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在无症状个体中,心脏代谢和甘油三酯-葡萄糖指数与左心室舒张功能的关系。

Association of cardiometabolic and triglyceride-glucose index with left ventricular diastolic function in asymptomatic individuals.

机构信息

Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China.

Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Nutr Metab Cardiovasc Dis. 2024 Jul;34(7):1590-1600. doi: 10.1016/j.numecd.2024.02.008. Epub 2024 Feb 20.

Abstract

BACKGROUND AND AIMS

Obesity and insulin resistance are associated with left ventricular diastolic dysfunction (LVDD) and increased risk of heart failure. Cardiometabolic index (CMI) and triglyceride glucose (TyG) are new indexes to assess visceral obesity and insulin resistance, respectively. The study aimed to investigate the clinical usefulness of these indexes for identifying LVDD individuals.

METHODS AND RESULTS

Overall, 1898 asymptomatic individuals were included in this cross-sectional study. Participants underwent anthropometrics, serum biochemical evaluation, and echocardiography. Multiple linear regression analysis revealed that both indexes were independent determinants of diastolic parameters among females; while for males, CMI and TyG were not associated with A velocity. In the multivariate logistic analysis, the proportion of LVDD in the third and fourth quartiles of CMI remained significantly greater than that in the lowest quartile in females (Q3 vs. Q1: odds ratio (OR) = 2.032, 95% confidence interval (CI): 1.181-3.496; Q4 vs. Q1: OR = 2.393, 95% CI: 1.347-4.249); while in males, the incidence of LVDD was significantly greater only in the fourth quartile. For TyG, the presence of LVDD in the fourth quartile was significantly greater in both genders. The discriminant values between the CMI (AUC: 0.704, 95% CI: 0.668-0.739) and TyG (AUC: 0.717, 95% CI: 0.682-0.752) were similar in females. Both indexes performed better in females than in males to identify LVDD.

CONCLUSION

The CMI and TyG might both serve as effective tools to identify LVDD in routine health check-ups in primary care, mainly in females. With simpler parameters, the CMI could be utilized in medically resource-limited areas.

摘要

背景与目的

肥胖和胰岛素抵抗与左心室舒张功能障碍(LVDD)和心力衰竭风险增加相关。代谢心脏指数(CMI)和甘油三酯-葡萄糖(TyG)分别是评估内脏肥胖和胰岛素抵抗的新指标。本研究旨在探讨这些指标在识别 LVDD 个体方面的临床应用价值。

方法和结果

本横断面研究共纳入 1898 名无症状个体。参与者接受了人体测量学、血清生化评估和超声心动图检查。多元线性回归分析显示,这两个指标均为女性舒张参数的独立决定因素;而对于男性,CMI 和 TyG 与 A 速度无关。在多元逻辑回归分析中,CMI 第三和第四四分位数的 LVDD 比例在女性中仍显著高于最低四分位数(Q3 与 Q1:比值比(OR)=2.032,95%置信区间(CI):1.181-3.496;Q4 与 Q1:OR=2.393,95%CI:1.347-4.249);而在男性中,仅第四四分位数的 LVDD 发生率显著更高。对于 TyG,在两性中,第四四分位数的 LVDD 发生率显著更高。CMI(AUC:0.704,95%CI:0.668-0.739)和 TyG(AUC:0.717,95%CI:0.682-0.752)之间的鉴别值在女性中相似。在识别 LVDD 方面,这两个指标在女性中的表现均优于男性。

结论

CMI 和 TyG 均可作为常规健康检查中识别 LVDD 的有效工具,主要适用于女性。CMI 参数更简单,可用于医疗资源有限的地区。

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