新型胰岛素抵抗指数与代谢性疾病相关性的 研究进展

Research Advances on the Correlation between Novel Insulin Resistance Indices and Metabolic Diseases

摘要: 胰岛素抵抗(Insulin Resistance, IR)作为关键的病理生理机制，与2型糖尿病、代谢综合征、动脉粥样硬化性心血管疾病以及缺血性脑卒中等多种疾病的发生发展密切相关。尽管高胰岛素–正葡萄糖钳夹技术被公认为评估胰岛素抵抗的传统金标准，但其操作流程复杂、实施成本较高且属于有创检查，因此在常规临床实践与大规模流行病学研究中难以广泛应用。近年来，多种基于常规代谢指标的新型胰岛素抵抗替代评估指数不断涌现，包括但不限于甘油三酯–葡萄糖指数(TyG)、其联合体质量指数的衍生指标(TyG-BMI)、胰岛素抵抗代谢评分(METS-IR)，以及血浆致动脉粥样硬化指数(AIP)等。这些新型指数综合了血糖、血脂、肥胖程度及脂质构成等多方面信息，具备操作简便、无创、成本低廉以及易于获取等显著优势。目前，它们已在代谢性疾病的危险分层、临床评估与预后预测中体现出重要的应用价值。本文旨在系统综述上述新型胰岛素抵抗指数的构建原理、临床应用现状及研究进展，以期为胰岛素抵抗及其相关疾病的早期识别与综合防治提供参考依据。

Abstract: Insulin Resistance (IR), as a key pathophysiological mechanism, is closely associated with the development and progression of various diseases, including type 2 diabetes, metabolic syndrome, atherosclerotic cardiovascular disease, and ischemic stroke. Although the hyperinsulinemic-euglycemic clamp is recognized as the traditional gold standard for assessing insulin resistance, its complex procedure, high cost, and invasive nature limit its widespread application in routine clinical practice and large-scale epidemiological studies. In recent years, a variety of novel surrogate indices based on routine metabolic parameters have emerged for evaluating insulin resistance. These include, but are not limited to, the Triglyceride-Glucose index (TyG), its derivative combined with Body Mass Index (TyG-BMI), the Metabolic Score for Insulin Resistance (METS-IR), and the Atherogenic Index of Plasma (AIP). These novel indices integrate information from various aspects such as blood glucose, blood lipids, obesity status, and lipid composition. They offer significant advantages, including simplicity of operation, non-invasiveness, low cost, and easy accessibility. Currently, they have demonstrated considerable value in risk stratification, clinical evaluation, and prognosis prediction of metabolic diseases. This article aims to provide a systematic review of the construction principles, current clinical applications, and research progress of these novel insulin resistance indices, intending to offer reference for the early identification, comprehensive prevention, and management of insulin resistance and its related diseases.