TYG指数对慢性肾脏病患者新发心血管事件的预测价值

The Predictive Value of TYG Index for New Cardiovascular Events in Patients with Chronic Kidney Disease

目的探讨甘油三酯葡萄糖乘积(TYG)指数对慢性肾脏病(CKD)患者新发心血管疾病(CVD)的预测价值。方法回顾性分析我院376例CKD患者的基线资料及随访期间CVD的发生情况。以TYG指数的中位数将纳入患者分为高低两组,比较两组基线资料及CVD累积发生率差异,采用Cox回归分析TYG指数与CVD发生的关联,绘制ROC曲线评估TYG指数对CVD发生的预测效能。结果与低TYG指数组相比,高TYG指数组的糖尿病和(或)高血压合并率较高,总胆固醇、血肌酐、低密度脂蛋白、甘油三酯、尿素氮、24hUTP、磷及PTH水平较高,而eGFR及高密度脂蛋白水平较低(P<0.05)。高TYG指数组的CVD累积发生率明显较高(P<0.05)。高水平的TYG指数为CVD发生的独立危险因素(P<0.05)。TYG指数预测CVD的ROC曲线下面积为0.683(95%CI 0.621~0.746,P<0.001),最佳截断值为8.91。结论TYG指数与CKD患者CVD发生独立相关,是便宜且简易的CVD预测指标。

Objective To investigate the predictive value of triglyceride-glucose product(TYG)index for new onset cardiovascular disease(CVD)in patients with chronic kidney disease(CKD).Methods The baseline data of 376 patients with CKD in our hospital and the occurrence of CVD during follow-up were retrospectively analyzed.The patients were divided into two groups according to the median of TYG index,the baseline data and cumulative incidence of CVD were compared between the two groups.Cox regression analysis was used to analyze the correlation between TYG index and the occurrence of CVD,ROC curve was drawn to evaluate the predictive efficacy of TYG index on the occurrence of CVD.Results Compared with the low TYG index group,the high TYG index group had higher rates of diabetes and/or hypertension,higher levels of total cholesterol,creatinine,low density lipoprotein,triglyceride,urea nitrogen,24hUTP,phosphorus and PTH,and lower levels of eGFR and high density lipoprotein(P<0.05).The cumulative incidence of CVD was significantly higher in high TYG index group(P<0.05)than that in low TYR index group.A high level of TYG index was an independent risk factor for CVD(P<0.05).The area under ROC curve for TYG index to predict CVD was 0.683(95%CI 0.621~0.746,P<0.001),the best truncation value was 8.91.Conclusion TYG index is independently correlated with CVD occurrence in patients with CKD,and is an affordable and simple predictor of CVD.