甘油三酯–葡萄糖指数对生长激素型垂体腺瘤患者经神经内镜经鼻蝶窦手术后住院时间延长的预测价值

曹世龙; 吕钿; 于霄

doi:10.70693/cjst.v2i1.1542

Authors

曹世龙云南省第一人民医院
吕钿浙江省诸暨市人民医院
于霄上海交通大学医学院附属第六人民医院

DOI:

https://doi.org/10.70693/cjst.v2i1.1542

Keywords:

生长激素腺瘤；神经内镜；经鼻蝶窦手术；甘油三酯–葡萄糖指数；预测价值

Abstract

探讨甘油三酯–葡萄糖（TyG）指数对生长激素腺瘤患者神经内镜下经鼻蝶窦术后住院时间（LOS）延长的预测价值。方法回顾性收集51例接受上述手术的生长激素腺瘤患者临床资料，按术后住院时间是否延长分为LOS组（14例）与对照组（37例），比较两组TyG指数及基线特征，通过ROC曲线确定TyG指数最佳截断值，采用单、多因素逻辑回归及亚组分析验证其关联性。结果 LOS组TyG指数（4.84±0.43）显著高于对照组（4.60±0.29）（P=0.024）；TyG指数预测术后住院时间延长的最佳截断值为4.75（灵敏度0.64、特异度0.73），且是术后住院时间延长的独立危险因素（OR=9.69，P=0.047）；亚组分析显示其在女性及无糖尿病病史患者中关联性更显著,结论 TyG指数可作为生长激素腺瘤患者神经内镜下经鼻蝶窦术后住院时间延长的独立预测指标，最佳截断值4.75具有较好的预测效能，尤其对女性及无糖尿病病史患者的预测价值更突出，可为临床围手术期风险分层及个体化管理提供重要参考。

References

[1]Petersenn S, Fleseriu M, Casanueva FF, et al. Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement[J]. Nat Rev Endocrinol, 2023, 19(12): 722-740.

[2]Asa SL, Ezzat S. An Update on Pituitary Neuroendocrine Tumors Leading to Acromegaly and Gigantism[J]. Journal of clinical medicine, 2021, 10(11): 2254.

[3]Störmann S, Meyhöfer SM, Groener JB, et al. Management of pasireotide-induced hyperglycemia in patients with acromegaly: An experts' consensus statement[J]. Front Endocrinol (Lausanne), 2024, 15: 1348990.

[4]Tomasik A, Stelmachowska-Banaś M, Maksymowicz M, et al. Clinical, hormonal and pathomorphological markers of somatotroph pituitary neuroendocrine tumors predicting the treatment outcome in acromegaly[J]. Front Endocrinol (Lausanne), 2022, 13: 957301.

[5]Khan DZ, Hanrahan JG, Baldeweg SE, et al. Current and Future Advances in Surgical Therapy for Pituitary Adenoma[J]. Endocrine reviews, 2023, 44(5): 947-959.

[6]Guo S, Wang Z, Kang X, et al. A Meta-Analysis of Endoscopic vs. Microscopic Transsphenoidal Surgery for Non-functioning and Functioning Pituitary Adenomas: Comparisons of Efficacy and Safety[J]. Front Neurol, 2021, 12: 614382.

[7]Bengtsson OF, Sunnergren O, Segerhammar I, et al. Remission, complications, and overall survival in transsphenoidal pituitary surgery-a Swedish single-center experience of 578 patients[J]. Acta Neurochir (Wien), 2023, 165(3): 685-692.

[8]Selvi NMK, Nandhini S, Sakthivadivel V, et al. Association of Triglyceride-Glucose Index (TyG index) with HbA1c and Insulin Resistance in Type 2 Diabetes Mellitus[J]. Maedica (Bucur), 2021, 16(3), 375-381.

[9]Che B, Zhong C, Zhang R, et al. Triglyceride-glucose index and triglyceride to high-density lipoprotein cholesterol ratio as potential cardiovascular disease risk factors: an analysis of UK biobank data[J]. Cardiovasc Diabetol, 2023, 22(1): 34.

[10]Liu X, Tan Z, Huang Y, et al. Relationship between the triglyceride-glucose index and risk of cardiovascular diseases and mortality in the general population: a systematic review and meta-analysis[J]. Cardiovasc Diabetol, 2022, 21(1), 124.

[11]Xuan W, Liu D, Zhong J, et al. Impacts of Triglyceride Glucose-Waist to Height Ratio on Diabetes Incidence: A Secondary Analysis of A Population-Based Longitudinal Data[J]. Front Endocrinol (Lausanne), 2022, 13: 949831.

[12]Xiang Q, Xu H, Zhan J, et al. Association between the Triglyceride-Glucose Index and Vitamin D Status in Type 2 Diabetes Mellitus[J]. Nutrients, 2023, 15(3): 639.

[13]Pan J, Yang X, Zhu W. Domino effect of pituitary growth hormone tumor complicated by diabetic ketoacidosis and pituitary apoplexy: a case report[J]. BMC Endocr Disord, 2021, 21(1): 109.

[14]Nair SK, Chakravarti S, Jimenez AE, et al. Novel Predictive Models for High-Value Care Outcomes Following Glioblastoma Resection. World Neurosurg. 2022, 161:572-579.

[15]Ma L, Zhu W, Wang Y, et al. Association of the triglyceride-glucose index with immunotherapy efficacy and long-term prognosis in advanced Non-small cell lung cancer[J]. Front Oncol, 2025, 15: 1616302.

[16]Okamura T, Hashimoto Y, Hamaguchi M, et al. Triglyceride-glucose index (TyG index) is a predictor of incident colorectal cancer: a population-based longitudinal study[J]. BMC Endocr Disord, 2020, 20(1): 113.

[17]Toh EMS, Lim AYL, Ming C, et al. Association of triglyceride-glucose index with clinical outcomes in patients with acute ischemic stroke receiving intravenous thrombolysis[J]. Scientific reports, 2022, 12(1): 1596.

[18]Hoshino T, Mizuno T, Ishizuka K, et al. Triglyceride-glucose index as a prognostic marker after ischemic stroke or transient ischemic attack: a prospective observational study[J]. Cardiovasc Diabetol, 2022, 21(1): 264.

[19]Kim SH, Park MJ. Effects of growth hormone on glucose metabolism and insulin resistance in human[J]. Ann Pediatr Endocrinol Metab, 2017, 22(3): 145-152.

Hori S, Imamura Y, Kanie Y, et al. Early postoperative hyperglycemia as a predictor of postoperative infectious complications and overall survival in non-diabetic patients with esophageal cancer[J]. J Gastrointest Surg, 2023, 27(12): 2743-2751.