探讨认知衰退与甘油三酯-葡萄糖指数之间的关联：系统评价和荟萃分析。

Exploring the Association Between Cognitive Decline and Triglyceride-Glucose Index: A Systematic Review and Meta-Analysis.

机构信息

Undergraduate Program in Neuroscience, University of British Columbia, British Columbia, Vancouver, Canada.

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Brain Behav. 2024 Nov;14(11):e70131. doi: 10.1002/brb3.70131.

DOI:10.1002/brb3.70131

PMID:39482852

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11527841/

Abstract

BACKGROUND

Cognitive decline and dementia are debilitating conditions that compromise the quality of life and charge the healthcare system with a substantial socioeconomic burden. In this context, emerging evidence supports an association between the triglyceride-glucose index (TyG), a surrogate insulin resistance marker, and cognitive decline and dementia. Hence, we systematically reviewed the studies assessing the TyG index in patients with cognitive decline and their controls.

METHODS

Online international databases (PubMed, Scopus, Embase, and the Web of Science) were searched comprehensively for studies showing the TyG index in patients with cognitive decline/impairment. Random-effect meta-analyses were conducted to calculate the standardized mean difference (SMD), pooled odds ratio (OR), and pooled area under the curve (AUC), in addition to 95% confidence intervals (CIs) for the comparisons of groups.

RESULTS

Seventeen studies were included in our analysis. Then, we conducted a meta-analysis, demonstrating that patients with cognitive decline had significantly higher levels of TyG index than those without (SMD 0.83, 95% CI 0.16 to 1.50, p = 0.015). Moreover, our data showed that a 1-unit increase in the TyG index was associated with higher odds of cognitive decline (adjusted OR [aOR] 2.86, 95% CI 1.49 to 5.50, p = 0.002). Further, we observed that patients in the fourth TyG quartile with higher values of the TyG index than the first quartile presented with more increased cognitive decline (aOR 1.62, 95%CI 1.11 to 2.38, p = 0.013). Finally, pooled AUC data for the diagnostic performance of the TyG index resulted in an overall AUC value of 0.73 (95% CI 0.66 to 0.79). Sensitivity and specificity were also calculated as 0.695 and 0.687, respectively.

CONCLUSION

This study supports the clinical utility of the TyG index in patients with cognitive decline and solicits more focused studies to consolidate its usage in clinical settings and real-world practice.

摘要

背景

认知能力下降和痴呆是使人衰弱的疾病，会降低生活质量，并使医疗保健系统承受巨大的社会经济负担。在这种情况下，越来越多的证据表明，甘油三酯-葡萄糖指数（TyG）作为一种替代的胰岛素抵抗标志物，与认知能力下降和痴呆之间存在关联。因此，我们系统地回顾了评估认知能力下降患者和对照组中 TyG 指数的研究。

方法

我们全面检索了在线国际数据库（PubMed、Scopus、Embase 和 Web of Science），以查找显示认知能力下降/障碍患者 TyG 指数的研究。我们进行了随机效应荟萃分析，以计算标准化均数差（SMD）、合并优势比（OR）和合并曲线下面积（AUC），并计算组间比较的 95%置信区间（CI）。

结果

我们的分析纳入了 17 项研究。然后，我们进行了荟萃分析，结果表明，与没有认知能力下降的患者相比，认知能力下降患者的 TyG 指数明显更高（SMD 0.83，95%CI 0.16 至 1.50，p = 0.015）。此外，我们的数据表明，TyG 指数增加 1 个单位，认知能力下降的可能性就会增加（调整后的 OR [aOR] 2.86，95%CI 1.49 至 5.50，p = 0.002）。此外，我们观察到，与第一四分位组相比，TyG 指数处于第四四分位组且 TyG 指数较高的患者认知能力下降更为明显（aOR 1.62，95%CI 1.11 至 2.38，p = 0.013）。最后，TyG 指数诊断性能的汇总 AUC 数据得出总体 AUC 值为 0.73（95%CI 0.66 至 0.79）。灵敏度和特异度分别计算为 0.695 和 0.687。