使用胰岛素抵抗替代标志物预测冠状动脉疾病的存在及严重程度：一项横断面研究。

Predicting the presence and severity of coronary artery disease using surrogate markers of insulin resistance: A cross-sectional study.

作者信息

Jahangiri Soodeh, Mosalamiaghili Seyed Arad, Heydarzadeh Reza, Yousefzadeh Mohammadali, Golchin Vafa Reza, Zarifkar Hooyar, Assadian Kasra, Sohrabizadeh Sina, Zarifkar Hourshad, Sadeghi Mehrdad, Hosseini Nazanin, Montaseri Mohammad, Hosseini Seyed Ali, Kojuri Javad

机构信息

Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

ARYA Atheroscler. 2025;21(1):44-53. doi: 10.48305/arya.2025.42573.2960.

DOI:10.48305/arya.2025.42573.2960

PMID:40401209

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12091249/

Abstract

BACKGROUND

The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, Metabolic Score for Insulin Resistance (METS-IR), triglyceride-glucose (TyG) index, and triglyceride-glucose body mass index (TyG-BMI) have been associated with the occurrence and severity of coronary artery disease (CAD), although evidence remains limited.

METHODS

A total of 1,017 patients undergoing coronary angiography for the first time were included. Insulin resistance (IR) indices were calculated based on patients' laboratory data. Significant CAD was defined as more than 50% stenosis observed in coronary angiography.

RESULTS

A positive correlation was found between CAD and the TyG index (ρ = 0.083, p = 0.008). Patients with CAD had a significantly elevated TyG index (9.02 ± 0.62) compared to those with single-vessel disease (SVD) (8.87 ± 0.59) (p = 0.012). A strong association was observed between CAD and the TG/HDL-C ratio (ρ = 0.114, p < 0.001). Patients with multi-vessel disease exhibited a considerably higher index (4.47 ± 2.46) compared to those with SVD (3.77 ± 2.45) (p = 0.003). The TyG index cut-off was 9.22 (27.5% sensitivity, 79.3% specificity, 82.2% positive predictive value (PPV), and 23.89% negative predictive value (NPV)), while the TG/HDL-C ratio cut-off was 3.6 (44% sensitivity, 65.2% specificity, 81.5% PPV, and 25.5% NPV).

CONCLUSION

Our findings indicate that the TG/HDL-C ratio, with a cut-off point of 3.6, and the TyG index, with a threshold of 9.22, are associated with the presence of CAD. (ClinicalTrials.gov registration number: NCT06237244).

摘要

背景

甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）、胰岛素抵抗代谢评分（METS-IR）、甘油三酯-葡萄糖（TyG）指数以及甘油三酯-葡萄糖体重指数（TyG-BMI）与冠状动脉疾病（CAD）的发生和严重程度相关，尽管证据仍然有限。

方法

共纳入1017例首次接受冠状动脉造影的患者。根据患者的实验室数据计算胰岛素抵抗（IR）指数。显著CAD定义为冠状动脉造影中观察到狭窄超过50%。

结果

CAD与TyG指数之间存在正相关（ρ = 0.083，p = 0.008）。与单支血管疾病（SVD）患者相比，CAD患者的TyG指数显著升高（9.02±0.62），SVD患者为（8.87±0.59）（p = 0.012）。CAD与TG/HDL-C比值之间存在强关联（ρ = 0.114，p < 0.001）。与SVD患者相比，多支血管疾病患者的该指数显著更高（4.47±2.46），SVD患者为（3.77±2.45）（p = 0.003）。TyG指数的截断值为9.22（敏感性27.5%，特异性79.3%，阳性预测值（PPV）82.2%，阴性预测值（NPV）23.89%），而TG/HDL-C比值的截断值为3.6（敏感性44%，特异性65.2%，PPV 81.5%，NPV 25.5%）。