivity 86.7%, specificity 80.1%) and area under the ROC curve (AUC) was 0.894. In conclusion, TyG index is effective to identify individuals at risk for metabolic syndrome.

Keywords : TyG index, Insulin resistance, Metabolic syndrome, HOMA-IR
꽌濡

씤뒓由 빆꽦 씤뒓由곗뿉 븳 꽭룷 誘쇨컧꽦 媛먯냼瑜 듅吏뺤쑝濡 븯뒗 궗利앺썑援곗쓽 二쇱슂 썝씤 以 븯굹씠떎(Moon et al., 2017). 씤뒓由 빆꽦쓣 룊媛븯뒗 吏곸젒쟻씤 諛⑸쾿쑝濡 몴以踰뺤씤 怨좎씤뒓由고삁利 젙긽 삁떦 겢옩봽(hyperinsulinemic euglycemic clamp) 씤뒓由 뼲젣 寃궗(insulin suppression test), 씤뒓由 궡꽦 寃궗(insulin tolerance test) 벑씠 엳쑝굹, 씠윭븳 寃궗뒗 移⑥뒿쟻씠怨 寃궗諛⑸쾿쓽 蹂듭옟꽦怨 鍮꾩슜쟻씤 臾몄젣濡 씤빐 엫긽뿉 쟻슜븯湲 뼱젮슫 젏씠 엳떎(DeFronzo et al., 1979; Bergman et al., 1981; Bergman et al., 1987). 뵲씪꽌 痢≪젙씠 媛꾨떒븳 媛꾩젒吏몴씤 HOMA-IR(homeostasis model assessment of insulin resistance)濡 씤뒓由 빆꽦쓣 異붿젙븯怨 엳쑝굹(Bonora et al., 2000), 理쒓렐뿉뒗 以묒꽦吏諛⑷낵 怨듬났삁떦쓣 씠슜븳 TyG (triglyceride and glucose) index媛 씤뒓由 빆꽦뿉 븳 쑀슜븳 吏몴濡 異붿쿇맂떎(Simental-Mendía et al., 2008; Guerrero-Romero et al., 2010). 以묒꽦吏諛⑹쓽 利앷뒗 洹쇱쑁-삁떦궗瑜 諛⑺빐븯硫, 씠뒗 삁泥 諛 議곗쭅뿉꽌쓽 以묒꽦吏諛 긽듅씠 씤뒓由 媛먯닔꽦쓣 媛먯냼떆궗 닔 엳쓬쓣 諛섏쁺븯뒗 寃곌낵씠떎(Pan et al., 1997; Kelley and Goodpaster, 2001). 硫뺤떆肄붿씤쓣 긽쑝濡 TyG index뿉 쓽븳 씤뒓由 빆꽦씠 泥섏쓬 痢≪젙릺뿀쑝硫(Simental-Mendía et al., 2008), 援궡뿉꽌뒗 Lee 벑(2014)씠 TyG index 떦눊蹂묒쓽 뿰愿꽦쓣 엯利앺븯떎.

씠 媛숈씠 TyG index뒗 떦눊蹂 諛 떖삁愿吏덊솚쓽 쐞뿕쓣 삁痢≫븷 닔 엳뒗 吏몴濡 蹂닿퀬릺怨 엳쑝굹(Lee et al., 2014; Sánchez-Íñigo et al., 2016), 궗利앺썑援곗뿉 븳 TyG index쓽 吏꾨떒젰뿉 빐꽌뒗 蹂닿퀬맂 諛붽 뾾떎. 뵲씪꽌 씠 뿰援ъ뿉꽌뒗 씤뒓由 빆꽦쓣 諛섏쁺븯뒗 媛꾪렪踰뺤씤 HOMA-IR怨 鍮꾧탳븯뿬 TyG index媛 궗利앺썑援곗쓣 吏꾨떒븯뒗뜲 쑀슜븳吏瑜 븣븘蹂닿퀬 떦븳 젅떒媛믪쓣 젣떆븯옄 븯떎.

옱猷 諛 諛⑸쾿

뿰援 긽옄

씠 뿰援ъ쓽 긽옄뒗 2016뀈 01썡遺꽣 2017뀈 01썡源뚯 寃쎄린吏뿭 J 醫낇빀蹂묒썝뿉꽌 嫄닿컯寃吏꾩쓣 떆뻾븳 20꽭 씠긽 80꽭 씠븯쓽 꽦씤 궓瑜 긽쑝濡 븯떎. 쟾泥 긽옄 珥 10,335紐 以 떊泥 怨꾩륫 諛 媛곴컖쓽 빐떦 삁븸 寃궗뿉 寃곗륫移섎 룷븿븯뒗 寃쎌슦, 븫, 媛꾩쭏솚, 떊옣吏덊솚, 뇤議몄쨷, 씪떆쟻씤 뿀삁꽦 諛쒖옉쓽 蹂묐젰씠 엳뒗 5,920紐낆쓣 젣쇅븳 4,415紐낆쓣 理쒖쥌 뿰援 긽옄濡 꽑젙븯쑝硫, 씠 以 궓꽦 2,361紐, 뿬꽦 2,054紐 씠뿀떎. 씠 뿰援щ뒗 寃쎄린吏뿭 醫낇빀蹂묒썝뿉꽌 湲곌깮紐낆쑄由ъ쐞썝쉶쓽 듅씤쓣 諛쏆븘 떆뻾릺뿀떎(IRB No: D-1207-003-0049).

궗利앺썑援 吏꾨떒 湲곗

꽑뻾뿰援щ뒗 NCEP-ATP III (National Cholesterol Education Program Adult Treatment Panel III)쓽 湲곗쑝濡 궗利앺썑援곗쓣 吏꾨떒븯쑝굹(Li 벑, 2017), 蹂 뿰援ъ뿉꽌뒗 理쒓렐 誘멸뎅 떦눊蹂묓븰쉶쓽 怨듬났삁떦옣븷 湲곗씤 100 mg/dL 씠긽쓣 諛섏쁺븳 AHA/NHLBI (American Heart Association/National Heart, Lung, and Blood Institute)쓣 궗利앺썑援 吏꾨떒 湲곗쑝濡 궪븯떎. AHA/NHLBI뿉꽌 젣떆븳 5媛吏 쐞뿕슂씤 以 3媛 씠긽 빐떦븯뒗 寃쎌슦 궗利앺썑援 吏꾨떒援(MetS; metabolic syndrome, n=496)쑝濡 뙋젙븯떎. 삉븳 0~2媛쒖쓽 쐞뿕슂씤쓣 룷븿븯뒗 寃쎌슦 젙긽援(Non-MetS, n=3,919)쑝濡 遺꾨쪟븯떎(Grundy et al., 2005). AHA/NHLBI뿉꽌 젣떆븳 5媛吏 궗利앺썑援 吏꾨떒 湲곗 몺 닔異뺢린 삁븬 ≥130 mmHg 삉뒗 씠셿湲 삁븬 ≥85 mmHg 몼 怨듬났삁떦 ≥100 mg/dL 몾 삁以 以묒꽦吏諛 ≥150 mg/dL 몿 삁以 HDL-肄쒕젅뒪뀒濡 궓꽦 <40 mg/dL, 뿬꽦 <50 mg/dL 뫀 뿀由щ몮젅 궓꽦 ≥102 cm, 뿬꽦 ≥88 cm쑝濡 젙쓽븯怨 엳쑝굹, 씠 뿰援ъ뿉꽌뒗 룞뼇씤쓽 蹂듬鍮꾨쭔 湲곗뿉 쟻빀븳 븘떆븘-깭룊뼇 吏뿭 湲곗(Asia-Pacific Criteria, APC)뿉 뵲씪 궓꽦 ≥90 cm, 뿬꽦≥80 cm쓣 蹂듬鍮꾨쭔쑝濡 쟻슜븯떎(WHO, 2000).

삁븸 寃궗

理쒖냼 8떆媛 씠긽 怨듬났 긽깭뿉꽌 쟾二쇱젙留(antecubital vein)뿉꽌 삁븸쓣 梨꾩랬븯뿬 삁븸 寃궗瑜 떆뻾븯떎. 珥앹퐳젅뒪뀒濡, HDL-肄쒕젅뒪뀒濡, LDL-肄쒕젅뒪뀒濡, 以묒꽦吏諛, 怨듬났삁떦, 怨좉컧룄 C-諛섏쓳떒諛깆쭏(high sensitivity C-reactive protein, hs-CRP), 슂궛쓣 TBA-200FR NEO (Toshiba, Tokyo, Japan) 깮솕븰 옄룞遺꾩꽍湲곕줈 痢≪젙븯떎. 떦솕삁깋냼(hemoglobin A1c, HbA1c)뒗 쟾삁 寃泥대줈 Variant II (Bio Rad, CA, USA) 옣鍮꾩뿉꽌 怨좎꽦뒫븸泥댄겕濡쒕쭏넗洹몃옒뵾踰(high performance liquid chromatography, HPLC)쓽 썝由щ줈 痢≪젙븯떎. 씤뒓由곗 Modular Analytics E170 (Roche, Mannheim, Germany)옣鍮꾨줈 쟾湲고솕븰諛쒓킅硫댁뿭遺꾩꽍踰(electrochemiluminescence immunoassay, ECLIA)쓽 썝由щ줈 寃궗븯떎. 씤뒓由 빆꽦쓣 룊媛븯뒗 HOMA-IR (homeostasis model assessment-insulin resistance) [怨듬났떆 씤뒓由 (μIU/mL) × 怨듬났떆 삁떦 (mg/dL)] / 405濡 怨꾩궛븯쑝硫(Matthews et al., 1985), TyG index뒗 Ln [TG (mg/dL) × FPG (mg/dL)/2]쓽 닔떇쑝濡 怨꾩궛븯떎(Simental-Mendía et al., 2008; Guerrero-Romero et al., 2010).

떊泥 怨꾩륫

옄룞 떊泥 怨꾩륫湲 DS-103M (Jenix, Seoul, Korea)濡 떊옣怨 泥댁쨷쓣 痢≪젙븯쑝硫, 泥댁쭏웾吏닔(body mass index, BMI)뒗 紐몃Т寃(kg)瑜 궎(m)쓽 젣怨깆쑝濡 굹늿 닔移섎줈 젣떆븯떎. 뿀由щ몮젅뒗 WHO쓽 몴以솕맂 봽濡쒗넗肄쒖뿉 뵲씪 吏곷┰ 옄꽭濡 뼇 諛쒖쓣 25~30 cm 젙룄 踰뚮━怨 닲쓣 궡돭 썑 媛덈퉬堉 媛옣 븘옒 쐞移섏 怨⑤컲쓽 媛옣 넂 쐞移섏쓽 以묎컙 吏젏뿉꽌 以꾩옄濡 痢≪젙븯쑝硫, 뿁뜦씠 몮젅뒗 뿁뜦씠쓽 媛옣 룎異쒕맂 遺遺꾩쓣 吏굹 룊뻾븯寃 痢≪젙븯떎. 삁븬 痢≪젙 10遺 씠긽 븞젙쓣 痍⑦븳 썑 븠 옄꽭뿉꽌 닔 삁븬怨꾨줈 痢≪젙븯쑝硫, 2遺 씠긽 쑕떇 썑 2踰 諛섎났 痢≪젙븯뿬 룊洹좉컪쓣 援ы븯떎.

옄猷 泥섎━ 諛⑸쾿

씠 뿰援щ뒗 SPSS Windows 18.0 (IBM, Armonk, USA) 넻怨 봽濡쒓렇옩쓣 씠슜븯뿬 옄猷 泥섎━瑜 븯쑝硫, 紐⑤뱺 湲곗닠 넻怨꾩튂뒗 룊洹좉낵 몴以렪李⑤줈 젣떆븯떎. 궗利앺썑援 吏꾨떒 쑀臾댁뿉 뵲瑜 씤泥 痢≪젙븰쟻 諛 깮솕븰쟻 蹂씤쓽 李⑥씠瑜 鍮꾧탳븯湲 쐞빐 룆由쏀몴蹂 t 寃젙(independent t-test)쓣 떎떆븯쑝硫, 궗利앺썑援 쑀臾댁뿉 뵲瑜 꽦蹂꾧낵 궗利앺썑援 媛곴컖쓽 쐞뿕슂씤쓽 李⑥씠, HOMA-IR怨 TyG index 궗遺꾩쐞닔뿉 뵲瑜 궗利앺썑援 쑀蹂묐쪧쓽 李⑥씠瑜 솗씤븯湲 쐞빐 移댁씠 젣怨 寃利(χ-square test)쓣 떆뻾븯떎. 삉븳 HOMA-IR怨 TyG index媛꾩쓽 긽愿꽦쓣 븣븘蹂닿린 쐞빐 뵾뼱뒯 긽愿怨꾩닔(Pearson Correlation Coefficient)濡 긽愿꽦쓣 솗씤븯떎. HOMA-IR怨 TyG index쓽 궗遺꾩쐞닔뿉 뵲瑜 궗利앺썑援 쑀蹂묐쪧쓽 援먯감鍮꾨 븣븘蹂닿린 쐞빐 꽦蹂, 뿰졊, 뿀由щ몮젅, BMI瑜 蹂댁젙븳 썑 濡쒖뒪떛 쉶洹遺꾩꽍(logistic regression)쓣 떆뻾븯쑝硫, 삤利덈퉬(odds ratio, OR) 95% 떊猶곌뎄媛(confidence interval, CI)쓣 젣떆븯떎. 씤뒓由 빆꽦쓣 痢≪젙븯뒗 TyG index媛 HOMA-IR怨 鍮꾧탳븯뿬 궗利앺썑援 吏꾨떒쓣 쐞븳 젙솗븳 吏몴씤吏瑜 솗씤븯湲 쐞빐 ROC 怨≪꽑(Receiver Operating Characteristic Curve)쓽 硫댁쟻쓣 鍮꾧탳븯쑝硫, 理쒖쟻 젅떒媛(optimum cut-off values)쓣 뙋떒븯湲 쐞빐 誘쇨컧룄(sensitivity) 듅씠룄(specificity)瑜 Youden index(誘쇨컧룄+듅씠룄-1)瑜 씠슜븯뿬 援ы븯떎. 씠 뿰援ъ쓽 넻怨꾪븰쟻 쑀쓽닔以 P<0.05濡 꽕젙븯떎.

寃곌낵

궗利앺썑援 쑀臾댁뿉 뵲瑜 긽옄쓽 듅吏

궗利앺썑援 吏꾨떒 쑀臾댁뿉 뵲瑜 긽옄쓽 듅吏뺤 Table 1怨 媛숇떎. 뿰졊怨 꽦蹂 以 궓꽦쓽 鍮꾩쑉 젙긽援곕낫떎 궗利앺썑援 吏꾨떒援곗씠 넂븯떎(媛곴컖 P<0.001). 떊泥 痢≪젙븰쟻 듅吏뺤쑝濡 떊옣 吏묐떒媛 李⑥씠媛 뾾뿀쑝굹, 泥댁쨷, BMI, 뿀由щ몮젅, 뿁뜦씠 몮젅뒗 젙긽援곕낫떎 궗利앺썑援 吏꾨떒援곗뿉꽌 넂븯떎(媛곴컖 P<0.001). 삉븳 닔異뺢린 씠셿湲 삁븬 젙긽援곕낫떎 궗利앺썑援 吏꾨떒援곗씠 쑀쓽븯寃 넂븯떎(媛곴컖 P<0.001). 깮솕븰쟻 蹂씤 以 珥앹퐳젅뒪뀒濡, LDL-肄쒕젅뒪뀒濡, 以묒꽦吏諛, 怨듬났삁떦, 슂궛, HbA1c, 씤뒓由, HOMA-IR, TyG index뒗 젙긽援곕낫떎 궗利앺썑援 吏꾨떒援곗뿉꽌 쑀쓽븯寃 넂븯떎(媛곴컖 P<0.001). 삉븳 hs-CRP뒗 궗利앺썑援 吏꾨떒援곗씠 젙긽援곕낫떎 넂븯쑝硫(P=0.030), HDL-肄쒕젅뒪뀒濡ㅼ 궗利앺썑援 吏꾨떒援곕낫떎 젙긽援곗뿉꽌 넂븯떎(P<0.001). 궗利앺썑援 쐞뿕슂씤씤 삁븬 긽듅, 怨듬났삁떦옣븷, 以묒꽦吏諛 긽듅, HDL-肄쒕젅뒪뀒濡 媛먯냼, 蹂듬鍮꾨쭔 젙긽援곕낫떎 궗利앺썑援 吏꾨떒援곗뿉꽌 넂 鍮덈룄瑜 蹂댁떎(媛곴컖 P<0.001).

Characteristics of the participants according to presence of metabolic syndrome

VariableNon-MetS (N=3,919)MetS (N=496)P-value
Age (yr)48.30±11.0955.02±10.73<0.001
Men (%)*2,040 (52.1)321 (64.7)<0.001
Height (cm)164.78±8.74165.28±10.050.291
Weight (kg)63.96±11.4075.05±12.48<0.001
BMI (kg/m2)23.44±3.0026.98±2.83<0.001
Waist circumference (cm)78.56±8.8489.40±7.29<0.001
Hip circumference (cm)93.23±20.1399.48±40.44<0.001
Systolic blood pressure (mmHg)109.10±13.60124.49±16.39<0.001
Diastolic blood pressure (mmHg)69.64±9.7578.65±10.46<0.001
Total cholesterol (mg/dL)195.03±35.02301.49±37.20<0.001
HDL-cholesterol (mg/dL)58.01±13.9244.57±9.83<0.001
LDL-cholesterol (mg/dL)120.08±31.90126.74±34.68<0.001
Triglyceride (mg/dL)108.95±72.36217.46±111.35<0.001
Fasting glucose (mg/dL)89.67±17.05109.64±29.27<0.001
hs-CRP (mg/dL)0.17±0.550.22±0.490.030
Uric acid (mg/dL)5.06±1.425.59±1.50<0.001
HbA1c (%)5.58±0.676.26±1.12<0.001
Insulin (μU/mL)4.53±2.727.68±4.00<0.001
HOMA-IR1.02±0.692.09±1.31<0.001
TyG index8.32±0.599.25±0.47<0.001
Metabolic syndrome components
 High blood pressure*439 (11.2)259 (52.2)<0.001
 Impaired fasting glucose*463 (11.8)304 (61.3)<0.001
 High triglyceride*712 (18.2)400 (80.6)<0.001
 Low HDL-cholesterol*452 (11.5)282 (56.9)<0.001
 Abdominal obesity*676 (17.2)391 (78.7)<0.001

Calculated by independent t-test.

Values are presented as mean ± SD.

*; Calculated by χ2-test. Data are presented as number (%).

Abbreviations: MetS, metabolic syndrome; BMI, body mass index; HDL, high density lipoprotein; LDL, low density lipoprotein; hs-CRP, high sensitivity C-reactive protein; HbA1c, hemoglobin A1c; HOMA-IR, homeostasis model assessment of insulin resistance; TyG index, triglyceride-glucose index


HOMA-IR怨 TyG index 궗遺꾩쐞닔뿉 뵲瑜 궗利앺썑援 쑀蹂묐쪧

HOMA-IR怨 TyG index瑜 궗遺꾩쐞닔濡 굹늻뼱 吏묐떒媛 궗利앺썑援 쑀蹂묐쪧쓽 李⑥씠瑜 鍮꾧탳븳 寃곌낵 HOMA-IR怨 TyG index뒗 遺꾩쐞닔媛 넂븘吏덉닔濡 궗利앺썑援 쑀蹂묐쪧씠 利앷븯쑝硫, 4궗遺꾩쐞닔뿉꽌 HOMA-IR 7.4%, TyG index뒗 9.4%쓽 궗利앺썑援 쑀蹂묐쪧쓣 蹂댁떎(媛곴컖 P<0.001) (Fig. 1).

Fig. 1.

Prevalence of metabolic syndrome according to HOMA-IR and TyG index quartile. Abbreviations: MetS, metabolic syndrome; HOMA-IR, homeostasis model assessment of insulin resistance; TyG index, triglyceride-glucose index; Q1, first quartile (HOMA-IR <0.59, TyG index <7.95); Q2, second quartile (0.59≤ HOMA-IR <0.93, 7.95≤ TyG index <8.41); Q3, third quartile (0.93≤ HOMA-IR <1.43, 8.41≤ TyG index <8.86); Q4, fourth quartile (1.43≤ HOMA-IR, 8.86≤ TyG index)


HOMA-IR怨 TyG index쓽 긽愿愿怨

궗利앺썑援 쐞뿕슂씤씤 뿀由щ몮젅, 닔異뺢린 씠셿湲 삁븬, 珥앹퐳젅뒪뀒濡, LDL-肄쒕젅뒪뀒濡, 以묒꽦吏諛, 怨듬났삁떦 TyG index 젙쟻 긽愿꽦쓣 蹂댁쑝硫, HDL-肄쒕젅뒪뀒濡ㅺ낵뒗 遺쟻 긽愿愿怨꾨 蹂댁떎(媛곴컖 P<0.001). HOMA-IR怨 TyG index뒗 r=0.498, r2=0.248濡 HOMA-IR쓽 蹂솕웾뿉 뵲씪 TyG index쓽 蹂솕웾뿉 빐 24.8% 꽕紐낅맆 닔 엳뒗 寃껋쑝濡 굹궗떎(P<0.001) (Table 2).

Correlation between HOMA-IR and TyG index

VariablesTyG index

rP-value
HOMA-IR0.498<0.001
Waist circumference (cm)0.481<0.001
Systolic blood pressure (mmHg)0.267<0.001
Diastolic blood pressure (mmHg)0.275<0.001
Total cholesterol (mg/dL)0.284<0.001
HDL-cholesterol (mg/dL)-0.486<0.001
LDL-cholesterol (mg/dL)0.248<0.001
Triglyceride (mg/dL)0.868<0.001
Fasting glucose (mg/dL)0.472<0.001

Calculated by correlation analysis.

Abbreviations: TyG index, triglyceride-glucose index; HOMA-IR, homeostasis model assessment of insulin resistance; HDL, high density lipoprotein; LDL, low density lipoprotein


HOMA-IR怨 TyG index쓽 궗遺꾩쐞닔뿉 뵲瑜 궗利앺썑援 쑀蹂묐쪧쓽 쐞뿕鍮

濡쒖뒪떛 쉶洹遺꾩꽍뿉 쓽빐 HOMA-IR怨 TyG index 궗遺꾩쐞닔뿉 뵲瑜 궗利앺썑援곌낵쓽 愿젴꽦쓣 遺꾩꽍븳 寃곌낵, HOMA-IR 1궗遺꾩쐞닔蹂대떎 3궗遺꾩쐞닔뿉꽌 궗利앺썑援 諛쒖깮씠 3.0諛 넂븯쑝硫(OR: 3.097, 95% CI: 1.841~5.208), 4궗遺꾩쐞닔뒗 1궗遺꾩쐞닔蹂대떎 궗利앺썑援 諛쒖깮 쐞뿕룄媛 8.1諛 넂寃 굹궗떎(OR: 8.145, 95% CI: 4.931~13.451). TyG index뒗 1궗遺꾩쐞닔뿉 鍮꾪빐 3궗遺꾩쐞닔뿉꽌 궗利앺썑援 諛쒖깮씠 8.5諛 넂븯쑝硫(OR: 8.476, 95% CI: 3.005~23.903), 4궗遺꾩쐞닔뒗 20.0諛 넂븯떎(OR: 20.025, 95% CI: 17.190~23.407). 洹몃윭굹 HOMA-IR怨 TyG index 紐⑤몢 1궗遺꾩쐞닔 2궗遺꾩쐞닔媛꾩쓽 궗利앺썑援 諛쒕퀝 쐞뿕뿉뒗 李⑥씠媛 뾾뿀떎(Table 3).

Odds ratios for metabolic syndrome in different quartiles of TyG index and HOMA-IR

VariablesOR (95% CI)for MetSP-value
TyG indexQ1 (reference)1
Q21.763 (0.557~5.577)0.334
Q38.476 (3.005~23.903)<0.001
Q420.025 (17.190~23.407)<0.001
HOMA-IRQ1 (reference)1
Q21.647 (0.935~2.901)0.084
Q33.097 (1.841~5.208)<0.001
Q48.145 (4.931~13.451)<0.001

Calculated by logistic regression analysis.

Logistic regression was adjusted for gender, age, waist circumference, BMI.

Abbreviations: Q1, first quartile; Q2, second quartile; Q3, third quartile; Q4, fourth quartile; TyG index, triglyceride-glucose index; HOMA-IR, homeostasis model assessment of insulin resistance


궗利앺썑援곗쓣 삁痢≫븯湲 쐞븳 HOMA-IR怨 TyG index쓽 젅떒媛

ROC 遺꾩꽍쓣 넻빐 궗利앺썑援곗쓣 吏꾨떒븯湲 쐞븳 HOMA-IR怨 TyG index쓽 쟻젙 젅떒媛믪쓣 痢≪젙븳 寃곌낵뒗 Table 4 媛숈쑝硫, Fig. 2뿉 ROC 怨≪꽑쑝濡 쐞뼇꽦쑉怨 洹몄뿉 븳 떎젣 뼇꽦쑉쓣 洹몃옒봽濡 굹깉떎. 怨≪꽑쓽 븘옒 硫댁쟻씤 AUC (area under the ROC curve)뒗 遺꾨쪟 젙솗룄瑜 굹궡뒗뜲, HOMA-IR쓽 AUC 媛믪 0.813, 젅떒媛믪 1.16, 誘쇨컧룄뒗 80.4%, 듅씠룄뒗 69.1%濡 굹궗떎. TyG index쓽 AUC 媛믪 0.894씠硫, 젅떒媛믪 8.81, 誘쇨컧룄뒗 86.7%, 듅씠룄뒗 80.1%떎.

ROC-curve analysis according to TyG index and HOMA-IR

 VariablesCutoff valueSensitivitySpecificityUAC (95% CI)P-value
TyG index8.8186.7%80.1%0.894 (0.881~0.906)<0.001
HOMA-IR1.1680.4%69.1%0.813 (0.793~0.833)<0.001

Abbreviations: ROC, receiver operating characteristic; AUC, area under the curve; TyG index, triglyceride-glucose index, HOMA-IR, homeostasis model assessment of insulin resistance.


Fig. 2.

ROC Curves for metabolic syndrome using the criteria of AHA/NHLBI. Abbreviations: ROC, receiver operating characteristic; HOMA-IR, homeostasis model assessment of insulin resistance; TyG index, triglyceride-glucose index


怨좎같

씠 뿰援щ뒗 HOMA-IR怨 鍮꾧탳븯뿬 TyG index媛 궗利앺썑援곗쓣 吏꾨떒븯뒗뜲 쑀슜븳吏瑜 븣븘蹂닿퀬 떦븳 젅떒媛믪쓣 젣떆븯怨좎옄 븯떎. 洹 寃곌낵 TyG index뒗 HOMA-IR쓣 룷븿븳 궗利앺썑援 쐞뿕슂씤怨 긽愿꽦쓣 蹂댁쑝硫, TyG index쓽 遺꾩쐞닔媛 利앷븷닔濡 궗利앺썑援 쑀蹂묐쪧 利앷븯떎. 삉븳 TyG index뒗 HOMA-IR蹂대떎 궗利앺썑援 쐞뿕쓣 삁痢≫븯뒗뜲 뜑 쑀슜븯寃 굹궗떎.

궗利앺썑援곗 떖삁愿 諛 뇤삁愿吏덊솚쓽 쐞뿕쓣 利앷떆궎硫, 궗利앺썑援곗쓣 吏꾨떒븷 닔 엳뒗 媛꾨떒븯怨 슚怨쇱쟻씤 吏몴瑜 꽕젙븯뒗 寃껋 궗利앺썑援곗쓣 룊媛븯뒗뜲 留ㅼ슦 以묒슂븯떎(Lakka et al., 2002; Rodriguez-Colon et al., 2009; Li et al., 2017). 씤뒓由 빆꽦 궗利앺썑援 諛쒕퀝뿉 以묒슂븳 뿭븷쓣 븯뒗 寃껋쑝濡 젣떆릺硫, 怨좎씤뒓由고삁利 젙긽 삁떦 겢옩봽(hyperinsulinemic euglycemic clamp)뒗 씤뒓由 誘쇨컧꽦쓣 媛옣 젙솗븯寃 痢≪젙븯뒗 諛⑸쾿씠吏留 留롮 떆媛꾧낵 鍮꾩슜씠 냼紐⑤맂떎(DeFronzo et al., 1979; Moon et al., 2017). Bonora 벑(2000) 洹쒕え 뿭븰뿰援ъ뿉꽌 몴以踰뺤씤 怨좎씤뒓由고삁利 젙긽 삁떦 겢옩봽 HOMA-IR궗씠뿉 媛뺥븳 뿭긽愿 愿怨꾨 蹂댁뿬 HOMA-IR씠 븞젙쟻쑝濡 씤뒓由 빆꽦쓣 痢≪젙븯뒗뜲 궗슜맆 닔 엳떎뒗 寃곕줎쓣 궡졇떎. 洹몃윭굹 씤뒓由 痢≪젙 몴以 遺꾩꽍踰뺤씠 뾾湲 븣臾몄뿉 씤뒓由 빆꽦쓣 異붿젙븯湲 쐞빐 씤뒓由곗쓣 룷븿븯吏 븡뒗 媛꾩젒 痢≪젙踰뺤쓣 媛쒕컻븯젮뒗 끂젰씠 吏냽릺뿀떎(Moon et al., 2017).

TyG index뒗 씤뒓由 痢≪젙씠 遺덇뒫븳 寃쎌슦 씤뒓由 떊 以묒꽦吏諛⑹쓣 씠슜븯뿬 씤뒓由 빆꽦쓣 솗씤븷 닔 엳뒗 泥 寃궗濡쒖꽌, 嫄닿컯씤쓣 긽쑝濡 씤뒓由 빆꽦쓣 룊媛븯뒗뜲 HOMA-IR怨 鍮꾧탳븳 寃곌낵 TyG index媛 넂 誘쇨컧룄 듅씠룄瑜 蹂댁떎(Simental-Mendía et al., 2008). Lee 벑(2014) 븳援씤쓣 긽쑝濡 TyG index 떦눊蹂묒쓽 뿰愿꽦쓣 엯利앺븯쑝硫, Navarro-Gonzalez 벑(2016) 쑀읇 諛깆씤 肄뷀샇듃뿉 洹쇨굅븯뿬 TyG index媛 젣 2삎 떦눊蹂묒쓽 쐞뿕쓣 議곌린뿉 諛쒓껄븯뒗뜲 쑀슜븿쓣 솗씤븯떎. 삉븳 Li 벑(2017) TyG index媛 떖삁愿吏덊솚쓽 쐞뿕쓣 삁痢≫븷 닔 엳뒗 吏몴씠硫, 以묎뎅씤쓣 긽쑝濡 궗利앺썑援곌낵 쑀쓽븳 愿젴씠 엳쓬쓣 蹂댁뿬二쇱뿀떎.

蹂 뿰援ъ뿉꽌 TyG index쓽 遺꾩쐞닔媛 利앷븷닔濡 궗利앺썑援 쑀蹂묐쪧 利앷븯쑝硫, TyG index媛 8.86 씠긽씤 4궗遺꾩쐞닔뿉꽌 궗利앺썑援 쑀蹂묐쪧怨 궗利앺썑援 諛쒕퀝 쐞뿕씠 湲됯꺽엳 利앷븯뒗 寃쏀뼢쓣 蹂댁떎. 삉븳 TyG index뒗 HOMA-IR쓣 룷븿븳 궗利앺썑援 쐞뿕슂씤怨 긽愿꽦쓣 蹂댁떎. Li 벑(2017)쓽 뿰援ъ뿉꽌 궗利앺썑援 쐞뿕슂씤씠 利앷븿뿉 뵲씪 TyG index뒗 궓 紐⑤몢뿉꽌 利앷븯쑝硫, NCEP-ATP III쓽 湲곗쑝濡 궗利앺썑援 吏꾨떒쓣 쐞븳 理쒖쟻젅떒媛믪 8.71, ROC 怨≪꽑쓽 AUC 媛믪 0.802濡 TyG index뒗 궗利앺썑援 吏꾨떒쓣 쐞븳 떊猶곗꽦 엳뒗 吏몴濡 蹂닿퀬븯떎.

蹂 뿰援ш껐怨 AHA/NHLBI 湲곗쑝濡 궗利앺썑援 吏꾨떒쓣 쐞븳 TyG index쓽 理쒖쟻 젅떒媛믪 8.81, AUC 媛믪 0.894씠뿀쑝硫, 誘쇨컧룄 듅씠룄뒗 媛곴컖 86.7% 80.1%濡 굹굹 HOMA-IR 닔移섎낫떎 TyG index媛 궗利앺썑援 쐞뿕쓣 삁痢≫븯뒗뜲 뜑 쑀슜븳 寃껋쑝濡 굹궗떎. 씠뒗 TyG index媛 AHA/NHLBI뿉꽌 젣떆븳 5媛吏 궗利앺썑援 쐞뿕슂씤 以 怨듬났삁떦怨 以묒꽦吏諛⑹쓽 2媛吏 쐞뿕슂씤쓣 寃고빀븯뿬 怨꾩궛떇쓣 궛異쒗븳 諛섎㈃, HOMA-IR 怨듬났삁떦留뚯쓣 怨꾩궛떇뿉 룷븿븯湲 븣臾몄쑝濡 깮媛곷맂떎. 洹몃윭誘濡 TyG index媛 HOMA-IR蹂대떎 궗利앺썑援 쐞뿕쓣 꽑蹂꾪븯뒗 뒫젰씠 슦닔븯吏留, 씤뒓由 痢≪젙씠 遺덇뒫븳 寃쎌슦 씤뒓由 빆꽦쓣 솗씤븯湲 쐞븳 蹂댁“쟻씤 寃궗濡 솢슜븯뒗 寃껋씠 떦븯寃좊떎(Guerrero-Romero et al., 2010). 씠 뿰援ъ뿉꽌 궗利앺썑援 吏꾨떒援곌낵 젙긽援곌컙뿉 꽦蹂꾧낵 뿰졊쓽 李⑥씠媛 議댁옱븯硫, 濡쒖뒪떛 遺꾩꽍뿉꽌뒗 꽦蹂꾧낵 뿰졊쓣 넻젣븯쑝굹 떎瑜 넻怨꾨텇꽍뿉꽌뒗 꽦蹂꾧낵 뿰졊쓣 셿쟾엳 넻젣븯吏 紐삵븳 젣븳젏씠 엳떎. 씠뿉 떎뼇븳 뿰졊 꽦蹂꾩쓣 援щ텇븯뿬 궗利앺썑援곗쓣 룊媛븯湲 쐞븳 TyG index쓽 쑀슜꽦뿉 븳 뿰援ш 븘슂븯寃좊떎.

寃곕줎쟻쑝濡, TyG index뒗 궗利앺썑援 쐞뿕슂씤怨 愿젴씠 엳쑝硫, 궗利앺썑援곗쓽 빑떖 吏몴씤 씤뒓由 빆꽦쓣 吏꾨떒븯뒗뜲 HOMA-IR蹂대떎 넂 誘쇨컧룄 듅씠룄瑜 굹궡뼱 HOMA-IR쓽 泥 吏몴濡쒖꽌 궗利앺썑援 쐞뿕쓣 솗씤븯뒗 쑀슜븳 諛⑸쾿쑝濡 솢슜맆 닔 엳쑝由щ씪 궗猷뚮맂떎.

ACKNOWLEDGEMENTS

None.

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