甘油三酯-葡萄糖指数与中性粒细胞与淋巴细胞比值与冠状动脉疾病的相关性。
Association of triglyceride-glucose index and neutrophil-to-lymphocyte ratio with coronary artery disease.
机构信息
Department of Cardiology, Zhongnan Hospital of Wuhan University, No 169 Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.
Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, No 169 Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.
出版信息
BMC Cardiovasc Disord. 2023 Nov 1;23(1):534. doi: 10.1186/s12872-023-03564-6.
OBJECTIVE
The present study aimed to investigate the association of triglyceride-glucose (TyG) index and neutrophil-to-lymphocyte ratio (NLR) with coronary artery disease (CAD), and evaluate the cumulative value of TyG index and NLR in identifying CAD, as well as the severity of CAD.
METHODS
This retrospective study enrolled 2867 patients who underwent coronary angiography (CAG) for the first time between January 2013 and June 2022 in Zhongnan Hospital of Wuhan University. There were 2109 patients with CAD and 758 patients without CAD. The CAD patients were divided into two groups based on the median of Gensini score (mild stenosis CAD group: Gensini score < 26 points; severe stenosis CAD group: Gensini score ≥ 26 points). To further evaluate the cumulative value of TyG index and NLR in identifying CAD and CAD severity, all patients were classified into four groups based on median of TyG index and NLR: (1) the control group: patients with low-TyG and low-NLR; (2) isolated high-NLR group: patients with low-TyG and high- NLR; (3) isolated high- TyG group: patients with high-TyG and low- NLR; (4) high-TyG combined with high-NLR group: patients with high-TyG and high- NLR.
RESULTS
Multivariate logistic regression analysis showed that both the TyG index and NLR were independent risk factors for CAD, and they were also independent risk factors for severe stenosis in CAD (P < 0.05). Compared with the low-TyG and low- NLR group, patients in high-TyG and high- NLR group had a 1.418 times higher odds ratio (OR) of having CAD and a 1.692 times higher OR of having severe stenosis in CAD in the multivariable logistic regression model. It is worth noting that the OR values of the high-TyG and high- NLR group were higher than those of the isolated high-NLR group and the isolated high- TyG group. The ROC analysis showed that the combination of the TyG index and NLR was superior to TyG index or NLR in predicting CAD and CAD severity.
CONCLUSION
Compared to TyG index or NLR, the combination of the TyG index and NLR is beneficial to improve the diagnostic accuracy of CAD and CAD severity.
目的
本研究旨在探讨甘油三酯-葡萄糖（TyG）指数和中性粒细胞与淋巴细胞比值（NLR）与冠状动脉疾病（CAD）的相关性，并评估 TyG 指数和 NLR 联合用于识别 CAD 及 CAD 严重程度的累积价值。
方法
本回顾性研究纳入了 2013 年 1 月至 2022 年 6 月期间在武汉大学中南医院首次接受冠状动脉造影（CAG）的 2867 例患者。其中 2109 例患者患有 CAD，758 例患者无 CAD。根据 Gensini 评分中位数（狭窄程度较轻的 CAD 组：Gensini 评分<26 分；狭窄程度较重的 CAD 组：Gensini 评分≥26 分），将 CAD 患者分为两组。为进一步评估 TyG 指数和 NLR 联合用于识别 CAD 和 CAD 严重程度的累积价值，根据 TyG 指数和 NLR 的中位数将所有患者分为四组：（1）对照组：低 TyG 和低 NLR 患者；（2）孤立性高 NLR 组：低 TyG 和高 NLR 患者；（3）孤立性高 TyG 组：高 TyG 和低 NLR 患者；（4）高 TyG 联合高 NLR 组：高 TyG 和高 NLR 患者。
结果
多变量 logistic 回归分析显示，TyG 指数和 NLR 均为 CAD 的独立危险因素，且均为 CAD 严重狭窄的独立危险因素（P<0.05）。与低 TyG 和低 NLR 组相比，多变量 logistic 回归模型中高 TyG 和高 NLR 组 CAD 的优势比（OR）为 1.418，严重狭窄 CAD 的 OR 为 1.692。值得注意的是，高 TyG 和高 NLR 组的 OR 值高于孤立性高 NLR 组和孤立性高 TyG 组。ROC 分析显示，TyG 指数和 NLR 联合优于 TyG 指数或 NLR，有助于提高 CAD 和 CAD 严重程度的诊断准确性。
结论
与 TyG 指数或 NLR 相比，TyG 指数和 NLR 的联合有助于提高 CAD 和 CAD 严重程度的诊断准确性。
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