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甘油三酯-葡萄糖指数是预测韩国年轻成年人未来心血管疾病和死亡率的有用指标:一项基于全国人群的队列研究。

Triglyceride-Glucose Index Is a Useful Marker for Predicting Future Cardiovascular Disease and Mortality in Young Korean Adults: A Nationwide Population-Based Cohort Study.

作者信息

Cho Yun Kyung, Han Kyung-do, Kim Hwi Seung, Jung Chang Hee, Park Joong-Yeol, Lee Woo Je

机构信息

Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea.

出版信息

J Lipid Atheroscler. 2022 May;11(2):178-186. doi: 10.12997/jla.2022.11.2.178. Epub 2022 Apr 21.

Abstract

OBJECTIVE

The triglyceride-glucose (TyG) index, the product of fasting triglycerides and glucose, is a useful and cost-effective marker of insulin resistance (IR). Furthermore, the TyG index is a known IR screening tool in healthy young adults but not in those with atherosclerotic cardiovascular disease (CVD). Thus, this study aimed to evaluate the TyG index as a predictor of CVD in healthy young adults.

METHODS

This study enrolled 6,675,424 adults aged 20-39 years without CVD from the National Health Information Database. We categorized them by TyG index quartile from 2009-2017. The study outcomes were stroke, myocardial infarction (MI), and mortality. All outcomes were analyzed by Cox proportional hazards regression analysis while controlling for baseline covariates.

RESULTS

During a mean 7.4 years of follow-up, 8,506 cases of stroke, 12,312 cases of MI, and 22,667 deaths were recorded. Multivariable-adjusted hazard ratios (HRs) for participants in the highest TyG index quartile demonstrated that they were at higher risk for stroke (HR, 1.253; 95% confidence interval [CI], 1.167-1.346), MI (HR, 1.258; 95% CI, 1.187-1.334), and mortality (HR, 1.151; 95% CI, 1.104-1.200) than those in the lowest TyG index quartile independent of age, sex, smoking, alcohol consumption, physical activity, income, body mass index, blood pressure, and total cholesterol. The HRs for outcomes in the highest quartiles were higher when the TyG index was applied than when triglyceride or fasting glucose alone was applied.

CONCLUSION

TyG index, a simple measure reflecting IR, can predict CVD and mortality in young and healthy populations.

摘要

目的

甘油三酯-葡萄糖(TyG)指数,即空腹甘油三酯与葡萄糖的乘积,是一种实用且经济有效的胰岛素抵抗(IR)标志物。此外,TyG指数是健康年轻成年人中已知的IR筛查工具,但在患有动脉粥样硬化性心血管疾病(CVD)的人群中并非如此。因此,本研究旨在评估TyG指数作为健康年轻成年人CVD预测指标的价值。

方法

本研究纳入了来自国家健康信息数据库的6,675,424名年龄在20-39岁且无CVD的成年人。我们根据2009-2017年的TyG指数四分位数对他们进行分类。研究结局为中风、心肌梗死(MI)和死亡率。所有结局均通过Cox比例风险回归分析进行分析,同时控制基线协变量。

结果

在平均7.4年的随访期间,记录了8506例中风、12312例MI和22667例死亡。最高TyG指数四分位数参与者的多变量调整风险比(HR)表明,与最低TyG指数四分位数的参与者相比,他们患中风(HR,1.253;95%置信区间[CI],1.167-1.346)、MI(HR,1.258;95%CI,1.187-1.334)和死亡率(HR,1.151;95%CI,1.104-1.200)的风险更高,且不受年龄、性别、吸烟、饮酒、体力活动、收入、体重指数、血压和总胆固醇的影响。当应用TyG指数时,最高四分位数结局的HR高于单独应用甘油三酯或空腹血糖时。

结论

TyG指数作为一种反映IR的简单指标,可以预测年轻健康人群中的CVD和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00f6/9133778/c23321d34169/jla-11-178-g001.jpg

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