Pala Arda Aybars, Urcun Yusuf Salim
Department of Cardiovascular Surgery, Adiyaman Training and Research Hospital, Adiyaman, Turkey.
Vascular. 2022 Jun;30(3):455-462. doi: 10.1177/17085381211018332. Epub 2021 May 27.
Triglyceride-glucose index (TyG index), which is defined as the simple and novel marker of insulin resistance, is becoming increasingly important as a promising predictive marker for atherosclerotic diseases. Chronic limb-threatening ischemia is defined as the most advanced stage of the lower extremity peripheral artery disease, whose main cause is atherosclerosis and is associated in this respect with amputation, impaired quality of life, and mortality. The main purpose of the present study was to investigate the relation between the calculated TyG index values and chronic limb-threatening ischemia development.
A total of 296 patients who were diagnosed with lower extremity peripheral artery disease in our outpatient clinic between October 2018 and October 2020 were included in this study retrospectively. Two groups were formed by clinically staging the patients according to Rutherford Classification. Patients who did not develop chronic limb-threatening ischemia were classified as "Group 1" ( = 224) and those who developed were classified as "Group 2" ( = 72).
The mean TyG index values that were calculated in Group 2 were significantly higher than in Group 1 (9.27 ± 0.31 vs. 9.00 ± 0.34, < 0.001). In the multivariate logistic regression analysis conducted to determine the predictors of chronic limb-threatening ischemia development, C-reactive protein (OR [Odds Ratio]: 1.220, 95% CI [confidence interval]: 1.092-1.363, < 0.001), high-density lipoprotein cholesterol (OR: 0.775, 95% CI: 0.715-0.839, < 0.001) and TyG index (OR: 5.796, 95% CI: 2.050-16.382, = 0.001) were identified as independent predictors. Receiver operating characteristic analysis revealed that the cut-off value of TyG index was 9.13 (area under the curve: 0.721, < 0.001) with 70.8% sensitivity and 65.2% specificity. The TyG index was significantly correlated with Rutherford category, high-density lipoprotein cholesterol and mean platelet volume.
Chronic limb-threatening ischemia development may be predicted with the TyG index value, which is calculated easily from routine biochemical parameters, in patients diagnosed with lower extremity peripheral artery disease.
甘油三酯-葡萄糖指数（TyG指数）被定义为胰岛素抵抗的一种简单且新颖的标志物，作为动脉粥样硬化性疾病的一种有前景的预测标志物正变得越来越重要。慢性肢体威胁性缺血被定义为下肢外周动脉疾病的最晚期阶段，其主要病因是动脉粥样硬化，在这方面与截肢、生活质量受损和死亡率相关。本研究的主要目的是探讨计算得出的TyG指数值与慢性肢体威胁性缺血发生之间的关系。
本研究回顾性纳入了2018年10月至2020年10月期间在我院门诊被诊断为下肢外周动脉疾病的296例患者。根据卢瑟福分类法对患者进行临床分期，从而形成两组。未发生慢性肢体威胁性缺血的患者被分类为“第1组”（n = 224），发生慢性肢体威胁性缺血的患者被分类为“第2组”（n = 72）。
第2组计算得出的平均TyG指数值显著高于第1组（9.27±0.31 vs. 9.00±0.34，P<0.001）。在确定慢性肢体威胁性缺血发生的预测因素的多因素逻辑回归分析中，C反应蛋白（比值比[OR]：1.220，95%置信区间[CI]：1.092 - 1.363，P<0.001）、高密度脂蛋白胆固醇（OR：0.775，95% CI：0.715 - 0.839，P<0.001）和TyG指数（OR：5.796，95% CI：2.050 - 16.382，P = 0.001）被确定为独立预测因素。受试者工作特征分析显示，TyG指数的截断值为9.13（曲线下面积：0.721，P<0.001），敏感性为70.8%，特异性为65.2%。TyG指数与卢瑟福分级、高密度脂蛋白胆固醇和平均血小板体积显著相关。
在被诊断为下肢外周动脉疾病的患者中，可通过TyG指数值预测慢性肢体威胁性缺血的发生，该指数可根据常规生化参数轻松计算得出。
