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甘油三酯-葡萄糖指数作为冠心病合并抑郁患者发生主要不良心脑血管事件的潜在预测指标。

Triglyceride-glucose index as a potential predictor of major adverse cardiovascular and cerebrovascular events in patients with coronary heart disease complicated with depression.

机构信息

The Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China.

Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.

出版信息

Front Endocrinol (Lausanne). 2024 Jun 26;15:1416530. doi: 10.3389/fendo.2024.1416530. eCollection 2024.

Abstract

BACKGROUND

Triglyceride-glucose (TyG) index is a surrogate marker of insulin resistance and metabolic abnormalities, which is closely related to the prognosis of a variety of diseases. Patients with both CHD and depression have a higher risk of major adverse cardiovascular and cerebrovascular events (MACCE) and worse outcome. TyG index may be able to predict the adverse prognosis of this special population.

METHODS

The retrospective cohort study involved 596 patients with both CHD and depression between June 2013 and December 2023. The primary outcome endpoint was the occurrence of MACCE, including all-cause death, stroke, MI and emergent coronary revascularization. The receiver operating characteristic (ROC) curve, Cox regression analysis, Kaplan-Meier survival analysis, and restricted cubic spline (RCS) analysis were used to assess the correlation between TyG index and MACCE risk of in patients with CHD complicated with depression.

RESULTS

With a median follow-up of 31 (15-62) months, MACCE occurred in 281(47.15%) patients. The area under the ROC curve of TyG index predicting the risk of MACCE was 0.765(0.726-0.804) (<0.01). Patients in the high TyG index group(69.73%) had a significantly higher risk of developing MACCE than those in the low TyG index group(23.63%) (<0.01). The multifactorial RCS model showed a nonlinear correlation (nonlinear <0.01, overall <0.01), with a critical value of 8.80 for the TyG index to predict the occurrence of MACCE. The TyG index was able to further improve the predictive accuracy of MACCE.

CONCLUSIONS

TyG index is a potential predictor of the risk of MACCE in patients with CHD complicated with depression.

摘要

背景

甘油三酯-葡萄糖(TyG)指数是胰岛素抵抗和代谢异常的替代标志物,与多种疾病的预后密切相关。患有 CHD 和抑郁症的患者发生主要不良心血管和脑血管事件(MACCE)的风险更高,结局更差。TyG 指数可能能够预测这一特殊人群的不良预后。

方法

这项回顾性队列研究纳入了 2013 年 6 月至 2023 年 12 月期间患有 CHD 和抑郁症的 596 例患者。主要终点是 MACCE 的发生,包括全因死亡、卒中和 MI 以及紧急冠状动脉血运重建。采用受试者工作特征(ROC)曲线、Cox 回归分析、Kaplan-Meier 生存分析和限制性立方样条(RCS)分析评估 TyG 指数与 CHD 合并抑郁症患者 MACCE 风险之间的相关性。

结果

中位随访 31(15-62)个月,281(47.15%)例患者发生 MACCE。TyG 指数预测 MACCE 风险的 ROC 曲线下面积为 0.765(0.726-0.804)(<0.01)。TyG 指数较高组(69.73%)发生 MACCE 的风险明显高于 TyG 指数较低组(23.63%)(<0.01)。多因素 RCS 模型显示存在非线性相关性(非线性<0.01,整体<0.01),TyG 指数预测 MACCE 发生的临界值为 8.80。TyG 指数能够进一步提高 MACCE 的预测准确性。

结论

TyG 指数是预测 CHD 合并抑郁症患者 MACCE 风险的潜在标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/345e/11240118/2636528d17f3/fendo-15-1416530-g001.jpg

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