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甘油三酯-葡萄糖相关指标作为2型糖尿病患者主要不良心血管事件和全因死亡率的预测指标

Triglyceride-glucose related indices as predictors for major adverse cardiovascular events and overall mortality in type-2 diabetes mellitus patients.

作者信息

Liu Mao-Jun, Pei Jun-Yu, Zeng Cheng, Xing Ying, Zhang Yi-Feng, Tang Pei-Qi, Deng Si-Min, Hu Xin-Qun

机构信息

Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.

出版信息

World J Diabetes. 2025 Mar 15;16(3):101488. doi: 10.4239/wjd.v16.i3.101488.

Abstract

BACKGROUND

Recent studies have indicated that triglyceride glucose (TyG)-waist height ratio (WHtR) and TyG-waist circumference (TyG-WC) are effective indicators for evaluating insulin resistance. However, research on the association in TyG-WHtR, TyG-WC, and the risk and prognosis of major adverse cardiovascular events (MACEs) in type 2 diabetes mellitus (T2DM) cases are limited.

AIM

To clarify the relation in TyG-WHtR, TyG-WC, and the risk of MACEs and overall mortality in T2DM patients.

METHODS

Information for this investigation was obtained from Action to Control Cardiovascular Risk in Diabetes (ACCORD)/ACCORD Follow-On (ACCORDION) study database. The Cox regression model was applied to assess the relation among TyG-WHtR, TyG-WC and future MACEs risk and overall mortality in T2DM cases. The RCS analysis was utilized to explore the nonlinear correlation. Subgroup and interaction analyses were conducted to prove the robustness. The receiver operating characteristic curves were applied to analysis the additional predicting value of TyG-WHtR and TyG-WC.

RESULTS

After full adjustment for confounding variables, the highest baseline TyG-WHtR cohort respectively exhibited a 1.353-fold and 1.420-fold higher risk for MACEs and overall mortality, than the lowest quartile group. Similarly, the highest baseline TyG-WC cohort showed a 1.314-fold and 1.480-fold higher risk for MACEs and overall mortality, respectively. Each 1 SD increase in TyG-WHtR was significantly related to an 11.7% increase in MACEs and a 14.9% enhance in overall mortality. Each 1 SD increase in TyG-WC corresponded to an 11.5% in MACEs and a 16.6% increase in overall mortality. Including these two indexes in conventional models significantly improved the predictive power for MACEs and overall mortality.

CONCLUSION

TyG-WHtR and TyG-WC were promising predictors of MACEs and overall mortality risk in T2DM cases.

摘要

背景

近期研究表明,甘油三酯葡萄糖(TyG)-腰高比(WHtR)和TyG-腰围(TyG-WC)是评估胰岛素抵抗的有效指标。然而,关于2型糖尿病(T2DM)患者中TyG-WHtR、TyG-WC与主要不良心血管事件(MACE)风险及预后之间关联的研究有限。

目的

阐明T2DM患者中TyG-WHtR、TyG-WC与MACE风险及全因死亡率之间的关系。

方法

本研究信息取自糖尿病心血管风险控制行动(ACCORD)/ACCORD随访(ACCORDION)研究数据库。采用Cox回归模型评估T2DM患者中TyG-WHtR、TyG-WC与未来MACE风险及全因死亡率之间的关系。利用限制立方样条(RCS)分析探索非线性相关性。进行亚组分析和交互作用分析以验证稳健性。应用受试者工作特征曲线分析TyG-WHtR和TyG-WC的额外预测价值。

结果

在对混杂变量进行充分调整后,基线TyG-WHtR最高的队列发生MACE和全因死亡率的风险分别比最低四分位数组高1.353倍和1.420倍。同样,基线TyG-WC最高的队列发生MACE和全因死亡率的风险分别高1.314倍和1.480倍。TyG-WHtR每增加1个标准差,MACE风险显著增加11.7%,全因死亡率增加14.9%。TyG-WC每增加1个标准差,MACE风险增加11.5%,全因死亡率增加16.6%。在传统模型中纳入这两个指标可显著提高对MACE和全因死亡率的预测能力。

结论

TyG-WHtR和TyG-WC是T2DM患者MACE和全因死亡风险的有前景的预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1de6/11885977/6538acfd3c52/101488-g001.jpg

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