Department of Critical Care Medicine, Tianjin Institute of Anesthesiology, Tianjin Medical University General Hospital, 154th Anshan Road, Tianjin, 300052, China.
Department of Pathogen Biology, School of Basic Medical Sciences, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
Lipids Health Dis. 2024 Jul 25;23(1):227. doi: 10.1186/s12944-024-02213-x.
It is well known that glucose and lipid metabolism disorders and insulin resistance are common in sepsis, which affect the occurrence and prognosis of multiple organ dysfunction in septic patients. Previous study reported the predictive value of triglyceride-glucose index (TyG), a clinical indicator for insulin resistance, in postoperative delirium patients. However, it remains unclear whether the TyG index is a novel predictive biomarker for sepsis-associated delirium. The aim of this study is to explore the relationship between TyG index and the risk of delirium in patients with sepsis.
Adult septic patients were identified from the MIMIC-IV database and divided into four groups based on the mean value of TyG. The primary outcome was the incidence of delirium. The association between TyG and the risk of developing delirium was evaluated by restricted cubic spline (RCS), multivariate logistic regression and subgroup analysis. Propensity Score Matching (PSM) method was used to balance the baseline data.
A total of 3,331 septic patients were included in the analysis, and further divided into four groups: Q1 (TyG ≤ 8.67), Q2 (8.67 < TyG ≤ 9.08), Q3 (9.08 < TyG ≤ 9.61), and Q4 (TyG > 9.61). The RCS curves demonstrated a non-linear positive relationship between TyG index and the risk of developing delirium, and an optimal cut-of value 9.09 was recommended. After balancing the baseline information by PSM, patients in the TyG > 9.09 group had a significant higher incidence of delirium compared with those in the TyG ≤ 9.09 group. In logistic regression analysis, TyG > 9.09 was significantly associated with lower risk of developing delirium in both original cohort (OR 1.54-1.78, all P < 0.001) and the PSM cohort (OR 1.41-1.48, all P < 0.001). No association was found between the TyG index and mortality (all P > 0.05). In subgroup analysis, our findings were consistent (all OR > 1 in all subgroups).
Our study demonstrated an independent association between TyG index and increased risk of delirium in septic patients, indicating that TyG index can serve as a biomarker for delirium in sepsis.
众所周知，葡萄糖和脂质代谢紊乱以及胰岛素抵抗在脓毒症中很常见，这会影响脓毒症患者多器官功能障碍的发生和预后。先前的研究报道了甘油三酯-葡萄糖指数（TyG）作为胰岛素抵抗的临床指标，在术后谵妄患者中的预测价值。然而，TyG 指数是否是脓毒症相关谵妄的新型预测生物标志物尚不清楚。本研究旨在探讨 TyG 指数与脓毒症患者发生谵妄的风险之间的关系。
从 MIMIC-IV 数据库中确定了成年脓毒症患者，并根据 TyG 的平均值将其分为四组。主要结局为谵妄发生率。通过限制性立方样条（RCS）、多变量逻辑回归和亚组分析评估 TyG 与发生谵妄风险之间的关系。采用倾向评分匹配（PSM）方法平衡基线数据。
共纳入 3331 例脓毒症患者，进一步分为四组：Q1（TyG≤8.67）、Q2（8.67< TyG≤9.08）、Q3（9.08< TyG≤9.61）和 Q4（TyG>9.61）。RCS 曲线表明 TyG 指数与发生谵妄的风险之间存在非线性正相关关系，建议最佳截断值为 9.09。通过 PSM 平衡基线信息后，TyG>9.09 组患者发生谵妄的发生率明显高于 TyG≤9.09 组。在逻辑回归分析中，TyG>9.09 与原始队列（OR 1.54-1.78，均 P<0.001）和 PSM 队列（OR 1.41-1.48，均 P<0.001）中发生谵妄的风险降低显著相关。TyG 指数与死亡率之间无关联（均 P>0.05）。亚组分析结果一致（所有亚组的 OR 值均>1）。
本研究表明 TyG 指数与脓毒症患者谵妄风险增加独立相关，提示 TyG 指数可作为脓毒症患者谵妄的生物标志物。
