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甘油三酯-葡萄糖指数作为无糖尿病肥厚型梗阻性心肌病潜在保护因素:来自一项两中心研究的证据

The triglyceride-glucose index as a potential protective factor for hypertrophic obstructive cardiomyopathy without diabetes: evidence from a two-center study.

作者信息

Meng Xiangbin, Gao Jun, Zhang Kuo, Jun Wen, Wang Jing-Jia, Wang Xu-Liang, Wang Yuan-Geng-Shuo, Zheng Ji-Lin, Liu Yu-Peng, Song Jing-Jing, Yang Jie, Zheng Yi-Tian, Li Chen, Wang Wen-Yao, Shao Chunli, Tang Yi-Da

机构信息

Department of Cardiology and Institute of Vascular Medicine, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Peking University Third Hospital, No.49 Huayuanbei Road, Beijing, 100191, China.

Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.

出版信息

Diabetol Metab Syndr. 2023 Jun 29;15(1):143. doi: 10.1186/s13098-023-01084-z.

Abstract

OBJECTIVE

This study aimed to investigate the relationship between the TyG (Triglyceride-glucose index) and the prognosis of patients with HOCM (hypertrophic obstructive cardiomyopathy) without diabetes.

RESEARCH DESIGN AND METHODS

A total of 713 eligible patients with HOCM were enrolled in this study and divided into two groups based on treatment: an invasive treatment group (n = 461) and a non-invasive treatment group (n = 252). The patients in both two groups were then divided into three groups based on their TyG index levels. The primary endpoints of this study were Cardiogenic death during long-term follow-up. Kaplan-Meier analysis was used to study the cumulative survival of different groups. Restricted cubic spline was used to model nonlinear relationships between the TyG index and primary endpoints. Myocardial perfusion imaging/Myocardial metabolic imaging examinations were performed to assess glucose metabolism in the ventricular septum of the HOCM patients.

RESULTS

The follow-up time of this study was 41.47 ± 17.63 months. The results showed that patients with higher TyG index levels had better clinical outcomes (HR, 0.215; 95% CI 0.051,0.902; P = 0.036, invasive treatment group; HR, 0.179; 95% CI 0.063,0.508; P = 0.001, non-invasive treatment group). Further analysis showed that glucose metabolism in the ventricular septum was enhanced in HOCM patients.

CONCLUSIONS

The findings of this study suggest that the TyG index may serve as a potential protective factor for patients with HOCM without diabetes. The enhanced glucose metabolism in the ventricular septum of HOCM patients may provide a potential explanation for the relationship between the TyG index and HOCM prognosis.

摘要

目的

本研究旨在探讨甘油三酯-葡萄糖指数(TyG)与无糖尿病的肥厚型梗阻性心肌病(HOCM)患者预后之间的关系。

研究设计与方法

本研究共纳入713例符合条件的HOCM患者,并根据治疗方式分为两组:有创治疗组(n = 461)和无创治疗组(n = 252)。然后,两组患者再根据TyG指数水平分为三组。本研究的主要终点是长期随访期间的心源性死亡。采用Kaplan-Meier分析研究不同组的累积生存率。使用受限立方样条来模拟TyG指数与主要终点之间的非线性关系。对HOCM患者进行心肌灌注成像/心肌代谢成像检查,以评估室间隔的葡萄糖代谢情况。

结果

本研究的随访时间为41.47±17.63个月。结果显示,TyG指数水平较高的患者临床结局更好(风险比,0.215;95%置信区间0.051,0.902;P = 0.036,有创治疗组;风险比,0.179;95%置信区间0.063,0.508;P = 0.001,无创治疗组)。进一步分析表明,HOCM患者室间隔的葡萄糖代谢增强。

结论

本研究结果表明,TyG指数可能是无糖尿病的HOCM患者的潜在保护因素。HOCM患者室间隔葡萄糖代谢增强可能为TyG指数与HOCM预后之间的关系提供了潜在解释。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f954/10308672/62e77ce7c00d/13098_2023_1084_Fig1_HTML.jpg

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