Aker Amir, Tarchitzky Tom, Avidan Yuval, Zafrir Barak
Technion Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa, Israel.
Department of Cardiology, Lady Davis Carmel Medical Center, Haifa, Israel.
CJC Open. 2025 Jan 9;7(4):465-472. doi: 10.1016/j.cjco.2025.01.005. eCollection 2025 Apr.
The triglyceride-glucose (TYG) index, which reflects insulin resistance, and the fibrosis-4 (FIB-4) index, a measure of liver fibrosis, are noninvasive laboratory-based indicators associated with cardiometabolic risk.
We performed a retrospective analysis of 12,165 patients who underwent coronary angiography, to investigate the association of the TYG and FIB-4 indices with the occurrence of myocardial infarction, stroke, or all-cause death (major cardiovascular events [MACE]), using multivariate Cox proportional hazards models.
The mean age of the study population was 65 ± 10 years; 63% presented with acute coronary syndrome. During a median follow-up period of 6.1 years, the first MACE occurred in 4174 patients. Compared to the TYG index ≤ 50th percentile (≤ 8.81), the multivariable adjusted hazard ratio (95% confidence interval) for MACE was 1.17 (1.10-1.45), 1.32 (1.23-1.43), and 1.72 (1.55-1.99) for TYG index levels ≥ 50th (> 8.81), ≥ 75th (> 9.23), and ≥ 90th (9.66) percentiles, respectively. FIB-4 index levels of 1.3-2.67 and > 2.67 were associated with an adjusted hazard ratio of 1.19 (1.11-1.27) and 1.67 (1.51-1.87), respectively, compared to FIB-4 index levels of < 1.3. Regarding the risk of developing MACE, no significant interaction was detected between TYG or FIB-4 index levels and the presence of diabetes or obesity. In a combined model of both predictive measures, a gradual increase in the incidence rate of MACE was observed, ranging from 3.93 (TYG index ≤ 8.81; FIB-4 index < 1.3) to 8.56 (TYG index > 9.23; FIB-4 index > 2.67) events per 100 patient-years.
The TYG and FIB-4 indices, both individually and when concomitantly elevated, were independently associated with an increased risk of developing MACE in patients undergoing coronary angiography. ,. These simple-to-calculate, noninvasive metabolic biomarkers may aid in the prediction of cardiovascular diseases.
反映胰岛素抵抗的甘油三酯-葡萄糖（TYG）指数和衡量肝纤维化的纤维化-4（FIB-4）指数是基于实验室的无创指标，与心脏代谢风险相关。
我们对12165例接受冠状动脉造影的患者进行了回顾性分析，使用多变量Cox比例风险模型研究TYG和FIB-4指数与心肌梗死、中风或全因死亡（主要心血管事件[MACE]）发生之间的关联。
研究人群的平均年龄为65±10岁；63%表现为急性冠状动脉综合征。在中位随访期6.1年期间，4174例患者发生了首次MACE。与TYG指数≤第50百分位数（≤8.81）相比，TYG指数水平≥第50百分位数（>8.81）、≥第75百分位数（>9.23）和≥第90百分位数（9.66）时，MACE的多变量调整风险比（95%置信区间）分别为1.17（1.10-1.45）、1.32（1.23-1.43）和1.72（1.55-1.99）。与FIB-4指数水平<1.3相比，FIB-4指数水平为1.3-2.67和>2.67时，调整后的风险比分别为1.19（1.11-1.27）和1.67（1.51-1.87）。关于发生MACE的风险，未检测到TYG或FIB-4指数水平与糖尿病或肥胖的存在之间存在显著相互作用。在两种预测指标的联合模型中，观察到MACE发病率逐渐增加，范围从每100患者年3.93例（TYG指数≤8.81；FIB-4指数<1.3）至8.56例（TYG指数>9.23；FIB-4指数>2.67）。
TYG和FIB-4指数单独以及同时升高时，均与接受冠状动脉造影的患者发生MACE的风险增加独立相关。这些易于计算的无创代谢生物标志物可能有助于预测心血管疾病。
