目的：探讨采用甘油三脂-葡萄糖(TyG)指数识别2型糖尿病患者发生糖尿病视网膜病变(DR)的有效性。

方法：横断面研究。对2021年来我院进行健康体检的上海地区1 061例2型糖尿病患者，所有受试者行问卷调查、体格检查、血液生化指标检测及眼底检查，根据眼底照片分为DR组(275例)和无DR组(786例)。采用单因素及多因素Logistic回归探讨DR形成的危险因素，使用受试者操作特性(ROC)曲线来探索TyG指数在DR中的预测价值。

结果：TyG指数升高是2型糖尿病患者发生DR的高危因素。在矫正各种混杂因素(性别、年龄、吸烟史、糖尿病病程、糖化血红蛋白、收缩压、舒张压、体质量指数和血尿酸)后，TyG指数Q4组相对于Q1组患DR的OR值为2.57(95%CI 1.56～4.05)，P<0.001。ROC曲线分析：TyG指数的最佳临界值是6.1762，灵敏度为66.92%，特异度为63.27%，AUC为0.6952，95%CI为0.6575～0.7329。TyG指数对于DR的预测价值要优于空腹血糖(AUC=0.6697)、糖化血红蛋白(AUC=0.6864)和甘油三酯(AUC=0.6521)。

结论：TyG指数与DR的发病风险显著相关，可作为2型糖尿病患者发生DR的一个早期有效的预测因子。

METHODS: A cross-sectional study. A total of 1061 type 2 diabetic patients in Shanghai who underwent health checkup in our hospital in 2021, all the subjects underwent questionnaire survey, physical examination, blood biochemical index detection and fundus examination. According to the fundus photos, they were divided into DR group(275 cases)and no DR group(786 cases). Risk factors for DR were evaluated by univariate and multivariate Logistic regression analyses, receiver operating characteristic(ROC)curve was used to analyse the predicted values of TyG with DR.

RESULT: Elevated TyG index was an high risk factor for development of DR in type 2 diabetic patients. After adjusting for multiple confounding factors(gender, age, smoking history, the course of diabetes, glycosylated hemoglobin, systolic blood pressure, diastolic blood pressure, body mass index and serum uric), the OR value of the DR in the TyG index Q4 group relative to the Q1 group was 2.57(95%CI: 1.56-4.05), P<0.001. ROC curve analysis: the optimal cutoff value of TyG index was 6.1762, with a sensitivity of 66.92% and a specificity 63.27%, the AUC was 0.6952 and 95%CI was 0.6575-0.7329.TyG index had better predictive abilities than fasting blood glucose(AUC=0.6697), glycosylated hemoglobin(AUC=0.6864)and triglycerides(AUC=0.6521).

CONCLUSION: The TyG index correlates well with the onset risk of DR and potentially is a useful predictive factors, especially in the early stages of DR in patients with type 2 diabetes.