Ma C R, Zhao M, Sun J H, Xi B
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University/Children Cardiovascular Research Center of Shandong University, Jinan 250012, China.
Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
Zhonghua Yi Xue Za Zhi. 2025 Apr 22;105(16):1240-1247. doi: 10.3760/cma.j.cn112137-20241213-02826.
To explore the association between triglyceride-glucose index (TyG) trajectory changes and left ventricular hypertrophy (LVH) in childhood. A total of 1 515 students from grades 1-5 were selected as subjects in a public primary school in Huantai County, Zibo City, Shandong Province by convenient cluster sampling method from November 2017. Follow-up surveys were conducted every 2 years (2019, 2021, 2023), which involved questionnaire survey, physical examination, cardiac ultrasound and blood biochemical examination. The correlation between changes in TyG and left ventricular structural indicators between 2017 and 2023 was analyzed using a multiple linear regression. The group based trajectory modelling was used to fit the childhood TyG change trajectory model, and divided into high, medium and low level trajectory groups. Additionally, multivariate logistic regression was employed to analyze the relationship between TyG trajectory and LVH in children. A total of 1 111 subjects with an average age of (8.3±1.5) years were included, including 582 (52.4%) boys. There were 391 (35.2%), 596 (53.6%) and 124 (11.2%) children in TyG low, medium and high level trajectory groups, respectively. TyG, left ventricular mass (LVM), left ventricular mass index (LVMI), left ventricular end-diastolic dimension (LVDD), left ventricular posterior wall thickness (LVPWT) and interventricular septal thickness (IVST) in TyG high level trajectory group were all higher than those in low and medium level trajectory groups (all <0.05). Compared with the TyG normal-normal group, the LVM, LVMI, LVDD in the TyG normal-high group, LVM in the TyG high-normal group and LVM, LVMI, LVDD, LVPWT and IVST in the TyG high-high group were all increased (all <0.05). Compared with the TyG low level trajectory group, the risk of LVH was increased in the total population [ (95%): 3.69 (1.79-7.61)] and boys [ (95%): 5.48 (1.95-15.44)]. High TyG in childhood increases the risk of LVH. If the TyG can be controlled to normal levels early, the risk of LVH can be effectively reduced.
探讨儿童甘油三酯-葡萄糖指数（TyG）轨迹变化与左心室肥厚（LVH）之间的关联。2017年11月，采用方便整群抽样法，选取山东省淄博市桓台县某公立小学1至5年级的1515名学生作为研究对象。每2年（2019年、2021年、2023年）进行一次随访调查，内容包括问卷调查、体格检查、心脏超声检查和血液生化检查。采用多元线性回归分析2017年至2023年TyG变化与左心室结构指标之间的相关性。采用基于群体的轨迹模型拟合儿童TyG变化轨迹模型，并分为高、中、低水平轨迹组。此外，采用多因素logistic回归分析儿童TyG轨迹与LVH之间的关系。共纳入1111名平均年龄为（8.3±1.5）岁的研究对象，其中男孩582名（52.4%）。TyG低、中、高水平轨迹组儿童分别有391名（35.2%）、596名（53.6%）和124名（11.2%）。TyG高水平轨迹组的TyG、左心室质量（LVM）、左心室质量指数（LVMI）、左心室舒张末期内径（LVDD）、左心室后壁厚度（LVPWT）和室间隔厚度（IVST）均高于低、中水平轨迹组（均P<0.05）。与TyG正常-正常组相比，TyG正常-高组的LVM、LVMI、LVDD，TyG高-正常组的LVM，以及TyG高-高组的LVM、LVMI、LVDD、LVPWT和IVST均增加（均P<0.05）。与TyG低水平轨迹组相比，总体人群[比值比（95%置信区间）：3.69（1.797.61）]和男孩[比值比（95%置信区间）：5.48（1.9515.44）]发生LVH的风险增加。儿童期高TyG增加LVH风险。若能早期将TyG控制在正常水平，可有效降低LVH风险。
