糖尿病是否会改变与心血管事件和死亡率相关的甘油三酯-葡萄糖指数？一项对50个队列、7239790名参与者的荟萃分析。
Does diabetes modify the triglyceride-glucose index associated with cardiovascular events and mortality? A meta-analysis of 50 cohorts involving 7,239,790 participants.
作者信息
Zhang Jun, Zhan Qiye, Deng Zhihao, Lin Ling, Feng Zhaolan, He Huabin, Zhang Deju, Zhao Huilei, Gu Xiang, Yin Xiaoping, Yu Peng, Liu Xiao
机构信息
Department of Cardiology, Affiliated Hospital of Jiujiang University, Jiujiang, China.
Jiujiang Clinical Precision Medicine Research Center, Jiujiang, China.
出版信息
Cardiovasc Diabetol. 2025 Jan 27;24(1):42. doi: 10.1186/s12933-025-02585-z.
INTRODUCTION
Previous studies highlighted the association between the triglyceride-glucose (TyG) index and cardiovascular events in patients with diabetes. However, whether diabetes affects TyG-cardiovascular diseases (CVD) is still unclear. This study aimed to evaluate the association between the TyG index and CVD risk, stratified by diabetes status, as well as the potential modifying effect of diabetic status.
METHODS/DESIGN: The PubMed, Cochrane Library, and Embase databases were searched for studies on the associations between the TyG index and cardiovascular events and mortality in patients with and without diabetes from inception to December 2, 2024. The random effects model was employed to pool the effect sizes.
RESULTS
A total of 50 cohort studies (7,239,790 participants) were included. The mean age of participants was 31.46 years (diabetes mellitus [DM]: 65.18; non-DM: 31.23), and 40.66% of participants were female (DM: 36.07%; non-DM: 40.70%). The associations between the TyG index and cardiovascular events (HR: 1.72 vs. 1.55, P = 0.55), major adverse cardiovascular and cerebrovascular events (HR: 2.02 vs. 1.91, P = 0.84), stroke (HR: 1.46 vs. 1.39, P = 0.77) and cardiovascular death (HR: 1.85 vs. 1.60, P = 0.56) were similar among DM and non-DM individuals. However, the associations between the TyG index and ischemic heart disease (IHD) (HR: 2.20 vs. 1.57, P = 0.03) as well as all-cause mortality (HR: 1.94 vs. 1.24, P = 0.01) were stronger in DM patients than in non-DM patients.
CONCLUSION
TyG index showed association with cardiovascular events, mortality, and all-cause mortality independent of diabetic status, with low to moderate certainty. The associations for IHD and all-cause death were stronger in diabetic patients than in individuals without diabetes. Future studies should explore the role of diabetes in the TyG index-associated CVD outcomes and mortality.
引言
先前的研究强调了糖尿病患者甘油三酯-葡萄糖（TyG）指数与心血管事件之间的关联。然而，糖尿病是否会影响TyG与心血管疾病（CVD）之间的关系仍不清楚。本研究旨在评估TyG指数与CVD风险之间的关联，并根据糖尿病状态进行分层，同时评估糖尿病状态的潜在调节作用。
方法/设计：检索了PubMed、Cochrane图书馆和Embase数据库，以查找从起始到2024年12月2日关于有或无糖尿病患者的TyG指数与心血管事件及死亡率之间关联的研究。采用随机效应模型汇总效应量。
结果
共纳入50项队列研究（7239790名参与者）。参与者的平均年龄为31.46岁（糖尿病[DM]：65.18岁；非糖尿病：31.23岁），40.66%的参与者为女性（DM：36.07%；非DM：40.70%）。TyG指数与心血管事件（风险比[HR]：1.72对1.55，P = 0.55）、主要心血管和脑血管不良事件（HR：2.02对1.91，P = 0.84）、中风（HR：1.46对1.39，P = 0.77）和心血管死亡（HR：1.85对1.60，P = 0.56）之间的关联在糖尿病患者和非糖尿病患者中相似。然而，TyG指数与缺血性心脏病（IHD）（HR：2.20对1.57，P = 0.03）以及全因死亡率（HR：1.94对1.24，P = 0.01）之间的关联在糖尿病患者中比在非糖尿病患者中更强。
结论
TyG指数与心血管事件、死亡率和全因死亡率之间存在关联，独立于糖尿病状态，确定性为低到中度。糖尿病患者中IHD和全因死亡的关联比无糖尿病个体更强。未来的研究应探讨糖尿病在TyG指数相关的CVD结局和死亡率中的作用。
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