Trigliserit/Glikoz İndeksi (TyG) ve Trigliserit/HDL-Kolesterol Oranı (TG/HDL-c) Gestasyonel Diyabeti Tahmin Edebilir mi?

Yıl 2023, Cilt: 56 Sayı: 2, 117 - 120, 30.09.2023

Seval Yılmaz Ergani , Tolgay Tuyan İlhan , Betül Tokgöz , Burak Bayraktar , Mevlüt Bucak , Müjde Can İbanoğlu , Kadriye Yakut Yücel , Kadriye Erdoğan , Cantekin İskender , Yaprak Üstün

https://doi.org/10.20492/aeahtd.1327956

Öz

AMAÇ: Birinci trimesterde trigliserit/glukoz indeksi (TyG) ve trigliserid/HDL-kolesterol oranı (TG /HDL-c) ölçümünün gestasyonel diyabetes mellitusu (GDM) tahmin edip edemeyeceğini araştırdık.
GEREÇ VE YÖNTEM: Gebelikte GDM'li 25 hasta ve glisemik kontrolü normal olan GDM'siz 52 hasta kontrol grubu olarak çalışmaya alındı. GDM tanısına hem insülin kontrollü diyabet hem de diyet kontrollü diyabet dahil edildi. İlk trimesterde ölçülen TG, HDL-c, TyG indeksi ve TG /HDL-c'yi içeren açlık glukoz ve plazma lipid profilleri analiz edildi.
BULGULAR: Trigliserit değerleri (ortalama gestasyonel diabetes grubunda 133±40 mg/dL, kontrol grubunda 100±54 mg/dL), TyG indeksi (ortalama gestasyonel diabetes grubunda 15,0±8,9, kontrol grubunda 8,8±5,0) ve TG/HDL-K oranı (ortalama gestasyonel diabetes grubunda 3,3±2,6 kontrol grubunda 1,9±2,6) GDM grubunda anlamlı olarak daha yüksek bulundu(sırasıyla p=0.01, p=0.01, p=0.01) GDM'yi öngörmek için TyG indeksi için optimal kesme değeri 10,4, duyarlılık %76, özgüllük %77 ve ROC analizinde eğri altında kalan alan (AUC) 0,765 idi (p < 0,001). GDM'yi öngörmek için TG/HDL-K oranı için optimal kesme değeri 2,3, duyarlılık %76, özgüllük 69, AUC 0,697 idi (p=0,005).
SONUÇ: İlk trimesterde ölçülen TyG ve TG/HDL-C oranının GDM'yi açlık plazma glukozundan daha iyi öngördüğü düşünülmektedir.

Anahtar Kelimeler

Gestasyonel diabetes mellitus, birinci trimester, gebelik, Trigliserit/Glikoz İndeksi, Trigliserit/HDL-Kolesterol Oranı

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Yok.

Can Triglyceride/Glucose Index (TyG) and Triglyceride/HDL-Cholesterol Ratio (TG/HDL-c) Predict Gestational Diabetes Mellitus?

Öz

AIM: We investigated whether measurement of triglyceride/glucose index (TyG) and triglyceride/HDL-cholesterol ratio (TG /HDL-c) in the first trimester can predict gestational diabetes mellitus (GDM).
MATERIAL AND METHOD: Twenty-five patients with GDM and 52 women without GDM with normal glycemic control during pregnancy were included in the study as a control group. Both insulin-controlled diabetes and diet-controlled diabetes were included in the diagnosis of GDM. Fasting glucose and plasma lipid profiles including TG, HDL-c, TyG index, and TG /HDL-c measured in the first trimester were analyzed.
RESULTS: Triglyceride values (mean 133±40 mg/dL in the gestational diabetes group, 100±54 mg/dL in the control group), TyG index (15.0±8.9 in the mean gestational diabetes group, 8.8±5.0 in the control group), and TG/HDL-C ratio (mean 3.3±2.6 in the gestational diabetes group and 1.9±2.6 in the control group) was found to be significantly higher in the GDM group (p=0.01, p=0.01, p=0.01, respectively). The optimal cutoff value for TyG index was 10.4, sensitivity was 76%, specificity was 77%, and area under the receiver characteristic curve (AUC) was 0.765 to predict GDM (p < 0.001). The optimal cutoff value for the TG /HDL-C ratio was 2.3, sensitivity was 76%, specificity was 69, AUC 0.697 to predict GDM (p=0.005).
CONCLUSION: TyG and TG/HDL-C ratio measured in the first trimester are thought to predict GDM better than fasting plasma glucose.

Anahtar Kelimeler

Gestational diabetes mellitus, first trimester, pregnancy, Triglyceride/Glucose Index, Triglyceride/HDL-Cholesterol Ratio

Proje Numarası

Yok

Kaynakça

• 1. Tenenbaum-Gavish K, Hod M. Impact of maternal obesity on fetal health. Fetal Diagn Ther. 2013;34(1):1-7.
• 2. Hajagos-Tóth J, Ducza E, Samavati R, Vari SG, Gaspar R. Obesity in pregnancy: a novel concept on the roles of adipokines in uterine contractility. Croat Med J. 2017;58(2):96-106.
• 3. Kim MH, Kwak SH, Kim S-H, et al. Pregnancy outcomes of women additionally diagnosed as gestational diabetes by the International Association of the Diabetes and Pregnancy Study Groups Criteria. Diabetes Metab J. 2019;43(6):766-775.
• 4. Navarro-González D, Sánchez-Íñigo L, Pastrana-Delgado J, Fernández-Montero A, Martinez JA. Triglyceride–glucose index (TyG index) in comparison with fasting plasma glucose improved diabetes prediction in patients with normal fasting glucose: the Vascular-Metabolic CUN cohort. Prev Med. 2016;86:99-105.
• 5. Low S, Khoo KCJ, Irwan B, et al. The role of triglyceride glucose index in development of Type 2 diabetes mellitus. Diabetes Res Clin Pract. 2018;143:43-49.
• 6. Babic N, Valjevac A, Zaciragic A, Avdagic N, Zukic S, Hasic S. The triglyceride/HDL ratio and triglyceride glucose index as predictors of glycemic control in patients with diabetes mellitus type 2. Med Arch. 2019;73(3):163.
• 7. Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982;144(7):768-773.
• 8. Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008;6(4):299-304.
• 9. Liu PJ, Liu Y, Ma L, et al. The predictive ability of two triglyceride-associated indices for gestational diabetes mellitus and large for gestational age infant among Chinese pregnancies: a preliminary cohort study. Diabetes Metab. Syndr. Obes.: Targets Ther. 2020;13:2025.
• 10. Pazhohan A, Rezaee Moradali M, Pazhohan N. Association of first-trimester maternal lipid profiles and triglyceride-glucose index with the risk of gestational diabetes mellitus and large for gestational age newborn. J Matern Fetal Neonatal Med. 2019;32(7):1167-1175.
• 11. Sánchez-García A, Rodríguez-Gutiérrez R, Saldívar-Rodríguez D, et al. Diagnostic accuracy of the triglyceride-glucose index for gestational diabetes screening: a practical approach. Gynecol Endocrinol. 2020;36(12):1112-1115.
• 12. Sánchez‐García A, Rodríguez‐Gutiérrez R, Saldívar‐Rodríguez D, et al. Early triglyceride and glucose index as a risk marker for gestational diabetes mellitus. Int J Gynaecol Obstet. 2020;151(1):117-123.
• 13. Kim JA, Kim J, Roh E, et al. Triglyceride and glucose index and the risk of gestational diabetes mellitus: A nationwide population-based cohort study. Diabetes Res Clin Pract. 2021;171:108533.
• 14. Song T, Su G, Chi Y, Wu T, Xu Y, Chen C. Triglyceride–glucose index predicts the risk of gestational diabetes mellitus: a systematic review and meta-analysis. Gynecol Endocrinol. 2022;38(1):10-15.
• 15. Chauhan A, Singhal A, Goyal P. TG/HDL Ratio: A marker for insulin resistance and atherosclerosis in prediabetics or not? J Family Med Prim Care. 2021;10(10):3700.
• 16. Zhou F, Sun X, Liu J, Li L, Li L, Li P. Triglyceride to high-density lipoprotein cholesterol ratio in adolescence as a predictive marker of metabolic syndrome and obesity in early adulthood in China. Endocrine. 2022;76(2):331-340.
• 17. Giannini C, Santoro N, Caprio S, et al. The triglyceride-to-HDL cholesterol ratio: association with insulin resistance in obese youths of different ethnic backgrounds. Diabetes Care. 2011;34(8):1869-1874.
• 18. Bulletins-Obstetrics C. ACOG practice bulletin no. 190: gestational diabetes mellitus. Obstet Gynecol. 2018;131(2):e49-e64.
• 19. Benhalima K, Hanssens M, Devlieger R, Verhaeghe J, Mathieu C. Analysis of pregnancy outcomes using the new IADPSG recommendation compared with the Carpenter and Coustan criteria in an area with a low prevalence of gestational diabetes. Int J Endocrinol. 2013;2013.
• 20. Organization WH. World health statistics 2015. World Health Organization; 2015.
• 21. http://data.oecd.org/healthcare/caesarean-sections.htm Hcu-Cs-ODItcJAf.