甘油三酯葡萄糖指数和体圆度指数的联合作用对中国老年人群痴呆发病风险的影响:一项基于CHARLS的队列研究

doi:10.3969/j.issn.1003-9198.2026.06.006

摘要/Abstract

摘要： 目的探讨甘油三酯葡萄糖指数(triglyceride glucose index, TyG)和体圆度指数(body roundness index, BRI)单独及联合作用对老年人群痴呆发病风险的影响。方法数据来源于2011年中国健康与养老追踪调查(CHARLS)项目,选取其中2 710名基线无痴呆的老年人作为研究对象,收集一般人口学资料和临床资料,计算TyG和BRI并按中位数分组;记录2018年随访时痴呆的发生情况。采用logistic回归模型分析TyG、BRI与痴呆发病之间的关联,并进一步分析其相加和相乘交互作用。结果 2 710名研究对象平均年龄为(66.5±5.5)岁。2018年随访时,共有443例新发痴呆病例,痴呆发病率为16.3%。在调整年龄、性别、教育水平、婚姻状况、居住地、BMI、吸烟、饮酒、社交活动、糖尿病、高血压、心血管疾病、血脂异常及基线认知功能后,高TyG(OR=1.41,95%CI:1.09~1.82)和高BRI(OR=1.68,95%CI:1.22~2.32)均增加痴呆发生风险。与低TyG和低BRI组相比,高TyG和高BRI组的痴呆风险最高(OR=2.28,95%CI:1.53~3.41)。未发现TyG与BRI存在显著的相加或相乘交互作用。分层分析结果显示,高TyG与高BRI的联合作用与痴呆风险的关联在≥65岁(OR=2.68, 95%CI:1.62~4.44)和当前吸烟(OR=3.29, 95%CI:1.53~7.08)的研究对象中更强。结论 TyG和BRI都与痴呆密切相关。TyG和BRI的联合评估增强了痴呆的预测能力,强调了胰岛素抵抗和内脏肥胖在识别和筛查痴呆风险中的关键作用。

关键词: 痴呆, 甘油三酯葡萄糖指数, 体圆度指数, 队列研究

Abstract: Objective To investigate the independent and joint effects of the triglyceride glucose index (TyG) and the body roundness index (BRI) on the risk of dementia in the elderly. Methods The data were obtained from the 2011 China Health and Retirement Longitudinal Study (CHARLS), and a total of 2 710 older adults without dementia at baseline were selected, who underwent questionnaire surveys and physical examinations. Participants were categorized based on the median values of TyG and/or BRI. The occurrence of dementia during the follow-up in 2018 was recorded. Logistic regression models were used to analyze the associations between TyG/BRI and dementia onset, and their additive and multiplicative interactions were further assessed. Results The mean age of the 2 710 participants was 66.5±5.5 years. During follow-up in 2018, a total of 443 incident dementia cases were identified, with an incidence rate of 16.3%. In the multivariable-adjusted models, after adjusting for age, gender, educational level, marital status, residence, body mass index, smoking, alcohol consumption, social engagement, diabetes, hypertension, cardiovascular disease, dyslipidemia, and baseline cognitive function, both high TyG (OR=1.41,95%CI:1.09-1.82) and high BRI(OR=1.68,95%CI:1.22-2.32)were associated with an increased risk of dementia. Compared to the low TyG/low BRI group, the group with high TyG and high BRI had the highest risk of dementia (OR=2.28,95%CI:1.53-3.41). No significant additive or multiplicative interaction was found between TyG and BRI. Subgroup analysis further revealed that the joint effect of high TyG and high BRI on dementia risk was more pronounced among participants aged ≥65 years(OR=2.68, 95%CI:1.62-4.44) and among current smokers(OR=3.29, 95%CI:1.53-7.08). Conclusions Both TyG and BRI are significantly associated with dementia. The combined assessment of TyG and BRI enhances the predictive capability for dementia, underscoring the critical role of insulin resistance and visceral obesity in identifying and screening individuals for dementia risk.

Key words: dementia, triglyceride glucose index, body roundness index, cohort study

中图分类号:

R 749.16

张丽颖, 张璐璐, 王娇. 甘油三酯葡萄糖指数和体圆度指数的联合作用对中国老年人群痴呆发病风险的影响:一项基于CHARLS的队列研究[J]. 实用老年医学, 2026, 40(6): 566-572.

ZHANG Liying, ZHANG Lulu, WANG Jiao. Joint effect of triglyceride glucose index and body roundness index on incidence risk of dementia in Chinese older adults: a cohort study of CHARLS[J]. Practical Geriatrics, 2026, 40(6): 566-572.

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