血浆动脉粥样硬化指数和甘油三酯葡萄糖指数及新风险评分模型对2型糖尿病合并冠心病患病风险评估初探

Risk assessment of type 2 diabetes with coronary artery disease via AIP,TyG index and new risk scoring model

目的探讨血浆动脉粥样硬化指数(atherogenic index of plasma,AIP)、甘油三酯葡萄糖(triglyceride glucose,TyG)指数及构建新风险评分模型为预测2型糖尿病合并冠心病(coronary artery disease,CAD)的价值。方法连续入选2011年11月至2017年5月承德医学院附属医院心内科住院患者共1623例,其中病例组为2型糖尿病合并CAD患者641例,对照组为无2型糖尿病非CAD患者982例。回顾性收集临床治疗。将男性、年龄≥65岁、吸烟史、高血压病、血脂异常、缺血性卒中、AIP≥-2.6、TyG指数≥8.02纳入风险预测模型,用多变量分析获得的回归系数(β),确定每个因素对2型糖尿病合并CAD患病的相对贡献。结果男性、年龄、吸烟史、高血压病、血脂异常、缺血性卒中、AIP、TyG指数的风险评分分别是2、5、2、4、3、2、4、3。AIP≥-2.6、TyG指数≥8.02、新风险评分>19是2型糖尿病合并CAD风险预测因子(P<0.05)。结论AIP≥-2.6和TyG指数≥8.02是2型糖尿病合并CAD的危险因素;相比较于Framingham评分,新风险评分诊断效能相近,但具有更高的灵敏度,是2型糖尿病合并CAD更简便实用的筛查方法。

Objective To investigate the effect of atherogenic index of plasma(AIP),triglyceride glucose(TyG)index and the new risk score model on providing a new basis for predicting coronary artery disease(CAD)in the patients with type 2 diabetes mellitus.Methods A total of 1623 inpatients were enrolled in the Department from November 2011 to May 2017,including 641 patients with type 2 diabetes complicated with CAD in case group and 982 patients without type 2 diabetes without CAD in control group.The clinical data was retrospectively collected.The male,age≥65 years,smoking history,hypertension,dyslipidemia,ischemic stroke,AIP≥-2.6,TyG index≥8.02 were included into the new risk score model.The relative contribution of each factor to CAD in type 2 diabetes mellitus was determined by regression coefficient(β)obtained from multivariate analysis.Results The risk scores of male,age,smoking history,hypertension,dyslipidemia,ischemic stroke,AIP,TyG index were 2,5,2,4,3,2,4,3,respectively.AIP≥-2.6,TyG index≥8.02 and new risk score>19 were the risk predictors of CAD in type 2 diabetes mellitus(P<0.05).Conclusion AIP≥-2.6 and TyG index≥8.02 both are the risk factors for CAD in type 2 diabetes mellitus.Compared with Framingham score,the new risk score has similar diagnostic efficacy but higher specificity,making it a more convenient and practical screening method for the patients with type 2 diabetes complicated with CAD.