目的 评估健康体检人群中不同胰岛素抵抗替代指数对胆囊结石患病风险的影响及其预测价值。方法 选取2018-01至2023-12在中国中医科学院西苑医院体检中心8 833名体检者为研究对象,使用多变量逻辑回归模型探讨不同胰岛素抵抗替代指数与胆囊结石患病风险之间的关系。广义加性模型用于检验是否存在非线性关联。构建一个两段线性回归模型,用递归算法计算拐点,并进行亚组分析和交互作用检验。此外,使用受试者工作特征(ROC)曲线评估不同胰岛素抵抗替代指数对胆囊结石的预测价值。结果 在调整了全部混杂变量的回归模型中,三酰甘油-葡萄糖指数(TyG)、三酰甘油葡萄糖-体重指数(TyG-BMI)、胰岛素抵抗代谢评分(METS-IR)与胆囊结石之间关联的OR(95%CI)分别为1.40(1.18,1.66),1.01(1.00,1.01)和1.04(1.02,1.05)。TyG、TyG-BMI和METS-IR与胆囊结石之间存在非线性关联,TyG-BMI和METS-IR转折点分别为162.12和26.63。TyG、TyG-BMI和METS-IR与胆囊结石之间关联在年龄中均存在交互作用。ROC曲线下面积分别为0.60,0.61,0.59。结论 成人胆囊结石的患病风险随TyG、TyG-BMI和METS-IR指数的升高而增加,TyG、TyG-BMI和METS-IR指数可能对胆囊结石的发病风险具有重要预测价值。
Abstract
Objective To evaluate the effect and predictive value of different insulin resistance replacement indices on the risk of gallbladder stones in healthy physical examination population. Methods A total of 8,833 individuals who underwent physical examination at the Physical Examination Center of Xiyuan Hospital of the China Academy of Traditional Chinese Medicine from January 2018 to December 2023 were selected as the research subjects, and a multivariate logistic regression model was used to explore the relationship between different insulin resistance replacement indices and the risk of gallbladder stone. A generalized additive model was used to test for the presence of nonlinear associations. The two-stage linear regression model was constructed and the turning points were calculated using the recursive algorithm, and subgroup analyses and interaction tests were also performed. In addition, the predictive value of different insulin resistance replacement indices for gallbladder stones was assessed using the receiver operating characteristic (ROC) curve. Results In the regression model adjusted for all confounding variables, the OR (95% CI) of the associations between riglyceride-glucose index (TyG), triglyceride-glucose-weight index (TyG-BMI) and insulin resistance metabolic score (METS-IR)(METS-IR) and gallbladder stones were 1.40 (1.18, 1.66), 1.01 (1.00, 1.01) and 1.04 (1.02, 1.05), respectively. There was nonlinear associations between TyG, TyG-BMI and METS-IR and gallbladder stones, with the turning points of TyG-BMI and METS-IR being 162.12 and 26.63, respectively. The associations between TyG, TyG-BMI and METS-IR and gallbladder stones were all interactive with age. The areas under the ROC curves were 0.60, 0.61, and 0.59, respectively. Conclusions The risk of gallbladder stones in adults increases with the increase of TyG, TyG-BMI and METS-IR indices, and TyG, TyG-BMI and METS-IR indices may have important predictive value for the risk of gallbladder stones.
关键词
胆囊结石 /
胰岛素抵抗 /
回顾性研究 /
预测价值
Key words
gallbladder stones /
insulin resistance /
retrospective study /
predictive value
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基金
北京中医药薪火传承“3+3”工程项目(2023-SZ-A-5);中国中医科学院科技创新工程(CI2021A03005);国家重点研发计划资助项目(2018YFC2000600)
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