Shanghai Heart Failure Research Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Cardiovasc Diabetol. 2024 Aug 7;23(1):292. doi: 10.1186/s12933-024-02352-6.
BACKGROUND: The American Heart Association (AHA) has recently introduced the concept of Cardiovascular-Kidney-Metabolic (CKM) syndrome, which is the result of an increasing emphasis on the interplay of metabolic, renal and cardiovascular diseases (CVD). Furthermore, there is substantial evidence of a correlation between the triglyceride glucose-body mass index (TyG-BMI ) and CVD as an assessment of insulin resistance (IR). However, it remains unknown whether this correlation exists in population with CKM syndrome. METHODS: All data for this study were obtained from the China Health and Retirement Longitudinal Study (CHARLS). The exposure was the participants' TyG-BMI at baseline, which was calculated using a combination of triglycerides (TG), fasting blood glucose (FBG) and body mass index (BMI). The primary outcome was CVD, which were determined by the use of a standardised questionnaire during follow-up. To examine the relationship between TyG-BMI and CVD incidence in population with CKM syndrome, both Cox regression analyses and restricted cubic spline (RCS) regression analyses were performed. RESULTS: A total of 7376 participants were included in the final analysis. Of these, 1139, 1515, 1839, and 2883 were in CKM syndrome stages 0, 1, 2, and 3, respectively, at baseline. The gender distribution was 52.62% female, and the mean age was 59.17 ± 9.28 (years). The results of the fully adjusted COX regression analyses indicated that there was a 6.5% increase in the risk of developing CVD for each 10-unit increase in TyG-BMI,95% confidence interval (CI):1.041-1.090. The RCS regression analyses demonstrated a positive linear association between TyG-BMI and the incidence of CVD in the CKM syndrome population (P for overall < 0.001, P for nonlinear = 0.355). CONCLUSIONS: This cohort study demonstrated a positive linear association between TyG-BMI index and increased CVD incidence in a population with CKM syndrome stage 0-3. This finding suggests that enhanced assessment of TyG-BMI index may provide a more convenient and effective tool for individuals at risk for CVD in CKM syndrome stage 0-3.
背景：美国心脏协会（AHA）最近提出了心血管-肾脏-代谢（CKM）综合征的概念，这是对代谢、肾脏和心血管疾病（CVD）相互作用日益重视的结果。此外，大量证据表明甘油三酯-葡萄糖-体重指数（TyG-BMI）与 CVD 之间存在相关性，可作为胰岛素抵抗（IR）的评估指标。然而，CKM 综合征患者中是否存在这种相关性尚不清楚。
方法：本研究所有数据均来自中国健康与养老追踪调查（CHARLS）。暴露因素为参与者基线时的 TyG-BMI，通过结合甘油三酯（TG）、空腹血糖（FBG）和体重指数（BMI）计算得出。主要结局为 CVD，通过随访期间使用标准化问卷确定。为了研究 CKM 综合征人群中 TyG-BMI 与 CVD 发生率之间的关系，同时进行了 Cox 回归分析和限制性立方样条（RCS）回归分析。
结果：共纳入 7376 名参与者进行最终分析。其中，1139、1515、1839 和 2883 名参与者在基线时分别处于 CKM 综合征 0、1、2 和 3 期。性别分布为 52.62%为女性，平均年龄为 59.17±9.28（岁）。完全调整后的 COX 回归分析结果表明，TyG-BMI 每增加 10 个单位，CVD 风险增加 6.5%，95%置信区间（CI）为 1.041-1.090。RCS 回归分析显示，在 CKM 综合征人群中，TyG-BMI 与 CVD 发生率之间存在正线性关联（整体 P<0.001，非线性 P=0.355）。
结论：本队列研究表明，CKM 综合征 0-3 期人群中 TyG-BMI 指数与 CVD 发生率增加呈正线性关联。这一发现表明，对 TyG-BMI 指数的强化评估可能为 CKM 综合征 0-3 期个体提供一种更方便、更有效的 CVD 风险评估工具。
Cardiovasc Diabetol. 2023-11-28
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