正常体重指数中老年人群三酰甘油葡萄糖指数与冠心病的关系

Association between triglyceride-glucose index and coronary artery disease in middle-aged and elderly population with normal BMI

目的分析正常体重指数(body mass index,BMI)中老年人群的三酰甘油葡萄糖(triglyceride-glucose,TyG)指数与冠心病的相关性,探讨TyG指数成为预测冠心病的生物学指标的可能性。方法回顾性研究696例因疑有冠心病而行冠脉造影的患者,根据TyG指数的四分位数由低到高分为Q_(1)、Q_(2)、Q_(3)、Q_(4)组。分析各组的基线资料特点,以及TyG指数与冠心病的相关性。结果与Q_(1)组相比,Q_(4)组2型糖尿病患者占比更大,舒张压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、空腹血糖、糖化血红蛋白等生物学参数均显著增高。冠心病的发生率在各组中呈线性趋势(χ_(趋势)^(2)=5.735,P=0.017)。在调整性别和年龄等协变量后,进行多因素非条件Logistic回归分析,结果显示以Q_(1)组为参照,Q_(2)、Q_(4)组TyG指数的调整OR(95%CI)值分别为1.833(1.012~3.317)和2.752(1.469~5.157),且差异有统计学意义(P<0.05);进一步调整吸烟状态、高血压病、2型糖尿病、BMI等协变量后,仍以Q_(1)组为参照,Q_(2)、Q_(4)组TyG指数的调整OR(95%CI)值分别为2.062(1.123~3.784)和2.007(1.031~3.905),且差异有统计学意义(P<0.05)。结论在BMI正常的中老年人群中,TyG指数可作为预测冠心病的有效指标。随着TyG指数的增大,冠心病的风险成倍增加。合并冠心病危险因素的患者应密切关注TyG指数变化。

Objective To investigate the correlation between triglyceride-glucose(TyG)index and coronary artery disease(CAD)in middle-aged and elderly population with normal body mass index(BMI),and to explore the possibility of TyG index as a biological predicting indicator of CAD.Methods A retrospective study was performed on 696 patients undergoing coronary angiography for suspected CAD;they were divided into Q_(1),Q_(2),Q_(3) and Q_(4) group according to the quartile of TyG index from the lowest to the highest.The characteristics of baseline data of each group,and the correlation between TyG index and CAD were analyzed.Results Compared with the Q_(1) group,the proportion of patients with type 2 diabetes is larger in the Q_(4) group;biological parameters such as diastolic blood pressure,total cholesterol,triglyceride,low density lipoprotein-cholesterol,fasting blood-glucose and glycosylated hemoglobin are significantly increased.The incidence of CAD shows a linear trend among all groups(χ_(trend)^(2)=5.735,P=0.017).After adjusting covariants such as sex and age,multivariate unconditional Logistic regression analysis is performed,and results show that compared with the Q_(1) group,the adjusted OR(95%CI)value of TyG index in the Q_(2),Q_(4) group are 1.833(1.012-3.317)and 2.752(1.469-5.157),respectively,with statistically significant differences(P<0.05).After further adjusting covariants such as smoking status,hypertension,type 2 diabetes and BMI,the adjusted OR(95%CI)value of TyG index in the Q_(2),Q_(4) group are 2.062(1.123-3.784)and 2.007(1.031-3.905),respectively,with statistically significant differences(P<0.05)if compared with the Q_(1) group.Conclusion TyG index can be used as an effective indicator for predicting CAD in middle-aged and elderly population with normal BMI.With the increase of TyG index,the risk of CAD will increase manyfold.Patients with risk factors of CAD should pay close attention to the changes of TyG index.