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非心脏手术后术前甘油三酯-葡萄糖指数与心肌损伤的关联:一项横断面研究

Association between the preoperative triglyceride-glucose index and myocardial injury following non-cardiac surgery: a cross-sectional study.

作者信息

Zhou Yuanjun, Chen Weiming, Liang Fei, Zhong Liping, Liao Yilin, Zhong Yuting

机构信息

Department of Anaesthesiology, Meizhou People's Hospital, Meizhou, Guangdong, China.

Department of Medical Data, Meizhou People's Hospital, Meizhou, Guangdong, China.

出版信息

BMJ Open. 2025 Mar 29;15(3):e091978. doi: 10.1136/bmjopen-2024-091978.

Abstract

OBJECTIVE

An elevated triglyceride-glucose (TyG) index positively correlates with adverse cardiovascular events. However, its association with myocardial injury after non-cardiac surgery (MINS) remains unclear. This study aimed to examine the association between the preoperative TyG index and MINS.

DESIGN

A cross-sectional study.

SETTING

Meizhou People's Hospital.

PARTICIPANTS

Adult patients under general anaesthesia and with MINS.

MAIN EXPOSURE MEASURE

The preoperative TyG index, calculated using triglyceride (TG) and fasting blood glucose (FBG) levels.

MAIN OUTCOME MEASURE

The occurrence of MINS, defined using postoperative troponin measurements.

RESULTS

889 patients were included, with an 8.3% incidence of MINS (74/889). The median TyG index was 8.57 (8.13, 9.02). TyG exhibited higher discriminatory ability for MINS than TG and FBG, with an area under the curve of 0.624, 0.544 and 0.500, respectively. Fully adjusted logistic regression indicated that an elevated TyG index was independently associated with MINS (OR 1.75, 95% CI 1.21 to 2.52; p=0.003). A multivariate restricted cubic spline suggested a linear relationship between TyG and MINS (p value for non-linearity=0.059). Subgroup analyses showed results consistent with the primary analysis, with no significant interaction effects between subgroups.

CONCLUSION

An elevated preoperative TyG index is independently associated with an increased incidence of MINS. Monitoring the TyG index perioperatively may improve the management of patients at risk for MINS.

TRIAL REGISTRATION NUMBER

ChiCTR2400082834.

摘要

目的

甘油三酯-葡萄糖(TyG)指数升高与不良心血管事件呈正相关。然而,其与非心脏手术后心肌损伤(MINS)的关联仍不明确。本研究旨在探讨术前TyG指数与MINS之间的关联。

设计

横断面研究。

地点

梅州市人民医院。

参与者

接受全身麻醉且发生MINS的成年患者。

主要暴露指标

术前TyG指数,采用甘油三酯(TG)和空腹血糖(FBG)水平计算得出。

主要结局指标

MINS的发生情况,通过术后肌钙蛋白测量来定义。

结果

纳入889例患者,MINS发生率为8.3%(74/889)。TyG指数中位数为8.57(8.13,9.02)。TyG对MINS的鉴别能力高于TG和FBG,曲线下面积分别为0.624、0.544和0.500。完全调整后的逻辑回归表明,TyG指数升高与MINS独立相关(比值比1.75,95%置信区间1.21至2.52;p = 0.003)。多变量受限立方样条分析表明TyG与MINS之间存在线性关系(非线性p值 = 0.059)。亚组分析结果与主要分析一致,亚组间无显著交互作用。

结论

术前TyG指数升高与MINS发生率增加独立相关。围手术期监测TyG指数可能改善MINS高危患者的管理。

试验注册号

ChiCTR2400082834。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4c/11956314/002a63f30bf7/bmjopen-15-3-g001.jpg

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