Hu Jie, Min Jie, Zong Dan
Huzhou Central Hospital, Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, Zhejiang, China; Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China.
Huzhou Central Hospital, Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, Zhejiang, China; Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China.
Am J Med Sci. 2025 Jun;369(6):664-670. doi: 10.1016/j.amjms.2025.03.009. Epub 2025 Mar 13.
Insulin resistance is common in critically ill patients. It is not known whether it is associated with the use of invasive ventilation. This study investigated the relationship between the triglyceride glycemic index (TyG) and the risk of invasive ventilator use in critically ill patients admitted to the intensive care unit (ICU).
The study utilized the Medical Information Mart for Intensive Care-IV database. All patients were divided into three groups according to the TyG index. The study employed univariable and multivariable logistic regression analysis, competing risk analysis, and 4-knot multivariate restricted cubic spline regression. ROC curves were used to determine if the TyG index improves the predictive value of disease scores.
Out of 2196 participants, 51.9 % had invasive ventilation. Multivariable logistic regression analyses and competing risk analyses revealed that the risk of Invasive ventilator use was significantly higher in the highest quartile of the TyG index. Meanwhile, the RCS analysis indicated S-typed relationships between the TyG index and invasive ventilator use, with inflection points at 9.40, respectively. The TyG index had an incremental effect on the AUC of existing severity of illness scores to predict invasive ventilation.
This study shows that an increased TyG index is a significant risk factor for invasive ventilation in patients in the ICU.
胰岛素抵抗在重症患者中很常见。目前尚不清楚它是否与有创通气的使用有关。本研究调查了甘油三酯血糖指数（TyG）与入住重症监护病房（ICU）的重症患者使用有创呼吸机风险之间的关系。
本研究使用重症监护医学信息集市-IV数据库。根据TyG指数将所有患者分为三组。本研究采用单变量和多变量逻辑回归分析、竞争风险分析和4节点多变量受限立方样条回归。ROC曲线用于确定TyG指数是否提高了疾病评分的预测价值。
在2196名参与者中，51.9%进行了有创通气。多变量逻辑回归分析和竞争风险分析显示，TyG指数最高四分位数组使用有创呼吸机的风险显著更高。同时，RCS分析表明TyG指数与有创呼吸机使用之间呈S型关系，拐点分别为9.40。TyG指数对现有疾病严重程度评分的AUC预测有创通气有增量作用。
本研究表明，TyG指数升高是ICU患者有创通气的重要危险因素。
