经皮冠状动脉介入治疗患者的甘油三酯-葡萄糖-体重指数与心血管结局的关系:一项回顾性研究。
Association between triglyceride glucose-body mass index and cardiovascular outcomes in patients undergoing percutaneous coronary intervention: a retrospective study.
机构信息
Clinical Medical College, Yangzhou University, Yangzhou, 225001, China.
The Yangzhou School of Clinical Medicine, Dalian Medical University, Dalian, 116044, China.
出版信息
Cardiovasc Diabetol. 2023 Mar 30;22(1):75. doi: 10.1186/s12933-023-01794-8.
BACKGROUND
The triglyceride glucose-body mass index (TyG-BMI index) has been considered a reliable surrogate measure of insulin resistance; however, its ability to predict the incidence of cardiovascular disease in individuals with coronary artery disease (CAD) remains uncertain. The aim of this study was to demonstrate the correlation between the TyG-BMI index and cardiovascular incidence.
METHODS
A total of 2533 consecutive participants who underwent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) implantation were included. Data from 1438 patients was analyzed in the study. The endpoint was defined as a composite of acute myocardial infarction, repeat revascularization, stroke, and all-cause mortality (major adverse cardiac and cerebrovascular events, MACCEs) at 34-month follow-up. The formula for calculating the TyG-BMI index is ln [fasting triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2] × BMI.
RESULTS
Among the 1438 participants, 195 incident patient cases of MACCEs were ascertained. The incidence of MACCEs showed no statistically significant differences in the TyG-BMI index tertiles in the overall population. Further exploratory subgroup analysis and multivariable logistic regression analysis revealed a linear relationship between the TyG-BMI index (per 1 SD increased) and MACCEs in the elderly patients (OR = 1.22, 95% CI 1.011-1.467, p = 0.038) and in the female patients (OR = 1.33, 95% CI 1.004-1.764, p = 0.047). The addition of the TyG-BMI index to traditional risk factor models in elderly and female patients did not improve risk prediction for MACCEs.
CONCLUSION
A higher TyG-BMI index was proportionally related to an increased incidence of MACCEs in the elderly or female patients. However, the inclusion of the TyG-BMI index did not provide better predictive performance for MACCEs in the elderly, specifically in female patients.
背景
三酰甘油葡萄糖-体重指数(TyG-BMI 指数)已被认为是胰岛素抵抗的可靠替代指标;然而,其在冠状动脉疾病(CAD)患者中预测心血管疾病发病率的能力仍不确定。本研究旨在证明 TyG-BMI 指数与心血管事件发生率之间的相关性。
方法
共纳入 2533 例连续接受经皮冠状动脉介入治疗(PCI)和药物洗脱支架(DES)植入术的患者。研究分析了 1438 例患者的数据。终点定义为 34 个月随访时急性心肌梗死、再次血运重建、卒中和全因死亡率(主要不良心脏和脑血管事件,MACCEs)的复合终点。TyG-BMI 指数的计算公式为 ln[空腹三酰甘油(mg/dL)×空腹血糖(mg/dL)/2]×BMI。
结果
在 1438 名参与者中,确定了 195 例 MACCE 事件的发病患者。在总体人群中,TyG-BMI 指数三分位数之间的 MACCE 发生率无统计学差异。进一步的探索性亚组分析和多变量逻辑回归分析显示,TyG-BMI 指数(每增加 1 个标准差)与老年患者(OR=1.22,95%CI 1.011-1.467,p=0.038)和女性患者(OR=1.33,95%CI 1.004-1.764,p=0.047)之间存在线性关系。在老年患者和女性患者中,将 TyG-BMI 指数添加到传统危险因素模型中并未改善 MACCE 的风险预测。
结论
较高的 TyG-BMI 指数与老年或女性患者 MACCE 发生率的增加呈比例相关。然而,TyG-BMI 指数的纳入并不能为老年患者,特别是女性患者提供更好的 MACCE 预测性能。