甘油三酯葡萄糖指数与急性胰腺炎患者急性呼吸衰竭风险之间的关联。
Association between the triglyceride glucose index and the risk of acute respiratory failure in patients with acute pancreatitis.
作者信息
Lv Jiao, Zhou Yuanjun, Tao Changyan, Cai Yan, Yang Hongfeng, Xu Juan, Chen Jun, Sun Ruxian
机构信息
Department of Gastroenterology, Zhenjiang First People's Hospital, Zhenjiang, Jiangsu Province, China.
Department of Critical Care Medicine, Zhenjiang First People's Hospital, No. 8 Dian Li Road, Zhenjiang, Jiangsu Province, 212000, China.
出版信息
BMC Gastroenterol. 2025 Mar 18;25(1):182. doi: 10.1186/s12876-025-03771-9.
BACKGROUND
The triglyceride glucose (TyG) index serves as a dependable marker for insulin resistance and has shown a significant correlation with the severity of acute pancreatitis (AP). However, no research exists regarding the association between the TyG index and the development of acute respiratory failure (ARF) in AP. This study assesses the association between TyG index and ARF in patients with AP.
METHODS
Retrospective cohort analysis was conducted with the MIMIC-IV 2.2 critical care data. The endpoint focused on ARF during hospitalization. Statistical analysis encompassed univariate and multivariate logistic regressions, alongside restricted cubic spline (RCS) analysis to explore potential nonlinear associations. Receiver operating characteristic (ROC) curve analysis was employed to identify the optimal TyG index cutoff, leading to the classification of patients into Low TyG and High TyG groups. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were subsequently applied to minimize the influence of confounding factors, thereby further clarifying the relationship between the TyG index and ARF in patients with AP.
RESULTS
A total of 758 patients were involved in this study, the incidence of ARF was 21.64%. Logistic regression analyses demonstrated a significant association between the TyG index and the incidence of ARF in patients with AP. The RCS model illustrated a nonlinear relationship between a higher TyG index and an increased risk of ARF. The cutoff value of TyG index was 9.099 for ARF in patients with AP based on the ROC curve analysis. Furthermore, following PSM and IPTW, multivariate logistic regression analysis indicated that the High TyG group exhibited a significantly higher risk of ARF compared to the Low TyG group (P < 0.05).
CONCLUSIONS
The TyG index is associated with ARF risk in AP patients and may aid in early risk assessment.
背景
甘油三酯葡萄糖（TyG）指数是胰岛素抵抗的可靠标志物，且已显示与急性胰腺炎（AP）的严重程度显著相关。然而，尚无关于TyG指数与AP患者急性呼吸衰竭（ARF）发生之间关联的研究。本研究评估AP患者中TyG指数与ARF之间的关联。
方法
利用MIMIC-IV 2.2重症监护数据进行回顾性队列分析。终点为住院期间的ARF。统计分析包括单变量和多变量逻辑回归，以及用于探索潜在非线性关联的限制性立方样条（RCS）分析。采用受试者工作特征（ROC）曲线分析确定TyG指数的最佳截断值，从而将患者分为低TyG组和高TyG组。随后应用倾向评分匹配（PSM）和治疗逆概率加权（IPTW）以尽量减少混杂因素的影响，从而进一步阐明AP患者中TyG指数与ARF之间的关系。
结果
本研究共纳入758例患者，ARF发生率为21.64%。逻辑回归分析表明，TyG指数与AP患者ARF的发生率之间存在显著关联。RCS模型显示较高的TyG指数与ARF风险增加之间存在非线性关系。根据ROC曲线分析，AP患者发生ARF时TyG指数的截断值为9.099。此外，在PSM和IPTW之后，多变量逻辑回归分析表明，高TyG组ARF风险显著高于低TyG组（P < 0.05）。
结论
TyG指数与AP患者的ARF风险相关，可能有助于早期风险评估。
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