甘油三酯-葡萄糖指数作为冠心病和高血压患者不良心血管预后的标志物。
Triglyceride-glucose index as a marker of adverse cardiovascular prognosis in patients with coronary heart disease and hypertension.
机构信息
Department of Cardiology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China.
Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China.
出版信息
Cardiovasc Diabetol. 2023 Jun 9;22(1):133. doi: 10.1186/s12933-023-01866-9.
BACKGROUND
The triglyceride-glucose (TyG) index has been proposed as a potential predictor of adverse prognosis of cardiovascular diseases (CVDs). However, its prognostic value in patients with coronary heart disease (CHD) and hypertension remains unclear.
METHODS
A total of 1467 hospitalized patients with CHD and hypertension from January 2021 to December 2021 were included in this prospective and observational clinical study. The TyG index was calculated as Ln [fasting triglyceride level (mg/dL) × fasting plasma glucose level (mg/dL)/2]. Patients were divided into tertiles according to TyG index values. The primary endpoint was a compound endpoint, defined as the first occurrence of all-cause mortality or total nonfatal CVDs events within one-year follow up. The secondary endpoint was atherosclerotic CVD (ASCVD) events, including non-fatal stroke/transient ischemic attack (TIA) and recurrent CHD events. We used restricted cubic spline analysis and multivariate adjusted Cox proportional hazard models to investigate the associations of the TyG index with primary endpoint events.
RESULTS
During the one-year follow-up period, 154 (10.5%) primary endpoint events were recorded, including 129 (8.8%) ASCVD events. After adjusting for confounding variables, for per standard deviation (SD) increase in the TyG index, the risk of incident primary endpoint events increased by 28% [hazard ratio (HR) = 1.28, 95% confidence interval (CI) 1.04-1.59]. Compared with subjects in the lowest tertile (T1), the fully adjusted HR for primary endpoint events was 1.43 (95% CI 0.90-2.26) in the middle (T2) and 1.73 (95% CI 1.06-2.82) in highest tertile (T3) (P for trend = 0.018). Similar results were observed in ASCVD events. Restricted cubic spline analysis also showed that the cumulative risk of primary endpoint events increased as TyG index increased.
CONCLUSIONS
The elevated TyG index was a potential marker of adverse prognosis in patients with CHD and hypertension.
背景
三酰甘油-葡萄糖（TyG）指数已被提出作为心血管疾病（CVDs）不良预后的潜在预测因子。然而，其在冠心病（CHD）和高血压患者中的预后价值尚不清楚。
方法
本前瞻性观察性临床研究纳入了 2021 年 1 月至 2021 年 12 月期间住院的 1467 例 CHD 和高血压患者。TyG 指数计算为 Ln[空腹三酰甘油水平（mg/dL）×空腹血糖水平（mg/dL）/2]。根据 TyG 指数值将患者分为三分位组。主要终点是复合终点，定义为在一年随访期间首次发生全因死亡或所有非致命性 CVD 事件。次要终点是动脉粥样硬化性 CVD（ASCVD）事件，包括非致命性卒中/短暂性脑缺血发作（TIA）和复发性 CHD 事件。我们使用限制立方样条分析和多变量调整 Cox 比例风险模型来研究 TyG 指数与主要终点事件的相关性。
结果
在一年的随访期间，记录了 154 例（10.5%）主要终点事件，包括 129 例（8.8%）ASCVD 事件。在调整混杂变量后，TyG 指数每增加一个标准差（SD），发生主要终点事件的风险增加 28%[风险比（HR）=1.28，95%置信区间（CI）1.04-1.59]。与最低三分位组（T1）相比，中间三分位组（T2）和最高三分位组（T3）的主要终点事件的校正后 HR 分别为 1.43（95%CI 0.90-2.26）和 1.73（95%CI 1.06-2.82）（趋势 P=0.018）。在 ASCVD 事件中也观察到了类似的结果。限制立方样条分析也表明，随着 TyG 指数的增加，主要终点事件的累积风险增加。
结论
升高的 TyG 指数是 CHD 和高血压患者不良预后的潜在标志物。
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