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维持性血液透析患者甘油三酯-葡萄糖指数与心力衰竭风险的关联:一项回顾性队列研究

Associations between the triglyceride-glucose index and the risk of heart failure in patients undergoing maintenance hemodialysis: a retrospective cohort study.

作者信息

Zhang Qiuyue, Zhou Kai, Li Yuchen, Dong Wen, Sun Yimiao, Wu Hui, Qiu Xiaonan, Liu Zhiyuan, Zhang Ying

机构信息

The Affliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.

Sihong People's Hospital, Suqian, Jiangsu, China.

出版信息

Front Endocrinol (Lausanne). 2025 Apr 3;16:1544591. doi: 10.3389/fendo.2025.1544591. eCollection 2025.

Abstract

BACKGROUND

Although the triglyceride-glucose (TyG) index levels have been shown to be a reliable predictor of major adverse cardiovascular events (MACE), few studies have investigated their association with heart failure (HF), especially in patients on dialysis. We therefore aimed to investigate the relationship between the TyG index and the incidence of HF in patients undergoing maintenance hemodialysis (MHD).

METHODS

A total of 183 participants who underwent MHD in the Blood Purification Center of the Affiliated Hospital of Xuzhou Medical University from September 2008 to October 2023 were included and followed up until March 2024. The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Participants were divided into two different groups according to the TyG index. The primary endpoint of this study was newly diagnosed HF events during the follow-up period. Cox proportional hazard models were used to examine the association between the TyG index and the risk of incident HF. To assess the dose-response relationship between TyG index and risk of HF, restricted cubic spline analysis was used.

RESULTS

Among the 183 participants, there were 61 incident cases of HF during a median follow-up period of 57 months. In comparison to the group with a lower TyG index, participants with a higher TyG index had a higher risk of HF (HR=2.590, 95%CI=1.490-4.500), regardless of whether a variety of potential confounders were adjusted. The association between TyG index and HF (P for non-linearity > 0.05) was confirmed by restricted cubic spline analysis.

CONCLUSION

The TyG index was positively associated with the risk of incident HF in patients undergoing MHD, which indicates that the TyG index might be useful to identify people at high-risk for developing HF.

摘要

背景

尽管甘油三酯-葡萄糖(TyG)指数水平已被证明是主要不良心血管事件(MACE)的可靠预测指标,但很少有研究探讨其与心力衰竭(HF)的关联,尤其是在透析患者中。因此,我们旨在研究TyG指数与维持性血液透析(MHD)患者HF发生率之间的关系。

方法

纳入2008年9月至2023年10月在徐州医科大学附属医院血液净化中心接受MHD的183名参与者,并随访至2024年3月。TyG指数计算为ln[空腹甘油三酯(mg/dL)×空腹血糖(mg/dL)/2]。参与者根据TyG指数分为两个不同的组。本研究的主要终点是随访期间新诊断的HF事件。采用Cox比例风险模型检验TyG指数与HF发生风险之间的关联。为了评估TyG指数与HF风险之间的剂量反应关系,采用了受限立方样条分析。

结果

在183名参与者中,中位随访期57个月期间有61例HF事件发生。与TyG指数较低的组相比,TyG指数较高的参与者发生HF的风险更高(HR=2.590,95%CI=1.490-4.500),无论是否调整了各种潜在混杂因素。受限立方样条分析证实了TyG指数与HF之间的关联(非线性P>0.05)。

结论

TyG指数与MHD患者发生HF的风险呈正相关,这表明TyG指数可能有助于识别发生HF的高危人群。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43f7/12003116/49817fc23d95/fendo-16-1544591-g001.jpg

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