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利用 MIMIC-IV 数据库的回顾性研究:甘油三酯-葡萄糖-体重指数与心力衰竭患者一年全因死亡率的关系。

Association between triglyceride glucose-body mass and one-year all-cause mortality of patients with heart failure: a retrospective study utilizing the MIMIC-IV database.

机构信息

Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwulu 157#, Xi'an, Shaanxi, 710004, China.

Clinical Research Center for Endemic Disease of Shaanxi Province, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwulu 157#, Xi'an, Shaanxi, 710004, China.

出版信息

Cardiovasc Diabetol. 2023 Nov 8;22(1):309. doi: 10.1186/s12933-023-02047-4.

Abstract

BACKGROUND

The triglyceride glucose-body mass (TyG-BMI) index is acknowledged as both a reliable indicator of the risk of cardiovascular disease and an accurate surrogate biomarker for evaluating insulin resistance (IR). The importance of the TyG-BMI index among people with heart failure (HF), however, requires more investigation. The objective of this study was to inquire about the relationship between HF patients' TyG-BMI index and their risk of 360-day mortality.

METHODS

The Medical Information Mart for Intensive Care (MIMIC-IV) database provided the study's patient data, which were divided into quartiles according to their TyG-BMI index. The endpoint was mortality from all causes within 360 days. Kaplan-Meier analysis was used to compare this primary endpoint amongst the four groups indicated above. The association between the TyG-BMI index and the endpoint was investigated using restricted cubic splines and Cox proportional hazards analysis.

RESULTS

The study enrolled a total of 423 patients with HF (59.2% male), of whom 70 patients (16.9%) died within 360 days. Patients with higher TyG-BMI indexes had significantly lower mortality risks, according to the Kaplan-Meier analysis (log-rank P = 0.003). Furthermore, the restricted cubic spline analysis illustrated a decrease in the risk of all-cause mortality with an increasing TyG-BMI index. Additionally, multivariable Cox proportional hazards analyses showed that the risk of 360-day death from all causes was considerably higher in the lowest quartile of TyG-BMI. In comparison to the lowest TyG-BMI group, the fully adjusted Cox model yielded a hazard ratio (HR) of 0.24 (95% CI: 0.10, 0.59; p = 0.002) for 360-day mortality.

CONCLUSIONS

In patients diagnosed with HF, a lower TyG-BMI index is strongly related to a higher risk of 360-day mortality. This index can be employed to categorize the risk levels of patients with HF and predict their one-year all-cause mortality .

摘要

背景

甘油三酯-葡萄糖-体重指数(TyG-BMI)指数被认为是心血管疾病风险的可靠指标,也是评估胰岛素抵抗(IR)的准确替代生物标志物。然而,心力衰竭(HF)患者的 TyG-BMI 指数的重要性需要更多的研究。本研究旨在探讨 HF 患者 TyG-BMI 指数与 360 天死亡率之间的关系。

方法

医学信息挖掘互动知识库(MIMIC-IV)数据库提供了本研究的患者数据,根据 TyG-BMI 指数将患者分为四分位组。终点是 360 天内所有原因的死亡率。Kaplan-Meier 分析用于比较上述四个组的主要终点。使用限制立方样条和 Cox 比例风险分析来研究 TyG-BMI 指数与终点之间的关系。

结果

本研究共纳入 423 例 HF 患者(59.2%为男性),其中 70 例(16.9%)在 360 天内死亡。根据 Kaplan-Meier 分析,TyG-BMI 指数较高的患者死亡率显著降低(对数秩 P=0.003)。此外,限制立方样条分析表明,随着 TyG-BMI 指数的增加,全因死亡率的风险降低。此外,多变量 Cox 比例风险分析显示,TyG-BMI 最低四分位组的全因 360 天死亡风险显著较高。与最低 TyG-BMI 组相比,完全调整的 Cox 模型得出的 360 天死亡率的危险比(HR)为 0.24(95%CI:0.10,0.59;p=0.002)。

结论

在诊断为 HF 的患者中,较低的 TyG-BMI 指数与较高的 360 天死亡率密切相关。该指数可用于对 HF 患者的风险水平进行分类,并预测其一年的全因死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baca/10634170/3a3a94e2647c/12933_2023_2047_Fig1_HTML.jpg

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