Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China.
Cardiovasc Diabetol. 2022 Jul 8;21(1):128. doi: 10.1186/s12933-022-01563-z.
Triglyceride-glucose (TyG) index as a reliable surrogate of insulin resistance (IR) has been shown to be related to adverse clinical outcomes in patients with acute coronary syndrome, heart failure, ischemic stroke and so on. However, the relationship between TyG index and all-cause mortality in intensive care unit (ICU) patients remains unknown. The purpose of this study was to investigate the correlation between TyG index and all-cause mortality to evaluate the impact of IR on the prognosis of this population.
This was a retrospective observational study that included 3026 patients who had an initial triglyceride and glucose data on the first day of ICU admission, and all data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. These patients were grouped into quartiles (Q1-Q4) according to TyG index. The Kaplan-Meier analysis was used to compare all-cause mortality among the above four groups. Cox proportional hazards analyses were performed to examine the association between TyG index and all-cause mortality.
During 10.46 years of follow-up, 1148 (37.9%) patients died, of which 350 (11.6%) occurred during the hospital stay and 258 (8.5%) occurred during the ICU stay. Kaplan-Meier analysis showed that the risk of all-cause mortality was significantly higher in patients with higher TyG index (log-rank P = 0.021). Multivariable Cox proportional hazards analyses showed that the TyG index was an independent risk predictor of ICU death (HR: 1.72, 95% CI 1.18-2.52, P = 0.005) and hospital death (HR: 2.19, 95% CI 1.59-3.03, P < 0.001), and each 1-unit increased in the TyG index, a 1.19-fold increase in the risk of death during the hospital stay.
TyG index is strongly related to the all-cause mortality increasing in critically ill patients. This finding indicates that the TyG index might be useful in identifying people at high risk of ICU death and hospital death.
甘油三酯-葡萄糖（TyG）指数作为胰岛素抵抗（IR）的可靠替代指标，已被证明与急性冠状动脉综合征、心力衰竭、缺血性卒中等患者的不良临床结局相关。然而，TyG 指数与重症监护病房（ICU）患者全因死亡率之间的关系尚不清楚。本研究旨在探讨 TyG 指数与全因死亡率之间的相关性，以评估 IR 对该人群预后的影响。
这是一项回顾性观察性研究，纳入了 3026 名 ICU 入院第一天初始甘油三酯和血糖数据的患者，所有数据均从医疗信息集市用于重症监护 III（MIMIC-III）数据库中提取。这些患者根据 TyG 指数分为四组（Q1-Q4）。采用 Kaplan-Meier 分析比较上述四组患者的全因死亡率。采用 Cox 比例风险分析检验 TyG 指数与全因死亡率之间的关系。
在 10.46 年的随访期间，1148 名（37.9%）患者死亡，其中 350 名（11.6%）发生在住院期间，258 名（8.5%）发生在 ICU 期间。Kaplan-Meier 分析显示，TyG 指数较高的患者全因死亡率明显较高（对数秩 P=0.021）。多变量 Cox 比例风险分析显示，TyG 指数是 ICU 死亡（HR：1.72，95%CI 1.18-2.52，P=0.005）和住院死亡（HR：2.19，95%CI 1.59-3.03，P<0.001）的独立危险因素，TyG 指数每增加 1 个单位，住院期间死亡的风险增加 1.19 倍。
TyG 指数与危重症患者全因死亡率的增加密切相关。这一发现表明，TyG 指数可能有助于识别 ICU 死亡和住院死亡风险较高的人群。
