2型糖尿病患者冠状动脉钙化与三酰甘油葡萄糖指数的相关性分析

Correlation between coronary artery calcification and triglyceride glucose index in patients with type 2 diabetes

目的:探讨2型糖尿病患者冠状动脉钙化(coronary artery calcification,CAC)与三酰甘油葡萄糖指数(triglyceride glucose,TyG)的相关性。方法:选取至南京医科大学附属淮安第一医院就诊的388例2型糖尿病患者,并根据冠状动脉计算机断层扫描(computed tomography,CT)结果分为非钙化组(101例)和钙化组(287例)。计算并比较两组间基线资料及TyG指数,采用二元Logistic回归模型、受试者工作特征(ROC)曲线探讨2型糖尿病患者CAC与TyG指数的相关性。结果:钙化组年龄、TyG指数、TG、HbA1c、FBG、载脂蛋白B(apolipoprotein B,ApoB)均高于非钙化组(P<0.05)。多因素Logistic回归分析显示,调整混杂因素后,TyG指数仍是2型糖尿病患者CAC的独立危险因素(OR=2.770,95%CI:1.525~5.033,P<0.001)。TyG指数预测2型糖尿病患者CAC的ROC曲线下面积为0.640(95%CI:0.571~0.709,P<0.001),最佳截断值为8.820,此时诊断敏感性和特异性最高,分别为97.9%和36.6%。结论:TyG指数与2型糖尿病患者发生冠状动脉钙化的风险呈正相关,可作为2型糖尿病患者发生冠状动脉钙化的风险预测因子。

Objective:To investigate the correlation between coronary artery calcification(CAC)and triglyceride glucose(TyG)index in patients with type 2 diabetes.Methods:A total of 388 patients admitted to the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University for type 2 diabetes during December 2022 to December 2023 were included and divided into no-CAC group(n=101)and CAC group(n=287)according to the results of coronary computed tomography.The level of FBG,HbA1c,TG and other clinical data were collected,and then the TyG index and baseline data were calculated and compared between different groups.Scatter plots were generated with R tidyverse package.binary logistic regression model and receiver operating characteristic(ROC)curve were used to explore the correlation between CAC and TyG index in patients with type 2 diabetes.Results:The levels of age,TyG index,TG,HbA1c,FBG and apolipoprotein B(ApoB)in the CAC group were higher than those in non-CAC group and there were statistical differences(P<0.05).Statistically significant differences in TyG index were observed between the CAC group and non-CAC group in the 45-59 and 60-74 age groups(P<0.05).Patients with a high TyG index exhibited higher incidence rates of CAC.The multivariate logistic analysis revealed that TyG index still was independent risk factors for CAC in patients with type 2 diabetes after adjusting for confounding factors.Specifically,the adjusted(OR=2.770,95%CI:1.525-5.033,P<0.001)for each unit increase in TyG index.The area under ROC curve for TyG index to predict CAC in patients with type 2 diabetes was 0.640(95%CI:0.571-0.709,P<0.001),and the best cutoff-value was 8.820.At this time,the sensitivity and specificity of diagnosis were are highest,at 97.9%and 36.6%.Conclusion:The TyG index was positively associated with the occurrence of CAC in patients with type 2 diabetes,and it was a risk predictor for the development of CAC in patients with type 2 diabetes.