甘油三酯-葡萄糖指数与心肌梗死风险相关：一项在开滦队列中进行的 11 年前瞻性研究。
Triglyceride-glucose index is associated with the risk of myocardial infarction: an 11-year prospective study in the Kailuan cohort.
机构信息
China National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Beijing, 100070, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
出版信息
Cardiovasc Diabetol. 2021 Jan 12;20(1):19. doi: 10.1186/s12933-020-01210-5.
BACKGROUND
The triglyceride-glucose (TyG) index, which is a simple surrogate marker of insulin resistance, has been suggested as a contributor of cardiovascular disease. However, evidence on the effect of long-term elevation of the TyG index exposure on myocardial infarction (MI) is limited. The current study aimed to evaluate the association of baseline and long-term elevation of the TyG index exposure with the risk of MI.
METHODS
A total of 98,849 participants without MI at baseline (2006) were enrolled from the Kailuan study. The baseline TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The long-term TyG index was characterized in two ways as follows. The updated mean TyG index was calculated as the mean of TyG index at all previous visits before MI occurred or the end of follow-up; alternatively, the TyG index was calculated as the number of visits with a high TyG index in 2006, 2008, and 2010, ranging from 0 (no exposure) to 3 (had high TyG index at all three study visits). Hazard ratio (HR) and 95% confidence interval (CI) was estimated using multivariable Cox proportion hazard models.
RESULTS
During a median follow-up of 11.03 years, 1555 incident MI occurred. In the multivariable-adjusted model, the risk of MI increased with quartiles of the baseline and updated mean TyG index, the HR in quartile 4 versus quartile 1 was 2.08 (95% CI,1.77-2.45) and 1.58 (1.18-2.12), respectively. Individuals with a high TyG index at all three visits had a 2.04-fold higher risk (95% CI, 1.63-2.56) of MI compared with no exposure. Subgroup analyses showed that the associations were more pronounced in women than in men (P = 0.0411).
CONCLUSIONS
Elevated levels of the baseline and long-term TyG index are associated with an increased risk of MI. This finding indicates that the TyG index might be useful in identifying people at high risk of developing MI.
背景
甘油三酯-葡萄糖（TyG）指数是一种简单的胰岛素抵抗替代标志物，被认为是心血管疾病的一个致病因素。然而，关于 TyG 指数长期升高暴露对心肌梗死（MI）的影响的证据有限。本研究旨在评估基线和长期 TyG 指数升高暴露与 MI 风险的关系。
方法
共纳入 98849 名基线（2006 年）无 MI 的参与者。基线 TyG 指数的计算方法为 ln[空腹甘油三酯（mg/dL）×空腹血糖（mg/dL）/2]。长期 TyG 指数的特征有两种方法。更新的平均 TyG 指数是通过 MI 发生或随访结束前所有既往就诊时的 TyG 指数的平均值计算得出；或者，TyG 指数的计算方法是在 2006 年、2008 年和 2010 年的三次研究就诊时将 TyG 指数高的就诊次数相加，范围从 0（无暴露）到 3（三次就诊时 TyG 指数均高）。使用多变量 Cox 比例风险模型估计风险比（HR）和 95%置信区间（CI）。
结果
在中位随访 11.03 年期间，发生了 1555 例 MI。在多变量调整模型中，MI 风险随基线和更新的平均 TyG 指数四分位的增加而增加，四分位 4 与四分位 1 的 HR 分别为 2.08（95%CI，1.77-2.45）和 1.58（1.18-2.12）。三次就诊时 TyG 指数均高的个体发生 MI 的风险增加 2.04 倍（95%CI，1.63-2.56），与无暴露相比。亚组分析显示，女性的相关性强于男性（P=0.0411）。
结论
基线和长期 TyG 指数升高与 MI 风险增加相关。这一发现表明，TyG 指数可能有助于识别发生 MI 风险较高的人群。
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