State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia; Pediatric Cardiothoracic Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Clinical Medical Research Institute, Xinjiang Medical University, Urumqi, China.
PeerJ. 2024 Oct 4;12:e18220. doi: 10.7717/peerj.18220. eCollection 2024.
The triglyceride-glucose (TyG) index is regarded as an independent predictor of cardiovascular disease consequences and a reliable surrogate measure of insulin resistance (IR). However, the correlation analysis between triglyceride glucose index and heart failure with preserved ejection fraction in patients with essential hypertension remains unknown.
A single-center, retrospective study was conducted with patients diagnosed with essential hypertension at the First Affiliated Hospital of Xinjiang Medical University, from December 2018 to September 2020. Participants were selected based on specific inclusion and exclusion criteria, with their clinical data and laboratory tests collected. The study employed Spearman's correlation analysis, logistic regression models, restricted cubic spline plots, and receiver operating characteristic (ROC) curves to investigate the relationships between the TyG index and HFpEF.
Out of 1,602 enrolled hypertensive patients, 992 were included in the analysis after applying exclusion criteria. Patients were categorized into tertiles based on the TyG index, which showed that patients in the highest tertile had characteristics associated with a higher risk of HFpEF, including age, body mass index (BMI), systolic blood pressure (SBP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and left ventricular mass index (LVMI). A significant, independent association between the TyG index and HFpEF was confirmed, with an odds ratio (OR) of 5.127 (95% CI [3.894-6.856]). Furthermore, an S-shaped nonlinear relationship was observed between the TyG index and the incidence of HFpEF (nonlinear < 0.001). TyG index (AUC: 0.824, 95% CI [0.795-0.854]), NT-proBNP (AUC: 0.840, 95% CI [0.816-0.864]), and LVMI (AUC: 0.847, 95% CI [0.820-0.875]) showed good predictive ability for HFpEF. In addition, the TyG+LVMI combination demonstrated the strongest predictive ability (AUC: 0.907, 95% CI [0.887-0.927]).
The study underscores a significant association between IR, as indicated by the TyG index, and the development of HFpEF in hypertensive patients. It highlights the critical role of metabolic dysfunction in the pathophysiology of HFpEF, advocating for a broader perspective on cardiovascular risk management.
三酰甘油葡萄糖（TyG）指数被认为是心血管疾病后果的独立预测因子，也是胰岛素抵抗（IR）的可靠替代指标。然而，原发性高血压患者的 TyG 指数与射血分数保留型心力衰竭（HFpEF）之间的相关性分析尚不清楚。
采用单中心、回顾性研究方法，收集 2018 年 12 月至 2020 年 9 月新疆医科大学第一附属医院诊断为原发性高血压的患者，根据纳入和排除标准进行筛选，收集患者的临床资料和实验室检查。采用 Spearman 相关分析、logistic 回归模型、限制性立方样条图和受试者工作特征（ROC）曲线探讨 TyG 指数与 HFpEF 的关系。
在纳入的 1602 例高血压患者中，应用排除标准后有 992 例患者纳入分析。根据 TyG 指数将患者分为三分位，结果显示 TyG 指数最高三分位的患者具有更高 HFpEF 风险的特征，包括年龄、体重指数（BMI）、收缩压（SBP）、N 末端脑钠肽前体（NT-proBNP）和左心室质量指数（LVMI）。TyG 指数与 HFpEF 之间存在显著的独立关联，比值比（OR）为 5.127（95%置信区间[3.894-6.856]）。此外，TyG 指数与 HFpEF 发生率之间呈“S”型非线性关系（非线性<0.001）。TyG 指数（AUC：0.824，95%置信区间[0.795-0.854]）、NT-proBNP（AUC：0.840，95%置信区间[0.816-0.864]）和 LVMI（AUC：0.847，95%置信区间[0.820-0.875]）对 HFpEF 具有较好的预测能力。此外，TyG+LVMI 联合预测能力最强（AUC：0.907，95%置信区间[0.887-0.927]）。
该研究强调了 IR 作为 TyG 指数与高血压患者 HFpEF 发展之间的显著关联，突出了代谢功能障碍在 HFpEF 病理生理学中的关键作用，倡导对心血管风险管理采取更广泛的视角。
