Hebei North University, Zhangjiakou, 075031, Hebei, China.
Three Departments of Respiration, Hebei Children's Hospital, Shijiazhuang, 050031, Hebei, China.
Sci Rep. 2024 Nov 19;14(1):28631. doi: 10.1038/s41598-024-74294-8.
This study aims to investigate the association between the triglyceride-glucose (TyG) index and the occurrence of acute respiratory failure in asthma patients. This retrospective observational cohort study utilized data from the Medical Information Mart for Intensive Care IV (MIMIC-IV 2.2) database. The primary outcome was the development of acute respiratory failure in asthma patients. Initially, the Boruta algorithm and SHapley Additive exPansions were applied to preliminarily determine the feature importance of the TyG index, and a risk prediction model was constructed to evaluate its predictive ability. Secondly, Logistic regression proportional hazards models were employed to assess the association between the TyG index and acute respiratory failure in asthma patients. Finally, subgroup analyses were conducted for sensitivity analyses to explore the robustness of the results. A total of 751 asthma patients were included in the study. When considering the TyG index as a continuous variable, logistic regression analysis revealed that in the unadjusted Model 1, the odds ratio (OR) was 2.381 (95% CI: 1.857-3.052; P < 0.001), in Model II, the OR was 2.456 (95% CI: 1.809-3.335; P < 0.001), and in the multivariable-adjusted model, the OR was 1.444 (95% CI: 1.029-2.028; P = 0.034). A consistent association was observed between the TyG index and the risk of acute respiratory failure in asthma patients. No significant interaction was found between the TyG index and various subgroups (P > 0.05). Furthermore, machine learning results indicated that an elevated TyG index was a significant feature predictive of respiratory failure in asthma patients. The baseline risk model achieved an AUC of 0.743 (95% CI: 0.679-0.808; P < 0.05), whereas the combination of the baseline risk model with the TyG index yielded an AUC of 0.757 (95% CI: 0.694-0.821; P < 0.05). The TyG index can serve as a predictive indicator for acute respiratory failure in asthma patients, albeit confirmation of these findings requires larger-scale prospective studies.
本研究旨在探讨甘油三酯-葡萄糖(TyG)指数与哮喘患者急性呼吸衰竭发生的关系。这项回顾性观察性队列研究利用了医疗信息互操作工具集 IV(MIMIC-IV 2.2)数据库中的数据。主要结局是哮喘患者发生急性呼吸衰竭。首先,应用 Boruta 算法和 SHapley Additive exPansions 初步确定 TyG 指数的特征重要性,构建风险预测模型评估其预测能力。其次,采用 Logistic 回归比例风险模型评估 TyG 指数与哮喘患者急性呼吸衰竭的关系。最后,进行亚组分析以探索结果的稳健性。共纳入 751 例哮喘患者。当将 TyG 指数视为连续变量时,logistic 回归分析显示,在未经调整的模型 1 中,比值比(OR)为 2.381(95%CI:1.857-3.052;P<0.001),在模型 2 中,OR 为 2.456(95%CI:1.809-3.335;P<0.001),在多变量调整模型中,OR 为 1.444(95%CI:1.029-2.028;P=0.034)。TyG 指数与哮喘患者急性呼吸衰竭风险之间存在一致的关联。在各种亚组之间未发现 TyG 指数与急性呼吸衰竭风险之间存在显著交互作用(P>0.05)。此外,机器学习结果表明,升高的 TyG 指数是哮喘患者呼吸衰竭的一个显著预测特征。基础风险模型的 AUC 为 0.743(95%CI:0.679-0.808;P<0.05),而基础风险模型与 TyG 指数的组合得到的 AUC 为 0.757(95%CI:0.694-0.821;P<0.05)。TyG 指数可作为哮喘患者急性呼吸衰竭的预测指标,但需要更大规模的前瞻性研究来证实这些发现。