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高血压患者心血管死亡的甘油三酯-葡萄糖指数阈值——URRAH项目

Triglyceride-glucose index threshold for cardiovascular mortality in hypertensive individuals - URRAH project.

作者信息

D'Elia Lanfranco, Galletti Ferruccio, Maria Masulli, Virdis Agostino, Casiglia Edoardo, Tikhonoff Valerie, Angeli Fabio, Barbagallo Carlo Maria, Bombelli Michele, Cappelli Federica, Cianci Rosario, Ciccarelli Michele, Cicero Arrigo F G, Cirillo Massimo, Cirillo Pietro, Desideri Giovambattista, Ferri Claudio, Gesualdo Loreto, Giannattasio Cristina, Grassi Guido, Iaccarino Guido, Lippa Luciano, Mallamaci Francesca, Maloberti Alessandro, Masi Stefano, Mazza Alberto, Mengozzi Alessandro, Muiesan Maria Lorenza, Nazzaro Pietro, Palatini Paolo, Parati Gianfranco, Pontremoli Roberto, Quarti-Trevano Fosca, Rattazzi Marcello, Reboldi Gianpaolo, Rivasi Giulia, Russo Elisa, Salvetti Massimo, Tocci Giuliano, Ungar Andrea, Verdecchia Paolo, Viazzi Francesca, Volpe Massimo, Borghi Claudio

机构信息

Department of Clinical Medicine and Surgery, "Federico II" University of Naples, 80131 Naples, Italy.

Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.

出版信息

Am J Prev Cardiol. 2025 Jun 29;23:101053. doi: 10.1016/j.ajpc.2025.101053. eCollection 2025 Sep.

Abstract

AIMS

The triglyceride-glucose (TyG) index is a surrogate marker of insulin resistance (IR). Data regarding this topic is constantly increasing, however, few and heterogeneous data are available on the relationship between this index and cardiovascular mortality risk in hypertensive populations. In this context, we aimed to explore the relationship between TyG and cardiovascular mortality in a large sample of hypertensive individuals from the URRAH cohort.

METHODS

A total of 12,275 hypertensive participants without previous cardiovascular events were included in this analysis. The risk of cardiovascular mortality was evaluated by the Cox regression analysis and competing risk regression analysis.

RESULTS

During a median follow-up of 10.5 years, 2151 deaths occurred, of which 986 were from cardiovascular disease. A linear association between TyG and cardiovascular mortality was found, in particular for a 1-standard deviation increase in TyG there was a significantly increased risk of 33 % ( < 0.0001). Furthermore, after stratification by the optimal cut-off point (4.54 Units), participants with TyG above the cut-off had a significantly increased risk of 67 % of cardiovascular mortality when compared with those with TyG below the cut-off ( < 0.0001). These results were also confirmed after adjustment for potential confounders.

CONCLUSIONS

The results of this study indicate that this TyG threshold is predictive of an increased risk of cardiovascular mortality in a large sample of hypertensive individuals. This cut-off can identify individuals at higher mortality risk in already high-risk patients, with a low-cost and simple non-invasive marker.

摘要

目的

甘油三酯-葡萄糖(TyG)指数是胰岛素抵抗(IR)的替代指标。关于这一主题的数据不断增加,然而,关于该指数与高血压人群心血管死亡风险之间关系的数据却很少且参差不齐。在此背景下,我们旨在探讨URRAH队列中大量高血压个体的TyG与心血管死亡之间的关系。

方法

本分析纳入了12275名无既往心血管事件的高血压参与者。通过Cox回归分析和竞争风险回归分析评估心血管死亡风险。

结果

在中位随访10.5年期间,发生了2151例死亡,其中986例死于心血管疾病。发现TyG与心血管死亡之间存在线性关联,特别是TyG每增加1个标准差,风险显著增加33%(<0.0001)。此外,按最佳切点(4.54单位)分层后,TyG高于切点的参与者与TyG低于切点的参与者相比,心血管死亡风险显著增加67%(<0.0001)。在对潜在混杂因素进行调整后,这些结果也得到了证实。

结论

本研究结果表明,这一TyG阈值可预测大量高血压个体心血管死亡风险增加。该切点可以通过一种低成本且简单的非侵入性标志物,识别出已经处于高风险患者中具有更高死亡风险的个体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2d3/12271081/2765120ff1d6/ga1.jpg

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