Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Nutrients. 2019 Nov 19;11(11):2838. doi: 10.3390/nu11112838.
The triglyceride-glucose (TyG) index has been correlated with insulin resistance. We aim to investigate the role of the TyG index on cardiovascular (CV) events in type 2 diabetes mellitus and compare the roles of fasting glucose, hemoglobin A, and the TyG index in predicting CV events. This retrospective study enrolled 3524 patients with type 2 diabetes from the Kaohsiung Medical University Research Database in 2009 in this longitudinal study and followed them until 2015. The TyG index was calculated as log (fasting triglyceride level (mg/dL) × fasting glucose level (mg/dL)/2). CV events included myocardial infarction, unstable angina, stroke, hospitalization for coronary artery disease, peripheral artery disease, and CV-related death. The association between variables and CV events was assessed using a multivariable stepwise Cox proportional hazard analysis. Two hundred and fifteen CV events (6.1%) were recorded during a follow-up period of 5.93 years. The multivariable stepwise analysis showed that high fasting glucose (HR, 1.007; < 0.001) and a high TyG index (HR, 1.521; = 0.004) but not hemoglobin A or triglycerides were associated with a higher rate of CV events. Adding fasting glucose and the TyG index to the basic model improved the predictive ability of progression to a CV event ( < 0.001 and = 0.018, respectively), over that of hemoglobin A ( = 0.084) and triglyceride ( = 0.221). Fasting glucose and the TyG index are useful parameters and stronger predictive factors than hemoglobin A and triglyceride for CV events and may offer an additional prognostic benefit in patients with type 2 diabetes.
三酰甘油-葡萄糖（TyG）指数与胰岛素抵抗相关。我们旨在研究 TyG 指数在 2 型糖尿病患者心血管（CV）事件中的作用，并比较空腹血糖、糖化血红蛋白和 TyG 指数在预测 CV 事件中的作用。这项回顾性研究纳入了 2009 年高雄医学大学研究数据库中的 3524 例 2 型糖尿病患者，对他们进行了纵向研究，随访至 2015 年。TyG 指数的计算方法为 log（空腹三酰甘油水平（mg/dL）×空腹血糖水平（mg/dL）/2）。CV 事件包括心肌梗死、不稳定型心绞痛、卒中等，还包括因冠状动脉疾病、外周动脉疾病和与心血管相关的死亡而住院的情况。采用多变量逐步 Cox 比例风险分析评估变量与 CV 事件之间的相关性。在 5.93 年的随访期间，记录了 215 例 CV 事件（6.1%）。多变量逐步分析表明，高空腹血糖（HR，1.007；<0.001）和高 TyG 指数（HR，1.521；=0.004），但糖化血红蛋白或三酰甘油与更高的 CV 事件发生率相关。将空腹血糖和 TyG 指数添加到基本模型中，改善了预测进展为 CV 事件的能力（分别为<0.001 和=0.018），优于糖化血红蛋白（=0.084）和三酰甘油（=0.221）。空腹血糖和 TyG 指数是有用的参数，是预测 2 型糖尿病患者 CV 事件的更强预测因素，可能为患者提供额外的预后获益。
