非心脏手术中术前甘油三酯葡萄糖指数与术后不良心血管事件的关联：一项来自中国的单中心研究。

The Association Between Preoperative Triglyceride Glucose Index and Postoperative Adverse Cardiovascular Events in Non-Cardiac Surgery: A Single-Center Study From China.

作者信息

Hao Jiandong, Qu Li, Yang Yang, Sun Yun, Xu Guiping

机构信息

Graduate School of Xinjiang Medical University, Urumqi, People's Republic of China.

Department of Anesthesiology, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Clinical Research Center for Anesthesia Management, Urumqi, People's Republic of China.

出版信息

Ther Clin Risk Manag. 2025 Apr 13;21:467-479. doi: 10.2147/TCRM.S518077. eCollection 2025.

DOI:10.2147/TCRM.S518077

PMID:40248335

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12005211/

Abstract

BACKGROUND

The incidence of postoperative adverse cardiovascular events (PACE) in non-cardiac surgery has significantly increased, severely affecting surgical outcomes and patient prognosis. This study investigates the relationship between preoperative triglyceride-glucose (TyG) index and PACE in patients who underwent non-cardiac surgery.

METHODS

We conducted a single-center retrospective study, including adult patients (age ≥18 years) who underwent non-cardiac surgery. Univariate and multivariate logistic regression analyses assessed the relationship between the TyG index and PACE. Nonlinear correlations were investigated using restricted cubic splines (RCS). Additionally, subgroup analysis was performed to evaluate the relationship between the TyG index and PACE in different subsamples.

RESULTS

16,066 patients were studied, among which 1505 cases (9.37%) developed PACE, with a median TyG index of 8.61 (8.22, 9.07). Using the lowest quartile of the TyG index as a reference, the fully adjusted (ORs) (95% CIs) for PACE in the second, third, and fourth quartiles of the TyG index were 1.78 (1.49~~2.11), 2.16 (1.81~~2.59), and 2.30 (1.88~~2.83), respectively. After adjusting for all confounding factors, we found that patients with the highest TyG index had a 68% increased risk of PACE (OR 1.68, 95% CI 1.50~~1.90). The results of the subgroup analysis were similar to those of the primary analysis. The RCS model suggests a linear positive correlation between the TyG index and the risk of PACE occurrence. (P for overall < 0.001, P for nonlinear = 0.547).

CONCLUSION

This cohort study indicates that preoperative TyG index is linearly and positively correlated with an increased incidence of PACE in the non-cardiac surgery population. This finding suggests that intensifying the evaluation of the TyG index may provide a more convenient and effective tool for identifying individuals at risk of PACE during non-cardiac surgeries.

摘要

背景

非心脏手术术后不良心血管事件（PACE）的发生率显著增加，严重影响手术结局和患者预后。本研究探讨非心脏手术患者术前甘油三酯-葡萄糖（TyG）指数与PACE之间的关系。

方法

我们进行了一项单中心回顾性研究，纳入接受非心脏手术的成年患者（年龄≥18岁）。单因素和多因素逻辑回归分析评估TyG指数与PACE之间的关系。使用受限立方样条（RCS）研究非线性相关性。此外，进行亚组分析以评估TyG指数与不同亚组中PACE之间的关系。

结果

共研究了16066例患者，其中1505例（9.37%）发生PACE，TyG指数中位数为8.61（8.22，9.07）。以TyG指数最低四分位数为参照，TyG指数第二、第三和第四四分位数中PACE的完全调整优势比（OR）（95%可信区间）分别为1.78（1.49~~2.11）、2.16（1.81~~2.59）和2.30（1.88~~2.83）。在调整所有混杂因素后，我们发现TyG指数最高的患者发生PACE的风险增加68%（OR 1.68，95%可信区间1.50~~1.90）。亚组分析结果与主要分析结果相似。RCS模型表明TyG指数与PACE发生风险呈线性正相关。（总体P<0.001，非线性P=0.547）。