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系统性硬化症患者甘油三酯葡萄糖指数与器官受累之间的关联。

Association between triglyceride glucose index and organ involvement in patients with systemic sclerosis.

作者信息

Yang Huidan, Cheng Hao, Yang Huifang, Zhang Xiaoying, Shang Lili, Yan Chenglan, Wen Hongyan

机构信息

Department of Rheumatology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.

Qinshui County People's Hospital, Jincheng, Shanxi, China.

出版信息

Sci Rep. 2025 May 29;15(1):18871. doi: 10.1038/s41598-025-99139-w.

Abstract

Patients with systemic sclerosis (SSc) exhibit an elevated risk of multi-organ involvement. Vasculopathy, a hallmark pathological feature of SSc, is closely related to cardiac and renal complications. The triglyceride glucose (TyG) index shows a strong association with vascular injury. In this study, we aimed to investigate the relationship between the TyG index and SSc-related organ involvement and assess its potential predictive value for cardiovascular disease risk. This retrospective cross-sectional study of 102 patients with systemic sclerosis and 89 age- and sex-matched healthy controls were enrolled. The TyG index was calculated by ln [fasting triglycerides (mg/dl) * fasting glucose (mg/dl)/2]. All systemic sclerosis patients were grouped according to the TyG quartile and whether combined with cardiovascular disease. The association between TyG and cardiovascular disease occurrence was evaluated by multivariate regression analysis, restricted cubic spline (RCS), and subgroup analysis. Receiver operating characteristic curves assessed the predictive value of TyG index. Mean TyG index was higher in systemic sclerosis patients versus controls (8.50 [Formula: see text] 0.45 vs. 8.33 [Formula: see text] 0.43; P = 0.006). Systemic sclerosis patients with cardiovascular disease or renal involvement had higher TyG index than those without [(8.69 [Formula: see text] 0.42) vs. (8.39 [Formula: see text] 0.43), P = 0.001; (8.65 [Formula: see text] 0.44) vs. (8.45 [Formula: see text] 0.41), P = 0.044], while patients with joint involvement had lower TyG index [(8.38 [Formula: see text] 0.44) vs. (8.59 [Formula: see text] 0.43), P = 0.019]. After grouping according to the TyG quartiles, the incidence of cardiovascular disease and modified Rodnan skin score (mRSS) gradually increased from Q1 to Q4. TyG showed a positive correlation with mRSS score (r = 0.307, P = 0.002). High TyG index was an independent risk factor for cardiovascular disease (OR = 4.03, 95% CI = 1.07-15.10, P = 0.039). TyG index had moderate predictive value for the risk of cardiovascular disease. The TyG index is associated with skin fibrosis and cardiovascular risk in systemic sclerosis and may serve as an effective biomarker for cardiovascular disease risk assessment.

摘要

系统性硬化症(SSc)患者出现多器官受累的风险升高。血管病变是SSc的标志性病理特征,与心脏和肾脏并发症密切相关。甘油三酯葡萄糖(TyG)指数与血管损伤密切相关。在本研究中,我们旨在探讨TyG指数与SSc相关器官受累之间的关系,并评估其对心血管疾病风险的潜在预测价值。本研究为回顾性横断面研究,纳入了102例系统性硬化症患者和89例年龄及性别匹配的健康对照。TyG指数通过ln[空腹甘油三酯(mg/dl)×空腹血糖(mg/dl)/2]计算得出。所有系统性硬化症患者根据TyG四分位数以及是否合并心血管疾病进行分组。通过多因素回归分析、限制性立方样条(RCS)和亚组分析评估TyG与心血管疾病发生之间的关联。采用受试者工作特征曲线评估TyG指数的预测价值。系统性硬化症患者的平均TyG指数高于对照组(8.50[公式:见正文]0.45对8.33[公式:见正文]0.43;P = 0.006)。合并心血管疾病或肾脏受累的系统性硬化症患者的TyG指数高于未合并者[(8.69[公式:见正文]0.42)对(8.39[公式:见正文]0.43),P = 0.001;(8.65[公式:见正文]0.44)对(8.45[公式:见正文]0.41),P = 0.044],而合并关节受累的患者TyG指数较低[(8.38[公式:见正文]0.44)对(8.59[公式:见正文]0.43),P = 0.019]。根据TyG四分位数分组后,心血管疾病的发生率和改良Rodnan皮肤评分(mRSS)从Q1到Q4逐渐升高。TyG与mRSS评分呈正相关(r = 0.307,P = 0.002)。高TyG指数是心血管疾病的独立危险因素(OR = 4.03,95%CI = 1.07 - 15.10,P = 0.039)。TyG指数对心血管疾病风险具有中等预测价值。TyG指数与系统性硬化症中的皮肤纤维化和心血管风险相关,可能作为心血管疾病风险评估的有效生物标志物。

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