甘油三酯葡萄糖指数、血尿酸/HDL-C比值对老年2型糖尿病肾病的影响及诊断价值研究

doi:10.3969/j.issn.1003-9198.2026.05.009

摘要/Abstract

摘要： 目的探讨甘油三酯葡萄糖指数(TyG指数)、血尿酸(SUA)/HDL-C比值(UHR)对老年2型糖尿病肾病的影响及诊断价值。方法对2023年2月至2025年10月南京中医药大学附属医院内分泌科收治的251例老年T2DM患者的临床资料进行回顾性分析,根据是否合并糖尿病肾病(DKD),分为单纯T2DM组(n＝150)及DKD组(n＝101)。对比2组基线临床资料、生化指标、TyG指数及UHR。采用Spearman秩相关分析TyG指数、UHR与其他指标的相关性,采用二元logistic回归分析探讨老年T2DM患者发生DKD的独立影响因素,采用ROC曲线评估TyG指数、UHR及联合检测对老年T2DM患者DKD的诊断价值。结果 DKD组TyG指数、UHR水平均高于单纯T2DM组(P＜0.05)。TyG指数与BMI、HbA1c、FPG、TG、TC、LDL-C、SUA、尿白蛋白/肌酐比值(UACR)及UHR呈正相关,与HDL-C呈负相关;UHR与BMI、DM病程、SBP、TG、SUA、血肌酐(Scr)、UACR、TyG指数呈正相关,与TC、HDL-C、eGFR呈负相关(P＜0.05)。多因素logistic回归分析显示,TyG指数、UHR均是老年T2DM患者DKD发生的独立危险因素(P＜0.05)。TyG指数、UHR单项及联合检测诊断老年T2DM患者发生DKD的AUC分别为0.765、0.831、0.882,联合检测的诊断效能优于单项检测(均P＜0.05)。结论 TyG指数、UHR与老年T2DM患者DKD发生密切相关,联合检测诊断效能高于单一指标。

关键词: 甘油三酯葡萄糖指数, 血尿酸/高密度脂蛋白胆固醇比值, 老年人, 2型糖尿病, 糖尿病肾病

Abstract: Objective To investigate the impact and diagnostic value of triglyceride glucose (TyG) index and serum uric acid (SUA)/high density lipoprotein cholesterol (HDL-C) ratio (UHR) for the occurence of diabetic kidney disease (DKD) in elderly patients with type 2 diabetes mellitus (T2DM). Methods A retrospective analysis was conducted on the clinical data of 251 elderly T2DM patients hospitalized in Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, from February 2023 to October 2025. According to whether they were complicated with DKD, all patients were divided into simple T2DM group (n=150) and combined DKD group (n=101). Baseline characteristics, biochemical parameters, TyG index and UHR were compared between the two groups. Spearman correlation analysis was adopted to assess the relationships among TyG index, UHR and other parameters. Binary logistic regression was applied to identify the risk factors for DKD. Receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of TyG index, UHR and combined detection for DKD. Results The levels of TyG index and UHR in the combined DKD group were higher than those in the simple T2DM group (P＜0.05). The TyG index was positively correlated with BMI, HbA1c, FPG, TG, TC, LDL-C, SUA, urinary albumin-to-creatinine ratio(UACR) and UHR, and negatively correlated with HDL-C. UHR was positively correlated with BMI, DM duration, SBP, TG, SUA, Scr, UACR and TyG index, and negatively correlated with TC, HDL-C and eGFR (P＜0.05). Both TyG index and UHR were independent risk factors for the occurrence of DKD (P＜0.05). The areas under the curve for the diagnosis of DKD were 0.765 for TyG index alone, 0.831 for UHR alone, and 0.882 for their combination, respectively. The diagnostic efficacy of the combined detection was superior to that of any single indicator (both P＜0.05). Conclusions The TyG index and UHR are closely related to DKD progression in elderly patients with T2DM. The combined detection of these two indicators demonstrates higher diagnostic efficacy than either indicator alone.

Key words: triglyceride glucose index, serum uric acid/high density lipoprotein cholesterol ratio, aged, type 2 diabetes mellitus, diabetic kidney disease

中图分类号:

李舒怡, 郭婧怡, 阮园, 孙心怡, 缪鋆鋆, 黄莉吉, 余江毅, 王丽娟. 甘油三酯葡萄糖指数、血尿酸/HDL-C比值对老年2型糖尿病肾病的影响及诊断价值研究[J]. 实用老年医学, 2026, 40(5): 479-483.

LI Shuyi, GUO Jingyi, RUAN Yuan, SUN Xinyi, MIAO Junjun, HUANG Liji, YU Jiangyi, WANG Lijuan. Study on the impact and diagnostic value of triglyceride glucose index and serum uric acid/HDL-C ratio on diabetic kidney disease progression in elderly patients with type 2 diabetes mellitus[J]. Practical Geriatrics, 2026, 40(5): 479-483.

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