Zhang Jiawei, Hou Qiqi, Han Quanle, Peng Xu, Cao Hongxia, Wu Shouling, Li Kangbo
Department of Rehabilitation Medicine, Kailuan Tangjiazhuang Hospital, 063000 Tangshan, Hebei, China.
Hebei Medical University, 050017 Shijiazhuang, Hebei, China.
Rev Cardiovasc Med. 2024 Jan 15;25(1):28. doi: 10.31083/j.rcm2501028. eCollection 2024 Jan.
Rheumatoid arthritis (RA) is a systemic and chronic autoimmune disease that is characterized by persistent joint inflammation. RA patients experience a considerably increased risk of cardiovascular-related morbidity and mortality. The current study investigated the association between triglyceride glucose (TyG) index and major adverse cardiovascular events (MACEs) in a predominantly male cohort of RA patients.
A total of 1613 RA patients (81.53% male) were selected from the Kailuan study. The TyG index was calculated as the logarithmic product of fasting blood triglyceride and fasting blood glucose divided by two. MACEs were defined as the composite of non-fatal myocardial infarctions and non-fatal strokes. Cox proportional hazards analysis was performed to study the association between the TyG index and MACEs.
A total of 59 MACEs occurred during the median follow-up time of 5.32 years. Following adjustment for age and gender, analysis by multivariable Cox proportional hazards (model 1) showed that an elevated TyG index was associated with an increased risk of MACEs (quartile 2, hazard ratio (HR): 2.741, 95% confidence interval (CI): 1.220-6.157, = 0.015; quartile 4, HR: 2.521, 95% CI: 1.074-5.917, = 0.034). After adjustment for other variables, Cox proportional hazards analysis (model 2) showed that an elevated TyG index was independently associated with an increased risk of MACEs (quartile 2, HR: 2.348, 95% CI: 1.009-5.465, = 0.048). In addition, subgroup analysis showed a higher TyG index was significantly linked to an increased risk of MACEs in patients aged more than 65 years (quartile 2, HR: 6.048, 95% CI: 1.311-27.908, = 0.021; quartile 4, HR: 12.074, 95% CI: 1.438-101.358, = 0.022).
The TyG index was associated with an increased risk of MACEs in a predominantly male cohort of RA patients. This index may be helpful for the prediction of MACEs in male patients with RA.
Registration number in the Chinese clinical trial registry: ChiCTR-TNRC-11001489.
类风湿关节炎（RA）是一种全身性慢性自身免疫性疾病，其特征为持续性关节炎症。RA患者发生心血管相关发病和死亡的风险显著增加。本研究调查了在以男性为主的RA患者队列中甘油三酯葡萄糖（TyG）指数与主要不良心血管事件（MACE）之间的关联。
从开滦研究中选取了1613例RA患者（81.53%为男性）。TyG指数计算为空腹血甘油三酯与空腹血糖的对数乘积除以二。MACE定义为非致命性心肌梗死和非致命性卒中的复合事件。进行Cox比例风险分析以研究TyG指数与MACE之间的关联。
在5.32年的中位随访期内共发生59例MACE。在调整年龄和性别后，多变量Cox比例风险分析（模型1）显示，TyG指数升高与MACE风险增加相关（四分位数2，风险比（HR）：2.741，95%置信区间（CI）：1.220 - 6.157，P = 0.015；四分位数4，HR：2.521，95% CI：1.074 - 5.917，P = 0.034）。在调整其他变量后，Cox比例风险分析（模型2）显示，TyG指数升高与MACE风险增加独立相关（四分位数2，HR：2.348，95% CI：1.009 - 5.465，P = 0.048）。此外，亚组分析显示，在年龄大于65岁的患者中，较高的TyG指数与MACE风险增加显著相关（四分位数2，HR：6.048，95% CI：1.311 - 27.908，P = 0.021；四分位数4，HR：12.074，95% CI：1.438 - 101.358，P = 0.022）。
在以男性为主的RA患者队列中，TyG指数与MACE风险增加相关。该指数可能有助于预测男性RA患者的MACE。
中国临床试验注册中心注册号：ChiCTR - TNRC - 11001489。
