甘油三酯-葡萄糖指数、高低密度脂蛋白胆固醇与中国一般老年人全因和心血管疾病死亡率的关系：一项回顾性队列研究。

Association of triglyceride-glucose index, low and high-density lipoprotein cholesterol with all-cause and cardiovascular disease mortality in generally Chinese elderly: a retrospective cohort study.

机构信息

Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.

Department of Orthopedics, Hongxing Hospital, 13th Division, Xinjiang Production and Construction Corps, Hami, Xinjiang, China.

出版信息

Front Endocrinol (Lausanne). 2024 Oct 29;15:1422086. doi: 10.3389/fendo.2024.1422086. eCollection 2024.

DOI:10.3389/fendo.2024.1422086

PMID:39534262

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11554468/

Abstract

BACKGROUND

The impact of baseline triglyceride-glucose (TyG) index and abnormal low or high-density lipoprotein cholesterol (LDL-C or HDL-C) levels on all-cause and cardiovascular disease (CVD) mortality remains unclear. This study aimed to investigate the relationship between TyG index and LDL-C or HDL-C and all-cause and CVD mortality.

METHODS

This retrospective cohort study analyzed data from health examinations of 69,068 older adults aged ≥60 in Xinzheng City, Henan Province, China, between January 2013 and January 2023. Cox proportional risk regression models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the TyG index and LDL-C or HDL-C about all-cause and CVD mortality. Restricted cubic spline was used to assess the dose-response relationship.

RESULTS

During 400,094 person-years of follow-up (median follow-up 5.8 years [interquartile range 3.0-9.12]), 13,664 deaths were recorded, of which 7,045 were due to CVD. Compared with participants in the second quartile of the TyG index, participants in the fourth quartile had a 16% increased risk of all-cause mortality (HR: 1.16, 95% CI: 1.12,1.22), and an 8% increased risk of CVD mortality (HR: 1.08, 95% CI: 1.01,1.16). Similar results were observed in LDL-C and HDL-C, with all-cause and CVD mortality risks for participants in the fourth quartile compared with participants in the third quartile for LDL-C of (HR: 1.07, 95% CI: 1.02,1.12) and (HR: 1.09, 95% CI: 1.01,1.17), respectively. The risk of all-cause and CVD mortality in participants in the fourth quartile group compared with those in the second HDL-C quartile group was (HR: 1.10, 95% CI: 1.05,1.16) and (HR: 1.11, 95% CI: 1.04,1.18), respectively. We found that the TyG index was nonlinearly associated with all-cause and CVD mortality (P non-linear <0.05), and LDL-C was nonlinearly associated with all-cause mortality (P non-linear <0.05) but linearly associated with CVD mortality (P non-linear >0.05). HDL-C, on the other hand, was in contrast to LDL-C, which showed a non-linear association with CVD mortality. We did not observe a significant interaction between TyG index and LDL-C or HDL-C (P >0.05).

CONCLUSION

TyG index and LDL-C or HDL-C increased the risk of all-cause and CVD mortality, especially a high TyG index combined with abnormal LDL-C.

摘要

背景

基线甘油三酯-葡萄糖（TyG）指数和异常低或高密度脂蛋白胆固醇（LDL-C 或 HDL-C）水平对全因和心血管疾病（CVD）死亡率的影响尚不清楚。本研究旨在探讨 TyG 指数与 LDL-C 或 HDL-C 与全因和 CVD 死亡率之间的关系。

方法

本回顾性队列研究分析了 2013 年 1 月至 2023 年 1 月期间河南省新郑市≥60 岁的 69068 名老年人健康检查的数据。使用 Cox 比例风险回归模型估计 TyG 指数和 LDL-C 或 HDL-C 与全因和 CVD 死亡率的风险比（HR）和 95%置信区间（CI）。受限立方样条用于评估剂量反应关系。

结果

在 400094 人年的随访期间（中位随访 5.8 年[四分位间距 3.0-9.12]），记录了 13664 例死亡，其中 7045 例死于 CVD。与 TyG 指数第二四分位数的参与者相比，第四四分位数的参与者全因死亡率风险增加 16%（HR：1.16，95%CI：1.12，1.22），CVD 死亡率风险增加 8%（HR：1.08，95%CI：1.01，1.16）。LDL-C 和 HDL-C 也观察到类似的结果，与 LDL-C 第三四分位数相比，第四四分位数的参与者全因和 CVD 死亡率风险分别为（HR：1.07，95%CI：1.02，1.12）和（HR：1.09，95%CI：1.01，1.17）。与 HDL-C 第二四分位数相比，第四四分位数的参与者全因和 CVD 死亡率风险分别为（HR：1.10，95%CI：1.05，1.16）和（HR：1.11，95%CI：1.04，1.18）。我们发现 TyG 指数与全因和 CVD 死亡率呈非线性相关（P 非线性<0.05），LDL-C 与全因死亡率呈非线性相关（P 非线性<0.05），但与 CVD 死亡率呈线性相关（P 非线性>0.05）。相反，HDL-C 与 LDL-C 呈非线性相关，与 CVD 死亡率呈非线性相关。我们没有观察到 TyG 指数和 LDL-C 或 HDL-C 之间存在显著的交互作用（P>0.05）。