Gül KIRTIL, Medine ALPDEMİR, Mehmet Fatih ALPDEMİR, Mehmet ŞENEŞ

İzole Bozulmuş Glukoz Toleransı Olan Erişkinlerde Bir İnsülin Direnci Belirteci Olarak Trigliserit-Glukoz İndeksinin Değerlendirilmesi

Giriş: Amacımız uzun dönem laboratuvar verilerini analiz ederek, izole bozulmuş açlık glukoz (BAG)'lu yetişkin popülasyon da TyG ile İnsülin Direncinin Homeostatik Modeli Değerlendirmesi (HOMA-IR) arasındaki ilişkiyi değerlendirmek ve IR'yi ön görmek için popülasyonumuzdaki TyG kesim değerini belirlemektir. Araçlar ve Yöntem: Bu çalışmada BAG ve sağlıklı toplam 440 erişkin birey retrospektif olarak değerlendirildi. Klinik veriler tıbbi kayıtlardan toplandı. Açlık glukozu, lipid paneli [total kolesterol, trigliserid (TG), düşük dansiteli lipoprotein (LDL), yüksek dansiteli lipoprotein (HDL)] ve insülin düzeyleri ticari reaktifler kullanılarak ölçüldü. (Roche Cobas C701, Roche Diagnostic, Germany). Hemoglobin A1c (HbA1c) ise yüksek performanslı likit kromotografi (HPLC) (Lifotronic H9, Lifotrophic Technology, China) ile ölçüldü. TyG, HOMA-IR ve TG/HDL-kolesterol hesaplandı. HOMA-IR ≥2.5 olanlar IR olarak tanımlandı. Bulgular: Çalışmamıza 230'u kontrol, 210'u BAG olan hasta dahil edildi. Kontrol hastaları için ortalama yaş 42.5±12.0 yıl ve BAG’li hasta grubu için 44.7±10.7 yıl idi. Glukoz, total kolesterol, HbA1c, TG, LDL-kolesterol, insülin, TG/HDL-kolesterol, HOMA-IR ve TyG indeksi BAG hasta grubunda anlamlı olarak yüksek bulundu (p<0.001). HOMA-IR ile TyG indeksi arasında zayıf fakat anlamlı bir korelasyon vardı (r=0.210, p=0.009). ROC analizine göre HOMA-IR için AUC 0.867 (%95 Güven Aralığı (GA), 0.833-0.900, p<0.001) ve TyG indeksi için AUC 0.708 (%95 GA, 0.659-0.758, p<0.001) bulundu. Sonuç: Çalışmamıza göre, TyG indeksi, BAG'li hastalarda IR’nin değerlendirmesi için nispeten doğru, basit, kolay erişilebilir ve düşük maliyetli bir belirteç olarak önerilmektedir. Ancak popülasyonumuz için daha yüksek hasta katılımı olan popülasyon temelli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

HOMA-IR, İnsülin direnci, TG/HDL-C, TyG indeksi, Bozulmuş açlık glukozu, Bozulmuş glukoz toleransı

Evaluation of the Triglyceride Glucose Index as a Marker of Insulin Resistance in Adults with Isolated Impaired Glucose Tolerance

Purpose: By analyzing long-term laboratory data, we aim to evaluate the relationship between the TyG and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in the adult population with isolated impaired fasting glucose (IFG), and also to determine the cut off value of The triglyceride (TG) to glucose index (TyG) to estimate the IR in our population. Materials and Methods: In this study, data were evaluated retrospectively from medical records. Fasting glucose, lipid panel [Total cholesterol, TG, High-density lipoprotein (HDL), Low-density lipoprotein (LDL)] and insulin levels were analyzed with commercially reagents. (Roche Cobas C701, Roche Diagnostic, Germany). High-Performance Liquid Chromatography (HPLC) method was used for hemoglobin A1c (HbA1c) (Lifotronic H9, Lifotrophic Technology, China). TyG, HOMA-IR, and TG/HDLcholesterol were calculated. IR was defined as HOMA-IR ≥2.5. Results: A total of 440 subject, (controls: 230 and IFG:210), were included in our study. The average age of the subjects was 42.5±12.0 years and 44.7±10.7 years for IFG and control, respectively. Glucose, total cholesterol, TG, LDL-cholesterol, insulin, HbA1c, TG/HDL-cholesterol, HOMA-IR, and TyG were significantly higher in the IFG group (p<0.001). There was a weak but significant correlation between HOMA-IR and the TyG (r=0.210, p=0.009). In the ROC analysis, the AUC for HOMA-IR and the TyG, respectively was 0.867 (95% CI, 0.833-0.900, p<0.001) and 0.708 (95% CI, 0.659-0.758, p<0.001). Conclusions: In our study, the TyG is proposed as a relatively accurate, simple, easily accessible, and low-cost marker for IR evaluation with IFG patients. However, population-based studies with higher patient participation are needed for future studies.

Keywords:

HOMA-IR, Insulin resistance, TG/HDL-C, TyG index, Impaired fasting glucose, Impaired glucose tolerance,

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