血清三酰甘油葡萄糖乘积指数与冠状动脉钙化的相关性研究

Correlation between serum triglyceride-glucose index and coronary artery calcification

目的分析血清三酰甘油葡萄糖乘积指数(TyG指数)与冠状动脉钙化(coronary artery calcification,CAC)的关系,探讨CAC的危险因素。方法回顾性分析2022年1月至2024年1月在宝鸡市中心医院心内科以胸闷或胸痛为主诉接受心脏冠状动脉CT检查的399例受试者,其中男192例,女207例,年龄(66.35±11.48)岁。根据有无CAC分为CAC组(245例)与非CAC组(154例),比较两组临床指标的差异,用二元logistic回归分析评估CAC的影响因素,用受试者操作特征曲线(ROC)评估TyG指数等对CAC的诊断价值。采用独立样本t检验、秩和检验、χ^(2)检验、Spearman相关性分析进行统计学分析。结果CAC组年龄、三酰甘油(TG)、空腹血糖(FBG)、血肌酐、尿酸、N末端脑钠肽前体(NT-proBNP)、D-二聚体、TyG指数、男性及吸烟比例均高于非CAC组,CAC组高密度脂蛋白胆固醇(HDL-C)、舒张压均低于非CAC组,差异均有统计学意义(均P<0.05)。Spearman相关性分析显示,CAC与年龄、TyG指数、尿酸呈正相关,与HDL-C呈负相关(r=0.424、0.151、0.196、-0.152,均P<0.05)。二元logistic回归分析显示,年龄(OR=1.087,95%CI 1.064~1.111,P<0.001)、男性(OR=1.830,95%CI 1.215~2.757,P=0.004)、TG(OR=1.364,95%CI 1.071~1.739,P=0.012)、FBG(OR=1.191,95%CI 1.079~1.314,P=0.001)、TyG指数(OR=1.589,95%CI 1.177~2.145,P=0.002)、血肌酐(OR=1.018,95%CI 1.009~1.028,P<0.001)、尿酸(OR=1.003,95%CI 1.001~1.005,P=0.001)是发生CAC的独立危险因素,HDL-C(OR=0.546,95%CI 0.399~0.880,P=0.013)是保护因素。ROC分析显示,TyG指数联合年龄的曲线下面积最大,为0.753(95%CI 0.704~0.802,P<0.001)。结论年龄、男性、TG、FBG、TyG指数、血肌酐、尿酸是发生CAC的独立危险因素,且TyG指数联合年龄对CAC有良好的诊断价值。

Objective To analyze the relationship between serum triglyceride-glucose index(TyG index)and coronary artery calcification(CAC),and investigate the risk factors of CAC.Methods A retrospective analysis was performed on 399 subjects who underwent coronary angiography with chest tightness or chest pain as the main complaint in the Department of Cardiology,Baoji Central Hospital from January 2022 to January 2024.Among them,there were 192 males and 207 females,aged(66.35±11.48)years.The patients were divided into a CAC group(245 cases)and a non-CAC group(154 cases)according to the presence or absence of CAC.The differences of clinical indicators were compared between the two groups,the influencing factors of CAC were evaluated by binary logistic regression analysis,and the diagnostic value of TyG index and other indicators for CAC was evaluated by the receiver operating characteristic curve(ROC).Independent sample t test,rank sum test,χ^(2) test,and Spearman correlation analysis were used for statistical analysis.Results The age,triglyceride(TG),fasting blood glucose(FBG),serum creatinine,uric acid,N-terminal brain natriuretic peptide precursor(NT-proBNP),D-dimer,TyG index,and male and smoking ratios in the CAC group were all higher than those in the non-CAC group,while the high-density lipoprotein cholesterol(HDL-C)and diastolic blood pressure in the CAC group were lower than those in the non-CAC group,with statistically significant differences(all P<0.05).Spearman correlation analysis showed that CAC was positively correlated with age,TyG index,and uric acid,and was negatively correlated with HDL-C(r=0.424,0.151,0.196,and-0.152,all P<0.05).Binary logistic regression analysis showed that age(OR=1.087,95%CI 1.064-1.111,P<0.001),male(OR=1.830,95%CI 1.215-2.757,P=0.004),TG(OR=1.364,95%CI 1.071-1.739,P=0.012),FBG(OR=1.191,95%CI 1.079-1.314,P=0.001),TyG index(OR=1.589,95%CI 1.177-2.145,P=0.002),serum creatinine(OR=1.018,95%CI 1.009-1.028,P<0.001),and uric acid(OR=1.003,95%CI 1.001-1.005,P=0.001)were independent risk factors for CAC,while HDL-C(OR=0.546,95%CI 0.399-0.880,P=0.013)was a protective factor.ROC analysis showed that the area under the curve of TyG index combined with age was the largest[0.753(95%CI 0.704-0.802),P<0.001].Conclusion Age,male,TG,FBG,TyG index,serum creatinine,and uric acid are independent risk factors for CAC,and TyG index combined with age has good diagnostic value for CAC.