急性冠状动脉综合征患者三酰甘油葡萄糖乘积指数与肾功能不全的相关性研究

Association between triglyceride glycemic index and renal insufficiency in patients with acute coronary syndrome

目的:三酰甘油葡萄糖乘积指数(TyG)是胰岛素抵抗的重要的替代指标。本研究旨在探讨TyG指数与肾功能不全的相关性。方法:纳入2018年1月至2018年12月,年龄在18~80岁之间并于北京安贞医院行经皮冠状动脉介入治疗的急性冠状动脉综合征患者3013例,分成有肾功能不全组(335例)以及无肾功能不全组(2678例),收集患者的基线资料、生化指标以及造影情况。多因素Logistic回归分析评估TyG指数与肾功能不全的关系。结果:入选患者特征:男性占75.3%,年龄(60.2±10.09)岁,BMI(25.9±3.26)kg/m^(2),糖尿病占41.2%,高脂血症占74%。相比较于无肾功能不全组患者,肾功能不全组患者男性更多,且年龄更大,TyG指数更高,合并更多的心血管危险因素。Logistic回归校正其他危险因素后显示,TyG指数每增加一个单位,肾功能不全的发生风险增加49%(OR=1.49,95%CI:1.10~2.01,P=0.01)。结论:TyG指数与冠心病患者肾功能不全的风险密切相关。二者之间关联的机制有待进一步研究的探讨。

Objective:Triglyceride glycemic index(TyG)is an important substitute index of insulin resistance.This study aimed to explore the correlation between TyG index and renal insufficiency.Methods:A total of 3013 patients with acute coronary syndrome(ACS),aged from 18 to 80 years old,who underwent percutaneous coronary intervention(PCI)in Beijing Anzhen Hospital from January 2018 to December 2018,were divided into two groups:renal insufficiency group(n=335)and non-renal insufficiency group(n=2678).The baseline characteristics,biochemical parameters and coronary angiology of patients were collected.Multivariate Logistic analysis was used to evaluate the relationship between TyG index and renal insufficiency.Results:A total of 3013 patients were included in the statistic analysis,male:75.3%,age(60.2±10.09)years old,BMI(25.9±3.26)kg/m^(2),diabetes:41.2%,hyperlipidemia:74%.Compared with the non-renal insufficiency group,the renal insufficiency group had more men and older patients,higher TyG index and more cardiovascular risk factors.Logistic regression analysis showed that for each unit increase in the TyG index,the risk of renal insufficiency increased by 49%(OR=1.49,95%CI:1.10-2.01,P=0.01).Similar to the general population,higher TyG levels were significantly associated with renal insufficiency regardless of whether the patients had diabetes or not(diabetic patients:OR=1.39,95%CI:1.08-1.80,P=0.01;non-diabetic patients:OR=1.45,95%CI:1.0-2.09,P-0.05).Conclusions:TyG index is closely related to the risk of renal insufficiency in patients with ACS.The mechanism of this association warrants further research.