Trigliserid-Glukoz İndeksinin Diyabete İlerleme Riskindeki Rolü: Vaka Kontrol Çalışması

Öz

Amaç: Bu çalışmanın amacı, TyG indeksinin prediyabeti öngörmedeki tanısal performansını değerlendirmek ve birinci basamak sağlık hizmetlerinde bir tarama aracı olarak uygulanabilirliğini incelemektir. Gereç ve Yöntemler: Tek merkezli, retrospektif olgu-kontrol çalışmamıza, aile hekimliği birimine kayıtlı ≥18 yaş bireyler dahil edilmiştir. Çalışmaya 350 prediyabetik birey ve 350 normoglisemik kontrol grubu dahil edilmiş; gruplar cinsiyet açısından eşleştirilmiş, yaş farklılıkları ise regresyon modellerinde düzeltilmiştir. Klinik, antropometrik ve laboratuvar verileri elektronik sağlık kayıtlarından elde edilmiştir. TyG indeksi, açlık glukozu ve trigliserid düzeylerinden hesaplanmıştır. Prediyabet öngörüsünde TyG indeksinin tanısal gücü lojistik regresyon modelleri ve ROC analizi ile değerlendirilmiştir. Bulgular: Prediyabet grubunda TyG indeksi anlamlı derecede yüksek bulunmuştur (8.75 ± 0.52 vs. 8.41 ± 0.52; p<0.001). TyG indeksindeki her bir birimlik artış, prediyabet riskini 2.26 kat artırmıştır (OR=2.26; %95 GA: 1.58–3.22; p<0.001). En yüksek TyG çeyreğinde yer alan bireylerin, en düşük çeyreğe göre 3.71–4.20 kat daha fazla prediyabet riski taşıdığı belirlenmiştir (p<0.001). ROC analizinde TyG indeksinin tek başına ayırt edici gücü orta düzeyde bulunmuş (AUC=0.680); açlık plazma glukozu ve yaşam tarzı değişkenleri eklendiğinde tanısal doğruluk artmıştır (AUC=0.834). TyG indeksi, HbA1c, açlık glukozu, lipid parametreleri ve bel çevresi ile anlamlı ilişki göstermiştir. Sonuç: TyG indeksi, birinci basamak sağlık hizmetlerinde prediyabetin erken tanısında kullanılabilecek, düşük maliyetli, erişilebilir ve etkili bir tarama aracıdır. Çalışmamız tek merkezli bir çalışma olduğu için elde edilen bulgular yalnızca bu hasta grubunu yansıtmaktadır. Bu konu ile ilgili ülkemiz adına çok merkezli ileri çalışmalara ihtiyaç vardır. Bununla birlikte, TyG indeksinin klinik uygulamalara entegrasyonu tip 2 diyabetin önlenmesine yönelik risk sınıflandırmasını geliştirebilir

Anahtar Kelimeler

• Trigliserid-glukoz indeksi
• Prediyabet
• Birinci basamak
• ROC analizi
• Risk öngörüsü

The Role of the Triglyceride-Glucose Index in the Risk of Progression to Type 2 Diabetes Mellitus: A Case Control Study

Öz

Aim: The objective of this research was to investigate the diagnostic ability of the triglyceride–glucose (TyG) index in identifying prediabetes and to determine whether it could serve as a feasible screening instrument in primary healthcare. Material and Methods: Our single-center, retrospective case–control study enrolled individuals aged 18 years or older who were registered at a family medicine unit. A total of 350 prediabetic individuals and 350 normoglycemic controls were included; the groups were matched by gender, while age differences were adjusted for in the regression models. Clinical, anthropometric, and laboratory data were retrieved from electronic health records. Fasting plasma glucose and triglyceride levels were used to calculate the TyG index. The diagnostic performance of the TyG index for predicting prediabetes was assessed through logistic regression modeling and receiver operating characteristic (ROC) analysis. Results: The TyG index was markedly elevated in individuals with prediabetes compared with those in the control group (8.75 ± 0.52 vs. 8.41 ± 0.52; p<0.001). Each one-unit increase in the TyG index was associated with a 2.26-fold higher risk of prediabetes (OR=2.26; 95% CI: 1.58–3.22; p<0.001). Individuals in the highest TyG quartile had a 3.71–4.20-fold greater risk of prediabetes compared with those in the lowest quartile (p<0.001). ROC analysis demonstrated moderate discriminatory ability of the TyG index alone (AUC=0.680); however, diagnostic accuracy improved when fasting plasma glucose and lifestyle variables were incorporated (AUC=0.834). The TyG index showed significant correlations with HbA1c, fasting plasma glucose, lipid parameters, and waist circumference. Conclusion: The TyG index is a low-cost, accessible, and effective screening tool that may facilitate the early detection of prediabetes in primary healthcare settings. As the study setting was restricted to a single center, the findings reflect only the characteristics of the studied patient group; therefore, multicenter studies at the national level are warranted. Nevertheless, the integration of the TyG index into clinical practice may enhance risk stratification strategies and help reduce the risk of progression to diabetes mellitus

Anahtar Kelimeler

• Triglyceride-glucose index
• Prediabetes
• Primary care
• ROC analysis
• Risk prediction

Kaynakça

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