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甘油三酯-葡萄糖指数对预测高血压患者主要不良心血管事件的预后价值:一项系统评价和荟萃分析

Prognostic value of triglyceride-glucose index on predicting major adverse cardiovascular events in hypertensive patients: a systematic review and meta-analysis.

作者信息

Dakota Iwan, Huang Wilbert, Wijayanto Matthew Aldo, Nurhafizah Apridya, Khairunnisa Alya Roosrahima, Rachmayanti Shela, Yuliana Enny, Sunjaya Angela Felicia, Siswanto Bambang Budi

机构信息

National Cardiovascular Center Harapan Kita, Indonesia.

Faculty of Medicine, University of Padjadjaran, Indonesia.

出版信息

Am J Prev Cardiol. 2025 Apr 19;22:100996. doi: 10.1016/j.ajpc.2025.100996. eCollection 2025 Jun.

Abstract

BACKGROUND

Triglyceride- glucose (TyG) index, a marker of insulin resistance, has been shown to be associated with the incidence of cardiometabolic diseases including hypertension. However, the prognostic role of TyG index is unknown. Hence, we aim to determine the association of TyG index with major adverse cardiovascular events (MACE) in hypertensive patients.

METHODS

Systematic searching was conducted on 3 databases up till November 2024. We included studies with hypertensive patients despite their comorbidities. Outcome measured is MACE and its individual components. Random effect model meta-analysis is done to pool the results with similar reference point.

RESULTS

Twenty observational studies with a total of 451,455 patients of 40 - 70 years old are included. Meta-analysis result shows that higher TyG index is associated with a statistically significant increased risk of MACE (HR 1.90, CI: 1.41 - 2.57, I 88 %), myocardial infarction (HR 1.55, CI: 1.27 - 1.88, I 0 %), stroke (HR 1.84, CI: 1.41 - 2.39, I 62 %), all- cause mortality (HR 1.86, CI: 1.70 - 2.03, I 0 %) and cardiovascular mortality (HR 1.08, CI: 1.04 - 1.11, I 0 %). Subgroups of older and younger population, male and female gender, diabetic and non- diabetic population, and higher BMI patients retains the statistically significant risk of MACE ( < 0.05). U- shaped phenomena of TyG index is also demonstrated with the risk of all- cause mortality.

CONCLUSION

TyG index is a reliable prognostic marker of MACE in hypertensive patients and can be utilized in population despite their age, diabetic status, and gender.

摘要

背景

甘油三酯-葡萄糖(TyG)指数是胰岛素抵抗的一个标志物,已被证明与包括高血压在内的心血管代谢疾病的发生率相关。然而,TyG指数的预后作用尚不清楚。因此,我们旨在确定TyG指数与高血压患者主要不良心血管事件(MACE)之间的关联。

方法

截至2024年11月,对3个数据库进行了系统检索。我们纳入了患有高血压的患者的研究,无论其合并症如何。测量的结局是MACE及其各个组成部分。采用随机效应模型荟萃分析来汇总具有相似参考点的结果。

结果

纳入了20项观察性研究,共451455名40至70岁的患者。荟萃分析结果表明,较高的TyG指数与MACE风险在统计学上显著增加相关(风险比1.90,置信区间:1.41 - 2.57,I² 88%)、心肌梗死(风险比1.55,置信区间:1.27 - 1.88,I² 0%)、中风(风险比1.84,置信区间:1.41 - 2.39,I² 62%)、全因死亡率(风险比1.86,置信区间:1.70 - 2.03,I² 0%)和心血管死亡率(风险比1.08,置信区间:1.04 - 1.11,I² 0%)。老年和年轻人群、男性和女性、糖尿病和非糖尿病人群以及较高体重指数患者的亚组中,MACE风险仍具有统计学显著性(P < 0.05)。TyG指数与全因死亡率风险之间还呈现出U形现象。

结论

TyG指数是高血压患者MACE的可靠预后标志物,无论年龄、糖尿病状态和性别如何,均可应用于人群。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3d6/12032867/fb0a65279d8c/ga1.jpg

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