甘油三酯葡萄糖指数与2型糖尿病患者骨质疏松症患病风险的关系OA

Objective To investigate the relationship between the triglyceride-glucose(TyG)index and the risk of osteoporosis(OP)in patients with type 2 diabetes mellitus(T2DM),and to evaluate its ability to identify the risk of OP in these patients.Methods A retrospective study was conducted on 464 T2DM patients.Bone mineral density(BMD)was measured at the L1-L4 lumbar spine,femoral neck,and distal one-third of the radius using dual-energy X-ray absorptiome-try(DXA).OP was defined as a T-score≤-2.5 at any measured site.Laboratory parameters including age,sex,BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),total cholesterol(TC),tri-glycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),glycated hemoglobin(HbA1C),blood urea nitrogen(BUN),uric acid(UA),creatinine(Cr),and 25-hydroxyvitamin D(25(OH)D)were collected.The TyG index was calculated based on FBG and TG.Patients were divided into low,intermedi-ate,and high TyG levels based on the ternary rank of the TyG index.Clinical data differences among patients with differ-ent TyG levels were compared.Multivariate Logistic regression analysis was used to analyze the relationship between TyG index and the risk of OP in patients with T2DM.Receiver operating characteristic(ROC)curves were used to evaluate the discriminative power of TyG index combined with age and gender for OP in T2DM patients.Results Among 464 T2DM patients,156 developed OP,with an OP prevalence of 33.6%.The number of patients with low,intermediate,and high TyG levels were 155,156,and 153,respectively.Statistically significant differences were found among patients with dif-ferent TyG levels in gender composition,OP prevalence,age,BMI,SBP,DBP,FBG,TG,HDL-C,HbA1C,UA,and Cr(all P<0.05).Logistic regression analysis showed that,after unadjusted and stepwise adjustments for age,sex,BMI,blood pressure,BUN,Cr,UA,and 25(OH)D,T2DM patients with intermediate and high TyG levels had a higher risk of OP than those with low TyG levels(P<0.05).ROC curve analysis showed that the area under the curve(AUC)for TyG index in distinguishing OP in T2DM patients was 0.782(95%CI:0.736-0.827,P<0.01);the AUCs for TyG in-dex combined with age,and TyG index combined with age and sex were 0.804(95%CI:0.763-0.846,P=0.021)and 0.820(95%CI:0.780-0.860,P<0.01),respectively.Conclusion Elevated TyG index is associated with an in-creased risk of OP in patients with T2DM;TyG index combined with age and sex can improve the ability to identify OP risk in T2DM patients.