Won Ki-Bum, Kim Yun Seok, Lee Byoung Kwon, Heo Ran, Han Donghee, Lee Ji Hyun, Lee Sang-Eun, Sung Ji Min, Cho Iksung, Park Hyung-Bok, Cho In-Jeong, Chang Hyuk-Jae
Division of Cardiology, Ulsan University Hospital Division of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine Division of Cardiology, Hanyang University Seoul Hospital, Hanyang University College of Medicine Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System Division of Cardiology, Chung-Ang University Hospital Division of Cardiology, Catholic Kwandong University International St. Mary's Hospital, Incheon, South Korea.
Medicine (Baltimore). 2018 May;97(21):e10726. doi: 10.1097/MD.0000000000010726.
The triglyceride glucose (TyG) index is a useful surrogate marker for insulin resistance, which is an important risk factor for coronary artery disease (CAD). However, data on the relationship of the TyG index and coronary plaque characteristics are limited.This study included 2840 participants with near-normal renal function who underwent coronary computed tomography angiography. CAD was defined as the presence of any plaques, and obstructive CAD was defined as the presence of plaques with ≥50% stenosis. The relationship between the TyG index and noncalcified plaque (NCP), calcified or mixed plaque (CMP), and coronary artery calcium score (CACS) was evaluated.All participants were stratified into 4 groups based on the quartiles of the TyG index. The prevalence of CAD and obstructive CAD significantly increased with increasing quartiles. The risk for NCP and obstructive NCP was not different among all groups. However, compared with group I (lowest quartile), the risk for CMP was higher in groups III (odds ratio [OR]: 1.438) and IV (highest quartile) (OR: 1.895) (P < .05), and that for obstructive CMP was higher in groups II (OR: 1.469), III (OR: 1.595), and IV (OR: 2.168) (P < .05). Multivariate regression analysis showed that the TyG index was associated with an increased risk for CAD (OR: 1.700), obstructive CAD (OR: 1.692), and CACS >400 (OR: 1.448) (P < .05).The TyG index was independently associated with the presence and severity of CAD due to an increased risk for CMP.
甘油三酯葡萄糖（TyG）指数是胰岛素抵抗的一个有用替代指标，而胰岛素抵抗是冠状动脉疾病（CAD）的一个重要危险因素。然而，关于TyG指数与冠状动脉斑块特征之间关系的数据有限。本研究纳入了2840名肾功能接近正常且接受冠状动脉计算机断层扫描血管造影的参与者。CAD定义为存在任何斑块，阻塞性CAD定义为存在狭窄≥50%的斑块。评估了TyG指数与非钙化斑块（NCP）、钙化或混合斑块（CMP）以及冠状动脉钙化积分（CACS）之间的关系。所有参与者根据TyG指数的四分位数分为4组。CAD和阻塞性CAD的患病率随四分位数增加而显著升高。所有组中NCP和阻塞性NCP的风险无差异。然而，与第一组（最低四分位数）相比，第三组（比值比[OR]：1.438）和第四组（最高四分位数）（OR：1.895）的CMP风险更高（P<0.05），第二组（OR：1.469）、第三组（OR：1.595）和第四组（OR：2.168）的阻塞性CMP风险更高（P<0.05）。多因素回归分析显示，TyG指数与CAD风险增加（OR：1.700）、阻塞性CAD风险增加（OR：1.692）以及CACS>400风险增加（OR：1.448）相关（P<0.05）。由于CMP风险增加，TyG指数与CAD的存在和严重程度独立相关。
