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| Cumulative TyG index exposure as a risk for colorectal cancer a prospective cohort study |
| 1Lin Yixin,2 Zhang Li,1 Zhou Jing,3Li Xinyuan,1 Dai Shilong,1 Zhang Qingsong |
| 1 Department of General Surgery Kailuan General Hospital North China University of Science and Technology Tangshan 063000
Hebei China
2 Department of General Surgery Luanzhou People's Hospital of Hebei Province Tangshan 063004 Hebei China
3 Department of Emergency Medicine Affiliated Hospital of North China University of Science and Technology Tangshan 063000
Hebei China |
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Abstract Objective This study aimed to investigate the relationship between cumulative Triglyceride - glucose index cumTyG
index and the risk of colorectal cancer CRC . Method Criteria for selecting the subjects were as follows A total of 68 902 in-service
and retired employees of Kailuan Group who had attended at three consecutive physical examinations in 2006- 2007 2008- 2009
2010-2011 and 2012-2013. According to the thirdtile of cumulative TyG the participants were divided into three groups namely
cumulative TyG1 cumTyG1 cumulative TyG2 cumTyG2 and cumulative TyG3 cumTyG3 . CRC was the primary endpoint.
Kaplan-Meier curve was used to calculate the cumulative incidence of CRC in different cumulative TyG groups and log-rank test was
used to compare the differences among groups. Cox proportional risk model was used to analyze the impact of different cumTyG and
used to exclude people taking hypoglycemic drugs lipid-lowering drugs and CRC events within one year on CRC. C-index and
time-dependent receiver operating characteristic curve time - roc were used to assess the diagnostic efficacy of cumTyG index
exposure and single-measured TyG index exposure on CRC. Result At average follow-up 10. 13±1. 95 years the incidence density
of cumTyG1~ cumTyG3 group was 4. 23 5. 56 and 6. 90 per 10 000 person-years respectively and with the increase of cumTyG
exposure level the cumulative incidence of CRC also showed an increasing trend and the difference was statistically significant by og-rank test χ2 = 15. 31 P<0. 001 . Cox proportional hazards model showed that after adjusting for potential confounding factors
the HR 95% CI of CRC in the cumTyG2 and cumTyG3 groups were 1. 20 0. 91 1. 57 and 1. 36 1. 03 1. 81 compared with the
cumTyG1 group. People taking hypoglycemic drugs lipid-lowering drugs and CRC within 1 year were excluded Cox proportional
hazards models and adjusting for potential confounding factors were repeated and the results showed that the risk of CRC in the three
groups was increased by 34% HR= 1. 34 95%CI = 1. 01~ 1. 78 38% HR = 1. 38 95%CI = 1. 05 ~ 1. 83 and 36% HR = 1. 36
95%CI = 1. 02~ 1. 82 respectively compared with the cumTyG1 group. The C-index and time-roc results showed that the AUC value
of cumulative TyG index exposure was consistently greater than that of single-measured TyG index exposure and tended to be stable
throughout the follow-up process. Conclusion High level of cumTyG index exposure is an independent risk factor for CRC. CumTyG
exposure has a better predictive value for CRC than single-measured TyG exposure.
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Received: 25 April 2023
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