Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung 82445, Taiwan.
School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan.
Int J Environ Res Public Health. 2021 Apr 12;18(8):4020. doi: 10.3390/ijerph18084020.
Increased triglyceride glucose (TyG) index appears to be linked to carotid and coronary atherosclerosis and calcifications and possesses an elevated future risk of developing cardiovascular disease. Corrected QT (QTc) interval prolongation is associated with ventricular arrhythmias and sudden cardiac death, and a high prevalence of prolonged QTc interval was previously reported in blue-collar workers. The purpose of this study was to find the possible causal inter-relationship between TyG index and QTc interval in a large population of Chinese male steelworkers. A total of 3189 male workers from two steel plants were enrolled. They responded to a cross-sectional questionnaire on basic attributes and lifestyle, including sleep patterns. All workers in the two plants underwent periodic health checkups, including twelve-lead electrocardiography. Structural equation modeling (SEM) was used to assess the direct and indirect effects of TyG index on QTc interval. With increasing TyG index tertile, the male steelworkers had an increased QTc interval. Applying multivariate analysis, TyG index was associated independently with the odds of QTc prolongation (adjusted odds ratio = 2.73, 95% confidence interval = 1.39-5.24, = 0.004). SEM revealed that TyG index, hypertension, obesity, lifestyle, white blood cell (WBC) count, and liver function had statistically significant direct effects on QTc interval. Furthermore, TyG index also had an indirect effect on QTc interval through hypertension, obesity, WBC count, and liver function. Moreover, lifestyle had an indirect effect on QTc interval through TyG index. The final model explained 14% of the variability in QTc interval. An increased TyG index was associated with QTc interval prolongation in this study, and SEM delineated possible causal pathways and inter-relationships of the risk factors contributing to the occurrence of QTc prolongation among Chinese male steelworkers.
甘油三酯-葡萄糖(TyG)指数升高似乎与颈动脉和冠状动脉粥样硬化及钙化有关,并且未来患心血管疾病的风险增加。校正的 QT(QTc)间期延长与室性心律失常和心源性猝死有关,先前有报道称蓝领工人的 QTc 间期延长患病率较高。本研究旨在探讨中国男性钢铁工人中 TyG 指数与 QTc 间期之间可能存在的因果关系。
共纳入来自两家钢铁厂的 3189 名男性工人。他们对基本属性和生活方式(包括睡眠模式)进行了横断面问卷调查。两家工厂的所有工人都定期进行健康检查,包括 12 导联心电图检查。结构方程模型(SEM)用于评估 TyG 指数对 QTc 间期的直接和间接影响。
随着 TyG 指数三分位的增加,男性钢铁工人的 QTc 间期延长。多变量分析显示,TyG 指数与 QTc 延长的比值比独立相关(调整比值比=2.73,95%置信区间=1.39-5.24,P=0.004)。SEM 显示 TyG 指数、高血压、肥胖、生活方式、白细胞(WBC)计数和肝功能对 QTc 间期有统计学显著的直接影响。此外,TyG 指数还通过高血压、肥胖、WBC 计数和肝功能对 QTc 间期产生间接影响。此外,生活方式通过 TyG 指数对 QTc 间期产生间接影响。最终模型解释了 QTc 间期变异性的 14%。
本研究中,TyG 指数升高与 QTc 间期延长相关,SEM 描绘了可能的因果途径和风险因素之间的相互关系,这些因素导致中国男性钢铁工人 QTc 延长的发生。