三酰甘油-葡萄糖指数与冠心病病人冠状动脉病变严重程度的相关性分析

Correlation analysis of the triglyceride-glucose index and severity of coronary lesions in patients with coronary artery disease

目的:探讨三酰甘油-葡萄糖(TyG)指数与冠心病病人冠状动脉病变严重程度的相关性。方法:选择2018-2019年于东南大学附属中大医院心内科住院治疗,行冠状动脉造影并确诊为冠心病的病人1804例,记录病人的临床特点、TyG指数及其他生化指标、心脏彩超结果,并根据冠状动脉造影结果计算Gensini评分。根据TyG指数,均分为4组:组1(451例,TyG指数≤8.38),组2(451例,8.38<TyG指数≤8.71),组3(451例,8.71<TyG指数≤9.14),组4(451例,TyG指数>9.14)。结果:TyG指数与冠心病病人Gensini评分呈线性正相关(r=0.049,P<0.05),TyG指数越高,病人冠状动脉病变越重。此外,高TyG指数组(组4)病人年龄较低,高脂血症、高血压、糖尿病发病率较高,血糖、总胆固醇、三酰甘油、低密度脂蛋白水平较高(P<0.05~P<0.01)。TyG指数评价冠状动脉重度病变(Gensini评分≥60分)的ROC曲线下面积为0.754(95%CI:0.722~0.787,P<0.05),最佳诊断值为TyG指数≥9.27,此时诊断的敏感度为0.612,特异度为0.805。结论:TyG指数与冠状动脉病变严重程度呈正相关,且与心血管疾病危险因素有紧密关系,可作为识别冠状动脉病变严重程度的有效工具。

Objective:To investigate the correlation between the triglyceride-glucose(TyG)index and severity of coronary lesions in patients with coronary artery disease.Methods:From 2018 to 2019,1804 patients with coronary heart disease diagnosed by coronary angiography from the Department of Cardiology of The Affiliated Zhongda Hospital of Southeast University were investigated,and the clinical characteristics,TyG index,other biochemical indexes and echocardiography imaging were recorded.The Gensini score was calculated according to the results of coronary angiography.According to the TyG index,the patients were divided into the group 1(451 cases,TyG index≤8.38),group 2(451 cases,8.38<TyG index≤8.71),group 3(451 cases,8.71<TyG index≤9.14)and group 4(451 cases,TyG index>9.14).Results:There was a positive linear correlation between the TyG index and Gensini score in patients with coronary heart disease(r=0.049,P<0.05).The higher TyG index was,the more severe the coronary artery lesions were.In addition,the patients with high TyG index(group 4)were young,high incidence rates of hyperlipidemia,hypertension and diabetes mellitus,and high levels of blood glucose,total cholesterol,triglyceride and low density lipoprotein(P<0.05 to P<0.01).The area under ROC curve for TyG index to evaluate severe coronary artery disease(Gensini score≥60 points)was 0.754(95%CI:0.722-0.787,P<0.05),and the best diagnostic value was TyG index≥9.27.At this time,the sensitivity and specificity of diagnosis were 0.612 and 0.805,respectively.Conclusions:The TyG index is positively correlated with the severity of coronary artery disease,and closely related to the risk factors of cardiovascular disease.It can be used as an effective tool to identify the severity of coronary artery disease.