甘油三酯葡萄糖乘积指数与2型糖尿病足溃疡复发的相关性研究

Correlation between triglyceride glucose index and foot ulcer recurrence in type 2 diabetes mellitus

  • 摘要:
    目的  探索甘油三酯葡萄糖(TyG)指数与2型糖尿病足溃疡(DFU)复发风险的相关性。
    方法  回顾性纳入2020年1月至2023年12月在天津医科大学朱宪彝纪念医院就诊的617例DFU患者,从电子医疗系统回顾性提取符合条件的患者数据。为了评估TyG与DFU复发之间的关联,构建4个多变量回归模型。根据性别、年龄等进行分层并分析其与TyG的交互作用。
    结果  在未调整模型中,与TyG指数三分位数1(T1)相比,三分位数3(T3)与DFU的复发有关[OR(95%CI) = 3.272(2.001,5.351),P < 0.001]。此外,这种关联在最后调整的模型中仍然存在[OR(95%CI) = 3.697(2.099,6.511),P < 0.001]。亚组及交互作用分析结果显示,溃疡部位、抗血小板药物使用情况以及BMI与TyG指数和DFU复发之间存在相互作用。在男性、年龄≥65岁、吸烟、糖尿病病程≥20年、溃疡位于足底、存在足部畸形、不使用他汀类药物、使用抗血小板药物、收缩压 < 140 mmHg以及BMI≥24 kg/m2的患者中发现了更明显的影响。
    结论  较高的TyG指数与2型糖尿病患者糖尿病足溃疡复发独立相关,TyG指数可以作为评估DFU复发风险的有效工具。

     

    Abstract:
    Objective  To investigate the correlation between triglyceride-glucose (TyG) index and the risk of foot ulcer recurrence in type 2 diabetes mellitus.
    Methods  Clinical data of 617 diabetic foot ulcer (DFU) patients admitted to Zhu Xianyi Memorial Hospital of Tianjin Medical University from January 2020 to December 2023 were retrospectively analyzed. Clinical data of eligible patients were extracted retrospectively from the electronic medical system. To evaluate the association between TyG and DFU recurrence, four multivariate regression models were constructed. After stratification based on covariates such as gender and age, their interaction with TyG was also analyzed.
    Results  In the unadjusted model, compared with TyG index tertiles 1 (T1) as a reference, tertiles 3 (T3) was associated with the recurrence of DFU (OR = 3.272, 95%CI: 2.001, 5.351, P < 0.001). In addition, this association still existed in the fully-adjusted model (OR = 3.697, 95% CI: 2.099, 6.511, P < 0.001). Subgroup and interaction analysis results showed that there was interaction between ulcer site, antiplatelet drug use, body mass index (BMI) and TyG index, and DFU recurrence. More significant effects were found in men, ≥65 years of age, smoking, diabetes mellitus with a course of ≥20 years, ulcers in the plantar region, foot deformities, no use of statins, use of antiplatelet drugs, systolic blood pressure < 140 mmHg, and BMI ≥ 24 kg/m2.
    Conclusion  A high TyG index is independently associated with the recurrence of DFU in type 2 diabetes mellitus patients. TyG index can serve as an effective tool for assessing the risk of DFU recurrence.

     

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