甘油三酯-葡萄糖-体重指数与心血管疾病发病率：队列研究的荟萃分析
Triglyceride-glucose-body mass index and the incidence of cardiovascular diseases: a meta-analysis of cohort studies.
作者信息
Rao Xiyun, Xin Ziyi, Yu Qingwen, Feng Lanlan, Shi Yongmin, Tang Ting, Tong Xuhan, Hu Siqi, You Yao, Zhang Shenghui, Tang Jiake, Zhang Xingwei, Wang Mingwei, Liu Ling
机构信息
Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Zhejiang Key Laboratory of Medical Epigenetics, School of Basic Medical Sciences, Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou Normal University, Hangzhou, 310015, China.
Hangzhou Lin'an Fourth People's Hospital, Hangzhou, 311321, China.
出版信息
Cardiovasc Diabetol. 2025 Jan 22;24(1):34. doi: 10.1186/s12933-025-02584-0.
BACKGROUND
Numerous studies have shown that insulin resistance (IR) is closely related to the pathogenesis of cardiovascular disease (CVD). This study aims to summarize the correlation between the triglyceride-glucose-body mass index (TyG-BMI index), a novel surrogate indicator of insulin resistance, and the incidence of CVD in patients without CVD at baseline through meta-analysis.
METHOD
Cohort studies assessing multivariate-corrected hazard ratios (HRs) for associations between the TyG-BMI index and cardiovascular disease (CVD) were obtained by searching PubMed, Cochrane Library, EMBASE, and Web of Science. Results were combined using a random-effects model to account for heterogeneity among the included studies. Robust error meta-regression was used to fit the nonlinear dose-response relationship. Statistical analysis was performed using Review Manager 5.4 and STATA 18.0.
RESULT
Ten cohort studies involving a total of 871,728 subjects were included. The results indicated that Compared with the lowest TyG-BMI index category, the highest TyG-BMI index was related to a higher incidence of cardiovascular diseases (CVD) (HR = 1.62; 95% confidence interval (CI): 1.35-1.95; I = 94%),coronary artery disease (CAD) (HR = 1.69; 95% (CI): 1.23-2.31; I = 94%). stroke(HR = 1.57; 95% (CI): 1.11-2.23; I = 94%).In the dose-response analysis, there was a linear association of the TyG-BMI index with the risk of CVD (P = 0.223), CAD (P = 0.693), and stroke (P = 0.122)No significant effects were observed regarding participants' gender, length of follow-up, sample size or mean age(P > 0.05).
CONCLUSION
Higher TyG-BMI may be independently associated with an increased risk of CVD in individuals without CVD at baseline. Numerous cohort studies are needed to further validate and elucidate the pathologic role between Tyg-BMI and CVD and to determine whether it can be incorporated into CVD risk prediction tools to enhance predictive accuracy.
背景
大量研究表明，胰岛素抵抗（IR）与心血管疾病（CVD）的发病机制密切相关。本研究旨在通过荟萃分析总结甘油三酯-血糖-体重指数（TyG-BMI指数）（一种新的胰岛素抵抗替代指标）与基线时无CVD患者的CVD发病率之间的相关性。
方法
通过检索PubMed、Cochrane图书馆、EMBASE和Web of Science获取评估TyG-BMI指数与心血管疾病（CVD）之间关联的多变量校正风险比（HRs）的队列研究。使用随机效应模型合并结果以考虑纳入研究之间的异质性。稳健误差元回归用于拟合非线性剂量反应关系。使用Review Manager 5.4和STATA 18.0进行统计分析。
结果
纳入了10项队列研究，共涉及871,728名受试者。结果表明，与TyG-BMI指数最低类别相比，TyG-BMI指数最高与心血管疾病（CVD）（HR = 1.62；95%置信区间（CI）：1.35 - 1.95；I² = 94%）、冠状动脉疾病（CAD）（HR = 1.69；95%（CI）：1.23 - 2.31；I² = 94%）、中风（HR = 1.57；95%（CI）：1.11 - 2.23；I² = 94%）的更高发病率相关。在剂量反应分析中，TyG-BMI指数与CVD（P = 0.223）、CAD（P = 0.693）和中风（P = 0.122）风险呈线性关联。未观察到参与者性别、随访时间、样本量或平均年龄的显著影响（P > 0.05）。
结论
较高的TyG-BMI可能与基线时无CVD个体的CVD风险增加独立相关。需要大量队列研究来进一步验证和阐明TyG-BMI与CVD之间的病理作用，并确定它是否可以纳入CVD风险预测工具以提高预测准确性。
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