Zhang Xin, Ye Runyu, Yu Chaoping, Liu Tianhu, Chen Xiaoping
Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
Department of Cardiology, Pidu District People's Hospital, The 3rd Affiliated Hospital of Chengdu Medical College, Chengdu, China.
Front Cardiovasc Med. 2022 Jul 5;9:903307. doi: 10.3389/fcvm.2022.903307. eCollection 2022.
Data are limited on the relationship between the cardio-ankle vascular index (CAVI) and non-insulin-based insulin resistance (IR) indices, including the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), fasting triglyceride and glucose index (TyG), and metabolic score for IR (METS-IR). In this study, we explored the relationship between TG/HDL-C, TyG, METS-IR, and the risk of increased arterial stiffness (CAVI ≥ 8.0) and compared their ability to detect arterial stiffness in the non-hypertensive Chinese population. A total of 3,265 non-hypertensive subjects were included. Spearman's and partial correlation analyses were used to assess the relationship between non-insulin-based IR indices and CAVI. The correlation between these indices and the risk of a CAVI ≥ 8.0 was explored by multiple logistic regression analysis. The area under the receiver-operating characteristic curve was used to compare the ability of TG/HDL-C, TyG, and METS-IR to detect a CAVI ≥ 8.0. After adjustment for confounding factors, linear regression analysis showed that the CAVI changed by 0.092 [95% confidence interval (CI) 0.035-0.149] per standard deviation increase in TyG. While, this linear relationship was not found when analyzing TG/HDL-C and METS-IR. Multiple logistic regression analysis showed that the proportion of patients with CAVI ≥ 8.0 in the fourth quartile of TG/HDL-C [Q4 vs. Q1: odds ratio (OR) 2.434, 95% CI 1.489-3.975], TyG (Q4 vs. Q1: OR 2.346, 95% CI 1.413-3.896), and METS-IR (Q4 vs. Q1: OR 2.699, 95% CI 1.235-5.897) was significantly higher than that in the lowest quartile. The area under the curve that could discriminate CAVI ≥ 8.0 was 0.598 (95% CI 0.567-0.629) for TG/HDL-C, 0.636 (95% CI 0.606-0.667) for TyG, and 0.581 (95% CI 0.550-0.613) for METS-IR. In this study, we demonstrated a significant association between increased arterial stiffness and non-insulin-based IR indices. Among them, TyG showed better discriminatory ability than TG/HDL-C or METS-IR.
关于心踝血管指数（CAVI）与非胰岛素抵抗（IR）指数之间的关系，包括甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）、空腹甘油三酯和血糖指数（TyG）以及IR代谢评分（METS-IR）的数据有限。在本研究中，我们探讨了TG/HDL-C、TyG、METS-IR与动脉僵硬度增加风险（CAVI≥8.0）之间的关系，并比较了它们在非高血压中国人群中检测动脉僵硬度的能力。共纳入3265名非高血压受试者。采用Spearman和偏相关分析评估非胰岛素抵抗指数与CAVI之间的关系。通过多因素逻辑回归分析探讨这些指数与CAVI≥8.0风险之间的相关性。采用受试者工作特征曲线下面积比较TG/HDL-C、TyG和METS-IR检测CAVI≥8.0的能力。在调整混杂因素后，线性回归分析显示，TyG每增加一个标准差，CAVI变化0.092[95%置信区间（CI）0.035 - 0.149]。而在分析TG/HDL-C和METS-IR时未发现这种线性关系。多因素逻辑回归分析显示，TG/HDL-C第四四分位数（Q4 vs. Q1：比值比（OR）2.434，95%CI 1.489 - 3.975）、TyG（Q4 vs. Q1：OR 2.346，95%CI 1.413 - 3.896）和METS-IR（Q4 vs. Q1：OR 2.699，95%CI 1.235 - 5.897）中CAVI≥8.0的患者比例显著高于最低四分位数。TG/HDL-C区分CAVI≥8.0的曲线下面积为0.598（95%CI 0.567 - 0.629），TyG为0.636（95%CI 0.606 - 0.667），METS-IR为0.581（95%CI 0.550 - 0.613）。在本研究中，我们证明了动脉僵硬度增加与非胰岛素抵抗指数之间存在显著关联。其中，TyG的鉴别能力优于TG/HDL-C或METS-IR。
