Wang Tingting, Xu Jiani, Zhang Hong, Tao Lichan, Huang Xiaolin
Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China.
Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, China.
Front Cardiovasc Med. 2023 Jan 30;10:1086978. doi: 10.3389/fcvm.2023.1086978. eCollection 2023.
The triglyceride-glucose (TyG) index has been identified as a reliable and simple surrogate of insulin resistance. In this study, we sought to determine the association between TyG index and cardiac function among asymptomatic individuals with type 2 diabetes (T2DM) without history of any cardiovascular disease.
The cross-sectional study enrolled 180 T2DM patients without cardiac symptoms. Heart failure with preserved ejection fraction (HFpEF) was defined as Heart Failure Association (HFA)-PEFF score ≥ 5 points.
A total of 38 (21.1%) diabetic patients were identified with HFpEF. Compared with the low-TyG group (TyG index <9.47), patients in high-TyG group (TyG index ≥9.47) showed increased risk of metabolic syndrome and diastolic dysfunction ( < 0.05 for each). Furthermore, after adjustment of confounding variables, the TyG index showed positive correlation with risk factors of metabolic syndrome (including BMI, waist circumference, blood pressure, HbA1c, TG, TC, non-HDL-C, and fasting blood glucose, < 0.05 for each) and parameters of diastolic dysfunction (E/e' ratio, < 0.0001) in patients with T2DM. Moreover, Receiver Operating Characteristic analysis showed that the TyG index could be better to predict the risk of suspected HFpEF than other indicators (AUC: 0.706, 95% CI: 0.612-0.801). According, on multiple regression analysis, TyG index was independently correlated with the incidence of HFpEF (odds ratio: 0.786, = 0.0019), indicating that TyG index could be a reliable biomarker to predict the risk of HFpEF.
The TyG index showed a positive correlation with the risk of subclinical HFpEF in patients with T2DM, providing a new marker to predict and treat HFpEF in diabetes.
甘油三酯-葡萄糖（TyG）指数已被确定为胰岛素抵抗的一种可靠且简单的替代指标。在本研究中，我们试图确定TyG指数与无任何心血管疾病史的2型糖尿病（T2DM）无症状个体心脏功能之间的关联。
这项横断面研究纳入了180例无心脏症状的T2DM患者。射血分数保留的心力衰竭（HFpEF）定义为心力衰竭协会（HFA）-PEFF评分≥5分。
共确定38例（21.1%）糖尿病患者患有HFpEF。与低TyG组（TyG指数<9.47）相比，高TyG组（TyG指数≥9.47）患者代谢综合征和舒张功能障碍风险增加（每项P<0.05）。此外，在调整混杂变量后，TyG指数与T2DM患者代谢综合征风险因素（包括体重指数、腰围、血压、糖化血红蛋白、甘油三酯、总胆固醇、非高密度脂蛋白胆固醇和空腹血糖，每项P<0.05）以及舒张功能障碍参数（E/e'比值，P<0.0001）呈正相关。此外，受试者工作特征分析表明，TyG指数比其他指标能更好地预测疑似HFpEF风险（曲线下面积：0.706，95%可信区间：0.612-0.801）。据此，多元回归分析显示，TyG指数与HFpEF发生率独立相关（优势比：0.786，P=0.0019），表明TyG指数可能是预测HFpEF风险的可靠生物标志物。
TyG指数与T2DM患者亚临床HFpEF风险呈正相关，为糖尿病患者HFpEF的预测和治疗提供了新的标志物。
