甘油三酯葡萄糖-体质指数与重症冠心病患者365天死亡率之间的关联。

Association between triglyceride glucose-body mass index and 365-day mortality in patients with critical coronary heart disease.

作者信息

Tian Jing, Dong Yan, Xu Zhongping, Ke Jin, Xu Hongyang

机构信息

Department of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, Jiangsu, China.

出版信息

Front Endocrinol (Lausanne). 2025 Apr 4;16:1513898. doi: 10.3389/fendo.2025.1513898. eCollection 2025.

DOI:10.3389/fendo.2025.1513898

PMID:40255500

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12006011/

Abstract

OBJECTIVES

The aim of this study was to analyze the association between TyG-BMI and 365-day mortality in critically ill patients with CHD.

METHODS

Patient data were extracted from the MIMIC-IV database. All patients were categorized into 3 groups based on TyG-BMI index: Low TyG-BMI index group, Medium TyG-BMI index group, and High TyG-BMI index group. Outcomes included primary and secondary outcomes, with the primary outcome being 365-day mortality and the secondary outcomes being hospital survival, intensive care unit (ICU) survival, and 28-day, 90-day, and 180-day mortality. The Kaplan-Meier survival curves were used to compare the outcomes of the three groups. The relationship between TyG-BMI index and 365-day mortality was assessed using multivariate Cox proportional risk regression models and restricted cubic spline curves (RCS).

RESULTS

889 critically ill patients with CHD were analyzed. Among them, 600 (67.50%) were male patients with a mean age of 68.37 years and 289 (32.50%) were female patients with a mean age of 73.91 years. Patients with a medium TyG-BMI index had the best 365-day prognostic outcome and the highest survival rate compared with patients in the Low and High TyG-BMI index groups [201 (67.68%) vs. 166 (56.08%), 188 (63.51%); P=0.013]. After fully adjusted modeling analysis, the hazard ratio (HR) for 365-day mortality was found to be 0.71 (95% CI 0.54-0.93, P=0.012) for the Medium TyG-BMI index group. Meanwhile, RCS analysis showed an L-shaped relationship between TyG-BMI index and 365-day mortality.

CONCLUSIONS

The TyG-BMI index is significantly associated with 365-day mortality in patients with severe CHD.

摘要

目的

本研究旨在分析冠心病重症患者的甘油三酯与体重指数（TyG-BMI）和365天死亡率之间的关联。

方法

从多中心重症医学信息数据库（MIMIC-IV）中提取患者数据。根据TyG-BMI指数将所有患者分为3组：低TyG-BMI指数组、中TyG-BMI指数组和高TyG-BMI指数组。结局包括主要结局和次要结局，主要结局为365天死亡率，次要结局为医院生存、重症监护病房（ICU）生存以及28天、90天和180天死亡率。采用Kaplan-Meier生存曲线比较三组的结局。使用多变量Cox比例风险回归模型和受限立方样条曲线（RCS）评估TyG-BMI指数与365天死亡率之间的关系。

结果

分析了889例冠心病重症患者。其中，男性患者600例（67.50%），平均年龄68.37岁；女性患者289例（32.50%），平均年龄73.91岁。与低TyG-BMI指数组和高TyG-BMI指数组的患者相比，中TyG-BMI指数组患者的365天预后结局最佳，生存率最高[201例（67.68%）对166例（56.08%），188例（63.51%）；P = 0.013]。经过完全调整的模型分析，发现中TyG-BMI指数组365天死亡率的风险比（HR）为0.71（95%CI 0.54 - 0.93，P = 0.012）。同时，RCS分析显示TyG-BMI指数与365天死亡率之间呈L形关系。