«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

27卷

期数:

2021年01期

页码:

11-16

栏目:

临床医学

出版日期:

2021-01-20

文章信息/Info

Title:

Significance of triglyceride to high-density lipoprotein ratio in predicting childhood metabolic syndrome

文章编号:

1006-8147（2021）01-0011-06

作者:

吴楚姗; 张聪; 蒋海燕; 郑荣秀

天津医科大学总医院儿科，天津 300052

Author(s):

WU Chu-shan; ZHANG Cong; JIANG Hai-yan; ZHENG Rong-xiu

Department of Pediatrics, General Hospital，Tianjin Medical University，Tianjin 300052，China

关键词:

TG/HDL-C; 代谢综合征; HOMA-IR; 儿童及青少年

Keywords:

triglyceride/HDL-cholesterol ratio; metabolic syndrome; HOMA-IR; childhood and adolescent

分类号:

R725.4

DOI:

-

文献标志码:

A

摘要:

目的：探讨甘油三酯与高密度脂蛋白-胆固醇比值（TG/HDL-C）和稳态模型评估-胰岛素抵抗指数 （HOMA-IR）在儿童代谢综合征（MS）中的预测价值。方法：收集自2015年1月—2019年12月在天津医科大学总 医院儿科诊断为肥胖的儿童203例，测量血压、腰围，于次日空腹行口服葡萄糖耐量试验（OGTT）并检测HbA1c 、血脂等。按照儿童青少年肥胖MS的诊断标准，分为MS组67例，对照组（非MS组）136例。根据OGTT计算 HOMA-IR、松田指数、稳态模型评估-胰岛β细胞功能指数（HOMA-β）、早期胰岛素分泌指数（ΔI30/ΔG30） 、血糖曲线下面积（血糖-AUC）、胰岛素曲线下面积（胰岛素-AUC），利用受试者工作特征（ROC）曲线评价 TG/HDL-C和HOMA-IR的特异性和灵敏性，以及两项指标联合预测与单独预测之间是否存在统计学差异。结果： 与非MS组相比， MS组TG/HDL-C比值（Z=-8.441，P=0.000）、HOMA-IR （Z=-4.476，P=0.000）升高。当 TG/HDL-C＞1.31时，其预测MS的敏感性为86.6%，特异性为84.6%。当HOMA-IR＞7.08时，预测MS的敏感性为 53.7%，特异性为77.9%。相较于单独应用HOMA-IR诊断MS，TG/HDL-C单独诊断MS（Z=3.425，P=0.000 6），以 及TG/HDL-C联合HOMA-IR诊断MS（Z=4.481，P＜0.000 1）更具敏感性。而单独应用TG/HDL-C与TG/HDL-C联合 HOMA-IR诊断MS相比时，两者间差异无显著统计学意义。结论：TG/HDL-C单独或者TG/HDL-C联合HOMA-IR，可作 为MS的一个良好预测指标。

Abstract:

Objective: To investigate the predictive value of triglyceride to high density lipoprotein-cholesterol ratio（TG/HDL-C） and homeostasis model assessment of insulin resistance index（HOMA-IR） in children with metabolic syndrome（MS）. Methods: A total of 203 children with obesity diagnosed in the Pediatrics of Tianjin Medical University General Hospital from January 2015 to December 2019 were collected. Blood pressure and waist circumference were measured. Oral glucose tolerance test（OGTT），glycated hemoglobin （HbA1c），and blood lipids were tested. According to the diagnostic criteria for obesity and metabolic syndrome in children and adolescents，all patients were divided into metabolic syndrome group（MS group，n=6）and control group（non-MS group，n=136）. According to OGTT，HOMA-IR，Matsuda index，islet cell function index （HOMA-β），early insulin secretion index（ΔI30/ΔG30），area under the blood glucose curve （Glycemic-AUC），area under the insulin curve（insulin-AUC） were calculated. The ROC curve was used to evaluate the specificity and sensitivity of TG/HDL-C and HOMA-IR，and whether there was statistical difference between the two indicators′ combined prediction and individual prediction. Results: Compared with non-MS group， TG/HDL-C ratio（Z=-8.441，P=0.000） and HOMA-IR（Z=-4.476，P=0.000） increased in the MS goup. When TG/HDL-C>1.31，the predicted sensitivity of MS was 86.6%，specificity was 84.6%. When HOMA-IR>7.08，the sensitivity of predicting MS was 53.7%，and the specificity was 77.9%. Compared with using HOMA-IR alone to diagnose MS，TG/HDL-C alone to diagnose MS（Z=3.425，P=0.0006） and TG/HDL-C combined with HOMA-IR to diagnose MS（Z=4.481，P＜0.000 1） were more sensitive. There was no significant statistical difference between TG/HDL-C alone and TG/HDL-C combined with HOMA-IR in the diagnosis of MS. Conclusion: TG/HDL-C alone or TG/HDL-C combined with HOMA-IR can be used as a good predictor for MS.

参考文献/References:

[1] Kumar S，Kelly A S. Review of childhood obesity: from epidemiology,etiology，and comorbidities to clinical assessment and treatment[J]. Mayo Clin Proc，2017，92（2）：251
[2] Weihe P，Weihrauch-Bluher S. Metabolic syndrome in children and adolescents：diagnostic criteria，therapeutic options and perspectives[J]. Curr Obes Rep，2019，8（4）：472
[3] Gregory J W. Prevention of obesity and metabolic syndrome in children[J]. Front Endocrinol （Lausanne），2019，10：669
[4] Deboer M D. Assessing and managing the metabolic syndrome in children and adolescents[J]. Nutrients，2019，11（8）：1788
[5] 程红，陈芳芳，叶佩玉. 2013—2015年中国7城市6~17岁儿童青少年心血管代谢危险因素的流行特征 [J]. 中华预防医学杂志，2018，52（11）：1130
[6] Tresaco B，Bueno G，Pineda I，et al. Homeostatic model assessment （HOMA） index cut-off values to identify the metabolic syndrome in children[J]. J Physiol Biochem，2005，61（2）：381
[7] Arellano-Ruiz P，Garcia-Hermoso A，Cavero-Redondo I，et al. Homeostasis model assessment cut-off points related to metabolic syndrome in children and adolescents：a systematic review and meta-analysis[J]. Eur J Pediatr，2019，178（12）：1813
[8] Yin J，Li M，Xu L，et al. Insulin resistance determined by homeostasis model assessment （ HOMA） and associations with metabolic syndrome among Chinese children and teenagers[J]. Diabetol Metab Syndr，2013，5（1）：71
[9] Iwani N A，Jalaludin M Y，Zin R M，et al. Triglyceride to HDL-C ratio is associated with insulin resistance in overweight and obese children[J]. Sci Rep，2017，7：40055
[10] Ren X，Chen Z A，Zheng S，et al. Association between triglyceride to HDL-C ratio（TG/HDL-C ） and insulin resistance in Chinese patients with newly diagnosed type 2 diabetes mellitus[J]. PLoS One，2016，11（4）：e154345
[11] Chu S Y，Jung J H，Park M J，et al. Risk assessment of metabolic syndrome in adolescents using the triglyceride/high-density lipoprotein cholesterol ratio and the total cholesterol/high-density lipoprotein cholesterol ratio[J]. Ann Pediatr Endocrinol Metab，2019， 24（1）：41
[12] Mclaughlin T，Abbasi F，Cheal K，et al. Use of metabolic markers to identify overweight individuals who are insulin resistant[J]. Ann Intern Med，2003，139（10）：802
[13] Urbina E M，Khoury P R，Mccoy C E，et al. Triglyceride to HDL-C ratio and increased arterial stiffness in children，adolescents，and young adults[J]. Pediatrics，2013，131（4）： e1082
[14] Di Bonito P，Valerio G，Grugni G，et al. Comparison of non-HDL-cholesterol versus triglycerides-to-HDL-cholesterol ratio in relation to cardiometabolic risk factors and preclinical organ damage in overweight/obese children： the CARITALY study[J]. Nutr Metab Cardiovasc Dis，2015，25（5）：489
[15] 中国肥胖问题工作组. 中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J]. 中华流行病学杂志 ，2004，25（2）：97
[16] 中华医学会儿科学分会内分泌遗传代谢学组，中华医学会儿科学分会心血管学组，中华医学会儿科学分 会儿童保健学组，等. 中国儿童青少年代谢综合征定义和防治建议[J]. 中华儿科杂志，2012，50（6）：420
[17] 米杰，王天有，孟玲慧，等. 中国儿童青少年血压参照标准的研究制定[J]. 中国循证儿科杂志，2010， 5（1）：4
[18] Zhang J，Wang H，Wang Z，et al. Prevalence and stabilizing trends in overweight and obesity among children and adolescents in China，2011-2015[J]. BMC Public Health，2018，18（1）：571.
[19] Zhang J，Li X，Hawley N，et al. Trends in the prevalence of overweight and obesity among Chinese school-age children and adolescents from 2010 to 2015[J]. Child Obes，2018，14（3）：182
[20] Ogden C L，Carroll M D，Lawman H G，et al. Trends in obesity prevalence among children and adolescents in the United States，1988-1994 through 2013-2014[J]. JAMA，2016，315（21）：2292
[21] Eckel R H，Grundy S M，Zimmet P Z. The metabolic syndrome[J]. Lancet，2005，365（9468）： 1415
[22] Bussler S，Penke M，Flemming G，et al. Novel insights in the metabolic syndrome in childhood and adolescence[J]. Horm Res Paediatr，2017，88（3-4）：181
[23] Liang J，Fu J，Jiang Y，et al. TriGlycerides and high-density lipoprotein cholesterol ratio compared with homeostasis model assessment insulin resistance indexes in screening for metabolic syndrome in the chinese obese children：a cross section study[J]. BMC Pediatrics，2015，15（1） ：138
[24] Krawczyk M，Rumińska M，Witkowska- S?誰dek E，et al. Usefulness of the triglycerides to high-density lipoprotein cholesterol ratio（TG/HDL-C） in prediction of metabolic syndrome in Polish obese children and adolescents[J]. Acta Biochimica Polonica，2018，65（4）：605
[25] Di Bonito P，Moio N，Scilla C，et al. Usefulness of the high triglyceride-to-HDL cholesterol ratio to identify cardiometabolic risk factors and preclinical signs of organ damage in outpatient children[J]. Diabetes Care，2011，35（1）：158
[26] Quijada Z，Paoli M，Zerpa Y，et al. The triglyceride/HDL-cholesterol ratio as a marker of cardiovascular risk in obese children; association with traditional and emergent risk factors [J]. Pediatric Diabetes，2008，9（5）：464
[27] Tresaco B，Bueno G，Pineda I，et al. Homeostatic model assessment （HOMA） index cut-off values to identify the metabolic syndrome in children[J]. J Physiol Biochem，2005，61（2）：381
[28] Singh Y，Garg M K，Tandon N，et al. A study of insulin resistance by HOMA-IR and its cut- off value to identify metabolic syndrome in urban Indian adolescents[J]. J Clin Res Pediatr Endocrinol，2013，5（4）：245

相似文献/References:

[1]郭彩云,聂秀玲,孙丽荣,等.高尿酸血症/痛风与非酒精性脂肪肝严重程度的相关研究[J].天津医科大学学报,2013,19(06):499.
　GUO Cai-yun,NIE Xiu-ling,SUN Li-rong,et al.Hyperuricemia or gout associated with the severity of nonalcoholic fatty liver disease[J].Journal of Tianjin Medical University,2013,19(01):499.
[2]高雪锦,吴存瑾,王 林,等.代谢综合征及非杓型血压与老年人右心室重构关系[J].天津医科大学学报,2014,20(04):293.
　GAO Xue-jin,WU Cun-jin,WANG Lin,et al.Relationship between right ventricular remodeling and the metabolic syndrome and non-dipper blood pressure in senior people[J].Journal of Tianjin Medical University,2014,20(01):293.
[3]张 甜,李明珍,孙丽荣,等.2型糖尿病患者代谢综合征组分与血清谷氨酰转肽酶的相关性研究[J].天津医科大学学报,2015,21(03):248.
　ZHANG Tian,LI Ming-zhen,SUN Li-rong,et al.Association of metabolism syndrome and its components with serum γ--glutamyl transpeptidase in patients with type 2 diabetes[J].Journal of Tianjin Medical University,2015,21(01):248.
[4]霍 焱,魏会宇,张 捷.辛伐他汀对代谢综合征患者血清内脂素水平的影响[J].天津医科大学学报,2015,21(05):430.
[5]李 杰 综述,刘春雨,解海杰 审校.代谢综合征与泌尿系结石关系的研究进展[J].天津医科大学学报,2017,23(06):576.
[6]宋伟航,韩广业.代谢综合征与经尿道前列腺绿激光剜除术后下尿路症状改善的相关性研究[J].天津医科大学学报,2023,29(06):647.
　SONG Wei-hang,HAN Guang-ye.Correlation between improvement of lower urinary tract symptoms and metabolic syndrome after transurethral green laser enucleation of prostate[J].Journal of Tianjin Medical University,2023,29(01):647.

备注/Memo

备注/Memo:

基金项目 天津市自然科学基金重点项目（17JCZDJC36400）；天津市卫计委重点攻关研究项目（16KG123）； 市科技局科学技术普及项目（18KPHDSF00140）
作者简介 吴楚姗（1993-），女，博士在读，研究方向：儿童内分泌； 通信作者：郑荣秀，E-mail： rzheng@tmu.edn.cn。

常用功能

更新日期/Last Update: 2021-01-10