Department of Emergency Medicine, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China.
Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China.
J Cell Mol Med. 2024 Aug;28(16):e70007. doi: 10.1111/jcmm.70007.
Although accumulating researches were done for investigating the relationship between triglyceride-glucose index (TyG index) and different diseases, none of the researches have been made in sepsis yet. In this study, we aimed to explore the relationship between TyG index and clinical outcomes in sepsis based on a large critical care public database. Sepsis patients in Medical Information Mart for Intensive Care IV (MIMIC-IV) Database were included. The exposure was TyG index, which was calculated by the equation: ln (TG (mg/dL) × FBG (mg/dL)/2). The outcomes were in-hospital mortality and 1-year mortality. The relationship between TyG index and outcomes was performed by Cox regression analysis. Smooth fitting curves were constructed by using generalized additive model. Kaplan-Meier analyses for cumulative hazard of 1-year mortality in different groups were done. 1103 sepsis patients were included with a median TyG index of 9.78. The mortalities of in-hospital and 1-year were 37.53% (n = 414) and 42.25% (n = 466), respectively. After adjusting confounders, there was a significantly negative relationship between TyG index and mortalities of in-hospital and 1-year. With the per unit increment in TyG index, the risk of in-hospital and 1-year mortality both decreased by 21% (HR = 0.79, 95% CI: 0.66-0.94, p = 0.0086 and HR = 0.79, 95% CI: 0.66-0.94, p = 0.0080, respectively). A negative relationship between TyG index and clinical outcomes in sepsis was found.
虽然已经有许多研究致力于探讨甘油三酯-葡萄糖指数（TyG 指数）与不同疾病之间的关系，但在脓毒症方面尚无相关研究。本研究旨在基于大型重症监护公共数据库，探讨 TyG 指数与脓毒症患者临床结局之间的关系。纳入 Medical Information Mart for Intensive Care IV（MIMIC-IV）数据库中的脓毒症患者。暴露因素为 TyG 指数，由公式：ln（TG（mg/dL）×FBG（mg/dL）/2）计算得出。结局为院内死亡率和 1 年死亡率。采用 Cox 回归分析 TyG 指数与结局之间的关系。采用广义加性模型构建平滑拟合曲线。对不同组别的 1 年累积死亡率进行 Kaplan-Meier 分析。共纳入 1103 例脓毒症患者，TyG 指数中位数为 9.78。院内和 1 年死亡率分别为 37.53%（n=414）和 42.25%（n=466）。校正混杂因素后，TyG 指数与院内和 1 年死亡率均呈显著负相关。TyG 指数每增加一个单位，院内和 1 年死亡率的风险分别降低 21%（HR=0.79，95%CI：0.66-0.94，p=0.0086 和 HR=0.79，95%CI：0.66-0.94，p=0.0080）。TyG 指数与脓毒症患者的临床结局呈负相关。
