甘油三酯血糖指数用于预测冠心病患者心血管预后的研究  

Triglyceride Glucose Index for Predicting Cardiovascular Outcomes in Patients with Coronary Artery Disease

作　　者：马凤莲[1,2] 靳景璐 郭远林 吴娜琼[1] 朱成刚[1] 高莹[1] 刘庚[1] 董倩[1] 李建军[1] MA Feng-lian;JIN Jing-lu;GUO Yuan-lin;WU Na-qiong;ZHU Cheng-gang;GAO Ying;LIU Geng;DONG Qian;LI Jian-jun(Department of Cardiology,Fuwai Hospital,National Center for Cardiovascular Disease,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China;Department of Geriatric Cardiology,Inner Mongolia Autonomous Region People’s Hospital,Hohhot 010020,Inner Mongolia,China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院心内科,北京市100037 [2]内蒙古自治区人民医院老年心内科,呼和浩特市010020

出　　处：《中国分子心脏病学杂志》2020年第6期3625-3630,共6页Molecular Cardiology of China

基　　金：首都卫生发展基金(201614035);CAMS重大协同创新项目(2016-I2M-1-011)。

摘　　要：目的甘油三酯血糖(triglyceride glucose,TyG)指数是代谢性疾病的一种新的标志物,最近有报道称,它与健康人群罹患心血管疾病(cardiovascular disease,CVD)的风险有关。然而,TyG指数对稳定性冠心病(coronary artery disease,CAD)患者预后的预测价值尚未明确。方法本研究纳入3745例稳定性CAD患者,随访11235人次年。通过多因素Cox回归模型及Kaplan-Meier分析来验证TyG指数在判断CAD患者预后中的应用价值。心血管事件(cardiovascular events,CVEs)定义为全因死亡、非致命性心肌梗死、卒中和出院后血运重建(经皮冠状动脉介入术或冠状动脉旁路移植术)。TyG指数的计算公式为In[空腹甘油三酯×空腹血糖2]。结果共有297例患者在随访中发生了CVEs。多因素Cox回归模型显示,TyG指数与CVEs发生的风险呈正相关(HR=1.370,95%CI:1.108-1.694,P=0.004)。所有研究对象按TyG指数的中位数分为两组,Kaplan-Meier分析显示,TyG指数高的患者生存率低(P=0.023)。此外,TyG指数每增加1个标准差,CVEs发生风险升高21.2%(HR=1.212,95%CI:1.075-1.366,P<0.05),优于甘油三酯或其他与血糖相关的标志物。结论TyG指数可能对稳定性CAD患者未来CVEs发生具有预测价值。Objective Triglyceride glucose(TyG)index is a novel marker for metabolic disorders,and recently it has been reported to be associated with cardiovascular disease(CVD)risk in apparently healthy individuals.However,the prognostic value of TyG index in patients with stable coronary artery disease(CAD)is not determined.Methods We consecutively enrolled 3745 patients with stable CAD.Patients were followed up for 11235 person-years.Multivariable Cox proportional hazards models and Kaplan-Meier analysis were used to evaluate the prognostic value of TyG index in patients with stable CAD.The cardiovascular events(CVEs)included all-cause death,non-fatal myocardial infarction(MI),stroke and post-discharge revascularization such as percutaneous coronary intervention(PCI)and coronary artery bypass grafting(CABG).TyG index was calculated as ln[fasting triglycerides×fasting plasma glucose2].Results During follow-up,297 CVEs occurred and patients were divided into two groups:CVE group and non-CVE group.Multivariable Cox proportional hazards models revealed that TyG index was positively associated with CVEs risk(HR=1.370,95%CI:1.108-1.694,P=0.004).The Kaplan–Meier analysis revealed that patients with the higher TyG index presented the lower event-free survival(P=0.023).Moreover,a 1-(SD)increment in TyG index was associated with 21.2%(HR=1.212,95%CI:1.075-1.366,P<0.05)higher risk of CVEs,which was superior to triglyceride or other glycemic related markers.Conclusion TyG index may be positively associated with future CVEs in patients with stable CAD.

关 键 词：TyG指数 稳定性冠状动脉粥样硬化性心脏病 预后 

分 类 号：R541.4[医药卫生—心血管疾病]