新冠病毒疾病患者甘油三酯-葡萄糖指数与血管危险因素及临床结局的关联：乌干达坎帕拉门戈医院的一项回顾性横断面研究
Association of triglyceride-glucose index with vascular risk factors and clinical outcomes among COVID-19 patients: a retrospective cross-sectional study in Mengo Hospital, Kampala, Uganda.
作者信息
Lumu William, Mutebi Ronald Kasoma, Nakireka Susan, Muyanja David, Eleku Simon, Kaddu Denis, Nunda Ezra, Kabugo Deus, Kinene Henry, Nambago Simon, Ninsiima Caroline, Kifuba Isa, Edemaga Deogratious, Atwiine Edgar, Mutebi Brian, Nandawula Majorine, Nakigudde Noeline, Kataike Zubeda, Nakachwa Jackline, Nakaayi Catherine, Lukyamuzi Paul, Ssebuufu Robinson, Mutumba Rose
机构信息
Department of Internal Medicine, Mengo Hospital, Kampala, Uganda.
出版信息
Pan Afr Med J. 2023 Dec 21;46:113. doi: 10.11604/pamj.2023.46.113.41795. eCollection 2023.
INTRODUCTION
triglyceride-glucose (TyG) index is a reliable surrogate marker of insulin resistance. We assessed the association between triglyceride-glucose (TyG) index and vascular risk factors and clinical outcomes of critically ill adult COVID-19 patients.
METHODS
data from the charts of all patients with a confirmed diagnosis of COVID-19 who were hospitalized at Mengo Hospital Uganda from December 2020 to August 2021 was used for this study. Data on demographics, past medical history, clinical presentation, laboratory findings and clinical outcomes within the first 10 days of admission was extracted. TyG index was calculated as Inverse (triglyceride (mg/dl) x fasting glucose level (mg/dl)/2 and defined vascular risk factors using standard methods. Bivariate and multivariate logistic regression was conducted to establish a significant association. Statistical significance was set at p< 0.05.
RESULTS
out of 314 patients, 176 (56%) were females. The mean age ± SD was 58.2 years ± 16.82. The median TyG index was 9.76 (9.29-10.33). A high TyG index was found among 85.4% (n= 268, 95% CI: 0.809-0.889) of patients. Elevated total cholesterol was in 55.4% (n=174), triglycerides 70.7% (n=222), LDL 64.7% (n=203), blood glucose 80.6% (n=253), systolic blood pressure 43% (n=135) and 24.8% (n=78) diastolic blood pressure. The majority 49.7% ( n=156) were discharged, 22.0% (n=69) needed admission to the intensive care unit (ICU), 15.3% (n=48) died in the unit and 13.0% (n=41) had a composite outcome. The TyG index was significantly associated with glycated hemoglobin (AOR=1.029, 95%CI 0.561-1.496, p<0.001), low-density lipoprotein cholesterol (AOR=0.121,95%CI 0.023-0.219, p=0.016), high-density cholesterol (AOR=1.956, 95%CI 1.299-2.945, p=0.001), total cholesterol (AOR=2.177, 95%CI 1.5222-3.144, p<0.001, hospital death (AOR=0.778, 95%CI 0.623-0.972, p=0.028) and composite outcome (AOR=1.823, 95% CI 1.221-2.559, p=0.023). There was no association between hypertension and TyG index.
CONCLUSION
a high TyG index was associated with vascular risk factors and clinical outcomes.
引言
甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗的可靠替代指标。我们评估了甘油三酯-葡萄糖（TyG）指数与危重症成年COVID-19患者的血管危险因素及临床结局之间的关联。
方法
本研究使用了2020年12月至2021年8月在乌干达蒙戈医院住院的所有确诊COVID-19患者病历中的数据。提取了入院前10天内的人口统计学数据、既往病史、临床表现、实验室检查结果及临床结局。TyG指数计算为ln（甘油三酯（mg/dl）×空腹血糖水平（mg/dl）/2），并使用标准方法定义血管危险因素。进行二元和多元逻辑回归以确定显著关联。统计学显著性设定为p<0.05。
结果
在314例患者中，176例（56%）为女性。平均年龄±标准差为58.2岁±16.82岁。TyG指数中位数为9.76（9.29 - 10.33）。85.4%（n = 268，95%CI：0.809 - 0.889）的患者TyG指数较高。总胆固醇升高的占55.4%（n = 174），甘油三酯升高的占70.7%（n = 222），低密度脂蛋白升高的占64.7%（n = 203），血糖升高的占80.6%（n = 253），收缩压升高的占43%（n = 135），舒张压升高的占24.8%（n = 78）。大多数患者（49.7%，n = 156）出院，22.0%（n = 69）需要入住重症监护病房（ICU），15.3%（n = 48）在病房死亡，13.0%（n = 41）出现复合结局。TyG指数与糖化血红蛋白（调整后比值比[AOR]=1.029，95%CI 0.561 - 1.496，p<0.001）、低密度脂蛋白胆固醇（AOR = 0.121，95%CI 0.023 - 0.219，p = 0.016）、高密度胆固醇（AOR = 1.956，95%CI 1.299 - 2.945，p = 0.001）、总胆固醇（AOR = 2.177，95%CI 1.5222 - 3.144，p<0.001）、医院死亡（AOR = 0.778，95%CI 0.623 - 0.972，p = 0.028）和复合结局（AOR = 1.823，95%CI 1.221 - 2.559，p = 0.023）显著相关。高血压与TyG指数之间无关联。
结论
高TyG指数与血管危险因素及临床结局相关。
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