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非酒精性脂肪性肝病患者 TyG 指数与颈动脉粥样硬化风险的关系:一项回顾性队列研究。

Association between TyG index and risk of carotid atherosclerosis in NAFLD patients: a retrospective cohort study.

机构信息

Health Management Center, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.

Department of Trauma Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.

出版信息

Front Endocrinol (Lausanne). 2024 Aug 20;15:1448359. doi: 10.3389/fendo.2024.1448359. eCollection 2024.

Abstract

BACKGROUND

The TyG index, or triglyceride-glucose index, is primarily used as a marker to assess insulin resistance and metabolic health. It increases mortality risk in patients with NAFLD, atherosclerosis, ischemic stroke, or heart failure. However, its association with Carotid Atherosclerosis (CAS) risk in NAFLD patients remains uncertain.

METHODS

This retrospective cohort study enrolled 739 individuals who participated comprehensive health evaluations at a large public hospital in Yangzhou, China, between January 2021 and December 2023. Among them, 436 were men and 303 were women, and their mean (SD) age was 51.53 ± 11.46 years. The individuals were categorized into three tertiles (Q1, Q2, and Q3), according to the baseline TyG index. Our investigation focused on exploring the correlativity between the TyG and the occurrence of CAS utilizing Cox regression and RCS analyses.

RESULTS

During a 3-year follow-up period, 199 patients developed CAS (cumulative incidence rate: 26.93%). A statistical model, adjusted for age, gender, BMI, and other confounders indicated that the HR (95%CI) values for CAS risk in the Q2 and Q3 groups were 3.11(1.87-5.17) and 4.51(2.69-7.56), respectively, with P-values <0.001 for both groups. A sensitivity analysis confirmed these results. Kaplan-Meier survival analysis revealed that CAS risk varied across the groups ( non-linear < 0.05).

CONCLUSION

In individuals diagnosed as NAFLD, the possibility for CAS escalates with the elevation of the TyG value. Therefore, the TyG index is an effective marker for assessing the risk of CAS within this demographic. Large-sample prospective studies are needed to confirm this conclusion in the future.

摘要

背景

甘油三酯-葡萄糖指数(TyG 指数)主要用作评估胰岛素抵抗和代谢健康的标志物。它增加了非酒精性脂肪性肝病(NAFLD)、动脉粥样硬化、缺血性卒中和心力衰竭患者的死亡风险。然而,它与 NAFLD 患者颈动脉粥样硬化(CAS)风险的关系尚不确定。

方法

这是一项回顾性队列研究,纳入了 2021 年 1 月至 2023 年 12 月期间在中国扬州一家大型公立医院参加全面健康评估的 739 名个体。其中,男性 436 人,女性 303 人,平均(SD)年龄为 51.53±11.46 岁。根据基线 TyG 指数,将个体分为三个三分位(Q1、Q2 和 Q3)。我们利用 Cox 回归和 RCS 分析研究了 TyG 与 CAS 发生之间的相关性。

结果

在 3 年的随访期间,有 199 名患者发生了 CAS(累积发生率:26.93%)。调整年龄、性别、BMI 和其他混杂因素的统计模型表明,Q2 和 Q3 组发生 CAS 的风险 HR(95%CI)值分别为 3.11(1.87-5.17)和 4.51(2.69-7.56),两组的 P 值均 <0.001。敏感性分析证实了这些结果。Kaplan-Meier 生存分析显示,CAS 风险在各组之间存在差异(非线性<0.05)。

结论

在诊断为 NAFLD 的个体中,CAS 的可能性随着 TyG 值的升高而增加。因此,TyG 指数是评估该人群中 CAS 风险的有效标志物。未来需要进行大样本前瞻性研究来证实这一结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd3c/11368734/51493bc4c751/fendo-15-1448359-g001.jpg

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