不同葡萄糖代谢状态人群AIP、Ty G与冠状动脉疾病及其严重程度的关系研究

Study on the association of AIP and TyG with coronary artery disease and its severity in populations with different glucose metabolic status

目的探讨不同葡萄糖代谢状态人群动脉粥样硬化指数(AIP)、甘油三酯-葡萄糖指数(TyG)与冠状动脉疾病(CAD)及其严重程度的关系。方法回顾性选取2021年1月至2024年3月在丽水市人民医院行冠状动脉CT血管造影检查的340例患者为研究对象,其中葡萄糖代谢状态正常153例,糖尿病前期110例,糖尿病77例。按照检查结果分为非CAD组92例、CAD单支血管狭窄组90例和CAD多支血管狭窄组158例。比较3组患者临床资料,采用多因素logistic回归和ROC曲线分析AIP、TyG与不同葡萄糖代谢状态下发生CAD及其严重程度的关系。结果3组患者吸烟比例、AIP、TyG、葡萄糖代谢状态、甘油三酯以及低密度脂蛋白胆固醇比较,差异均有统计学意义(均P<0.01)。无论葡萄糖代谢状态如何,AIP、TyG均是发生CAD的独立危险因素(均P<0.01);AIP、TyG预测葡萄糖代谢状态正常患者发生CAD的AUC、最佳截断值分别为0.703、0.174和0.738、3.120,预测糖尿病前期患者发生CAD的AUC、最佳截断值分别为0.725、0.159和0.706、2.803,预测糖尿病患者发生CAD的AUC、最佳截断值分别为0.711、0.150和0.709、2.776。AIP是葡萄糖代谢状态正常患者发生CAD严重程度的独立危险因素(P<0.001);预测葡萄糖代谢状态正常患者发生CAD严重程度的AUC、最佳截断值为0.713、0.293。结论AIP、TyG有助于诊断不同葡萄糖代谢状态下发生CAD及其严重程度,及早识别CAD高危人群。

Objective To investigate the association of atherogenic index of plasma(AIP)and triglyceride-glucose index(TyG)with coronary artery disease(CAD)and its severity in subjects with different glucose metabolic status.Methods Three hundred and forty subjects who underwent coronary CT angiography at Lishui People's Hospital from January 2021 to March 2024 were selected.Among them,153 cases had normal glucose metabolism,110 cases had pre diabetes,and 77 cases had diabetes.They were divided into non-CAD group(92 cases),single-vessel stenosis group(90 cases)and multi-vessel stenosis group(158 cases)based on coronary CT angiography.The clinical data were compared among the three groups.Multivariate logistic regression and ROC curve analysis were used to analyze the association of AIP and TyG with CAD and its severity in subjects with different glucose metabolic status.Results Smoking rate,AIP,TyG,glucose metabolism status,triglycerides,and LDL-C were significantly different among three groups(all P<0.01).Regardless of glucose metabolism status,AIP and TyG were independent risk factors for developing CAD(all P<0.01).The AUC and optimal cut-off values for predicting new-onset CAD in patients with normal glucose metabolism as assessed by AIP and TyG were 0.703 and 0.174,as well as 0.738 and 3.120,respectively.For patients with prediabetes,the AUC and optimal cut-off values were 0.725 and 0.159,and 0.706 and 2.803,respectively.In patients with diabetes,the AUC and optimal cut-off values for predicting new-onset CAD were 0.711 and 0.150,as well as 0.709 and 2.776,respectively.AIP is an independent risk factor for the severity of newly diagnosed CAD in patients with normal glucose metabolism(P<0.001).The AUC and optimal cut-off values for predicting the severity of newly diagnosed CAD in patients with normal glucose metabolism are 0.713 and 0.293,respectively.Conclusion AIP and TyG are useful for diagnosing new-onset CAD and assessing its severity across various glucose metabolism states,as well as for early identification of populations at high risk for CAD.