甘油三酯葡萄糖指数与甘油三酯葡萄糖-肥胖复合指数之间的关联以及缺血性心脏病风险

[Association Between Triglyceride Glucose Index and Triglyceride Glucose-Obesity Composite Indices and the Risk of Ischemic Heart Disease].

作者信息

Yang Jing, Zhu Chenyan, Yuan Lu, Zhang Tao, Li Jiayuan, Jiang Xia, Long Lu, Liao Jiaqiang, Ma Tianpei

机构信息

（ 611743） Hongguang Community Health Service Center, Pidu District, Chengdu 611743, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2024 Sep 20;55(5):1123-1132. doi: 10.12182/20240960103.

DOI:10.12182/20240960103

PMID:39507981

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11536227/

Abstract

OBJECTIVE

To explore the association between the triglyceride-glucose index (TyG) and TyG-obesity composite indices, including TyG-waist circumference (TyG-WC), TyG-body mass index (TyG-BMI), and TyG-waist-to-height ratio (TyG-WHtR), and the risk of ischemic heart disease (IHD), and to provide reference for the prevention of IHD.

METHODS

The sample of this study was derived from the West China Elderly Preventive and Treatment Merging Cohort, from which 9628 elderly individuals from the retrospective cohort were selected. Cox regression models were used to analyze the association between TyG-related indices and the risk of IHD. Receiver operating characteristic (ROC) curves were plotted to assess and compare the performance of TyG-related indices in predicting the occurrence of IHD.

RESULTS

The participants were followed up for a median of 2.82 years, with 7.2% (694/9628) of the participants experiencing IHD events. Multivariate Cox regression showed that after controlling for the covariates, including sex, age, educational attainment, smoking, drinking, exercise, dietary habits, medication history, and whether the participant had hypertension, every time TyG, TyG-WC, TyG-BMI and TyG-WHtR increased by one standard deviation (SD), the risk of IHD increased by 12% (hazard ratio [HR]=1.12, 95% confidence interval [CI]: 1.04-1.20), 21% (HR=1.21, 95% CI: 1.12-1.31), 20% (HR=1.20, 95% CI: 1.12-1.29), and 19% (HR=1.19, 95% CI: 1.10-1.28), respectively. Both the TyG index and TyG-obesity composite indices were positively correlated with IHD risk, showing a linear relationship (<0.05). TyG-WC (area under the curve[AUC]=0.680, 95% CI: 0.660-0.700, <0.001), TyG-BMI (AUC=0.674, 95% CI: 0.654-0.695, <0.001), and TyG-WHtR (AUC=0.678, 95% CI: 0.658-0.698, <0.001) demonstrated better predictive performance than TyG did (AUC=0.669, 95% CI: 0.648-0.689, <0.001).

CONCLUSION

Elevated levels of TyG and TyG-obesity composite indices were associated with a higher risk for IHD, and combining TyG with BMI, WC, and WHtR may lead to better performance in risk assessment for IHD than using TyG alone.

摘要

目的

探讨甘油三酯-葡萄糖指数（TyG）与TyG-肥胖复合指数，包括TyG-腰围（TyG-WC）、TyG-体重指数（TyG-BMI）和TyG-腰高比（TyG-WHtR），与缺血性心脏病（IHD）风险之间的关联，并为IHD的预防提供参考。

方法

本研究样本来自华西老年预防与治疗合并队列，从中选取回顾性队列中的9628名老年人。采用Cox回归模型分析TyG相关指数与IHD风险之间的关联。绘制受试者工作特征（ROC）曲线，以评估和比较TyG相关指数在预测IHD发生方面的性能。

结果

参与者的中位随访时间为2.82年，7.2%（694/9628）的参与者发生了IHD事件。多变量Cox回归显示，在控制了协变量，包括性别、年龄、教育程度、吸烟、饮酒、运动、饮食习惯、用药史以及参与者是否患有高血压后，每次TyG、TyG-WC、TyG-BMI和TyG-WHtR增加一个标准差（SD），IHD风险分别增加12%（风险比[HR]=1.12，95%置信区间[CI]：1.04-1.20）、21%（HR=1.21，95%CI：1.12-1.31）、20%（HR=1.20，95%CI：1.12-1.29）和19%（HR=1.19，95%CI：1.10-1.28）。TyG指数和TyG-肥胖复合指数均与IHD风险呈正相关，呈线性关系（<0.05）。TyG-WC（曲线下面积[AUC]=0.680，95%CI：0.660-0.700，<0.001）、TyG-BMI（AUC=0.674，95%CI：0.654-0.695，<0.001）和TyG-WHtR（AUC=0.678，95%CI：0.658-0.698，<0.001）的预测性能优于TyG（AUC=0.669，95%CI：0.648-0.689，<0.001）。