甘油三酯-葡萄糖指数对非糖尿病高血压患者心血管疾病风险的影响：一项为期10年的前瞻性队列研究。

Impact of triglyceride-glucose index on risk of cardiovascular disease among non-diabetic hypertension patients: a 10-year prospective cohort study.

作者信息

Chen Xin, Yang Jinyou, Wang Dan, Liu Jiali, Jin Hang, Zhang Yongqing, Xiang Quanyong

机构信息

School of Public Health, Southeast University, Nanjing. 87 Dingjiaqiao Road, Nanjing, China.

Department of Health and Rehabilitation, Jiangsu College of Nursing, 9 Keji Road, Huaian, Jiangsu Province, China.

出版信息

BMC Public Health. 2025 Jan 25;25(1):326. doi: 10.1186/s12889-025-21522-z.

DOI:10.1186/s12889-025-21522-z

PMID:39863839

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11765933/

Abstract

BACKGROUND

Triglyceride-glucose (TyG) index was regarded as a cost-efficient and reliable clinical surrogate marker for insulin resistance (IR), which was significantly correlated with cardiovascular disease (CVD). However, the TyG index and incident CVD in non-diabetic hypertension patients remains uncertain. The aim of study was to explore the impact of TyG index level and variability on risk of CVD among non-diabetic hypertension patients.

METHODS

A total of 9313 hypertensive patients without diabetes aged 30-70 years in Jiangsu Province who participated in the baseline survey from January 2010 to December 2010 and were followed up to May 2020 were included in this study. The TyG index was calculated as ln [fasting triglyceride (TG) (mg/dl) × fasting plasma glucose (FPG) (mg/dl)/2] and variation degree was calculated as the TyG index at first year follow-up (2011) minus that at baseline (2010). Cox proportional analysis regression and restricted cubic spline were used to investigate the association between TyG index level as well as variability and CVD risk.

RESULTS

Of 9313 included participants, 5423(58.23%) were female. During a mean follow-up of 8.32 ± 1.43 years, 890(9.56%) CVD events was identified. Cox regression analysis showed that with the highest TyG index in Q4 group at baseline, the incidence of CVD risk increased by 33.6% after adjustment for multiple confounders compared to Q1 group. Compared with TyG index variation degree 0 ~ < 1, the hazard ratios (HR) and 95% confidence interval (CI) respectively in < 0, 1 ~ < 2 and 2 ~ were 0.326(0.276, 0.384), 3.216(2.697,3.835) and 4.225(3.359,5.314). The restricted cubic spline indicated that there was a non-linear dose-response relationship between the change degree of TyG and risk of CVD. Similar results were obtained by subgroup analysis and sensitivity analysis.

CONCLUSION

Elevated TyG index may be used as a surrogate for IR and help optimize risk stratification of CVD as well as prevention and management.

摘要

背景

甘油三酯-葡萄糖（TyG）指数被视为胰岛素抵抗（IR）的一种经济高效且可靠的临床替代指标，与心血管疾病（CVD）显著相关。然而，TyG指数与非糖尿病高血压患者发生CVD的关系仍不明确。本研究旨在探讨TyG指数水平及变异性对非糖尿病高血压患者CVD风险的影响。

方法

本研究纳入了2010年1月至2010年12月参加基线调查且随访至2020年5月的江苏省9313例年龄在30 - 70岁的非糖尿病高血压患者。TyG指数计算为ln[空腹甘油三酯（TG）（mg/dl）×空腹血糖（FPG）（mg/dl）/2]，变异程度计算为第一年随访（2011年）时的TyG指数减去基线（2010年）时的TyG指数。采用Cox比例分析回归和受限立方样条来研究TyG指数水平及变异性与CVD风险之间的关联。

结果

在纳入的9313名参与者中，5423名（58.23%）为女性。在平均8.32±1.43年的随访期间，共识别出890例（9.56%）CVD事件。Cox回归分析显示，基线时处于Q4组的TyG指数最高，在调整多个混杂因素后，与Q1组相比，CVD风险发生率增加了33.6%。与TyG指数变异程度0至<1相比，<0、1至<2和2及以上时的风险比（HR）和95%置信区间（CI）分别为0.326（0.276，0.384）、3.216（2.697，3.835）和4.225（3.359，5.314）。受限立方样条表明TyG变化程度与CVD风险之间存在非线性剂量反应关系。亚组分析和敏感性分析也得到了类似结果。