三酰甘油-葡萄糖指数与70岁以上老年心房颤动合并早期肾功能不全的相关性

Correlation between triglyceride-glucose index and atrial fibrillation combined with early renal insufficiency in patients over 70 years old

[目的]探讨三酰甘油-葡萄糖(TyG)指数与70岁以上老年心房颤动(AF)合并早期肾功能不全的相关性,旨在为临床上预防和治疗老年AF合并早期肾功能不全提供理论依据.[方法]收集2021年1月至2022年12月间接受住院治疗的170例70岁以上老年AF患者临床资料,根据胱抑素C(Cys-C)指标分为早期肾功能不全组(Cys-C>0.95 mg/L,n=90)和肾功能正常组(Cys-C≤0.95 mg/L,n=80),计算中性粒细胞与淋巴细胞比值(NLR)和BMI.采用Spearman分析TyG指数与AF合并早期肾功能不全的相关性;利用二元Logistic回归分析观察TyG指数是否为影响AF合并早期肾功能不全的独立影响因素;采用受试者工作特征曲线(ROC)评价TyG指数对AF合并早期肾功能不全的预测价值.[结果]两组患者心功能不全情况、总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇水平、NLR及TyG指数间差异均有统计学意义(P<0.05).TyG指数、NLR、空腹血糖(FBG)、糖化血红蛋白、三酰甘油(TG)及血肌酐水平与AF合并早期肾功能不全呈正相关.校正后二元Logistic回归分析结果显示,Ty G指数和NLR是AF合并早期肾功能不全发生的独立危险因素(OR=15.966,95%CI:4.395~59.005,P<0.001;OR=1.311,95%CI:1.037~1.659,P=0.024).TyG指数、NLR可预测AF合并早期肾功能不全的发生,ROC曲线下面积分别为0.809(95%CI:0.742~0.865,P<0.001)和0.706(95%CI:0.504~0.657,P<0.001),最佳截断值分别为6.971和2.350,敏感度和特异度分别为94.4%、63.7%和72.2%、62.5%.[结论]TyG指数、NLR、FBG、糖化血红蛋白及TG水平与AF合并早期肾功能不全呈正相关;TyG指数、NLR是AF合并早期肾功能不全发生的独立危险因素;TyG指数、NLR可预测AF合并早期肾功能不全的发生,且TyG指数的预测价值更高.

OBJECTIVE To evaluate the correlation between triglyceride-glucose(TyG)index and atrial fibrillation(AF)combined with early renal insufficiency in patients over 70 years old,and to provide a theoretical basis for the prevention and treatment of AF combined with early renal insufficiency in elderly patients.METHODS A total of 170 AF patients over 70 years old admitted from January 2021 to December 2022 were included.According to cystatin C(Cys-C),they were divided into early renal insufficiency group(Cys-C≥0.95 mg/L,n=90)and normal renal function group(Cys-C≤0.95 mg/L,n=80).Basic and clinical data were recorded,neutrophil to lymphocyte ratio(NLR)and BMI were calculated.Spearman correlation analysis was used to analyze the correlation between TyG index and AF combined with early renal insufficiency.Binary Logistic regression was used to analyze whether TyG index was an independent factor affecting AF combined with early renal insufficiency.Receiver operating characteristic curve(ROC)was used to evaluate the predictive value of TyG index in AF combined with early renal insufficiency.RESULTS There were statistically significant differences in cardiac insufficiency,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,NLR and TyG index between the two groups(P<0.05).TyG index,NLR,fasting blood glucose(FBG),glycosylated hemoglobin,triglycerides(TG)and serum creatinine were positively correlated with AF combined with early renal insufficiency.Binary Logistic regression analysis showed that TyG index and NLR were independent risk factors for AF combined with early renal insufficiency after adjusting for related factors(OR-15.966,95%CI:4.395-59.005,P<0.001;OR=1.311,95%CI:1.037-1.659,P-=0.024).TyG index and NLR could predict the occurrence of AF combined with early renal insufficiency,and the area under the curve was 0.809(95%CI:0.742-0.865,P<0.001)and 0.706(95%CI:0.504-0.657,P<0.001),respectively.The best truncation values of TyG index and NLR were 6.971 and 2.350,respectively.The sensitivity and specificity of TyG index and NLR in predicting AF combined with early renal insufficiency were 94.4%,63.7%and 72.2%,62.5%,respectively.CONCLUSION TyG index,NLR,FBG,glycosylated hemoglobin and TG were positively correlated with AF combined with early renal insufficiency.TyG index and NLR were independent risk factors for AF combined with early renal insufficiency.TyG index and NLR can predict the occurrence of AF combined with early renal insuficiency,and TyG index has the highest predictive value.