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甘油三酯-葡萄糖指数对冠状动脉粥样硬化性心脏病患者抑郁症发生的影响

The Impact of the Triglyceride-Glucose Index on the Development of Depression in Patients with Coronary Atherosclerotic Heart Disease.

作者信息

Guan Jing, Wang Yue, Dong Changjun, Chen Yuwen, Li Bingqing, Zhou Yilu, Huang Fanke, Sun Peiyuan, Tian Xue, Ran Feng, Lv Jianfeng

机构信息

ChinaThree Gorges University, Yichang, People's Republic of China.

Department of Cardiology, Affiliated Renhe Hospital of China Three Gorges University, Yichang, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2024 Nov 11;20:2105-2113. doi: 10.2147/NDT.S484745. eCollection 2024.

Abstract

BACKGROUND

Depression is common among patients with coronary atherosclerotic heart disease and is a prevalent mental health issue, particularly among those with cardiovascular diseases. Depression is commonly associated with elevated blood glucose and lipid levels. The triglyceride-glucose index is a novel indicator reflecting insulin resistance, which has been proven in numerous studies to be associated with cardiovascular diseases.

PURPOSE

Study on the impact of the triglyceride-glucose index (TyG index) on the development of depression in patients with coronary atherosclerotic heart disease (CHD).

PATIENTS AND METHODS

Using the Patient Health Questionnaire-9 (PHQ-9), 197 CHD patients were classified into a non-depressed group (n = 44, PHQ-9 < 5) and a depressed group (n = 153, PHQ-9 ≥ 5). Fasting blood glucose (GLU), HDL, total cholesterol (TC), LDL, triglycerides (TG), and TyG index were compared between groups. Depression risk factors were identified via logistic regression, and the predictive value of TyG index was evaluated using ROC analysis.

RESULTS

In depressed patients, TyG index, TG, TC, LDL, and GLU were significantly higher, while HDL was lower than in the non-depressed group (p < 0.05). Logistic regression identified TyG index, LDL, GLU, TG, TC, HDL, female sex, smoking, alcohol consumption, and older age as independent risk factors for depression in CHD patients (p < 0.05). ROC analysis showed the TyG index had an AUC of 0.76 (95% CI 0.687-0.829, p < 0.001) for predicting depression, with a cutoff of 1.613, sensitivity of 45.1%, and specificity of 97.7%. Endpoint events were more frequent in the depression group (χ² = 8.015, p = 0.005).

CONCLUSION

The TyG index is an independent risk factor for depression in patients with CHD, indicating a significant predictive value. Depressed patients have a higher rate of readmission, and managing depression effectively contributes to better prognosis.

摘要

背景

抑郁症在冠状动脉粥样硬化性心脏病患者中很常见,是一个普遍存在的心理健康问题,尤其是在心血管疾病患者中。抑郁症通常与血糖和血脂水平升高有关。甘油三酯-葡萄糖指数是反映胰岛素抵抗的一个新指标,众多研究已证实其与心血管疾病有关。

目的

研究甘油三酯-葡萄糖指数(TyG指数)对冠状动脉粥样硬化性心脏病(CHD)患者抑郁症发生的影响。

患者与方法

使用患者健康问卷-9(PHQ-9),将197例CHD患者分为非抑郁症组(n = 44,PHQ-9<5)和抑郁症组(n = 153,PHQ-9≥5)。比较两组患者的空腹血糖(GLU)、高密度脂蛋白(HDL)、总胆固醇(TC)、低密度脂蛋白(LDL)、甘油三酯(TG)和TyG指数。通过逻辑回归确定抑郁症的危险因素,并使用受试者工作特征(ROC)分析评估TyG指数的预测价值。

结果

抑郁症患者的TyG指数、TG、TC、LDL和GLU显著高于非抑郁症组,而HDL低于非抑郁症组(p<0.05)。逻辑回归确定TyG指数、LDL、GLU、TG、TC、HDL、女性、吸烟、饮酒和年龄较大是CHD患者抑郁症的独立危险因素(p<0.05)。ROC分析显示,TyG指数预测抑郁症的曲线下面积(AUC)为0.76(95%可信区间0.687-0.829,p<0.001),截断值为1.613,灵敏度为45.1%,特异度为97.7%。抑郁症组的终点事件更频繁(χ² = 8.015,p = 0.005)。

结论

TyG指数是CHD患者抑郁症的独立危险因素,具有显著的预测价值。抑郁症患者的再入院率较高,有效管理抑郁症有助于改善预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e66a/11566584/b3349d73e86d/NDT-20-2105-g0001.jpg

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