Liu Xiao-Cong, He Guo-Dong, Lo Kenneth, Huang Yu-Qing, Feng Ying-Qing
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Department of Epidemiology, Center for Global Cardio-Metabolic Health, Brown University, Providence, RI, United States.
Front Cardiovasc Med. 2021 Jan 14;7:628109. doi: 10.3389/fcvm.2020.628109. eCollection 2020.
The triglyceride-glucose (TyG) index could serve as a convenient substitute of insulin resistance (IR), but epidemiological evidence on its relationship with the long-term risk of mortality is limited. Participants from the National Health and Nutrition Examination Survey during 1999-2014 were grouped according to TyG index (<8, 8-9, 9-10, >10). Cox regression was conducted to compute the hazard ratios (HRs) and 95% confidence interval (CI). Restricted cubic spline and piecewise linear regression were performed to detect the shape of the relationship between TyG index and mortality. A total of 19,420 participants (48.9% men) were included. On average, participants were followed-up for 98.2 months, and 2,238 (11.5%) and 445 (2.3%) cases of mortality due to all-cause or cardiovascular disease were observed. After adjusting for confounders, TyG index was independently associated with an elevated risk of all-cause (HR, 1.10; 95% CI, 1.00-1.20) and cardiovascular death (HR, 1.29; 95% CI, 1.05-1.57). Spline analyses showed that the relationship of TyG index with mortality was non-linear (All non-linear < 0.001), and the threshold value were 9.36 for all-cause and 9.52 for cardiovascular death, respectively. The HRs above the threshold point were 1.50 (95% CI, 1.29-1.75) and 2.35 (95% CI, 1.73-3.19) for all-cause and cardiovascular death. No significant difference was found below the threshold points (All > 0.05). Elevated TyG index reflected a more severe IR and was associated with mortality due to all-cause and cardiovascular disease in a non-linear manner.
甘油三酯-葡萄糖（TyG）指数可作为胰岛素抵抗（IR）的便捷替代指标，但关于其与长期死亡风险关系的流行病学证据有限。1999年至2014年美国国家健康与营养检查调查的参与者根据TyG指数（<8、8-9、9-10、>10）进行分组。采用Cox回归计算风险比（HRs）和95%置信区间（CI）。进行限制立方样条回归和分段线性回归以检测TyG指数与死亡率之间关系的形态。共纳入19420名参与者（48.9%为男性）。平均随访98.2个月，观察到2238例（11.5%）全因死亡和445例（2.3%）心血管疾病死亡病例。校正混杂因素后，TyG指数与全因死亡风险升高（HR，1.10；95%CI，1.00-1.20）和心血管疾病死亡风险升高（HR，1.29；95%CI，1.05-1.57）独立相关。样条分析显示，TyG指数与死亡率的关系呈非线性（所有非线性<0.001），全因死亡和心血管疾病死亡的阈值分别为9.36和9.52。高于阈值点的全因死亡和心血管疾病死亡的HR分别为1.50（95%CI，1.29-1.75）和2.
