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甘油三酯-葡萄糖指数与难治性高血压的相关性及列线图模型构建。

Association of the Triglyceride-Glucose Index With Resistant Hypertension and a Nomogram Model Construction.

机构信息

State Key Laboratory of Cardiovascular Disease Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.

Department of Cardiology First Affiliated Hospital of Xinjiang Medical University Urumqi China.

出版信息

J Am Heart Assoc. 2024 Oct;13(19):e034136. doi: 10.1161/JAHA.123.034136. Epub 2024 Sep 18.

Abstract

BACKGROUND

Resistant hypertension (RH) remains one of the major risk factors for cardiovascular disease. This study aims to investigate the association between the triglyceride-glucose (TyG) index and RH incidence in patients with hypertension and to construct a nomogram for predicting the occurrence of RH.

METHODS AND RESULTS

A retrospective cohort study was conducted on 1635 patients initially diagnosed with hypertension at the Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University from August 2019 to August 2021. Patients were followed up for a median of 31 months, with 373 cases (22.81%) developing RH. Least absolute shrinkage and selection operator regression and multivariable Cox regression analysis identified the TyG index as the strongest predictor of RH (hazard ratio, 5.472 [95% CI, 4.028-7.433]; <0.001). Consistent results were also observed in subgroup analyses across different ages and sexes. In addition to the TyG index, other independent risk factors, including uric acid, age, and the apnea-hypopnea index, were noted. A nomogram model was subsequently developed using these risk factors, and including the TyG index notably enhanced the diagnostic effectiveness of the model in predicting the occurrence of RH.

CONCLUSIONS

The TyG index appears to be a potential predictor of RH in patients with hypertension, indicating that insulin resistance might be an important factor in the development and progression of RH.

摘要

背景

高血压抵抗(RH)仍然是心血管疾病的主要危险因素之一。本研究旨在探讨甘油三酯-葡萄糖(TyG)指数与高血压患者 RH 发生率之间的关系,并构建预测 RH 发生的列线图。

方法和结果

本研究对 2019 年 8 月至 2021 年 8 月在新疆医科大学附属中医医院初诊为高血压的 1635 例患者进行了回顾性队列研究。中位随访 31 个月,373 例(22.81%)患者发生 RH。最小绝对收缩和选择算子回归和多变量 Cox 回归分析确定 TyG 指数是 RH 的最强预测因子(风险比,5.472[95%CI,4.028-7.433];<0.001)。在不同年龄和性别的亚组分析中也观察到了一致的结果。除 TyG 指数外,尿酸、年龄和呼吸暂停低通气指数等其他独立危险因素也被发现。随后使用这些危险因素开发了一个列线图模型,包括 TyG 指数显著提高了该模型预测 RH 发生的诊断效果。

结论

TyG 指数似乎是高血压患者 RH 的一个潜在预测因子,这表明胰岛素抵抗可能是 RH 发生和发展的一个重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4f9/11681483/101b80ca6757/JAH3-13-e034136-g003.jpg

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