新疆哈萨克族和维吾尔族甘油三酯葡萄糖乘积指数与心血管疾病发生风险的回顾性队列研究

The relationship between triglyceride glucose index and risk of cardiovascular disease among Kazakh and Uygur population in Xinjiang:a retrospective cohort analysis

目的探讨甘油三酯葡萄糖乘积(TyG)指数与新疆哈萨克族和维吾尔族心血管疾病(CVD)发病的关联及其对CVD发生风险的预测价值。方法选取新源县及伽师县哈萨克族和维吾尔族5375名居民为研究对象。根据TyG指数水平将研究对象分为4组(Q_(1)~Q_(4)组),采用Cox回归模型分析TyG指数与CVD发病风险的关联,采用限制性立方样条分析TyG指数与CVD发病风险的剂量-反应关系;采用受试者工作特征曲线下面积、净重新分类指数(NRI)与整体鉴别指数(IDI)评估TyG指数对CVD发生风险的预测价值;采用中介效应模型分析体重指数与CVD发病关联中TyG指数的中介效应。结果研究对象年龄M(Q_(1),Q_(3))为41.06(30.11,53.00)岁,46.30%(2489/5375)为男性。经多因素调整后,随着TyG指数的升高,新疆哈萨克族和维吾尔族CVD发生风险呈明显上升趋势(P趋势<0.001),与TyG指数的Q_(1)组相比,Q_(2)、Q_(3)、Q_(4)组的HR值分别为1.53、1.23和1.73。限制性立方样条显示,TyG指数与CVD发病风险呈线性正相关。TyG指数可提升Framingham模型对CVD发病的预测能力,NRI为0.106(P=0.010);IDI为0.003(P=0.030)。中介效应分析显示,在体重指数与CVD发病的关联中,TyG指数具有中介效应(P<0.001),其百分比为12.69%。结论TyG指数是新疆哈萨克族和维吾尔族CVD发生的预测因子,对CVD发病风险具有良好的预测价值。

Objective To analyze whether triglyceride-glucose(TyG)index is associated with increased risk of cardiovascular diseases(CVD)and the value of TyG index in predicting CVD risk among Kazakh and Uighur population of Xinjiang.Methods In this study,5375 Kazakh and Uygur people of Xinyuan county and Jiashi county were selected as the research objects.Subjects were divided into four groups based on the quartile of the TyG index level.Cox regression model was used to analyze the association between TyG index with the risk of CVD.The dose-response relationship between TyG index and CVD risk was described by restricted cubic splines.The area under the receiver operating characteristic curve,net reclassification improvement(NRI),and integrated discrimination improvement(IDI)were used to estimate the value of TyG index for predicting CVD.Mediating effect analysis was conducted to analyze the mediating effect of TyG index in the association between body mass index and CVD.Results The age of subjects was 41.06(30.11,53.00)years old,with 46.30%(2489/5375)was male.After multivariate adjustment,there was an increasing trend between the risk of CVD and the higher TyG index Ptrend<0.001,compared with subjects of TyG index in Q_(1),the HR(95%CI)of Q_(2),Q_(3),and Q_(4) groups was 1.53,1.23 and 1.73,respectively.Restricted cubic splines showed that TyG index was the linearly associated with the risk of CVD.TyG index could improve the prediction ability of Framingham model for the risk of CVD(NRI=0.106,P=0.010;IDI=0.003,P=0.030).The mediating effect analysis showed that in the relationship between body mass index and CVD,the TyG index had a mediating effect(P<0.001),and the ratio of mediating effect was 12.69%.Conclusion TyG index is an independent predictor of CVD risk among kazakh and Uygur population in Xinjiang and has a good predictive value for the risk of CVD.