评估甘油三酯升高、甘油三酯-葡萄糖指数（TyG）和TG/HDL比值对20年随访期间心血管疾病和死亡率的预测价值：德黑兰脂质与葡萄糖研究。

Assessing the predictive value of elevated triglycerides, triglyceride-glucose index (TyG), and TG/HDL ratios for cardiovascular disease and mortality during 20 years of follow-up: Tehran lipid and glucose study.

作者信息

Khalili Shayesteh, Amouzegar Atieh, Dorost Seyed Sattar, Azizi Fereidoun, Salahi-Niri Aryan

机构信息

Department of Internal Medicine School of Medicine Imam Hossein Hospital Shahid Beheshti University of Medical Sciences Tehran Iran.

Endocrine Research Center Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran.

出版信息

Clin Biochem. 2025 Mar;136:110891. doi: 10.1016/j.clinbiochem.2025.110891. Epub 2025 Jan 23.

DOI:10.1016/j.clinbiochem.2025.110891

PMID:39862946

Abstract

OBJECTIVES

Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality globally, influenced by a complex interplay of risk factors including lipid disorders and insulin resistance (IR). The triglyceride-glucose (TyG) index and the triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio have emerged as potential indicators for assessing cardiovascular risk. This study aimed to evaluate the predictive value of hypertriglyceridemia, the TyG index, and the TG/HDL ratio for mortality and CVD occurrence within an Iranian population.

DESIGN AND METHODS

Conducted within the Tehran Lipid and Glucose Study over 20 years, this research analyzed 7,117 participants to assess the association between these lipid biomarkers and CVD risk and mortality. Participants were stratified by their TyG and TG/HDL indices, with Cox proportional hazards models determining risk ratios across three adjusted models considering various demographic and clinical variables.

RESULTS

The study found significant associations between elevated triglycerides, TyG, and TG/HDL levels with increased risks of mortality and CVD during the 20-year follow-up. Specifically, the hazard ratios for CVD events were notably significant in the second triglyceride group (150-250 mg/dL), with a hazard ratio of 1.36 (1.19-1.55) in both Model 1 and Model 2, and in the third group (250-400 mg/dL), with ratios of 1.88 (1.63-2.17) in Model 1, 1.90 (1.65-2.19) in Model 2, and 1.44 (1.24-1.67) in Model 3.

CONCLUSION

Hypertriglyceridemia, the TyG index, and the TG/HDL ratio are easily calculable and clinically relevant markers for cardiovascular risk assessment. Their integration into routine health evaluations could facilitate early detection and management of at-risk individuals, potentially reducing the incidence and impact of CVD within the community.

摘要

目的

心血管疾病（CVD）仍然是全球发病和死亡的主要原因，受包括血脂异常和胰岛素抵抗（IR）在内的多种危险因素复杂相互作用的影响。甘油三酯 - 葡萄糖（TyG）指数和甘油三酯与高密度脂蛋白胆固醇（TG/HDL）的比值已成为评估心血管风险的潜在指标。本研究旨在评估高甘油三酯血症、TyG指数和TG/HDL比值对伊朗人群死亡率和CVD发生的预测价值。

设计与方法

在德黑兰血脂与血糖研究的20年期间进行，本研究分析了7117名参与者，以评估这些血脂生物标志物与CVD风险和死亡率之间的关联。参与者按其TyG和TG/HDL指数分层，Cox比例风险模型在考虑各种人口统计学和临床变量的三个调整模型中确定风险比。

结果

研究发现，在20年的随访期间，甘油三酯升高、TyG和TG/HDL水平与死亡率和CVD风险增加之间存在显著关联。具体而言，在第二个甘油三酯组（150 - 250mg/dL）中，CVD事件的风险比在模型1和模型2中均显著，风险比为1.36（1.19 - 1.55），在第三个组（250 - 400mg/dL）中，模型1中的风险比为1.88（1.63 - 2.17），模型2中的风险比为1.90（1.65 - 2.19），模型3中的风险比为1.44（1.24 - 1.67）。