Department of Cardiovascular Medicine, Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Zunyi, Guizhou, 563099, China.
Cardiovasc Diabetol. 2024 Jan 13;23(1):24. doi: 10.1186/s12933-024-02124-2.
Studies have shown that insulin resistance is strongly associated with the development of cardiovascular disease, and the triglyceride glucose-body mass index (TyG-BMI index) is considered to be a reliable surrogate marker of insulin resistance. There are limited studies on the relationship between TyG-BMI index and the extent of coronary artery disease in patients with acute coronary syndrome (ACS). This study aimed to investigate the relationship between TyG-BMI index and the extent of coronary artery disease in patients with ACS.
Overall, 2,317 patients with ACS who underwent percutaneous coronary intervention at the Affiliated Hospital of Zunyi Medical University were included in this study. The TyG-BMI index was grouped according to the tertile method. The extent of coronary artery disease in patients with ACS was quantitatively assessed using the SYNTAX score, which was categorised as low (≤ 22), intermediate (23-32), and high risk (≥ 33).
In the overall population, multivariate logistic regression analyses showed that TyG-BMI index was associated with mid/high SYNTAX score in patients with ACS (odds ratio [OR] = 1.0041; 95% confidence interval [CI] = 1.0000-1.0079; p = 0.0310). Subgroup analyses showed that TyG-BMI index was an independent risk factor for mid/high SYNTAX score in female ACS patients after adjusting for multiple confounders (OR = 1.0100; 95% CI = 1.0000-1.0200; p = 0.0050), and that the risk of mid/high SYNTAX score was 2.49 times higher in the T3 group (OR = 2.4900; 95% CI = 1.2200-5.0600; p = 0.0120). Restricted cubic spline analysis showed a linear correlation between TyG-BMI index and complex coronary artery disease (SYNTAX score > 22) in women with ACS. In female ACS patients, inclusion of the TyG-BMI index did not improve the predictive power of the underlying risk model (net reclassification improvement: 0.0867 [-0.0256-0.1989], p = 0.1301; integrated discrimination improvement: 0.0183 [0.0038-0.0329], p = 0.0135).
TyG-BMI index is linearly associated with the degree of complex coronary artery disease in female ACS patients. However, the inclusion of the TyG-BMI index did not improve the predictive power of the underlying risk model for female ACS patients.
研究表明，胰岛素抵抗与心血管疾病的发生发展密切相关，甘油三酯-葡萄糖-体重指数（TyG-BMI 指数）被认为是胰岛素抵抗的可靠替代标志物。目前关于急性冠脉综合征（ACS）患者 TyG-BMI 指数与冠状动脉病变程度的关系研究较少。本研究旨在探讨 TyG-BMI 指数与 ACS 患者冠状动脉病变程度的关系。
选取遵义医科大学附属医院行经皮冠状动脉介入治疗的 2317 例 ACS 患者，采用三分位法将 TyG-BMI 指数分组，采用 SYNTAX 评分定量评估 ACS 患者的冠状动脉病变程度，分为低危（≤22 分）、中危（23-32 分）和高危（≥33 分）。
在全人群中，多因素 logistic 回归分析显示 TyG-BMI 指数与 ACS 患者中/高危 SYNTAX 评分相关（比值比[OR]＝1.0041；95%置信区间[CI]＝1.0000-1.0079；p＝0.0310）。亚组分析显示，在调整了多个混杂因素后，TyG-BMI 指数仍是女性 ACS 患者中/高危 SYNTAX 评分的独立危险因素（OR＝1.0100；95%CI＝1.0000-1.0200；p＝0.0050），且 TyG-BMI 指数第 3 组的中/高危 SYNTAX 评分风险是第 1 组的 2.49 倍（OR＝2.4900；95%CI＝1.2200-5.0600；p＝0.0120）。受限立方样条分析显示，TyG-BMI 指数与 ACS 女性患者复杂冠状动脉疾病（SYNTAX 评分>22）呈线性相关。在 ACS 女性患者中，纳入 TyG-BMI 指数并不能提高基础风险模型的预测能力（净重新分类改善：0.0867[-0.0256-0.1989]，p＝0.1301；综合判别改善：0.0183[0.0038-0.0329]，p＝0.0135）。
TyG-BMI 指数与 ACS 女性患者复杂冠状动脉疾病程度呈线性相关。然而，TyG-BMI 指数的纳入并不能提高 ACS 女性患者基础风险模型的预测能力。
