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甘油三酯-葡萄糖指数可作为老年危重症谵妄患者的有效预测指标:一项多中心研究的证据。

Triglyceride-glucose index as a valuable predictor for aged 65-years and above in critical delirium patients: evidence from a multi-center study.

机构信息

Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.

School of Nursing, Jinan University, Guangzhou, 510630, China.

出版信息

BMC Geriatr. 2023 Oct 30;23(1):701. doi: 10.1186/s12877-023-04420-0.

Abstract

BACKGROUND

The triglyceride-glucose index (TyG), an established indicator of insulin resistance, is closely correlated with the prognosis of several metabolic disorders. This study aims to investigate the association between the TyG index and the incidence of critical delirium in patients aged 65 years and older.

METHODS

We focused on evaluating patients aged 65 years and older diagnosed with critical delirium. Data were obtained from the Medical Information Database for Intensive Care (MIMIC-IV) and the eICU Collaborative Research Database (eICU-CRD). Multivariate logistic regression and restricted cubic spline (RCS) regression were used to determine the relationship between the TyG index and the risk of delirium.

RESULTS

Participants aged 65 years and older were identified from the MIMIC-IV (n = 4,649) and eICU-CRD (n = 1,844) databases. Based on optimal thresholds derived from RCS regression, participants were divided into two cohorts: Q1 (< 8.912), Q2 (≥ 8.912). The logistic regression analysis showed a direct correlation between the TyG index and an increased risk of critical delirium among ICU patients aged 65 and older. These findings were validated in the eICU-CRD dataset, and sensitivity analysis further strengthened our conclusions. In addition, the subgroup analysis revealed certain differences.

CONCLUSION

This study highlights a clear, independent relationship between the TyG index and the risk of critical delirium in individuals aged 65 years and older, suggesting the importance of the TyG index as a reliable cardio-cerebrovascular metabolic marker for risk assessment and intervention.

摘要

背景

三酰甘油-葡萄糖指数(TyG)作为胰岛素抵抗的一种既定指标,与多种代谢紊乱的预后密切相关。本研究旨在探讨 TyG 指数与 65 岁及以上重症患者发生严重谵妄的相关性。

方法

我们专注于评估年龄在 65 岁及以上、确诊为严重谵妄的患者。数据来自医疗信息数据库重症监护(MIMIC-IV)和 eICU 协作研究数据库(eICU-CRD)。采用多变量逻辑回归和限制立方样条(RCS)回归来确定 TyG 指数与谵妄风险之间的关系。

结果

从 MIMIC-IV(n=4649)和 eICU-CRD(n=1844)数据库中确定了 65 岁及以上的参与者。基于 RCS 回归得出的最佳阈值,将参与者分为两个队列:Q1(<8.912)、Q2(≥8.912)。逻辑回归分析显示,TyG 指数与 65 岁及以上 ICU 患者发生严重谵妄的风险呈正相关。这些发现在 eICU-CRD 数据集得到了验证,敏感性分析进一步加强了我们的结论。此外,亚组分析显示出一定的差异。

结论

本研究强调了 TyG 指数与 65 岁及以上个体发生严重谵妄的风险之间存在明确的、独立的关系,提示 TyG 指数作为一种可靠的心血管代谢标志物,可用于评估风险和干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f0c/10617052/c5549f1b6837/12877_2023_4420_Fig1_HTML.jpg

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