甘油三酯-葡萄糖指数和甘油三酯-葡萄糖-体重指数与普通人群心原性猝死的关系。

Association of triglyceride glucose index and triglyceride glucose-body mass index with sudden cardiac arrest in the general population.

机构信息

The Affiliated Rehabilitation Hospital (Zhejiang Rehabilitation Medical Center)Zhejiang Chinese Medical University, Hangzhou, 310053, China.

The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, 310053, China.

出版信息

Cardiovasc Diabetol. 2024 May 18;23(1):173. doi: 10.1186/s12933-024-02275-2.

BACKGROUND

Insulin resistance (IR) significantly contributes to cardiovascular disease (CVD) development. Triglyceride glucose (TyG) index and triglyceride glucose-body mass index (TyG-BMI) are recognised as convenient proxies for IR. However, their relationship with sudden cardiac arrest (SCA) remains unclear.

METHODS

This prospective cohort analysis included 355,242 UK Biobank participants with available TyG index and TyG-BMI data and no history of CVD. Cox proportional risk models assessed the association between the TyG index, TyG-BMI and SCA risk. Additionally, Accelerated Failure Time (AFT) models were employed to investigate the timing of SCA onset. The impact of dynamic increases in TyG index and TyG-BMI levels on SCA risk was examined using restricted cubic spline.

RESULTS

Over a median follow-up period of 165.4 months (interquartile range 156.5-174 months), 1,622 cases of SCA were recorded. Multivariate Cox regression analysis revealed a 9% increase in SCA risk per standard deviation increase in TyG index (adjusted hazard ratio (aHR) = 1.09, 95% confidence interval (CI) 1.04-1.15) and an 14% increase per standard deviation increase in TyG-BMI (aHR 1.14, 95% CI 1.09-1.2). AFT models indicated earlier median times to SCA occurrence with increasing quintiles of TyG index and TyG-BMI compared to the lowest quintile (P for trend < 0.05). SCA risk was linearly (P = 0.54) and non-linearly (P = 0.007) correlated with gradual increases in TyG index and TyG-BMI levels, respectively. Sex-stratified analyses showed stronger associations in women.

CONCLUSIONS

Higher TyG index and TyG-BMI levels are associated with an increased SCA risk and earlier onset, particularly in women.

背景

胰岛素抵抗（IR）是心血管疾病（CVD）发展的重要因素。甘油三酯葡萄糖（TyG）指数和甘油三酯葡萄糖体重指数（TyG-BMI）被认为是 IR 的便捷替代指标。然而，它们与心搏骤停（SCA）的关系尚不清楚。

方法

本前瞻性队列分析纳入了 355242 名英国生物库参与者，他们具有可用的 TyG 指数和 TyG-BMI 数据且无 CVD 病史。Cox 比例风险模型评估了 TyG 指数、TyG-BMI 与 SCA 风险之间的关系。此外，还采用加速失效时间（AFT）模型研究了 SCA 发病的时间。使用限制性立方样条检查 TyG 指数和 TyG-BMI 水平动态升高对 SCA 风险的影响。

结果

在中位数为 165.4 个月（四分位距 156.5-174 个月）的随访期间，记录到 1622 例 SCA。多变量 Cox 回归分析显示，TyG 指数每增加一个标准差，SCA 风险增加 9%（调整后的危险比[aHR]为 1.09，95%置信区间[CI]为 1.04-1.15），TyG-BMI 每增加一个标准差，SCA 风险增加 14%（aHR 为 1.14，95%CI 为 1.09-1.2）。AFT 模型表明，与最低五分位组相比，TyG 指数和 TyG-BMI 五分位组升高时，SCA 发生的中位时间更早（趋势 P 值均<0.05）。SCA 风险与 TyG 指数和 TyG-BMI 水平的逐渐升高呈线性（P=0.54）和非线性（P=0.007）相关。性别分层分析显示女性相关性更强。