甘油三酯-葡萄糖（TyG）指数与美国人群胸痛发病率和死亡率的关系。

Associations of triglyceride-glucose (TyG) index with chest pain incidence and mortality among the U.S. population.

机构信息

Department of Cardiovascular Surgery, Changhai Hospital, Naval Military Medical University, Shanghai, 200433, China.

Department of Cardiovasology, Changhai Hospital, Naval Military Medical University, 168 Changhai Road, Shanghai, 200433, China.

出版信息

Cardiovasc Diabetol. 2024 Mar 30;23(1):111. doi: 10.1186/s12933-024-02209-y.

BACKGROUND

The triglyceride and glucose (TyG) index, a simple surrogate marker of insulin resistance, is related to cardiovascular disease. However, there is a lack of evidence for the relationship between the TyG index and chest pain. This study aimed to investigate the association of the TyG index with chest pain and to evaluate the relationship between the TyG index and all-cause mortality in participants with or without chest pain.

METHODS

The present study utilized data from the 2001-2012 National Health and Nutrition Examination Survey (NHANES), employing a combination of cross-sectional and cohort study designs. The association between the TyG index and chest pain was investigated using weighted logistic regression models. Weighted Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for all-cause mortality. Restricted cubic spline analysis was used to explore linear or nonlinear relationships between the TyG index and chest pain or all-cause mortality.

RESULTS

The findings revealed a positive correlation between the TyG index and chest pain, even after adjusting for potential confounding factors (quartile 4 versus quartile 1, odds ratio [OR] 1.42, 95% confidence interval [CI] 1.14-1.77, P = 0.002). During a mean follow-up time of 139 months, a total of 2286 individuals (27.43%) experienced mortality. Weighted multivariate Cox regression models indicated that for each one-unit increase in the TyG index, the adjusted hazard ratio (HR) for mortality was 1.14 (95% CI = 0.94-1.37) for participants with chest pain and 1.25 (95% CI = 1.09-1.43) for those without chest pain. Furthermore, restricted cubic spline analysis revealed a linear relationship between the TyG index and chest pain (P for nonlinearity = 0.902), whereas a nonlinear relationship was shown between the TyG index and all-cause mortality among populations regardless of chest pain (all P for nonlinearity < 0.01).

CONCLUSION

The TyG index was positively linked to a higher incidence of chest pain. Moreover, the TyG index was associated with all-cause mortality not only in participants with chest pain but also in those without chest pain.

背景

三酰甘油和葡萄糖（TyG）指数是胰岛素抵抗的简单替代标志物，与心血管疾病有关。然而，关于 TyG 指数与胸痛之间的关系，证据还很缺乏。本研究旨在探讨 TyG 指数与胸痛之间的关系，并评估 TyG 指数与有或无胸痛人群的全因死亡率之间的关系。

方法

本研究利用了 2001-2012 年全国健康和营养调查（NHANES）的数据，采用了横断面和队列研究设计的组合。使用加权逻辑回归模型来研究 TyG 指数与胸痛之间的关联。使用加权 Cox 比例风险模型来估计全因死亡率的风险比（HR）和 95%置信区间（95%CI）。限制性立方样条分析用于探索 TyG 指数与胸痛或全因死亡率之间的线性或非线性关系。

结果

研究结果显示，即使在调整了潜在混杂因素后，TyG 指数与胸痛之间仍存在正相关关系（四分位 4 与四分位 1 相比，比值比 [OR] 1.42，95%置信区间 [CI] 1.14-1.77，P=0.002）。在平均 139 个月的随访期间，共有 2286 人（27.43%）死亡。加权多变量 Cox 回归模型表明，对于 TyG 指数每增加一个单位，有胸痛的参与者的调整后死亡风险比（HR）为 1.14（95%CI：0.94-1.37），无胸痛的参与者的 HR 为 1.25（95%CI：1.09-1.43）。此外，限制性立方样条分析显示 TyG 指数与胸痛之间存在线性关系（非线性 P 值=0.902），而无论是否存在胸痛，TyG 指数与全因死亡率之间都存在非线性关系（所有 P 值均<0.01）。