Cui Xiaodong, Li Mingyang, Jing Anran, Zhang Yan, Zheng Liuying, Li Ting, Hao Tianxu, Lang Jiachun, Guo Zhihao, Cong Hongliang, Zhang Yingyi
Clinical School of Thoracic, Tianjin Medical University, Tianjin, People's Republic of China.
Department of Cardiology, Tianjin Chest Hospital, Tianjin, People's Republic of China.
Diabetes Metab Syndr Obes. 2025 Apr 8;18:1061-1072. doi: 10.2147/DMSO.S510851. eCollection 2025.
The triglyceride-glucose (TyG) index is a reliable marker of insulin resistance, and the atherogenic index of plasma (AIP) reflects atherosclerosis. However, the relationship between these biomarkers-particularly AIP-and coronary microvascular dysfunction (CMD) in hypertensive patients has not been systematically studied. This study investigates the association between TyG, AIP, and CMD in hypertensive individuals.
We included 155 hypertensive patients with coronary anatomy confirmed by coronary angiography (CAG) or computed tomography angiography (CTA) within six months of SPECT imaging. CMD was diagnosed with a summed stress score (SSS) ≥4 and a summed difference score (SDS) ≥2. Patients were stratified into tertiles by TyG index and AIP. Logistic regression, adjusted for traditional cardiovascular risk factors, was used to explore the relationship with CMD. The predictive value of TyG and AIP was assessed using receiver operating characteristic (ROC) curves, and decision curve analysis (DCA) evaluated their clinical benefit.
Logistic regression revealed that both TyG and AIP were independently associated with coronary artery disease (CAD) (P<0.05 for both). The area under the ROC curve (AUC) for TyG, AIP, and their combined predictive capacity for CMD was 0.744, 0.707, and 0.748, respectively (P<0.001 for all). The optimal cutoff values for TyG and AIP were 7.012 and 0.5175, respectively. Combining both biomarkers enhanced clinical decision-making and patient benefit.
Higher levels of TyG and AIP are significantly associated with an increased risk of CMD in hypertensive patients. Both biomarkers exhibit strong predictive value, with AIP showing greater specificity and TyG higher sensitivity. Their combined use can improve clinical decision-making and patient outcomes.
甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗的可靠标志物，血浆致动脉粥样硬化指数（AIP）反映动脉粥样硬化。然而，这些生物标志物尤其是AIP与高血压患者冠状动脉微血管功能障碍（CMD）之间的关系尚未得到系统研究。本研究调查了高血压个体中TyG、AIP与CMD之间的关联。
我们纳入了155例高血压患者，这些患者在SPECT成像后6个月内通过冠状动脉造影（CAG）或计算机断层扫描血管造影（CTA）确认了冠状动脉解剖结构。CMD的诊断标准为总应激评分（SSS）≥4且总差异评分（SDS）≥2。患者按TyG指数和AIP分层为三分位数。采用经传统心血管危险因素校正的逻辑回归分析来探讨与CMD的关系。使用受试者工作特征（ROC）曲线评估TyG和AIP的预测价值，并通过决策曲线分析（DCA）评估其临床获益。
逻辑回归分析显示，TyG和AIP均与冠状动脉疾病（CAD）独立相关（两者P均<0.05）。TyG、AIP及其联合预测CMD的ROC曲线下面积（AUC）分别为0.744、0.707和0.748（所有P均<0.001）。TyG和AIP的最佳截断值分别为7.012和0.5175。联合使用这两种生物标志物可增强临床决策并使患者获益。
高血压患者中较高水平的TyG和AIP与CMD风险增加显著相关。两种生物标志物均具有较强的预测价值，AIP具有更高的特异性，TyG具有更高的敏感性。联合使用它们可改善临床决策和患者预后。
