Centre for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Nutr Diabetes. 2024 Jun 6;14(1):39. doi: 10.1038/s41387-024-00295-1.
Insulin resistance (IR) is indicated to be linked with adverse outcomes of acute myocardial infarction (AMI), for its pro-inflammatory and pro-thromboplastic function. The triglyceride-glucose (TyG) index is a newly developed substitute marker for IR. The aim of this pooled analysis was to provide a summary of the relationship of TyG index with occurrences of major adverse cardiovascular and cerebrovascular events (MACCEs) among populations suffering from AMI.
Cohorts reporting multivariate-adjusted hazard ratios of TyG index with MACCEs or its independent events were identified through systematically searching PubMed, MEDLINE, Web of science, Embase and Cochrane databases. Results were combined using a random-effects model.
21 cohorts comprising 20403 individuals were included. Compared to individuals in the lowest TyG category, patients in the highest TyG category exhibited elevated risks of both MACCEs (P < 0.00001) and all-cause death (P < 0.00001). These findings were in line with the results as TyG analyzed as continuous variables (MACCEs: P = 0.006; all-cause death: P < 0.00001). Subgroup analysis demonstrated that diabetic status, type of AMI, nor the reperfusion therapy did not destruct this correlation (for subgroups, all P < 0.05).
All these indicated that higher TyG index could potentially predict MACCEs and all-cause death in patients with AMI as an independent indicator.
胰岛素抵抗（IR）被认为与急性心肌梗死（AMI）的不良结局有关，因为它具有促炎和促血栓形成的作用。甘油三酯-葡萄糖（TyG）指数是一种新开发的 IR 替代标志物。本荟萃分析的目的是总结 TyG 指数与 AMI 患者主要不良心血管和脑血管事件（MACCEs）发生之间的关系。
通过系统搜索 PubMed、MEDLINE、Web of science、Embase 和 Cochrane 数据库，确定了报告 TyG 指数与 MACCEs 或其独立事件的多变量调整风险比的队列。使用随机效应模型合并结果。
纳入了 21 项队列研究，共 20403 例患者。与 TyG 最低类别中的个体相比，TyG 最高类别中的患者发生 MACCEs（P<0.00001）和全因死亡（P<0.00001）的风险均升高。这些发现与 TyG 作为连续变量进行分析的结果一致（MACCEs：P=0.006；全因死亡：P<0.00001）。亚组分析表明，糖尿病状态、AMI 类型或再灌注治疗并未破坏这种相关性（对于亚组，均 P<0.05）。
所有这些都表明，较高的 TyG 指数可能作为独立指标，预测 AMI 患者的 MACCEs 和全因死亡。
