摘要
目的分析反复妊娠丢失(RPL)患者血糖、血脂及胰岛素的代谢情况,比较甘油三酯血糖指数(TyG)、甘油三酯血糖体质指数(TyG-BMI)和稳态模型评估胰岛素抵抗指数(HOMA-IR)对RPL的预测效能。方法选择573例RPL患者为RPL组,另选取同时期因男方不育因素行辅助生殖技术助孕的652例女性作为对照组,回顾分析两组的一般资料,并比较两组体质量指数(BMI)、空腹血糖(FPG)、空腹甘油三酯(FTG)、空腹胰岛素(FINS)、TyG、TyG-BMI及HOMA-IR水平。采用Spearman相关分析验证TyG指数、TyG-BMI指数与HOMA-IR的相关性,同时用受试者工作曲线(ROC)评估TyG指数、TyG-BMI指数、HOMA-IR对RPL发生的预测效能,计算出最佳预测截点。结果RPL组的BMI、FPG、FTG、TyG指数、TyG-BMI指数及HOMA-IR显著高于对照组,差异有统计学意义(P<0.05)。TyG指数、TyG-BMI指数与HOMA-IR呈正相关,相关系数分别为0.442、0.505(P<0.001)。ROC曲线分析显示,TyG-BMI指数预测RPL发生的曲线下面积0.579(95%CI:0.551~0.607,P<0.001),大于TyG指数的0.557(95%CI:0.529~0.585,P<0.001)及HOMA-IR的0.535(95%CI:0.507~0.563,P<0.05),其中TyG-BMI指数与HOMA-IR曲线下面积的差异有统计学意义(P<0.05)。TyG-BMI指数、TyG指数、HOMA-IR预测RPL发生的最佳截点分别为172.3(敏感度75.7%,特异度37.06%),8.32(敏感度59.44%,特异度51.61%),3.58(敏感度25.87%,特异度81.62%)。结论RPL患者中超重、血糖血脂及胰岛素代谢异常发生率较正常女性高。TyG指数、TyG-BMI指数可以作为HOMA-IR之外评估RPL患者胰岛素代谢状态的指标,且TyG-BMI指数预测RPL发生的效能较HOMA-IR更高。
Objective To analyze the metabolism of blood glucose,blood lipid and insulin in patients with recurrent pregnancy loss(RPL),and to compare the predictive efficacy of triglyceride glycemic index(TyG),triglyceride glycemic body mass index(TyG-BMI)and homeostatic model assessment of insulin resistance(HOMA-IR)for RPL.Methods A total of 573 patients with RPL were selected as the RPL group,and 652 women who received assisted reproductive technology for male infertility were selected as the control group.The general data of the two groups were retrospectively analyzed.The levels of body mass index(BMI),fasting blood glucose(FPG),fasting triglyceride(FTG),fasting insulin(FINS),TyG index,TyG-BMI index and HOMA-IR were compared between the two groups.Spearman correlation analysis was used to verify the correlation between TyG index,TyG-BMI index and HOMA-IR.Receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of TyG index,TyG-BMI index and HOMA-IR for RPL occurrence,and the optimal predictive cut-off point was calculated.Results The BMI,FPG,FTG,TyG index,TyG-BMI index and HOMA-IR in the RPL group were significantly higher than those in the control group(P<0.05).TyG index and TyG-BMI index were positively correlated with HOMA-IR,and the correlation coefficients were 0.442 and 0.505,respectively(P<0.001).ROC curve analysis showed that the area under the curve of TyG-BMI index predicting RPL was 0.579(95%CI:0.551-0.607,P<0.001),which was greater than that of TyG index of 0.557(95%CI:0.529-0.585,P<0.001)and HOMA-IR of 0.535(95%CI:0.507-0.563,P<0.05),among which the difference between TyG-BMI index and HOMA-IR index area under the curve was statistically significant(P<0.05).The optimal cut-off points of TyG-BMI index,TyG index and HOMA-IR for predicting RPL were 172.3(sensitivity 75.7%,specificity 37.06%),8.32(sensitivity 59.44%,specificity 51.61%)and 3.58(sensitivity 25.87%,specificity 81.62%),respectively.Conclusion The incidence of overweight,abnormal blood glucose,lipid and insulin metabolism in RPL patients is higher than that in normal women.TyG index and TyG-BMI index can be used as indicators of insulin metabolic status in RPL population besides HOMA-IR,and TyG-BMI index has a higher efficacy in predicting the occurrence of RPL compared to HOMA-IR.
作者
薛吟霜
何英明
黄悦
刘振冉
张品
向卉芬
Xue Yinshuang;He Yingming;Huang Yue;Liu Zhenran;Zhang Pin;Xiang Huifen(Reproductive Medicine Center,Dept of Obstetrics and Gynecology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022;Anhui Province Key Laboratory of Reproductive Health and Genetics,Anhui Medical University,Hefei 230022;Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs,Hefei 230051)
出处
《安徽医科大学学报》
CAS
北大核心
2023年第6期1020-1024,共5页
Acta Universitatis Medicinalis Anhui
基金
国家自然科学基金(编号:82071614)
国家重点研发计划项目(编号:2021YFC2700600)。
