Índice triglicéridos-glucosa en la predicción de prediabete
DOI:
https://doi.org/10.37135/ee.04.25.02Keywords:
triglicéridos, glucemia, diabetes mellitus, estado prediabético, resistencia a la insulinaAbstract
La prediabetes es un estado de alteración metabólica caracterizado por la resistencia a la insulina mucho antes del diagnóstico de diabetes mellitus tipo 2 (T2DM) y representa una oportunidad clave para la intervención y prevención hacia T2DM. El índice triglicéridos-glucosa (ITG) se ha identificado como un marcador accesible de resistencia a la insulina, con valor diagnóstico potencial en este contexto. El objetivo de este estudio fue evaluar la precisión diagnóstica del ITG en la predicción del estado prediabético en adultos no diabéticos. Se realizó un estudio de casos y controles con datos retrospectivos de 663 adultos no diabéticos atendidos entre 2019 y 2023 en un centro de atención ambulatoria de Guayaquil. Se seleccionaron 221 casos con prediabetes y 442 controles emparejados por edad y sexo. Se aplicaron pruebas no paramétricas, regresión logística binaria y análisis de curvas ROC. El ITG se asoció significativamente OR: 2,83 [IC95 % 1.94 – 4.14]. Un punto de corte del ITG ≥8.54 presentó sensibilidad de 75,1 %, especificidad de 58,1 %, y valor predictivo negativo de 0,82. La combinación de ITG con sobrepeso/obesidad y albúmina <4,15 g/dL mejoró la especificidad hasta 86,7 %. La albúmina baja y el sobrepeso también se asociaron independientemente con mayor riesgo de prediabetes. El ITG mostró adecuada capacidad diagnóstica en la detección de prediabetes, por lo que representa un marcador útil y económico para el tamizaje de T2DM. Su combinación con otras variables mejora la precisión diagnóstica, además de futuras validaciones a fin de ampliar la aplicación clínica.
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