甘油三酯-葡萄糖指数对心血管疾病高危人群的预后价值。
Prognostic value of triglyceride glucose index in population at high cardiovascular disease risk.
机构信息
Cardiology, Department of Cardiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, China.
Center for Cardiovascular Epidemiology Research and Prevention Of Fujian Provincial Hospital, Fuzhou, Fujian Province, China.
出版信息
Cardiovasc Diabetol. 2023 Aug 3;22(1):198. doi: 10.1186/s12933-023-01924-2.
BACKGROUND
Early identification of populations at high cardiovascular disease (CVD) risk and improvement of risk factors can significantly decrease the probability of CVD development and improve outcomes. Insulin resistance (IR) is a CVD risk factor. The triglyceride glucose (TyG) index is a simple and reliable index for evaluating IR. However, no clinical studies on the prognostic value of the TyG index in a high risk CVD population have been conducted. This study evaluated the relationship between the TyG index and prognosis in a high risk CVD population.
METHODS
This study enrolled 35,455 participants aged 35-75 years who were at high CVD risk and visited selected health centers and community service centers between 2017 and 2021. Their general clinical characteristics and baseline blood biochemical indicators were recorded. The TyG index was calculated as ln[fasting triglyceride (mg/dl)× fasting blood glucose (mg/dl)/2]. The endpoints were all-cause death and cardiovascular death during follow-up. Cox proportional hazard models and restricted cubic spline (RCS) analysis were used to evaluate the correlation between the TyG index and endpoints.
RESULTS
In the overall study population, the mean age of all participants was 57.9 ± 9.6 years, 40.7% were male, and the mean TyG index was 8.9 ± 0.6. All participants were divided into two groups based on the results of the RCS analysis, with a cut-off value of 9.83. There were 551 all-cause deaths and 180 cardiovascular deaths during a median follow-up time of 3.4 years. In the multivariate Cox proportional hazard model, participants with a TyG index ≥ 9.83 had a higher risk of all-cause death (Hazard ratio [HR] 1.86, 95% Confdence intervals [CI] 1.37-2.51, P<0.001) and cardiovascular death (HR 2.41, 95%CI 1.47-3.96, P = 0.001) than those with a TyG index < 9.83. Subgroup analysis revealed that there was no interaction between the TyG index and variables in all subgroup analyses.
CONCLUSIONS
The high TyG index was associated with an increased risk of all-cause death and cardiovascular death in people at high risk of CVD. This finding demonstrates the value of the TyG index in the primary prevention of CVD.
TRIAL REGISTRATION
retrospectively registered, the registration number is K2022-01-005 and the date is 2022.01.30.
背景
早期识别心血管疾病（CVD）高危人群并改善危险因素可显著降低 CVD 发展的概率，并改善预后。胰岛素抵抗（IR）是 CVD 的一个危险因素。甘油三酯-葡萄糖（TyG）指数是评估 IR 的一种简单可靠的指标。然而，尚未有研究探讨 TyG 指数在高危 CVD 人群中的预后价值。本研究旨在评估 TyG 指数与高危 CVD 人群预后之间的关系。
方法
本研究纳入了 2017 年至 2021 年间在选定的健康中心和社区服务中心就诊的 35455 名年龄在 35-75 岁之间的 CVD 高危人群，记录了他们的一般临床特征和基线血液生化指标。TyG 指数的计算方法为 ln[空腹甘油三酯（mg/dl）×空腹血糖（mg/dl）/2]。终点事件为随访期间的全因死亡和心血管死亡。Cox 比例风险模型和限制性立方样条（RCS）分析用于评估 TyG 指数与终点事件之间的相关性。
结果
在整个研究人群中，所有参与者的平均年龄为 57.9±9.6 岁，40.7%为男性，平均 TyG 指数为 8.9±0.6。所有参与者根据 RCS 分析的结果分为两组，截断值为 9.83。中位随访时间为 3.4 年期间，共有 551 例全因死亡和 180 例心血管死亡。多变量 Cox 比例风险模型显示，TyG 指数≥9.83 的患者发生全因死亡的风险更高（风险比 [HR] 1.86，95%置信区间 [CI] 1.37-2.51，P<0.001）和心血管死亡（HR 2.41，95%CI 1.47-3.96，P=0.001）高于 TyG 指数<9.83 的患者。亚组分析显示，在所有亚组分析中，TyG 指数与变量之间均无交互作用。
结论
高 TyG 指数与 CVD 高危人群的全因死亡和心血管死亡风险增加相关。这一发现表明 TyG 指数在 CVD 的一级预防中有一定价值。
试验注册
回顾性注册，注册号为 K2022-01-005，注册日期为 2022.01.30。
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