Lambrinoudaki Irene, Kazani Maria Vasiliki, Armeni Eleni, Georgiopoulos Georgios, Tampakis Konstantinos, Rizos Demetrios, Augoulea Areti, Kaparos Georgios, Alexandrou Andreas, Stamatelopoulos Kimon
2(nd) Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece.
Department of Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece.
Heart Lung Circ. 2018 Jun;27(6):716-724. doi: 10.1016/j.hlc.2017.05.142. Epub 2017 Jun 16.
The present study aims to examine the association of the metabolic syndrome (MS) as well as of the triglyceride-glucose index (TyG-Index), a novel marker of insulin resistance, with subclinical atherosclerosis in a cohort of postmenopausal women, stratified according to their body mass index.
A total of 473 informed-consenting, non-diabetic postmenopausal women, without overt cardiovascular disease, were included in this study. We aimed to compare the association between structural and functional indices of subclinical atherosclerosis (i.e. carotid artery intima-media thickness (IMT), flow-mediated dilation of the brachial artery, pulse wave velocity (PWV)) with the TyG-index or MS, separately for lean and overweight/obese women.
The TyG-Index correlated significantly with carotid IMT (r=0.155, p=0.012) and PWV (r=0.157, p=0.013) only in the group of lean women. Multivariate analysis showed that subclinical atherosclerosis was predicted by MS, in the overweight/obese group (OR=2.517, 95% CI: 1.078-5.878, p=0.033), and by the TyG-Index the lean group (OR=3.119, 95% CI: 1.187-8.194, p<0.001). Using a TyG-Index cut-off value of 8.0 in the lean subpopulation, women above the cut-off had 44.1% prevalence of subclinical atherosclerosis compared to 29.4% in women below the cut-off (p=0.043).
The TyG-Index is associated with carotid atherosclerosis and arterial stiffness mainly in lean postmenopausal women, while the MS serves as a better predictor of subclinical atherosclerosis in overweight/obese women. The TyG-Index may prove a useful marker for identifying high-risk women in the normal-weight postmenopausal population.
本研究旨在探讨代谢综合征（MS）以及甘油三酯-葡萄糖指数（TyG指数，一种新的胰岛素抵抗标志物）与绝经后女性队列中亚临床动脉粥样硬化的关联，并根据她们的体重指数进行分层。
本研究纳入了473名签署知情同意书、无糖尿病且无明显心血管疾病的绝经后女性。我们旨在分别比较瘦型和超重/肥胖女性中亚临床动脉粥样硬化的结构和功能指标（即颈动脉内膜中层厚度（IMT）、肱动脉血流介导的舒张功能、脉搏波速度（PWV））与TyG指数或MS之间的关联。
仅在瘦型女性组中，TyG指数与颈动脉IMT（r=0.155，p=0.012）和PWV（r=0.157，p=0.013）显著相关。多变量分析显示，超重/肥胖组中亚临床动脉粥样硬化由MS预测（OR=2.517，95%CI：1.078-5.878，p=0.033），而瘦型组中由TyG指数预测（OR=3.119，95%CI：1.187-8.194，p<0.001）。在瘦型亚组中使用TyG指数截断值8.0，截断值以上的女性亚临床动脉粥样硬化患病率为44.1%，而截断值以下的女性为29.4%（p=0.043）。
TyG指数主要与瘦型绝经后女性的颈动脉粥样硬化和动脉僵硬度相关，而MS是超重/肥胖女性亚临床动脉粥样硬化的更好预测指标。TyG指数可能被证明是识别正常体重绝经后人群中高危女性的有用标志物。
